Nutritional interventions in primary mitochondrial disorders: Developing an evidence base.

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

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

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.

ABSTRACTThis study was conducted among pharmacy students in Karachi, Pakistan, to document prevalence, opinions and their attitudes toward dietary supplement (DS) use. A cross-sectional study was conducted for a period of four months. The study used a specially formulated dietary supplement questionnaire (DSQ). The prevalence of DS use was reported at 48.2%: 51% in males and 47.3% in females. Physician recommendation was cited by majority of students as reason for DS use (n = 153, 25%). Most of the students used multivitamins (n = 315, 51.5%). The average monthly cost attributed to DS use was reported at PKR 1,396.3 (USD 13.55). For every year increase in age, DS use in students decreased (OR = 0.917). Male students were more likely to recommend DS use (OR = 1.425). The most noteworthy finding was the cautious approach of students as the majority reported DS use only upon recommendation of a physician.

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.

Background:Dietary supplement use received wide attention and interest throughout the world, particularly in Gulf countries, because of advanced economic and industrial growth.Objective:The present study aimed to determine the prevalence and correlates of dietary supplement use among medical students at Jouf University, Saudi Arabia.Methods:For this cross-sectional study, an anonymous self-administered structured questionnaire was distributed among medical students at Jouf University, Saudi Arabia. Out of the 381 medical students, 366 answered the questionnaire with a response rate of 96%. Analysis of data was done using the Statistical Package for Social Science (SPSS) program, version 24. Statistical significance was considered at P values &lt;0.05.Results:Regarding the prevalence of dietary supplement use, 36.3% (n=133) and 29.5% (n=108) of the respondents were previous and current users of dietary supplements, respectively. Multivitamins and vitamin D were the most prevalent dietary supplements used by the participants. The students reported that the internet was the main source of knowledge concerning dietary supplements. The significant predictors of dietary supplement use in the logistic regression analysis were: age &gt;21 years (odds ratio (OR): 3.26; confidence interval (CI): 1.67-10.53), females sex (odds ratio (OR): 2.23; confidence interval (CI): 2.34-6.84), and being in the third academic year or more (odds ratio (OR): 2.58; confidence interval (CI): 1.82-5.37). The most reported reasons for utilizing dietary supplements were nutritional supplementation and health promotion. Nearly three-quarters of the students agreed that dietary supplementation is good for health and recommended others to use them after doctor recommendation.Conclusion:Dietary supplement use was remarkably high among medical students at Jouf University, Saudi Arabia. Consumption of dietary supplements increased significantly among older students, females, and those in the third academic year or more. This study recommends other studies involving students from non-health domain colleges to detect if there is a difference in the prevalence of dietary supplement use within this population.

Background/Objectives: Cancer survivors are a growing population in the United States, with projections of 22.5 million by 2030. Cancers of the prostate (PC) and breast (BC) are among the most prevalent. Despite a high burden of disease, African American survivors are underrepresented in health behavior research. Leveraging two large databases, this study uniquely characterizes dietary supplement (DS) use among African American cancer survivors to explore potential intervention points. Methods: Characteristics from 376 African American cancer survivors (130 PC; 246 BC) in lifestyle intervention trials were examined. DS use was self-reported and categorized by type. A logistic regression model examined associations between use and survivor characteristics. Results: Overall, 215 (63.80%) survivors with baseline medication log data (N = 337) reported using at least one DS, with a higher prevalence among BC survivors (67.44%) than PC survivors (57.38%). Vitamin D ± calcium combinations, multivitamins, omega-3 fatty acids, calcium, Vitamin B12, and Vitamin C were the most frequently reported. Total comorbidities (mean = 2.38, SD = 1.66) significantly predicted increased DS use among BC and PC survivors. Educational attainment (≤12th grade vs. graduate/professional education) and diet quality (high vs. low) were significantly associated with lower odds of DS use for PC survivors. Only diet quality (moderate vs. low) was significantly associated with higher odds of DS use in BC survivors. Conclusions: DS use is common among African American PC and BC survivors participating in lifestyle interventions. These findings underscore the need for evidence-based guidelines regarding DS use among cancer survivors and the need to include diverse populations.

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.

Objectives To assess how postmenopausal women with severe vasomotor symptoms who volunteer for an acupuncture trial (ACUFLASH) differ from the general population (the Norwegian Women and Cancer study, NOWAC); and to describe the use of dietary supplements and medication during trial intervention and follow-up.Methods Questionnaire data on postmenopausal women regarding demography and use of dietary supplements and medication were compared between the ACUFLASH trial (baseline, 2006–2007, n = 267) and the NOWAC study (2004–2005, n = 331). Additionally, the trial intervention groups, acupuncture and self-care (n = 134) or self-care alone (n = 133), were compared regarding supplements and medication use.Results The prevalence of dietary supplement use was higher among women with severe vasomotor symptoms (83.9%) than in the population-based sample (74.3%), with particularly extensive use of cod liver oil. The prevalence of medication use was 46.4% in ACUFLASH and 55.0% in NOWAC. Trial participants reported poorer self-reported health, higher education level and tended to be former oral contraceptive users and smokers. At trial baseline, 48.5% of the acupuncture group and 60.3% of the self-care group used dietary supplements (p > 0.05), while 48.5% in the acupuncture group and 45.0% in the self-care group used medication (p > 0.05). Use of supplements for vasomotor symptoms increased significantly in the self-care group at 12 weeks, while it remained unchanged in the acupuncture group. Hormone therapy use increased significantly in both groups after intervention.Conclusion Postmenopausal women suffering severe vasomotor symptoms used more dietary supplements than the general population. They also had poorer self-reported health, but their medication use was similar to that of the general population. Acupuncture did not influence use of dietary supplements in the randomized intervention.

