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WELLNESS AND AGE
CHAPTER IX
Emergency Medicine Department of Child Neurosurgery and Emergency
Medicine Clinic, School of Public Health in Bytom,
Medical University of Silesia in Katowice
Katedra Neurochirurgii Dziecięcej i Medycyny Ratunkowej,
Zakład Medycyny Ratunkowej, Wydział Zdrowia Publicznego w Bytomiu,
Śląski Uniwersytet Medyczny w Katowicach
* Department of Health Economics and Health Management,
School of Public Health in Bytom,
*Zakład Ekonomiki i Zarządzania w Ochronie Zdrowia,
Wydział Zdrowia Publicznego w Bytomiu,
Śląski Uniwersytet Medyczny w Katowicach
**Department of Palliative Medicine and Palliative Care,
School of Health Sciences in Katowice,
**Zakład Medycyny i Opieki Paliatywnej,
Wydziału Nauk o Zdrowiu w Katowicach,
Śląski Uniwersytet Medyczny w Katowicach, Katowice
DARIUSZ MYRCIK, MAGDALENA TRZEPIZUR,
JOANNA MAKARSKA, KAROLINA JĘDRYSZEK,
DOROTA SZAŁABSKA*, KAROLINA SOBCZYK*,
WIKTORIA DYJAS, ADRIANNA DONIEC, AGATA ZYCH,
MARTA KOWOLIK, MARCIN JANECKI**,
ARKADIUSZ NICZYPORUK, TOMASZ STĘPIEŃ,
BOGUSŁAW BUCKI, ANNA DUBIEL, MAREK MANDERA
Dietary supplementation among university students of Silesian
and Lesser Poland Voivodeships
Suplementacja diety wśród studentów z wyższych uczelni województwa
śląskiego i małopolskiego
WELLNESS AND AGE
Key words: Nutritional supplements, students, health, vitamins, minerals
Słowa Klucz: Suplementy diety, studenci, zdrowie, witaminy, składniki mineralne
INTRODUCTION
Efficient human organism functioning is conditioned by many various factors.
One of them is the regulation of cellular fluids, as well as the maintenance of proper
concentration of nutrients, oxygen and other gases, ions and other compounds necessary for metabolic processes. Human organism is consisted of tissues and organs
which form systems, working together in order to perform certain functions. Among
those systems one can distinguish such systems as: osseous, muscular, cardiovascular, nervous, digestive, respiratory, genitounitary, excretory, lymphatic, endocrine
and immune. Each of them is responsible for certain functions – from life support up
to the whole organism development. Human organism, in almost 99%, is consisted
of four elements: hydrogen (H), carbon (C), nitrogen (N) and oxygen (O) which are
linked with nuclear binding energy, forming basic components: water, carbohydrates, proteins and energy, which are crucial for life processes [4, 5].
The basic structural unit of human organism is a cell, which consists
of macromolecules – atoms, consisting of subatomic molecules which can be divided into giant molecules such as carbohydrates, lipids, proteins and nucleic acids,
and small molecules which include amino acids, chromosomes, coenzymes, nucleotides and enzymes. In each of the cell 100 to 300 million chemical reactions per
minute take place. That is why, for their proper functioning, it is crucial to provide
them with an adequate amount of nutrients [4, 5, 16]. In order to ensure wellbeing
and proper systems functioning, about 45 of nutrients are needed [4, 5]. Maintaining
balance between consumed food, beverages, as well as vitamins and dietary supplements included into them is concerned with meeting the needs of the organism.
Requirements for certain nutrients should be adjusted individually, and the factors
responsible for nutritional needs are as follows: age, sex, body weight, physiological
state and physical activity [5].
