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Abstract
Despite decades-old efforts to inform and educate consumers about healthier lifestyles
through established dietary guidelines, diet-related diseases are on the rise. At the same
time, consumers have developed more favorable attitudes towards nutritional
supplements as a perceived alternative way to improve diet quality. Thus, there is a need
to understand the role of nutritional supplements in U.S. consumers’ diets, given that
supplements might serve as a possible policy tool to improve dietary behavior. We use
data from the National Health and Nutrition Examination Survey (NHANES) to estimate
the impact of nutritional supplements intake on respondent’s body weight outcomes,
while controlling for diet quality based on individual Healthy Eating Index (HEI-2010)
scores. Our analysis applies a set of innovative Propensity Score Matching (PSM)
estimators that account for potential selection bias and endogeneity of the self-reported
behavior and diet-health outcomes. The empirical analysis demonstrates a negative
association between nutritional supplement intake and BMI. Our findings suggest that
health-conscious individuals overinvest in health by taking nutritional supplements
instead of improving diet quality through more appropriate food choices. Nutritional
supplements have been discussed as a disease-preventative input that may enhance the
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diets and health of at-risk populations. The analysis in this paper suggests that consuming
supplements should not be thought of as a replacement for a healthy food-based diet. Our
study provides an important contribution to the literature on a key food policy issue and
contributes new insight with regard to the relationship between dietary choices and health
behavior