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.

IntroductionDespite the limited evidence about the efficacy and safety of dietary supplement use for mental health, people tend to use them quite often. Generally the use of supplements among Saudi population shown to be prevalent, although limited studies that assessed their use for the improvement of mental health.ObjectivesIdentify the prevalence of dietary supplements use for mental health among the population in Saudi Arabia and also determine the factors that affect the use of dietary health supplements for mental health.MethodsA cross-sectional study of a convenience sample of 443 participants from various regions in Saudi Arabia. Questionnaire includes demographics, dietary use supplement assessment, and mental health assessment via the patient health questionnaire (PHQ-9), generalized anxiety disorder questionnaire (GAD-7), and insomnia severity index (ISI).ResultsThe prevalence of DS among the Saudi population reached 44%. Vitamin D and Melatonin were the most commonly reported DS used for mental health among the study population. The use of DS was associated with three times higher odds in patients who had previous mental health disorder diagnoses (OR 2.972; 95%CI; 1.602-5.515). The chance of using DS almost doubled in patients with subthreshold and moderate-severe insomnia (OR 1.930;95% CI 1.191-3.126) and (OR 2.485; 95% CI 1.247- 4.954) respectively.ConclusionsDespite the limited evidence about the efficacy and safety of dietary supplement use for mental health, people tend to use them quite often. Although the use of supplements among Saudi population shown to be prevalent, limited studies assessed their use for the improvement of mental health.DisclosureNo significant relationships.

Dietary Supplement Use Is Associated with Select Serum Nutrient Biomarkers among Postmenopausal Women: Results from a Controlled Feeding Study.

Dietary Supplement Use among Adult Cancer Survivors in the United States

BackgroundPrior research on the use of dietary supplements (DSs) has examined the characteristics of users compared to non‐users; however, most studies have generally surveyed healthy populations and have not asked whether users discuss their DS intake with their healthcare providers.ObjectivesThe objective of this study was to characterise the use of select DSs among individuals with chronic disease, and to assess the degree to which they discussed DS use with their healthcare provider.MethodsA telephone survey was administered to a subset of individuals who were subsequently randomised into a larger clinical trial. Participants were asked about the frequency and types of DS used, with electronic medical records used to capture clinical characteristics. Participants were aged ≥40 years and had diabetes mellitus or atherosclerotic cardiovascular disease.ResultsAmong the 833 survey respondents, 56.3% of respondents reported daily DS use. Daily DS users were more likely to be older, female, have lower blood pressure, lower cholesterol levels and better medication adherence. The most commonly used supplements were multivitamins, omega 3 supplements and vitamin D. Approximately one‐third of users reported that they had not discussed DS use with their healthcare provider.ConclusionsGiven the high prevalence of DS use in this population, it is critical that healthcare providers discuss DS use with their patients so that the safety and health of these patients are not compromised.

In the past decade, a body of evidence has reported that dietary supplement use is related to prohibited performance enhancing substance use (i.e., doping). To help international and national sport organisations understand the degree to which dietary supplement use is related to doping, the objectives of this systematic review and meta-analysis were to 1) compare the prevalence of doping between dietary supplement users and non-users and 2) identify whether supplement use is related to doping social cognitive factors. We searched for studies sampling athletes and that measured both dietary supplement use and doping in EMBASE, MEDLINE, PsychINFO, CINAHL and SPORTDiscus from database creation to May 2022. Risk of bias was assessed using JBI Critical Appraisal Checklist for cross-sectional studies and the STROBE checklist. Twenty-six cross-sectional studies, involving 13,296 athletes were included. Random-effect models revealed that doping was 2.74 (95% CI=2.10 to 3.57) times more prevalent in dietary supplement users (pooled prevalence = 14.7%) than non-users (6.7%), and that users reported stronger doping intentions (r=0.26, 0.18 to 0.34) and attitudes (r=0.21, 0.13 to 0.28) compared to non-users. Preliminary evidence also suggests that dietary supplement users were less likely to dope if they were more task oriented and had a stronger sense of morality. Results of the review are limited by the cross-sectional design used in all studies and lack of consistency in measurement of dietary supplement use and doping. Data indicate that athletes using dietary supplements are more likely to self-report doping Anti-doping policy should, therefore, target dietary supplement use in anti-doping education programmes by providing alternative strategies for performance enhancement or highlighting the safest ways they can be consumed. Similarly, as a large proportion of athletes use dietary supplements without doping, further research is needed to understand the factors that protect a dietary supplement user from doping. No funding was received for the review. A study protocol can be found here: https://osf.io/xvcaq.