Eaten food includes organic substances such as: vitamins, minerals and secondary plant substances which are said to be essential for life processes. The sources of
energy are: proteins, fats and carbohydrates [5]. The energy provided by them is
used for life functions maintenance. The aforementioned functions are responsible
for bones and tissues structuring, hormones production, maintenance of body temperature and muscles movement. Whereas, the role of vitamins and minerals is necessary for organism processes management [4]. Vitamins, as chemical compounds,
take part in a vast number of metabolic reactions, blood clotting and bones structuring. They also aid the immune system, strengthen nails and hair, as well as decide
about wellbeing [4, 5]. Vitamins are classified as exogenous substances which
means that they have to be provided along with food since the organism is unable to
synthesise them on its own [4,5]. The research conducted so far has shown 13 vitamins which are divided into fat-soluble vitamins such as: A (retinol), D (calcipherol), E (tocopherol), K (phylloquinone) and the water-soluble vitamins, such as: C
90
Dariusz Myrcik, Magdalena Trzepizur, Joanna Makarska, Karolina Jędryszek,
Dorota Szałabska, Karolina Sobczyk, Wiktoria Dyjas, Adrianna Doniec,
Agata Zych, Marta Kowolik, Marcin Janecki, Arkadiusz Niczyporuk,
Tomasz Stępień, Bogusław Bucki, Anna Dubiel, Marek Mandera
Dietary supplementation among university students
of Silesian and Lesser Poland Voivodeships
(ascorbic acid), vitamins from group B: B1 (thiamine), B2 (riboflavin), B3 (niacin),
B5 (pantothenic acid), B6 (pyridoxine), B12 (cyanocobalamin), H (biotin) and folic
acid [8]. The process of absorption (bioavailability) of vitamins takes place in the
small intestine. The final products of proteins, fats, carbohydrates, water and vitamins digestion are absorbed into small intestine mucosa and then are passed to the
blood [2].
It is possible to distinguish a few factors which influence proper absorption process. The first of them is the source of vitamins, consumed amount and whether they
are provided by food or a pharmaceutical. Second is the chemical form, then the
efficiency of intestine absorption mechanisms and finally, nutritional status which is
the presence of the compound facilitating or hampering the absorption of certain
nutrient, as well as the presence of coupling and metabolic disorder which is concerned with diseases and medicines intake [4].
Taking into consideration the quality and chemical structure, natural supplements, in comparison to synthetic supplements, are more difficult to obtain and a
production process is more expensive and time-consuming. However, what characterizes them is better bio-availability. Synthetic supplements production is faster.
That is why they are more common and much cheaper. The organism requirement
for vitamins depends on such factors as age, sex, health condition, physical activity
and type of work [6].
Along with food, the organism has to be provided with chemical elements which
participate in metabolic processes, necessary for proper growth and development.
They are constituents of bones, hair, teeth, they maintain water-mineral balance, are
included in enzymes, cells, body fluids, as well as they sustain acid-base balance [3].
If a daily requirement for chemical elements equals less than 100 mg, they are called
microelements or trace elements, whereas if the requirement is over 100 mg, they
are defined as macronutrients or mineral salts. The most important minerals are:
chlorine (Cl), phosphor (P), magnesium (Mg), potassium (K), sulfur (S), sodium
(Na) and calcium (Ca). The most vital for human organism trace elements are chromium (Cr), zinc (Zn), fluorine (F), iodine (I), manganese (Mn), molybdenum (Mo),
selenium (Se), vanadium (V) and iron (Fe) [3, 6, 15]. The factors influencing chemical elements and vitamins bioactivity, are similar. Vitamins also have
a positive impact on the elements absorption. C vitamin stimulates iron absorption,
whereas D vitamin facilitates calcium absorption [4, 5].
Neither deficiency nor excess of nutrients are recommended for the efficient
functioning of human organism. They may result in organism intoxication, as well
as in illnesses. In order to sustain mineral balance of organism, it is possible to
choose proper supplements [3]. It is important to adhere to nutritional standards
when it comes to certain requirement of vitamins and minerals to meet them according to sex, physiological condition, age and physical activity [4, 13]. These values
are included in Nutrition Standards provided by National Food and Nutrition Insti91
WELLNESS AND AGE
tute. They are prepared for certain group of healthy people of medium built, average
size of fatty tissue, as well as of normal absorption and excretion processes. Stressrelated situation, exhaustion, pregnancy, breastfeeding or illness can influence on
the increased demand for minerals [13, 15],
Dietary supplements are “the food products” intended to complement a regular
diet, with concentrated source of single or compound vitamins, minerals, as well as
other nutritional or physiological substances, implemented into organism in a form
which is possible to dose. [16]. The group of supplements include vitamin-mineral
preparations, amino acids, probiotics and prebiotics, fatty acids and fibre. Including
supplements into diverse diet, contributes to organism regeneration, aids the organism during increased physical activity and nourishes it [1, 9]. Vitamin-mineral preparation intake without knowledge about side effects, generates the risk of illnesses.
