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King A, Kwan K, Jukic I, Zinn C, Helms E. Fueling for and recovering from resistance training: The periworkout nutrition practices of competitive powerlifters. Nutrition 2024; 122:112389. [PMID: 38428220 DOI: 10.1016/j.nut.2024.112389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 01/30/2024] [Accepted: 02/02/2024] [Indexed: 03/03/2024]
Abstract
PURPOSE Nutrient timing is a concept that emphasizes the intentional ingestion of whole or fortified foods, and dietary supplements, to adequately fuel for, and recover from, acute and chronic exercise. The nutrition strategies used by powerlifters around training sessions have not, to our knowledge, been previously investigated. This study explored the self-reported periworkout (before, during, and after) nutrition practices of competitive powerlifters, including what, why, and information source that informed practice, with comparison to current sport nutrition guidelines. METHODS Actively competing male (n = 240) and female (n = 65) powerlifters completed a cross-sectional online survey of self-reported periworkout nutrition practices in the pre-, intra-, and postexercise periods, fasted training, and supplementation. Data are presented as the number (n) and percentage (%) of all powerlifters practicing a given strategy followed by a % of responses reporting various practices or beliefs within this strategy. Categorical subgroups (sex, age, and weight class; and competitive caliber) were analyzed with a chi-square test or Fisher's exact test and denoted where significant (P ≤ 0.05). RESULTS Most powerlifters reported paying specific attention to nutrition practices in the pre-exercise period (n = 261; 85.6%) by ingesting more carbohydrate (CHO) rich foods (n = 234; 89.6%) for the purpose of assisting in training performance (n = 222; 85.1%). Most powerlifters reported intraexercise nutrition strategies (n = 211; 69.2%), of which most included ingesting more CHO rich foods (n = 159; 74.5%) for the purpose of feeling less hungry and/or boosting energy levels during training (n = 129; 61.1%). Most powerlifters reported paying attention to postexercise nutrition (n = 244; 80%), by ingesting more protein rich foods (n = 182; 74.6%) for the purpose of recovering better for the whole day (n = 152; 62.3%) and enhancing the benefits of training (n = 149; 61.1%). Most powerlifters did not complete training sessions in the fasted state (n = 262; 85.9%). Most powerlifters reported paying attention to supplementation before training (n = 237; 77.7%), of which preworkout formulas (n = 137; 57.8%), energy drinks (n = 101; 42.6%), creatine (n = 88; 37.1%), and caffeine pills (n = 70; 29.5%) were most reported. Supplementation was used to assist in training performance (n = 197; 83.1%) and increase wakefulness/alertness (n = 183; 77.2%). Males reported more often than females that they informed multiple elements of their nutrition practices with the information they read or watched somewhere (P = 0.002-0.012). CONCLUSION The periworkout nutrition practices used by competitive powerlifters followed current sport nutrition guidelines, by using CHO sources to fuel for training and ensuring the provision of protein postexercise. Competitive powerlifters may wish to exert caution with supplementation, as there is a risk of harm or inadvertent doping.
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Affiliation(s)
- Andrew King
- Sport Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, Auckland, New Zealand.
| | - Kedric Kwan
- Sport Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, Auckland, New Zealand
| | - Ivan Jukic
- Sport Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, Auckland, New Zealand
| | - Caryn Zinn
- Sport Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, Auckland, New Zealand
| | - Eric Helms
- Sport Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, Auckland, New Zealand; Department of Exercise Science and Health Promotion, Muscle Physiology Laboratory, Florida Atlantic University, Boca Raton, Florida, USA
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Allem JP. The Need for Research on the Wellness Industry's Impact on Health Decisions. Am J Prev Med 2024:S0749-3797(24)00166-1. [PMID: 38777206 DOI: 10.1016/j.amepre.2024.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 05/14/2024] [Accepted: 05/14/2024] [Indexed: 05/25/2024]
Affiliation(s)
- Jon-Patrick Allem
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, The State University of New Jersey, New Brunswick, New Jersey.
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Salih AK, Alwan AH, Khadim M, Al-Qaim ZH, Mardanov B, El-Sehrwy AA, Ahmed YI, Amerizadeh A. Effect of ginger (Zingiber officinale) intake on human serum lipid profile: Systematic review and meta-analysis. Phytother Res 2023; 37:2472-2483. [PMID: 36786398 DOI: 10.1002/ptr.7769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 01/04/2023] [Accepted: 01/22/2023] [Indexed: 02/15/2023]
Abstract
Dyslipidemia is associated with an increased risk of cardiovascular events. Effect of ginger supplementation on lipid profile in humans remains controversial particularly in diabetic patients. A systematic search was performed covering PubMed, Medline, and Scopus, Web of Science (ISI), and Google scholar from January 2010 to January 2022. Inclusion criteria were randomized controlled clinical trials (RCT) study design, at least one of lipid profile components triglyceride (TG), total cholesterol (TC), low-density lipoprotein (LDL-C), and high-density lipoprotein (HDL-C) measured before and after ginger consumption. For quantitative data synthesis, a random-effects model was applied. Pooled data showed that ginger intake reduced TC (SMD -0.44; 95% CI: -0.86, -0.02; p = 0.025) and TG (SMD -0.61; 95% CI: -1.14, -0.08; p = 0.024) levels significantly, but it has no significant effect on improving HDL-C (SMD 0.40; 95% CI: -0.01, 0.80; p = 0.057) and LDL-C (SMD -0.34; 95% CI: -0.81, 0.13; p = 0.153). Ginger supplementation decreased TG in obese and diabetic subjects more efficiently. In terms of ginger dose, the result of meta-regression found to be significant only for TC, so that increasing daily doses of ginger reduces TC levels by (β: -0.67; 95% CI: -1.28, -0.07; p = 0.028). Therefore, ginger could be considered as an effective lipid lowering nutraceuticals.
