Dietary supplements are a $50+ billion industry in the United States. Yet scientific evidence varies widely across products. Last month’s survey explored what you take, why you take it and how confident you are that it improves your health.

Here are the results:

My thoughts: Almost 90% of readers report taking at least one supplement weekly. Full transparency: I don’t answer my own survey questions online, but I take creatine to support muscle strength and exercise recovery, despite the lack of definitive evidence that it improves long-term health outcomes.

What surprised me most was not the high usage rate, but the degree of confidence. More than 70% of respondents were very or somewhat confident these products improve their health, even though rigorous evidence remains limited for the most popular supplements.

That said, the decision many readers are making is understandable. For relatively low cost and with generally few reported side effects, supplements can feel like a reasonable “win if it helps, little lost if it doesn’t” choice.

My interpretation of the science is that supplements may play a modest supporting role, particularly for individuals with a documented deficiency. But the strongest evidence for extending both lifespan and health span still lies in the fundamentals: nutrition, physical activity, restorative sleep, social connection and early prevention.

Although not addressed in last month’s survey, what concerns me most is that our nation pays little more than lip service to the greatest determinant of longevity. Social determinants (including income, housing, education and community conditions) influence health outcomes roughly three times more than the medical care people receive. Yet as a country, we continue to underinvest in these foundations while overspending on medications, procedures and other downstream interventions.

Thanks to all who voted! To see the final results of this survey, and for access to timely news and opinion on American healthcare, sign up for my free (and ad-free) newsletter Monthly Musings on American Healthcare.

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Dr. Robert Pearl is the former CEO of The Permanente Medical Group, the nation’s largest physician group. He’s a Forbes contributor, bestselling author, Stanford University professor, and host of two healthcare podcasts. Check out Pearl’s newest book, ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine with all profits going to Doctors Without Borders