Herbal and supplement use - Alternative Therapies

Nutrition Research Newsletter, Feb, 2004

Dietary supplements include products that contain a vitamin, mineral, herb, botanical metabolite, constituent, or food extract; are to be ingested as pills, capsules, tablets, or liquid; are labeled as 'dietary supplements'; and are not intended for consumption as the sole item of a meal or as a conventional food. In 1994, the US Congress passed the Dietary Supplements Health and Education Act (DSHEA), which allows manufacturers to make nutritional claims on labels regarding how an ingredient acts to maintain structure or function in humans--without first obtaining approval from the US Food and Drug Administration. This has opened up the market to many products that would have otherwise needed safety testing before being sold. Since this deregulation of the industry, herbal supplement sales jumped 70% from 1994 to 1997, and reached $3.3 billion in 1999.

Information regarding patterns and correlates of herbal and specialty supplement use can help nutritionists understand which compounds are most commonly used, who are likely to use them, and whether the choice of herbal supplements appears to be motivated by specific health concerns. The data used in the present study are from the Vitamins and Lifestyle (VITAL) study, a longitudinal cohort of 77,500 fifty- to seventy-six-year old adults. The present analysis utilizes data from 61,587 participants, who completed a self-administered mailed questionnaire in 2000-2002 on current dietary supplement use, demographic and lifestyle characteristics, and medical history. The questionnaire asked specific questions about 20 herbal/specialty supplements, multivitamins, and 17 individual vitamins and minerals.

Overall, one third of the VITAL cohort reported current use of at least one of the 20 herbal/specialty supplements. Although women are more likely to take supplements overall (36% of women vs 29% of men), men used more garlic pills, ginseng, and lycopene. The five most commonly used herbal/specialty supplements by men were glucosamine, chondroitin, saw palmetto, garlic pills, and ginko biloba. Women most frequently used glucosamine, chondroitin, ginko biloba, fish oils, and garlic pills. When compared with no supplement use, herbal/special supplement use was significantly higher among respondents who were older, female, educated, had a normal BMI, were nonsmokers, engaged in exercise, and ate a diet lower in fat and higher in fruits and vegetables. Similar trends were observed when herbal/specialty supplement users were compared with vitamin/mineral users. For specific supplements and medical conditions, the strongest associations were cranberry pills and multiple bladder infections, acidophilus pills and lactose intolerance, and saw palmetto and enlarged prostate.

The results of this study show that the odds of supplement use are high for certain demographic and lifestyle characteristics. Additionally, persons with specific medical conditions are using supplements promoted as helping to reduce the risks for their particular conditions. Nutrition professionals should be aware of the potential risks and benefits associated with the use of herbal/ specialty supplements.

S Gunther, R Patterson, A Kristal, et al. Demographic and health-related correlates of herbal and specialty supplement use. JADA 104:27-34 (January 2004) [Correspondence: Ruth E. Patterson, PhD, RD, Cancer Prevention Research Program, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, Seattle, WA 98109-1024. E-mail: rpatters@fhcrc.org.]