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Affiliation(s)
| | - Ala Hadi Alwan
- Ibn Al-Bitar Specialized Center for Cardiac Surgery, Baghdad, Iraq
| | - Murad Khadim
- Imam Sadiq Hospital, Babylon Cardiac Center, Babylon, Iraq
| | | | - Bobosher Mardanov
- Department of Surgical Diseases, Samarkand State Medical Institute, Samarkand, Uzbekistan
| | - Amr A El-Sehrwy
- Department of Internal Medicine, Mansoura Specialized Medical Hospital, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | | | - Atefeh Amerizadeh
- Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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Hewlings SJ. Eating Disorders and Dietary Supplements: A Review of the Science. Nutrients 2023; 15:2076. [PMID: 37432190 DOI: 10.3390/nu15092076] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 04/15/2023] [Accepted: 04/24/2023] [Indexed: 07/12/2023] Open
Abstract
Disordered eating is a serious health concern globally. The etiology is complex and multidimensional and differs somewhat for each specific eating disorder. Several risk factors have been identified which include psychological, genetic, biochemical, environmental, and sociocultural factors. Poor body image, low self-esteem, teasing, family dynamics, and exposure to media images have also been identified as risk factors. While it is enticing to consider a single behavioral risk factor, doing so fails to consider the documented environmental, social, psychological, biological, and cultural factors that contribute to the development of an eating disorder in a multidimensional and complex integration that is undoubtedly unique to everyone. Focusing only on any one factor without taking the complex etiology into account is remiss. For example, it has been suggested that the use of dietary supplements may lead to eating disorders, despite a lack of evidence to support this conjecture. Therefore, the purpose of this review is to examine the evidence-based risk factors for eating disorders and discuss why connecting dietary supplements to eating disorder etiology is not supported by the scientific literature and may interfere with treatment. Established, effective prevention and treatment approaches for eating disorders should be the focus of public health initiatives in this domain.
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Affiliation(s)
- Susan J Hewlings
- Nutrasource Pharmaceutical and Nutraceutical Services, Inc., Guelph, ON N1G 0B4, Canada
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Wróbel K, Zastawna B, Milewska AJ, Marczak M, Kozłowski R. Comparison between the American and the European Systems of Monitoring Adverse Effects of Dietary Supplements and Their Usefulness on the Polish Market. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:902. [PMID: 36673658 PMCID: PMC9859348 DOI: 10.3390/ijerph20020902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 01/02/2023] [Accepted: 01/03/2023] [Indexed: 06/17/2023]
Abstract
Many Polish patients do not inform physicians about supplements they use in addition to prescribed medicines. This may be because they consider dietary supplements as being rather natural products that cannot cause health problems. Although dietary supplements may produce side effects, Poland's food safety system and medical statistics do not recognise the necessity of reporting such cases. However, a different approach is observed in France and the United States where adverse effects of food supplements as well as drugs are reported. The aim of this study was to determine the need for creating in Poland a general model of a register monitoring dietary supplements and their adverse effects. In order to achieve this goal, a detailed comparison between the American and European monitoring systems was made. It showed the relationship between negative symptoms caused by specific components in supplements and t profiles of patients who reported side effects. Additionally, it was found that there is a real risk associated with side effects caused by dietary supplements. Therefore, it necessary to establish in Poland a special system for recording such cases as it should be beneficial to patients, including polypragmatic patients.
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Affiliation(s)
- Kacper Wróbel
- Department of Management and Logistics in Healthcare, Medical University of Lodz, 90-131 Lodz, Poland
| | - Beata Zastawna
- Department of Management and Logistics in Healthcare, Medical University of Lodz, 90-131 Lodz, Poland
| | - Anna Justyna Milewska
- Department of Biostatistics and Medical Informatics, Medical University of Bialystok, 15-089 Bialystok, Poland
| | - Michał Marczak
- Department of Management and Logistics in Healthcare, Medical University of Lodz, 90-131 Lodz, Poland
| | - Remigiusz Kozłowski
- Centre for Security Technologies in Logistics, Faculty of Management, University of Lodz, 90-237 Lodz, Poland
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Advances in Nanofabrication Technology for Nutraceuticals: New Insights and Future Trends. BIOENGINEERING (BASEL, SWITZERLAND) 2022; 9:bioengineering9090478. [PMID: 36135026 PMCID: PMC9495680 DOI: 10.3390/bioengineering9090478] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 08/26/2022] [Accepted: 09/06/2022] [Indexed: 11/19/2022]
Abstract
Bioactive components such as polyphenolics, flavonoids, bioactive peptides, pigments, and essential fatty acids were known to ward off some deadliest diseases. Nutraceuticals are those beneficial compounds that may be food or part of food that has come up with medical or health benefits. Nanoencapsulation and nanofabricated delivery systems are an imminent approach in the field of food sciences. The sustainable fabrication of nutraceuticals and biocompatible active components indisputably enhances the food grade and promotes good health. Nanofabricated delivery systems include carbohydrates-based, lipids (solid and liquid), and proteins-based delivery systems. Solid nano-delivery systems include lipid nanoparticles. Liquid nano-delivery systems include nanoliposomes and nanoemulsions. Physicochemical properties of nanoparticles such as size, charge, hydrophobicity, and targeting molecules affect the absorption, distribution, metabolism, and excretion of nano delivery systems. Advance research in toxicity studies is necessary to ensure the safety of the nanofabricated delivery systems, as the safety of nano delivery systems for use in food applications is unknown. Therefore, improved nanotechnology could play a pivotal role in developing functional foods, a contemporary concept assuring the consumers to provide programmed, high-priced, and high-quality research toward nanofabricated delivery systems.
