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An Exploratory Indirect Association Analysis of Dietary Supplement Use and Metabolic Risk in Korean Adolescents: A
Jeoungmi Kim1, Vasuki Rajaguru2
1Department of Nursing, Kaya University, Gimhae 50382, Republic of Korea.
Aims:
Dietary supplement use has increased among adolescents, but its association with metabolic health remains unclear. This study examined the relationship between dietary supplement use, diet quality, obesity, and metabolic risk among Korean adolescents.
Methods:
This cross-sectional study used nationally representative KNHANES 2022-2024 data. A total of 1550 adolescents aged 10-18 years were included. Dietary supplement use during the previous year was assessed by questionnaire. Diet quality was evaluated using diet quality score based on selected dietary guideline-related components. Survey-weighted logistic and linear regression analyses were conducted after adjustment for demographic and dietary covariates. An exploratory indirect association analysis was performed to examine whether diet quality was statistically associated with the relationship between supplement use and metabolic risk clustering.
Results:
Overall, 43.1% of adolescents reported dietary supplement use. Supplement users had significantly better diet quality scores than non-users (β = 0.30, p < 0.001). Dietary supplement use was significantly associated with BMI (p = 0.011) and waist circumference (p = 0.010), but not with metabolic risk clustering (OR = 0.91, 95% CI: 0.67-1.24), fasting glucose, triglycerides, or HDL-cholesterol levels. Obesity was strongly associated with metabolic risk clustering regardless of supplement use. Compared with non-obese non-users, obese non-users (OR = 5.31, 95% CI: 3.22-8.78) and obese supplement users (OR = 3.68, 95% CI: 2.07-6.53) had significantly higher odds of metabolic risk clustering. Exploratory indirect association analysis showed that diet quality did not significantly mediate the association between dietary supplement use.
Conclusions:
Dietary supplement use was associated with better diet quality and favorable anthropometric indicators, but not with metabolic risk clustering or biochemical metabolic markers. These findings suggest that supplement use may reflect broader health-related behaviors rather than direct metabolic protection among Korean adolescents.