Dietary Botanicals and Supplements

Use of dietary and herbal supplements in adult patients with epilepsy

Vitamins and minerals are micronutrients required by the body to carry out a range of normal functions. The regular diet of common man is obtained deficient in certain nutrients, so dietary supplements are commonly prescribed in this study combination of vitamins and minerals in the form of bilayer tablet is proposed as a dietary supplement. The current stud aimed to assess dietary supplement use and determine its associated factors among adult population in southern bangladesh In that we include, various nutraceuticals like prebiotic, probiotics, PUFA (poly unsaturated fatty acid), vitamins, spices, polyphenols and antioxidant vitamins etc. these neutraceuticals are used in eye health, mental health, sleep enhancement, cancer prevention, bone health, skin health and oral health. Dietary supplement used was more common in male as well as female. Common types on dietary supplement used in India are the multivitamin and multi-mineral products and health along with herbs for treatment of health or health promotion. Dietary supplements come in a variety of forms, including tablets, capsules, gummies, and powders as well as drinks and energy bars. Dietary food supplement is intended to provide nutrients that may otherwise not be consumed in sufficient manner. the supplement are generally understood as food they are included, vitamins, minerals, fibers, and fatty acid or amino acid, among other substance.

Dietary supplements that contain ephedra alkaloids (sometimes called ma huang) are widely promoted and used in the United States as a means of losing weight and increasing energy. In the light of recently reported adverse events related to use of these products, the Food and Drug Administration (FDA) has proposed limits on the dose and duration of use of such supplements. The FDA requested an independent review of reports of adverse events related to the use of supplements that contained ephedra alkaloids to assess causation and to estimate the level of risk the use of these supplements poses to consumers. We reviewed 140 reports of adverse events related to the use of dietary supplements containing ephedra alkaloids that were submitted to the FDA between June 1, 1997, and March 31, 1999. A standardized rating system for assessing causation was applied to each adverse event. Thirty-one percent of cases were considered to be definitely or probably related to the use of supplements containing ephedra alkaloids, and 31 percent were deemed to be possibly related. Among the adverse events that were deemed definitely, probably, or possibly related to the use of supplements containing ephedra alkaloids, 47 percent involved cardiovascular symptoms and 18 percent involved the central nervous system. Hypertension was the single most frequent adverse effect (17 reports), followed by palpitations, tachycardia, or both (13); stroke (10); and seizures (7). Ten events resulted in death, and 13 events produced permanent disability, representing 26 percent of the definite, probable, and possible cases. The use of dietary supplements that contain ephedra alkaloids may pose a health risk to some persons. These findings indicate the need for a better understanding of individual susceptibility to the adverse effects of such dietary supplements.

Epidemiology of dietary supplement use in Serbia: Report from Novi Sad

The prevalence of dietary supplement use among athletes continues to rise with 60–80% of athletes often reporting current or previous use of dietary supplements. While select dietary ingredients have been shown to improve acute performance and enhance training adaptations over time, it is important to still consider the risk vs. reward for athletes before opting to consume a dietary supplement. Previous work has indicated that certain dietary supplements may pose risks for inadvertent doping, may be susceptible to mislabelling, could be banned by certain governing bodies of sport, or pose health risks for certain populations. The purpose of the current narrative review is to summarize the prevalence of adulteration in dietary sport supplement products, outline the risks of inadvertent doping for athletes, and highlight best practices regarding safe supplementation strategies. Analytical studies have found anywhere from 14 to 50% of samples analyzed from dietary supplement products have tested positive for anabolic agents or other prohibited substances. It is important for the consumer to adhere to safe supplementation strategies, which include following serving size recommendations, cross-referencing ingredient profiles with the list of prohibited substances, choosing quality products that have been verified by a third-party certification program, and being cognizant of consuming multiple dietary supplement products with overlapping ingredient profiles. Once these practices have been considered, it is reasonable for an athlete to utilize dietary supplements as a strategy to optimize performance and health, with a low risk of failing a drug test (adverse analytical finding) and experiencing adverse events.

Dietary supplements are extensively used in the United States, especially by people age 50 and over. Surveys have shown that magazines and other news media are an important source of information about nutrition and dietary supplements for the American public. It is uncertain, however, whether magazines provide their readers with adequate information about the safety aspects of supplement use. This report presents an analysis of supplement safety information in articles published during 1994-1998 in 10 major magazines popular among older readers. This time period was chosen to allow the impact of the 1994 Dietary Supplement Health and Education Act (DSHEA) to be assessed. The evaluation included 254 magazine articles. More than two-thirds of the articles did not include comprehensive information about the safety aspects of the dietary supplements that were discussed. Information about safety issues such as maximum safe doses and drug-supplement interactions was often lacking even in otherwise informative and well-researched articles. A total of 2,983 advertisements for more than 130 different types of supplements were published in the magazines surveyed. The number of advertisements per year increased between 1995 and 1998. Supplements of particular interest to older adults (such as antioxidants, calcium, garlic, ginkgo biloba, joint health products, liquid oral supplements, and multivitamins) were among the most frequently advertised products. Although magazines popular among older readers contain extensive information about dietary supplements, these publications cannot be relied upon to provide readers with all of the information that they need in order to use supplements safely.