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Rauf A, Akram M, Anwar H, Daniyal M, Munir N, Bawazeer S, Bawazeer S, Rebezov M, Bouyahya A, Shariati MA, Thiruvengadam M, Sarsembenova O, Mabkhot YN, Islam MN, Emran TB, Hodak S, Zengin G, Khan H. Therapeutic potential of herbal medicine for the management of hyperlipidemia: latest updates. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:40281-40301. [PMID: 35320475 DOI: 10.1007/s11356-022-19733-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 03/10/2022] [Indexed: 06/14/2023]
Abstract
Hyperlipidemia, the most common form of dyslipidemia, is the main source of cardiovascular disorders, characterized by elevated level of total cholesterol (TC), triglycerides (TG) and low-density lipoprotein cholesterol (LDL-C) with high-density lipoprotein cholesterol (HDL-C) in peripheral blood. It is caused by a defect in lipid metabolism in the surface of Apoprotein C-II or a defect in lipoprotein lipase activity as well as reported in genetic, dietary and environmental factors. Several electronic databases were investigated as information sources, including Google Scholar, PubMed, Web of Science, Scopus, ScienceDirect, SpringerLink, Semantic Scholar, MEDLINE and CNKI Scholar. The current review focused on the risk factors of dyslipidemia, synthetic medication with their side effects and different types of medicinal plants having significant potential for the management of hyperlipidemia. The management of hyperlipidemia mostly involves a constant decrease in lipid level using different remedial drugs like statin, fibrate, bile acid sequestrates and niacin. However, this extensive review suggested that the consequences of these drugs are arguable, due to their numerous adverse effects. The selected parts of herb plants are used intact or their extracts containing active phytoconstituents to regulate the lipids in blood level. It was also noted that the Chinese herbal medicine and combination therapy is promising for the lowering of hyperlipidemia. This review intends to provide a scientific base for future endeavors, such as in-depth biological and chemical investigations into previously researched topics.
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Affiliation(s)
- Abdur Rauf
- Department of Chemistry, University of Swabi, Anbar, 23430, Khyber Pakhtunkhwa, Pakistan.
| | - Muhammad Akram
- Department of Eastern Medicine, Government College University Faisalabad, Faisalabad, Pakistan
| | - Hina Anwar
- Department of Eastern Medicine, Government College University Faisalabad, Faisalabad, Pakistan
| | - Muhammad Daniyal
- TCM and Ethnomedicine Innovation and Development International Laboratory, School of Pharmacy, Hunan University of Chinese Medicine, Changsha, 410208, China
| | - Naveed Munir
- Department of Biochemistry, Government College University Faisalabad, Faisalabad, Pakistan
| | - Sami Bawazeer
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Umm Al-Qura University, P.O. Box 42, Makkah, Saudi Arabia
| | - Saud Bawazeer
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Umm Al-Qura University, P.O. Box 42, Makkah, Saudi Arabia
| | - Maksim Rebezov
- V. M. Gorbatov Federal Research Center for Food Systems of Russian Academy of Sciences, Moscow, Russian Federation
- Prokhorov General Physics Institute, Russian Academy of Sciences, Moscow, Russian Federation
- K.G. Razumovsky Moscow State University of Technologies and Management (the First Cossack University), Moscow, Russian Federation
| | - Abdelhakim Bouyahya
- Laboratory of Human Pathology Biology, Faculty of Sciences, and Genomic Center of Human Pathology, Mohammed V University, Rabat, Morocco
| | - Mohammad Ali Shariati
- K.G. Razumovsky Moscow State University of Technologies and Management (the First Cossack University), Moscow, Russian Federation
| | | | | | - Yahia N Mabkhot
- Department of Pharmaceutical Chemistry, College of Pharmacy, King Khalid University, Abha, 61421, Saudi Arabia
| | - Mohammad Nazmul Islam
- Department of Pharmacy, International Islamic University Chittagong, Chittagong, 4318, Bangladesh
| | - Talha Bin Emran
- Department of Pharmacy, BGC Trust University Bangladesh, Chittagong, 4381, Bangladesh
| | - Sergey Hodak
- K.G. Razumovsky Moscow State University of Technologies and Management (the First Cossack University), Moscow, Russian Federation
| | - Gokhan Zengin
- Department of Biology, Science Faculty, Selcuk University, Campus, Konya, Turkey.
| | - Haroon Khan
- Department of Pharmacy, Abdul Wali Khan University Mardan, Mardan, 23200, Pakistan
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Sportsmen's Attitude towards Dietary Supplements and Nutrition Knowledge: An Investigation in Selected Roman Area Gyms. Nutrients 2022; 14:nu14050945. [PMID: 35267920 PMCID: PMC8912719 DOI: 10.3390/nu14050945] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 02/18/2022] [Accepted: 02/19/2022] [Indexed: 01/27/2023] Open
Abstract
The non-professional sport environment is a grey zone not as widely assessed as that of elite athletes. The purpose of this research was to investigate the dietary supplementation habits and the nutrition knowledge on sport (NKS) in a sample of gym users. The level of adequacy of NKS was set at ≥60% of correct answers. Almost half (46.4%) of respondents stated they used food supplements, in particular multivitamins (31.0%), amino acid pills (29.5%), minerals (29.1%), and protein powders (28.7%). Supplements were used to increase muscle mass (36.9%) and to repair muscle (35.1%). Gym trainers were the preferred source of information on the use of supplements, especially in males (84%). The NKS correct response rate was 57.1% and the proportion of respondents with a sufficient level of NKS was 47.3%. The prevalence of correct answers was highest in males (61.5%) and for respondents with the highest educational attainment levels (44.5% and 53%). This study demonstrated that non-professional sportsmen do not have sufficient knowledge of nutrition and that the gym environment does not facilitate the circulation of the correct information on the role of supplementation. Considering the importance of nutrition for sportsmen, it is necessary to put in place actions aimed at increasing the knowledge of nutrition of gym users and their trainers.