That is why, thoughtful consumer’s decision should be made, as well as medical
consultation is necessary before dietary supplement intake [6].
Minerals and vitamins deficiencies is observed in every age group, regardless of
sex or nationality. That is why supplementation in each person is recommended as a
complementation of a rational diet [5, 14, 15]. What is also important, is diversification of eaten products because of the differences which characterise certain substances. Meals ought to be diverse and balanced. Except for a diet, physical activity
and body weight control are equally significant [15].
The factors responsible for the choice of certain dietary supplement include:
composition, size of pill, price, concentration of active ingredient, advertisement
and packaging. Supplements can be found in form of capsules, pills or powder.
The group, which is exposed to nutrients deficiency or excess, includes university students, characterised by irregularity of eating, inefficient amount and quality of
nutrients, or preparation intake without appropriate knowledge about their dosage
[12].
The aim of this paper is to evaluate dietary supplements intake among university
students in terms of their sex and kind of university. What is more, the frequency of
dietary supplements intake, the reasons of using them, as well as the criteria according to which students choose certain supplement were also taken into account in this
work.
MATERIAL AND METHODS
The research was conducted among 200 college students in Silesian and Lesser
Poland voivodeships in a time period from 1st November 2015 to 31st January 2016.
The research involved students of: Medical University of Silesia, The Jerzy Kukuczka Academy of Physical Education, University of Silesia, Silesian University of
Technology, University of Economics and Jagiellonian University. The study group
consisted of 120 women (60%) and 80 men (40%) aged from 19 to 25 years. A
method used in the study was a diagnostic survey, a technique: survey and a research tool: an original questionnaire wrote by the author. Participation in the survey
was voluntary, and the questionnaires were anonymous. All the questionnaires were
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correctly filled in. Data obtained from questionnaires were collected in the form of a
MS EXCEL computer database. The obtained results were transferred to STATISTICA 10 software and presented in the form of figures and tables.
RESULTS
The great majority of respondents declare taking dietary supplements – 147
(73.5%) respondents, out of which there were 75% (90) of women and 71% (57) of
men. The rest 25% (30) of women and 29% (23) of men, do not enrich their diets
with any of the supplements, consisting vitamins and minerals.
Fig. 1 The frequency of dietary supplements intake in the surveyed group
of university students in Silesia and Lesser Poland voivodeships,
in terms of gender.
In the surveyed group also a question about the frequency of taking dietary supplements appeared: Most of the students claim that they reach for supplements only
in case of occurrence of certain diseases – 58 of the pollees. Not more than once a
month intake of supplements was declared by 19 students. 24 students take supplements more often, because at least once a week. Bigger amount of the pollees – 41
students, take supplements every day. The frequency of supplements intake was also
analysed in terms of the kind of university which the student attends. 6 students
(17.65%) of University of Silesia takes supplements at least once in a day, 14 (28%)
students of Medical University of Silesia, 4 (20%) students of Jagiellonian University, 6 (23.1%) students of University of Economics, 7 (12.96%) students of Silesian
University of Technology and 4 (25%) students of The Jerzy Kukuczka Academy of
Physical Education. The percentage of other students, taking supplements once a
week, is as follows: 3 students (8.82%) of University of Silesia, 5 students (10%) of
Medical University of Silesia, 6 students (30%) of Jagiellonian University,
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WELLNESS AND AGE
3 students (11.54%) of University of Economy, 4 students (7%) of Silesian University of Technology and 3 students (18.75%) of The Jerzy Kukuczka Academy of
Physical Education. The largest number of students who do not enrich their diets
with supplements applies to Silesian University of Technology students where the
percentage was equal to 44.44% (24 students). The detailed analysis is shown in
Figure 2.
Fig. 2. The frequency of dietary supplements intake in the surveyed group
of university students in Silesia and Lesser Poland voivodeships,
taking into account types of universities
The students were also asked about the reason of taking dietary supplements.
