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  1. Costello, Rebecca B. PhD, FAHA
  2. Dwyer, Johanna T. DSc, RD
  3. Bailey, Regan L. PhD, MPH, RD
  4. Saldanha, Leila G. PhD, RD, FAND
  5. French, Steven MBA


It is complicated to ascertain the composition and prevalence of the use of highly fortified food and supplement products (HFPs) because HFP foods and HFP supplements have different labeling requirements. However, HFPs (energy bars, energy drinks, sports drinks, protein bars, energy shots, and fortified foods/beverages) are popular in the United States. A Web-based survey balanced to reflect US census data was used to describe their use in a sample of 2355 US adults older than 18 years in 2011 and trends in their use from 2005. In 2011, 33% of adults reported using HFPs; use was significantly higher among males, African Americans, Hispanics, and more highly educated individuals (eg, some college or more) and those younger than 45 years compared with nonusers. Multiple product use was common. Of users, 46% consumed sports drinks, 37% fortified foods/beverages, 32% protein bars, 27% energy drinks, 24% energy bars, and 12% consumed energy shots. For those HFP products as a group, prevalence of use was 36% (n = 2039) in 2005, 35% in 2009 (n = 2010), and 30% in 2011 (n = 2355). Although use was significantly lower in 2011 than in 2005 especially among females, non-Hispanics, and those with high school education or less (P <= .05), HFPs, particularly energy and sports drinks, continue to be widely used by many US adults.