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Behl A, Mishra A, Sharma GP. A Critical Scientific Review on Withania somnifera, Garcinia cambogia and
Curcumin Supplements: Food Forensics Perspective. CURRENT NUTRITION & FOOD SCIENCE 2022. [DOI: 10.2174/1573401317666210910114721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Abstract:
Food forensics is an emerging branch that applies scientific knowledge for the verification
and authentication of food supplements. The term “dietary supplement” refers to a diverse
set of preparations that are deemed to be essential for the well-being of the human body.
These supplements consist of various physiologically active substances that produce effects on
the body. However, a major issue with these supplements is that they are neither considered as
medicines nor as a food products. Due to this, such food supplements are prone to adulteration
and counterfeiting. In this review, three widely used supplements, namely Curcuma longa,
Withania somnifera, and Garcinia cambogia supplements, are considered. Chemistry, pharmacology,
and benefits of three are being discussed along with the analytical techniques for their
analysis. Chromatographic techniques are popular for the examination of dietary supplements.
Several such analytical techniques are being used to detect and identify the physiologically active
constituents as well as adulterants in dietary products. This review intends to demonstrate
the overall issues regarding dietary supplements.
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Affiliation(s)
- Akanksha Behl
- Amity Institute of Forensic Sciences, Amity University Uttar Pradesh, Noida, India
| | - Amarnath Mishra
- Amity Institute of Forensic Sciences, Amity University Uttar Pradesh, Noida, India
| | - G. P. Sharma
- National Food Laboratory,
Ghaziabad, Uttar Pradesh, India
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Montuori P, Loperto I, Paolo C, Castrianni D, Nubi R, De Rosa E, Palladino R, Triassi M. Bodybuilding, dietary supplements and hormones use: behaviour and determinant analysis in young bodybuilders. BMC Sports Sci Med Rehabil 2021; 13:147. [PMID: 34819149 PMCID: PMC8613966 DOI: 10.1186/s13102-021-00378-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 11/05/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Among athletes, bodybuilders are more predisposed to the use of dietary supplements (DS) and hormones (H) to increase in adaptations to physical training and performance. The purpose of the study was to identify social, psychological, and organisational factors that are associated with the use of food supplements and hormones in young bodybuilders of the metropolitan area of Naples. METHODS 107 athletes, practicing bodybuilding, were consecutively recruited in 30 gyms, randomly selected in the metropolitan area of Naples. Athletes were administered an anonymous questionnaire. The questionnaire consists of 5 sections (socio-demographic, frequency and reasons for bodybuilding, knowledge, attitudes and behaviours). Descriptive statistics were performed using T-test and Chi-square statistics. A score was created for knowledge, attitudes, behaviours. Multivariable logistic regression models were employed to assess association between each score and the use of DS and H. Statistical analyses were carried out using STATA 15. RESULTS 81.31% of the subjects reported to use DS while 35.51% H. Females are less likely to practise bodybuilding frequently than males (OR 0.18 (95% CI 0.05-0.69), p = 0.01). Subjects who have attended high school or university have a lower probability of taking DS (OR 0.17 (95% CI 0.04-0.65), p = 0.01). H users also use supplements more frequently (OR 61.21 (95% CI 3.99-939.31), p < 0.001). Those who scored higher on knowledge scores are more likely to take DS (OR 1.53 (95% CI 1.11-2.12), p < 0.001). Attitudes are correlated with the use of DS; those who scored higher were less likely to use DS (OR 0.77 (95% CI 0.30-0.98), p = 0.03). People who use DS are 30 times more likely to use H at the same time (OR 30.25 (95% CI 2.51-365.24), p < 0.001). Subjects who have a higher score for knowledge and attitudes are less likely to use H (OR 0.68 (95% CI 0.54-0.87), p < 0.001, OR 0.75 (95% CI 0.62-0.90), p < 0.001). CONCLUSIONS Prevalence of H and DS' use, although lower than reported in the literature, is a worrying public health problem. Better knowledge can lead to an informed use. Gym instructors should be trained to provide accurate and scientifically sound information. Health professionals should combine their expertise to provide more comprehensive guidance to the exercisers.
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Affiliation(s)
- Paolo Montuori
- Department of Public Health, University of Naples "Federico II", Via S. Pansini, 5, 80131, Naples, Italy
| | - Ilaria Loperto
- Department of Public Health, University of Naples "Federico II", Via S. Pansini, 5, 80131, Naples, Italy.