Each of the surveyed person could choose more than one option. The most common
reason for using dietary supplements for students were: vitamins deficiency com94
plementation – 90 students and will to improve skin, hair and nails condition – 54
respondents. Students also admitted they take dietary supplements while increased
physical activity – such response was given 48 times. What is more, 46 answers
involved taking diet supplements in periods of tiredness, weakness and fatigue.
Considerably smaller number of answers (12) suggested taking dietary supplements
as an aid in common cold treatment. The detailed analysis is depicted
in Figure 3.
Fig. 3. Reasons for taking supplements in the surveyed group
of university students in Silesia and Lesser Poland voivodeships
In the research, it was attempted to determine what is the reason of dietary supplements taking resignation. The most common reason of not taking them is the
belief that supplements do not positively influence on human organism – such answer was given by 55% of the surveyed students. The costs concerned with buying
supplements were also problematic – among the students 27% do not take supplements because they are too expensive. Whereas 10% of the surveyed students do not
consume supplements since they have not got such recommendation given by a
doctor The least percentage of the surveyed students give up taking supplements, for
they perceive their diet as well-balanced and there is no need of supplementation –
8% of the pollees (Figure 4.)
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WELLNESS AND AGE
Fig. 4. Reasons for not taking supplements in the surveyed group of university
students in Silesia and Lesser Poland voivodeships
In case of a question, regarding factors influencing the decision on selecting supplements, 56 (28%) of respondents indicated that the biggest impact are their own
experiences. An important aspect was also a composition of supplements which was
a guidance for 44 (22%) of the surveyed students. Prices of supplements were important for 24 (12%) respondents. The advice of a doctor was important for 26
(13%) students, while pharmacists’ advices are used only by 12 (6%) of the respondents. Finally, only 5% of respondents said that their choice of supplements is
guided by the advertising press, television or radio.
Fig. 5. Selection criteria for specific supplements in the surveyed group
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The vast majority of survey participants, 184 (92%) of students, knew a correct
definition of dietary supplements, knew what supplements should be used for, as
well as how they influence a human body. Only 16 of all the students (8%) did not
have such knowledge.
Students were also asked about the source of their knowledge about supplements. Most of them, 88 (44%) students answered they derive much information
from the Internet. Another source of information is the media - radio and television such answers were given respectively by 8 (16%) and 30 (15%) students. Nutritionists (18%) and doctors (20%) are also sources of information about supplements.
Only 6 students, representing 3% of the respondents answered that they gain information from the press. A detailed analysis of the problem is shown in Figure 6.
Fig. 6. Sources of knowledge about supplements in the surveyed group
DISCUSSION
Dietary supplements are the source of valuable vitamins and minerals which
provide nutrients into daily diet. The market of supplements is constantly developing
and offering more and more compounds of certain substances. The following factors
lead to deficiency o minerals in organism: stress, bad nutritional habits, unbalanced
diet or rush. That is way it is important to take supplements by the people exposed to
those factors, including university students [1].
From the author’s own research it is concluded that dietary supplements are quite
common among university students from Silesian and Lesser Poland voivodeships –
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WELLNESS AND AGE
73% of the surveyed students declared taking them. Similar results were obtained by
Ciszek et al. study, [1] where 72% of students of University of Rzeszów admitted
that they take supplements. Similar frequency of dietary supplements intake, among
young people, is described in Michota-Katulska et al. study [8] – 74% of respondents took supplements. Frequent dietary supplements intake can be the proof of great
knowledge, acquired by the society, about the need of taking supplements if the diet
is improperly balanced. The results, obtained during the research, can also be the
proof of better consciousness of the consumers on dietary supplements, as well as
the need of taking them and the developing market of the offered dietary supplements. In the surveyed group of university students, there were more women who
admitted taking the preparations. It can be concerned with the fact that the frequent
reason of supplements intake was the need of improving condition of skin, hair and
nails – 54%, while attention to physical appearance usually concerns more women
than men. Similar results were obtained in Sigłowa et al. study [11] – among university students in Warsaw and Tarnów, 54.7% of women and 48.3% of men took dietary supplements once a day.