Dietary supplement use has continued to rise. In addition to supplement-drug interactions, it is prudent to consider how dietary supplements may interact with a patient's specific pharmacogenetics. Variations in genes associated with CYP 450 enzymes have evidence of impacting drug metabolism and adverse effects. This research was performed to evaluate CYP P450 enzyme activity of the top 15 dietary supplements used in the USA in order to initiate pharmacogenetic considerations specific to commonly used dietary supplements. The most common dietary supplements used in the USA were obtained from the National Health and Nutrition Examination Survey (NHANES). Primary literature detailing supplement CYP P450 activity was compiled from PubMed using MeSH search terms: supplement name(s), cytochrome P450 enzymes, metabolism, and pharmacokinetics. Additional resources utilized for documented CYP enzyme genotypes were the pharmacogenetic databases from Clinical Pharmacogenetics Implementation Consortium and The Pharmacogenomic Variation Consortium. Of the 15 most common dietary supplements used in the USA, 53% (cranberry, echinacea, garlic, ginkgo biloba, ginseng, melatonin, milk thistle, and valerian) exhibit CYP P450 metabolism, with some having possible induction activity as well. Melatonin and garlic are substrates of CYP1A2 and CYP2C19, respectively. Additionally, there is evidence of echinacea having possible CYP3A4 induction activity. CYP P450 activity is an important consideration for any patient but becomes increasingly critical if patients have certain CYP P450 phenotypes that impact metabolism. These popular supplements have the potential for changes in supplement exposure, and adverse effects based on pharmacogenetic profiles. Furthermore, these sites of metabolism are shared with many medications, setting the stage for possibly more profound interactions between medications and supplements. This paper highlights the mechanisms in which dietary supplements may constitute a risk for patients with certain CYP P450 phenotypes. Further research is needed in the area of dietary supplements and their pharmacogenomic implications.

Dietary supplement use is common among children and adolescents. During 2013-2014, approximately one third of children and adolescents (persons aged ≤19 years) in the United States were reported to use a dietary supplement in the past 30 days, and use varied by demographic characteristics (1,2). Dietary supplements can contribute substantially to overall nutrient intake, having the potential to both mitigate nutrient shortfalls as well as to lead to nutrient intake above recommended upper limits (3). However, because nutritional needs should generally be met through food consumption according to the 2015-2020 Dietary Guidelines for Americans, only a few dietary supplements are specifically recommended for use among children and adolescents and only under particular conditions (4). The most recently released data from the National Health and Nutrition Examination Survey (NHANES) during 2017-2018 were used to estimate the prevalence of use among U.S. children and adolescents of any dietary supplement, two or more dietary supplements, and specific dietary supplement product types. Trends were calculated for dietary supplement use from 2009-2010 to 2017-2018. During 2017-2018, 34.0% of children and adolescents used any dietary supplement in the past 30 days, with no significant change since 2009-2010. Use of two or more dietary supplements increased from 4.3% during 2009-2010 to 7.1% during 2017-2018. Multivitamin-mineral products were used by 23.8% of children and adolescents, making these the products most commonly used. Because dietary supplement use is common, surveillance of dietary supplement use, combined with nutrient intake from diet, will remain an important component of monitoring nutritional intake in children and adolescents to inform clinical practice and dietary recommendations.

The objective of the present study was to investigate the types of dietary supplements administered to healthy 6-month-old infants and to identify the factors influencing the use of such supplements. The present study was based on the Taiwan Birth Cohort Study database. Questionnaires were used to collect information on the use of dietary supplements from birth, infant feeding practices, and other covariates at 6 months of age. We excluded low-birth-weight, preterm babies, and those whose caregivers returned incomplete questionnaires, leaving a sample size of 18,658. Multiple logistic regression was used to determine the characteristics capable of predicting the use of supplements in this population. A total of 34.9% of infants were fed dietary supplements from birth. The most common types of supplements administered to infants were probiotics, calcium, and multivitamin/mineral supplements. Formula feeding, earlier weaning, and earlier complementary feeding were positively related to the use of several supplements. The present study demonstrates that the use of pediatric dietary supplements is relatively common among infants in Taiwan, even in the earliest stages of life. For infants whose diet is adequate, no need exists for dietary supplements, and excessive intake can adversely influence health. Communication between health professionals and child caregivers should be promoted to increase understanding of infant feeding, as well as the safety and efficacy of dietary supplements.