| | - Carmine Paolo
- Department of Public Health, University of Naples "Federico II", Via S. Pansini, 5, 80131, Naples, Italy
| | - Davide Castrianni
- Department of Public Health, University of Naples "Federico II", Via S. Pansini, 5, 80131, Naples, Italy
| | - Raffaele Nubi
- Department of Public Health, University of Naples "Federico II", Via S. Pansini, 5, 80131, Naples, Italy
| | - Elvira De Rosa
- Department of Public Health, University of Naples "Federico II", Via S. Pansini, 5, 80131, Naples, Italy
| | - Raffaele Palladino
- Department of Public Health, University of Naples "Federico II", Via S. Pansini, 5, 80131, Naples, Italy
| | - Maria Triassi
- Department of Public Health, University of Naples "Federico II", Via S. Pansini, 5, 80131, Naples, Italy
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Abstract
Abstrakt
Rynek suplementów diety rozwija się bardzo dynamicznie, co ma związek z rozpowszechnieniem tej kategorii produktów w środkach masowego przekazu, stosunkowo bezproblemową procedurą wprowadzenia na polski rynek oraz powszechną dostępnością (można je nabyć w aptece, sklepach zielarskich, spożywczych oraz w Internecie). Z definicji suplementy mają być uzupełnieniem diety, zaliczają się do żywności oraz nie mogą wykazywać działania leczniczego. Ich postać, która została ustawowo określona, może być wizualnie identyczna z postacią farmaceutyczną produktów leczniczych, co może wprowadzać konsumentów w błąd, jeżeli nie wiedzą, jak rozróżniać te dwie grupy. Polska legislacja nie uwzględnia żadnych wymogów dotyczących parametrów technologicznych czy właściwości fizycznych gotowych produktów. Na bezpieczeństwo stosowania suplementów diety, oprócz ich jakości i rzeczywistej zawartości deklarowanych składników, składa się również ewentualna obecność zanieczyszczeń i niedozwolonych substancji dodatkowych. Wybiórcza kontrola rynku oraz brak szczegółowych wytycznych dotyczących parametrów postaci suplementów daje znaczną dowolność producentom, jednocześnie umożliwia wprowadzenie na rynek produktów o wątpliwej jakości, które mogą zagrażać konsumentom, będąc całkowicie pozbawionymi działania prozdrowotnego. Ze względu na rosnące zainteresowanie tą grupą produktów przez konsumentów, przedstawiono w pracy sytuację prawną suplementów diety na polskim rynku, odnosząc się także do legislacji europejskiej i amerykańskiej. Omówiono procedurę wprowadzania na rynek, podstawowe wytyczne stawiane tej grupie produktów, wskazania do stosowania oraz aspekty związane z bezpieczeństwem i zagrożeniami wynikającymi ze stosowania suplementów diety.
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Vancini RL, Rufo-Tavares W, de Paula Oliveira HR, Viana RB, Andrade MDS, Knechtle B, Nikolaidis PT, Gentil P, de Lira CAB. Knowledge and Prevalence of Supplements Used by Brazilian Resistance Training Practitioners Before Coronavirus Outbreak. Open Access J Sports Med 2021; 12:139-146. [PMID: 34557044 PMCID: PMC8453301 DOI: 10.2147/oajsm.s323562] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 09/02/2021] [Indexed: 11/23/2022] Open
Abstract
Introduction The use of dietary supplements and ergogenic aids (DSEA) is popular among physical activity enthusiasts. Particularly, resistance training (RT) practitioners represent important DSEA consumers due to its easy access and the appeal of claims related to muscle hypertrophy, aesthetics, and physical performance improvements. Methods Our aim was to study knowledge, prevalence, and profile of DSEA used by Brazilian recreational RT practitioners. For this, RT practitioners of both sexes (n=129, female=58 and male=71) answered a paper-based questionnaire. The questionnaire was specifically created for the studied population to assess different aspects of the DSEA used and sociodemographic variables. Results Seventy-seven percent of the participants (n=99) declared that they had already used DSEA. The majority (53%) searched the internet to obtain information about DSEA. Whey protein (66%) was the most used followed by branched chain amino acids (48%). Conclusion The use of DSEA, before coronavirus outbreak, was popular among RT practitioners; protein and amino acids were the most used DSEA. Most users used internet to obtain information about DSEA. The results suggest the need for appropriate attitude and guidance by health professionals who deal with this population, especially dietitians, nutritionists, and physical training professionals in order to promote best and security practices.
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Affiliation(s)
- Rodrigo Luiz Vancini
- Centro de Educação Física e Desportos, Universidade Federal do Espírito Santo, Espírito Santo, Brasil
| | - Weverton Rufo-Tavares
- Centro de Educação Física e Desportos, Universidade Federal do Espírito Santo, Espírito Santo, Brasil
| | | | - Ricardo Borges Viana
- Escola Superior de Educação Física e Fisioterapia do Estado de Goiás, Universidade Estadual de Goiás, Goiânia, Brasil.,Faculdade Estácio de Sá, Goiânia, Departamento de Educação Física, Goiânia, Brasil
| | | | - Beat Knechtle
- Medbase St. Gallen Am Vadianplatz, St. Gallen and Institute of Primary Care, University of Zurich, Zurich, Switzerland
| | | | - Paulo Gentil
- Setor de Fisiologia Humana e do Exercício, Faculdade de Educação Física e Dança, Universidade Federal de Goiás, Goiânia, Brasil
| | - Claudio Andre Barbosa de Lira
- Setor de Fisiologia Humana e do Exercício, Faculdade de Educação Física e Dança, Universidade Federal de Goiás, Goiânia, Brasil
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Brzezińska J, Szewczyk A, Brzezicha J, Prokopowicz M, Grembecka M. Evaluation of Physicochemical Properties of Beetroot-Based Dietary Supplements. Foods 2021; 10:foods10081693. [PMID: 34441471 PMCID: PMC8393586 DOI: 10.3390/foods10081693] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 07/11/2021] [Accepted: 07/17/2021] [Indexed: 12/19/2022] Open
Abstract
In the European Union, no specific requirements for the physicochemical parameters of dietary supplements have been established, contrary to the United States of America. This research aimed to assess the selected physical parameters of 31 commercially available beetroot-based dietary supplements in the form of tablets and capsules following the United States Pharmacopoeia (USP) guidelines and the Food and Drug Administration (FDA) recommendations. There was also estimated zinc and iron content by atomic absorption spectroscopy with flame detection. Results showed that nine products did not meet the USP requirements. Seven supplements needed more than 30 min to disintegrate. Two products in the form of tablets did not pass the friability test because of cracking. The hardness values varied significantly between manufacturers, demonstrating values from 59.1 to 455.8 N. The iron-enriched supplements differed significantly in iron content compared with the manufacturers’ declaration (84.91–140.69%). Inappropriate quality of dietary supplements, which may constitute a potential risk to consumers, can be related to the lack of specific regulations in Europe; hence, similar to the USA requirements should be considered in the European Union. The work emphasizes the need to better control the quality of dietary supplements before they are introduced to the European market.