The above research has shown that, one of the main reasons of dietary supplements intake among students, is the need of complementation of nutrients deficiency
– that issue was provided by 90% of the surveyed students. Such a considerable
percentage may be caused by better consciousness of university students on the need
of nutrient deficiency supplementation which are caused by unhealthy lifestyle of
unbalanced diet. The information about dietary supplements were mainly found on
the Internet, taken from a doctors, nutritionists of friends. Similar results were obtained by Spiołek et al. [14] who analysed vitamin-mineral preparations intake
among secondary students. Furthermore, those authors showed that one of the most
important criteria, determining the choice of certain dietary supplement, is its components, and the most common place where it was bought, was the pharmacy.
Moreover, the research also showed that students often buy supplements in the internet shops.
The most popular and the most commonly chosen dietary supplements are pills
because of their easy dosage, storage and availability. Regular dietary supplements
intake, at least once a day, was similar among Medical University of Silesia, The
Jerzy Kukuczka Academy of Physical Education, University of Silesia and University of Economics students. Supplements were taken less often by students of Silesian
University of Technology and Jagiellonian University. Among the respondents, 184
students (92%) know what dietary supplements are, whereas merely 8% (16) of the
students found it problematic. What is more, the students acquired knowledge about
the need to include them into daily diet, in order to somplement vitamins and minerals deficiencies. The increased consciousness on supplementation is the result of
learning during their studies, as well as it derives from the need of forming proper
nutritional habits.
Enriching one’s daily diet with supplements facilitates organism functioning, its
regeneration, as well as it aids the organism during increased physical activity [1, 9].
Taking vitamin-mineral preparations recklessly, without appropriate knowledge
about side effects, is very risky and may result in overdosing and side effects occur98
rence. That is why, it is essential to make a decision, being fully aware of the eventual consequences, and to have medical consultation before taking certain preparation. Most of the respondents took the information about dietary supplements from
the Internet which is a significant source of knowledge, but only while browsing
proper portals and websites. The Information are very often unreliable or they are
not verified by specialists which can cause many mistakes while dietary supplements intake. It should be a nutritionist or a doctor who is perceived as a reliable
source of information about way of eating and the need of enriching diet with certain
supplements. Unfortunately, only 9 and 10% of respondents go to specialists.
Dietary supplements intake is more often perceived by society as complementation of healthy lifestyle, compensation for unbalanced diet, physical activity, as well
as of stress or rush [8, 10]. Moreover, one of the most crucial reason of ill health or
nutrients deficiency is smoking. Among the respondents 36% (76) of students admit
to it, whereas 64% (128) of students declare that they do not smoke. For comparison, in the research conducted by Król et al. [7], 30% of the respondents admitted to
smoke and 70% of students said that they do not. It is visible that smoking is becoming more popular among the students and, in such cases, it is recommended to take
antioxidant vitamins which help to hamper production of free radicals in human
organism. Except for available dietary supplements, one of the best source of antioxidant vitamins are fruit and vegetables.
CONCLUSIONS
1. Most of the respondents take dietary supplements, yet there are more women
among this group.
2. The largest group of students who take dietary supplements study at Jagiellonin
University, and the smallest – at Silesian University of Technology.
3. Most of the students, taking the supplements, use them only in case of certain
symptoms – the most common are vitamins deficiencies.
4. The Internet is the most common source of information about dietary supplements.
5. The most common criteria which influence choice of supplements are one’s own
experiences.
REFERENCES
1. Ciszek P. et al.: Analiza stosowania suplementów diety i świadomości zagrożeń
wynikających z ich pobrania wśród studentów Uniwersytetu Rzeszowskiego.
Bromat. Chem. Toksykol., 2013, 3: pp. 404-412.
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2. Gawęcki J. Witaminy, jako składnik pożywienia. [W.] Gawęcki J. Witaminy.
Poznań: Wydawnictwo Akademii Rolniczej im. Augusta Cieszkowskiego
w Poznaniu, 2002: pp. 7-14
3. Gawęcki J. et al.: Zalecane spożycie witamin z żywnością i suplementami. [W.]
Gawęcki J. Witaminy. Poznań: Wydawnictwo Akademii Rolniczej im. Augusta
Cieszkowskiego w Poznaniu, 2002.