Dietary supplement use and associated variables among Turkish women

Consumption and reasons for use of dietary supplements in an Australian university population

Introduction: The use of dietary supplements has been a common practice for US Olympians and Olympic hopefuls for well over two decades. However, data on dietary supplement use by US elite athletes is limited. Data that does exist indicate that use has increased, as has the variety of supplements used. Processing athletes for the Summer Olympic Games in Sydney offered the opportunity to collect data on dietary supplement use by athletes comprising the U.S. Olympic Team. Methods: Team processing was conducted at ASW Naval Base & Bayside Convention Center, San Diego, California from August 15 to September 13, 2000. Athletes were processed as teams, prior to departing for Sydney. One step of the physical exam process was completion of the Athlete Medical History Form. Three questions on dietary supplement use were included on the medical history form. A team physician or certified athletic trainer reviewed the self-reported data with each athlete after completion of the form. Questions elicited information on frequency of supplement use, types of supplements taken in the past year, and reasons for use. Each of the questions allowed for multiple answers. Frequencies were performed for all variables concerning supplement use, stratified by gender and sport. Correlations were computed to identify relationships between supplement use (frequency, type and reason) and sport classifications. Analysis of variance was used to determine differences in gender, sport, types of supplements and reason for supplement use. In 1988, 66% of the athletes on the U.S. Summer Olympic Team were surveyed on use of ergogenic aids (Miles, 1991). While the instrument utilized was different from the one used in the study reported here, some comparisons of data were possible. Results: There were 602 athletes from 28 sports on the Olympic Team roster who were processed for Sydney. Completed medical history forms were obtained on 543 (90%) of the athletes, 241 females and 302 males. Group size ranged from 123 athletes on the track and field team to one athlete on the badminton team. Two hundred and twenty-two female athletes reported using dietary supplements, whereas 272 male athletes said they did. This represents 92% of the females and 90% of the males, with a combined average of 91% from whom data were obtained. Responses to frequency of use ranged from “never” to “daily”. Reasons for using dietary supplements included: 1) to correct an inadequate diet 2) to increase muscle mass/body weight 3) to lose weight 4) to prevent illness and disease 5) to treat a medical condition or an injury 6) to increase energy 7) to enhance performance and 8) no specific reason. Of surprise to the investigators was that 33% of the athletes who reported taking supplements reported taking herbals. In 1988 only 1% of those completing a supplement survey reported taking herbals. Discussion: It is known that elite level US athletes have historically reported a higher use of vitamin/mineral supplements than the general public. Prior to this survey, it was not possible to estimate, with any degree of accuracy, the percentage of Olympic athletes taking dietary supplements. Comparing this data to data from surveys on limited numbers of Olympic athletes and a 1988 survey conducted during team processing, indicate that not only has the use of dietary supplements increased, but also the number of substances taken.

Purpose: The factors associated with the dietary supplement (DS) use of Asian breast cancer survivors in consideration of the duration of use and types of DS have not been well established. Methods: We recruited 693 Korean female breast cancer survivors at two university-affiliated hospitals and collected study data through a self-administered questionnaire and a review of medical records. A multiple logistic regression analysis was conducted to evaluate the multivariable-adjusted association between DS use and study variables. Results: The prevalence of any (≥2 weeks) and long-term (≥6 months) DS use among study participants was 48.2% and 12.0%, respectively. Education level, alcohol use, adequate physical activity (≥150 min/week), and time lapse after cancer diagnosis were positively associated with any DS use. Among DS users, as compared with short-term (≥2 weeks and <6 months) users, long-term users were more likely to have a higher cancer stage, more diverse cancer treatment modalities, a shorter time since cancer diagnosis, and lower fear of cancer recurrence. When we repeated the analysis for each DS type, time lapse after cancer diagnosis showed a consistently inverse association with long-term use of the most frequently consumed DS (multivitamins, followed by vitamin D/calcium, vitamin C, and omega-3). The number of cancer treatment modalities was positively associated with the long-term use of multivitamins and vitamin D/calcium. Alcohol consumption and low bone mineral density were positively associated with long-term vitamin D/calcium use. Conclusions: The factors associated with DS use differed by the duration of DS use and specific DS type. Long-term DS use was more frequently associated with cancer-related factors.

Dietary Supplement Use among Adult Cancer Survivors in the United States

Background and objectives: The use of dietary supplements is extremely common among cancer patients. It is estimated that 20–90% of cancer patients use some form of dietary supplement. Most often, they are “self-selected” supplements or selected from unverified Internet sources, without consulting a specialist. Components in such supplements can interact with the applied therapy and impact cancer patients’ treatment. The aim of this study was to examine the frequency and type of supplementation used by cancer patients. Methods: A cross-sectional observational study was conducted on 52 cancer patients (mean age: 58 years) by using a study-specific questionnaire, conducted between February and July 2022 at the University Clinical Hospital Mostar, Bosnia and Herzegovina. Results: More than half of the respondents (62%) use some dietary or herbal supplements daily. The most common dietary supplements were probiotics (22%), B complex vitamins (22%), and vitamin D (22%). Patients (46.8%) used supplements based on their own or their family–friend’s recommendation, and 90% of them started to use supplementation during therapy. The main reason for use, as stated by 71.8% of the respondents, was to support immunity. Approximately 56.2% of them said that they had noticed a positive effect on their health. It is concerning that 78.8% of patients did not research the possible side effects and risks of taking supplements during therapy. Conclusions: Doctors, nutritionists, and nurses should improve communication with patients by giving them reliable information and evidence-based recommendations about dietary supplements and complementary therapy in general. During consultations, professionals should offer assistance and discuss potential benefits and risks with the patient in order to achieve a mutually informed decision on dietary supplement use.