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Affiliation(s)
- Joanna Brzezińska
- Department of Bromatology, Faculty of Pharmacy, Medical University of Gdańsk, Gen. J. Hallera Avenue 107, 80-416 Gdańsk, Poland; (J.B.); (J.B.)
| | - Adrian Szewczyk
- Department of Physical Chemistry, Faculty of Pharmacy, Medical University of Gdańsk, Gen. J. Hallera Avenue 107, 80-416 Gdańsk, Poland; (A.S.); (M.P.)
| | - Justyna Brzezicha
- Department of Bromatology, Faculty of Pharmacy, Medical University of Gdańsk, Gen. J. Hallera Avenue 107, 80-416 Gdańsk, Poland; (J.B.); (J.B.)
| | - Magdalena Prokopowicz
- Department of Physical Chemistry, Faculty of Pharmacy, Medical University of Gdańsk, Gen. J. Hallera Avenue 107, 80-416 Gdańsk, Poland; (A.S.); (M.P.)
| | - Małgorzata Grembecka
- Department of Bromatology, Faculty of Pharmacy, Medical University of Gdańsk, Gen. J. Hallera Avenue 107, 80-416 Gdańsk, Poland; (J.B.); (J.B.)
- Correspondence:
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Duiven E, van Loon LJC, Spruijt L, Koert W, de Hon OM. Undeclared Doping Substances are Highly Prevalent in Commercial Sports Nutrition Supplements. J Sports Sci Med 2021; 20:328-338. [PMID: 34211326 PMCID: PMC8219275 DOI: 10.52082/jssm.2021.328] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 03/05/2021] [Indexed: 12/13/2022]
Abstract
Sports nutrition supplements have previously been reported to contain undeclared doping substances. The use of such supplements can lead to general health risks and may give rise to unintentional doping violations in elite sports. To assess the prevalence of doping substances in a range of high-risk sports nutrition supplements available from Dutch web shops. A total of 66 sports nutrition supplements - identified as potentially high-risk products claiming to modulate hormone regulation, stimulate muscle mass gain, increase fat loss, and/or boost energy - were selected from 21 different brands and purchased from 17 web shops. All products were analyzed for doping substances by the UK life sciences testing company LGC, formerly known as the Laboratory of the Government Chemist, using an extended version of their ISO17025 accredited nutritional supplement screen. A total of 25 out of the 66 products (38%) contained undeclared doping substances, which included high levels of the stimulants oxilofrine, β-methylphenethylamine (BMPEA) and N,β-dimethylphenethylamine (NBDMPEA), the stimulant 4-methylhexan-2-amine (methylhexaneamine, 1,3-dimethylamylamine, DMAA), the anabolic steroids boldione (1,4-androstadiene-3,17-dione) and 5-androstene-3β,17α-diol (17α-AED), the beta-2 agonist higenamine and the beta-blocker bisoprolol. Based upon the recommended dose and the potential variability of analyte concentration, the ingestion of some products identified within this study could pose a significant risk of unintentional doping violations. In addition to inadvertent doping risks, the prescribed use of 3 products (4.5%) could likely impose general health risks.
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Affiliation(s)
- Erik Duiven
- Doping Authority Netherlands, PO Box 5000, 2900 EA Capelle aan den IJssel, The Netherlands
| | - Luc J C van Loon
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Laila Spruijt
- Doping Authority Netherlands, PO Box 5000, 2900 EA Capelle aan den IJssel, The Netherlands
| | - Willem Koert
- Doping Authority Netherlands, PO Box 5000, 2900 EA Capelle aan den IJssel, The Netherlands
| | - Olivier M de Hon
- Doping Authority Netherlands, PO Box 5000, 2900 EA Capelle aan den IJssel, The Netherlands
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15
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Filkova S, Pashaliska Cvetkov B, Patcheva J, Pejkovska S, Krstic Nakovska O, Karkinski D. Patients’ knowledge and awareness of herbal medicines efficacy and safety in hospital settings. MAKEDONSKO FARMACEVTSKI BILTEN 2020. [DOI: 10.33320/maced.pharm.bull.2020.66.03.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Sanja Filkova
- Public institution for the needs of University Clinics, Institutes and Urgent Centre, Department of Clinical Pharmacy, Majka Tereza 17, 1000 Skopje, Republic of North Macedonia
| | | | - Jasminka Patcheva
- Pharmaceutical Chamber of Macedonia, 50 Divizija 34, 1000 Skopje, Republic of North Macedonia
| | - Sava Pejkovska
- University Clinic of Pulmology and Allergology, Majka Tereza 17, 1000 Skopje, Republic of North Macedonia
| | - Olivera Krstic Nakovska
- University Clinic of Pulmology and Allergology, Majka Tereza 17, 1000 Skopje, Republic of North Macedonia
| | - Dimitar Karkinski
- University Clinic of Pulmology and Allergology, Majka Tereza 17, 1000 Skopje, Republic of North Macedonia
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Vasilakes J, Bompelli A, Bishop JR, Adam TJ, Bodenreider O, Zhang R. Assessing the enrichment of dietary supplement coverage in the Unified Medical Language System. J Am Med Inform Assoc 2020; 27:1547-1555. [PMID: 32940692 DOI: 10.1093/jamia/ocaa128] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 05/09/2020] [Accepted: 06/03/2020] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE We sought to assess the need for additional coverage of dietary supplements (DS) in the Unified Medical Language System (UMLS) by investigating (1) the overlap between the integrated DIetary Supplements Knowledge base (iDISK) DS ingredient terminology and the UMLS and (2) the coverage of iDISK and the UMLS over DS mentions in the biomedical literature. MATERIALS AND METHODS We estimated the overlap between iDISK and the UMLS by mapping iDISK to the UMLS using exact and normalized strings. The coverage of iDISK and the UMLS over DS mentions in the biomedical literature was evaluated via a DS named-entity recognition (NER) task within PubMed abstracts. RESULTS The coverage analysis revealed that only 30% of iDISK terms can be matched to the UMLS, although these cover over 99% of iDISK concepts. A manual review revealed that a majority of the unmatched terms represented new synonyms, rather than lexical variants. For NER, iDISK nearly doubles the precision and achieves a higher F1 score than the UMLS, while maintaining a competitive recall. DISCUSSION While iDISK has significant concept overlap with the UMLS, it contains many novel synonyms. Furthermore, almost 3000 of these overlapping UMLS concepts are missing a DS designation, which could be provided by iDISK. The NER experiments show that the specialization of iDISK is useful for identifying DS mentions. CONCLUSIONS Our results show that the DS representation in the UMLS could be enriched by adding DS designations to many concepts and by adding new synonyms.