4. Griffith D.W. et al.: Wielki leksykon witamin, ziół, składników mineralnych
i suplementów. Wydawnictwo „Amber”, Warszawa, 2002.
5. Herman Z.S. Hormony, witaminy, leki: przeciwnowotworowe, immunosupresyjne: autakoidy. Wydawnictwo Lekrskie PZWL, Warszawa, 2010.
6. Jarosz M. Praktyczny podręcznik dietetyki. Instytut Żywności i Żywienia, Warszawa, 2010.
7. Król E. et al.: Palenie papierosów a spożycie witamin i składników mineralnych
o działaniu antyoksydacyjnym. Przegląd lekarski, 2011, 68 (10): pp. 852 –854.
8. Michota–Katulska E. et al.: Suplementy diety – popularność stosowania
a świadomość młodych konsumentów. Żywienie człowieka i metabolizm, 2009,
1: pp. 85 – 89.
9. Omelaniuk W. et al.: Sposób odżywiania studentek wyższej szkoły kosmetologii
i ochrony zdrowia w Białymstoku w przypadku trądziku skóry. Bromat. Chem.
Toksykol. 2011, (3): pp. 484-490.
10. Sadowski J. et al.: Ocena stosowania metod odchudzających oraz używania
preparatów wspomagających odchudzanie przez młode kobiety. Roczn. PZH,
2011, 62 (3): pp. 343 – 350.
11. Sigłowa A. et al.: Suplementacja diety wśród studentów. Żywność. Nauka.
Technologia. Jakość, 2009, 4 (65), pp. 236 – 249.
12. Socha K. et al.: Ocena sposobu odżywiania studentek wyższej szkoły kosmetologii i ochrony zdrowia w Białymstoku. Bromat. Chem. Toksykol. 2009, (3): pp.
704 – 708.
13. Spiołek K. et al.: Ocena czynników wpływających na zakup i stosowanie preparatów witaminowo – mineralnych przez uczniów szkół policealnych. Bromat.
Chem. Toksykol. 2011, (3): pp. 987 – 992.
14. Szczepańska B. et al.: Ocena spożycia witamin i składników mineralnych przez
dziewczęta z warszawskiego gimnazjum sportowego, Probl. Hig. Epidemiol,
2011, 92 (3): pp. 644-647.
15. Włodarek D. et al.: Dietoteriapia. Wydawnictwo Lekarskie PZWL, Warszawa:
Wydanie I; 2014.
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ABSTRACT
The aim of this study is to evaluate dietary supplements intake among university
students in Silesian and Lesser Poland voivodeships. The research was conducted on
200 university students with use of the authorial survey. Most of the respondents
take dietary supplements, yet there are more women among this group. The largest
group of students who take dietary supplements study at Jagiellonin University, and
the smallest – at Silesian University of Technology. Most of the students, taking the
supplements, use them only in case of certain symptoms – the most common are
vitamins deficiencies. The Internet is the most common source of information about
dietary supplements. The most common criteria which influence choice of supplements are one’s own experiences.
STRESZCZENIE
Ocena stanu wiedzy oraz częstotliwość stosowania suplementów diety przez studentów wybranych uczelni wyższych na terenie województwa śląskiego
i małopolskiego, oraz ocena czynników, którymi kierują się studenci badanej grupy
przy wyborze suplementu diety. Badanie przeprowadzono wśród studentów wybranych uczelni wyższych na terenie województwa śląskiego i małopolskiego. Uczestniczyło w nim łącznie 200 osób. Zastosowano autorski kwestionariusz ankiety. Z
badań wynika, że 71 % studentów stosuje suplementy diety. Badani studenci najczęściej sięgali po suplementy diety celu uzupełnienia niedoborów witamin i składników mineralnych. Źródłem informacji dotyczących suplementów diety był Internet
(44 % odpowiedzi). Przy wyborze najczęściej kierują się składem (22 % ankietowanych). Badania wykazały, że znaczna część studentów stosuje i ma świadomość
korzystnego działania suplementów diety. 1/5 młodzieży akademickiej stosuje je
codziennie. Studenci Uniwersytetu Medycznego i Akademii Wychowania Fizycznego znacznie częściej stosują suplementy diety oraz przestrzegają zasad zdrowego
żywienia.
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