Suboptimal Safety Practices Persist Despite Widespread Dietary Supplement and Natural Product Use During the Endemic Transition: A Cross-Sectional Study.

IntroductionDietary supplements (DS) and natural products were widely used in Malaysia before COVID-19, and post-pandemic demand remains high, raising safety concerns.MethodsThis study examined current usage practices during the endemic phase through an online cross-sectional survey among 464 predominantly young, educated Malaysian adults (2023-2024). A validated questionnaire assessed product use, reasons for consumption, frequency, and safety practices, with data analysed using descriptive statistics, Chi-square tests, Spearman's rank correlation and multivariate logistic regression.ResultsVitamin C (78.4%), honey (40.5%), lemon (31.0%), fish oil (30.6%), and green tea (26.5%) were the most commonly consumed products, primarily to boost immunity (89.2%). Although 90.7% of respondents reported no adverse effects, 41.4% engaged in suboptimal safety practices, specifically failing to consult healthcare providers or verify product registration. Usage frequency was significantly associated with the geographic state of residence and correlated with age, knowledge, and practice risk. Multivariate analysis identified age as the sole sociodemographic predictor of frequent use (p = 0.048), while high-risk practices were prevalent universally across all demographic groups.ConclusionDespite widespread use, unsafe practices persist, highlighting the need for public education, regulatory oversight, and evidence-based guidance to ensure safe and informed use of DS and natural products.