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Affiliation(s)
- Jake Vasilakes
- Institute for Health Informatics, University of Minnesota, Minneapolis, Minnesota, USA.,Department of Pharmaceutical Care and Health Systems, University of Minnesota, Minneapolis, Minnesota, USA
| | - Anusha Bompelli
- Institute for Health Informatics, University of Minnesota, Minneapolis, Minnesota, USA
| | - Jeffrey R Bishop
- Department of Experimental and Clinical Pharmacy, University of Minnesota, Minneapolis, Minnesota, USA
| | - Terrence J Adam
- Institute for Health Informatics, University of Minnesota, Minneapolis, Minnesota, USA.,Department of Pharmaceutical Care and Health Systems, University of Minnesota, Minneapolis, Minnesota, USA
| | - Olivier Bodenreider
- Lister Hill National Center for Biomedical Communications, National Library of Medicine, Bethesda, Maryland, USA
| | - Rui Zhang
- Institute for Health Informatics, University of Minnesota, Minneapolis, Minnesota, USA.,Department of Pharmaceutical Care and Health Systems, University of Minnesota, Minneapolis, Minnesota, USA
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Chiba T, Kobayashi E, Okura T, Sekimoto M, Mizuno H, Saito M, Umegaki K. An educational intervention improved knowledge of dietary supplements in college students. BMC Public Health 2020; 20:633. [PMID: 32381078 PMCID: PMC7204311 DOI: 10.1186/s12889-020-08786-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 04/27/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND We have previously reported on the prevalence of dietary supplements among college students; it was deduced that their intake of supplements increased according to their grade (i.e., 13.1% in the first grade to 20.5% in the sixth grade). We also reported that some students had experienced adverse events in Japan due to their intake of these supplements. However, awareness of dietary supplements among college students remains limited, even among pharmaceutical students. Being appropriately educated about them is important for pharmaceutical students, both for themselves as well as for their future careers as pharmacists. METHODS We conducted a lecture-based educational intervention about dietary supplements on 328 college students in Japan-184 from pharmaceutical science and 144 from environmental science or food and life science disciplines. The purpose of this study was to evaluate the effects of an educational intervention on college students' understanding of dietary supplements. The intervention involved a lecture that covered the quality of dietary supplements, how they differed from drugs, and a summary of their adverse events. The lecture was evaluated using a 14-question questionnaire. We then compared the pre- and post-intervention responses to the same questionnaire using a Wilcoxon signed-rank test. The questions were assessed using a Likert scale that ranged from "strongly agree" to "strongly disagree"; the latter being the preferred answer. RESULTS Before the intervention had taken place, the students' understanding of dietary supplements was shown to be deficient. Conversely, post-intervention, their knowledge levels had significantly improved, especially concerning agreement on whether "Dietary supplements are safe because they are just food items". Pre-intervention, 2.7% strongly agreed and 37.5% agreed; post-intervention, 1.2% strongly agreed and 15.6% agreed. On whether "Dietary supplements made from natural ingredients or herbs are safe", at the pre-intervention stage 2.8% strongly agreed and 44.0% agreed and post-intervention, 2.2% strongly agreed and 16.9% agreed. On whether "Dietary supplements made from food items are safe", 4.0% strongly agreed and 43.6% agreed pre-intervention and 0.9% strongly agreed and 16.6% agreed post-intervention. Despite there being a greater number of pharmaceutical students who had a correct understanding of dietary supplements before the intervention, these students still showed improvement after the lecture. CONCLUSION An intervention in the form of a single educational lecture has the capacity to improve college students' understanding of dietary supplements. It is important for pharmacists to be appropriately educated about dietary supplements when they consult with patients. We will evaluate the long-term effects of the intervention on the alumni (pharmacists) in a subsequent study.
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Affiliation(s)
- Tsuyoshi Chiba
- Department of Food Function and Labeling, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8636, Japan.
| | - Etsuko Kobayashi
- Department of Food Function and Labeling, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8636, Japan
| | - Takashi Okura
- Laboratory of Pharmaceutics, Faculty of Pharma-Sciences, Teikyo University, Tokyo, Japan
| | - Masashi Sekimoto
- Laboratory of Environmental Hygiene, Department of Environmental Science, School of Life and Environmental Science, Azabu University, Kanagawa, Japan
| | - Hideya Mizuno
- School of Pharmacy and Pharmaceutical Sciences, Mukogawa Women's University, Hyogo, Japan
| | - Maki Saito
- Division of Molecular and Cellular Pharmacology, Department of Pathophysiology and Pharmacology, School of Pharmacy, Iwate Medical University, Iwate, Japan
| | - Keizo Umegaki
- Department of Food Safety and Management, Showa Women's University, Tokyo, Japan
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Abstract
Synthesis of pooled data on herbal medicinal products used during and after pregnancy highlights the need for robust safety studies. OBJECTIVE: To report the incidence and nature of herbal medicinal products' adverse events and herb–drug interactions used by some pregnant and postnatal women. DATA SOURCES: The Allied and Complementary Medicine Database, the Cumulative Index to Nursing and Allied Health Literature, EMBASE, the Cochrane Library, MEDLINE, Scopus, Web of Science, and ClinicalTrials.gov were searched from inception until August 2018. METHODS OF STUDY SELECTION: Any studies reporting adverse events, herb–drug interactions or absence thereof associated with herbal medicinal products used during pregnancy or the postnatal period were included. Conference abstracts, pilot studies, and nonhuman studies were excluded. All included studies were critically appraised by two independent reviewers. TABULATION, INTEGRATION AND RESULTS: Database searches retrieved 3,487 citations. After duplicate removal and review of titles, abstracts, and full-text, 115 articles were critically appraised. After excluding irrelevant and low-quality articles, 74 articles were included for data extraction and synthesis. Adverse drug reactions, congenital malformations, fetal growth retardation or herb–drug interactions were the primary study objective reported by 19 of the 74 included studies, 16 cohort studies, one cross-sectional survey, and two randomized controlled trials. A total of 47 herbal medicinal products and 1,067,071 women were included in this review. Use of almond oil was associated with preterm birth (odds ratio 2.09, 95% CI 1.07–4.08), oral raspberry leaf was associated with cesarean delivery (adjusted odds ratio [AOR] 3.47, 95% CI 1.45–8.28); heavy licorice use was associated with early preterm birth by 3.07-fold (95% CI 1.17–8.05). African herbal medicine mwanaphepo was associated with maternal morbidity (AOR 1.28; 95% CI 1.09–1.50), and neonatal death or morbidity. Fourteen studies reported absence of adverse events. Four studies reported herb–drug interactions, but none studied adverse events arising from them. CONCLUSION: The use of herbal medicinal products during pregnancy and the postnatal period should be discouraged until robust evidence of safety is available. SYSTEMATIC REVIEW REGISTRATION: PROSPERO, CRD42017081058.
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Abdulla NM, Aziz F, Blair I, Grivna M, Adam B, Loney T. Prevalence of, and factors associated with health supplement use in Dubai, United Arab Emirates: a population-based cross-sectional study. Altern Ther Health Med 2019; 19:172. [PMID: 31299957 PMCID: PMC6624985 DOI: 10.1186/s12906-019-2593-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 07/04/2019] [Indexed: 01/07/2023]
Abstract
BACKGROUND Health supplement (HS) products that are available in the Emirate of Dubai (United Arab Emirates; UAE) contain chemicals that may adversely affect human health. This study aimed to investigate the prevalence of, and factors associated with HS consumption, knowledge, related adverse events, and reporting practices of adverse events amongst the general population in Dubai, UAE. METHODS A cross-sectional household telephone survey using a computer-assisted questionnaire was conducted amongst a random representative sample (n = 1203) of the Dubai population that assessed HS use and knowledge. Dependent variables were supplement use and reports of adverse events while independent variables included socio-demographic factors, knowledge, attitudes, and practice. Logistic regression analysis was performed to identify factors independently associated with HS use. RESULTS Among the 1203 participants in this study, 455 (37.8%) reported ever using HS. Amongst ever-users, reasons for use were to improve health (66.1%), for bodybuilding (9.9%), disease prevention (6.8%), and weight management (5.3%). The majority of users purchased their HS from pharmacies (88.4%) or were prescribed HS (46.6%). Vitamins were the most commonly used HS (87.9%) followed by minerals (10.5%) and sports nutrition products (10.5%). Only 2.9% of users experienced an adverse event associated with HS use which all resolved when the HS was discontinued. Only three of those affected reported the incident. Multivariate logistic regression analysis revealed that HS use was independently associated with female gender (adjusted odds ratio [AOR]; 3.26, 95% confidence interval [CI]: 2.26-4.70), higher income (AOR 2.41, 95% CI: 1.20-4.83), being a past-smoker (AOR 2.39, 95% CI: 1.27-4.48), having an allergy (AOR 1.75, 95% CI: 1.14-2.66), more frequent doctor visits (AOR 1.86, 95% CI: 1.02-3.39), taking prescribed medications (AOR 1.47, 95% CI: 1.04-2.06), and knowledge about HS (AOR 3.91, 95% CI: 2.26-6.76). CONCLUSIONS Our study provides the first population-based estimates of HS use and HS-related adverse events in the Gulf region. Adverse events associated with HS are infrequent and this may be due to the well-developed regulatory framework in Dubai and the high level of knowledge amongst consumers who mainly consume vitamins and minerals on the advice of pharmacists or healthcare professionals.
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Gyamfi ET. Metals and metalloids in traditional medicines (Ayurvedic medicines, nutraceuticals and traditional Chinese medicines). ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:15767-15778. [PMID: 31004267 DOI: 10.1007/s11356-019-05023-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 03/27/2019] [Indexed: 06/09/2023]
Abstract
Traditional medicine (TM) including Ayurvedic medicines, traditional Chinese medicines and nutraceuticals are popular across the globe as dietary supplements and traditional and alternative medicines. Health risks from these remedies continue to present serious concerns, with occurrences of poisoning by metals and metalloids present at concentrations above acceptable regulatory standards. This review overviews the prevalence of TM use, cases of metal and metalloid poisoning following TM consumption, and forms of TM contamination and adulteration. The review summarises regulations by the World Health Organization (WHO) and other relevant bodies. Finally, the review recommends how to protect consumers.
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Affiliation(s)
- Eva T Gyamfi
- Department of Environmental Sciences, Macquarie University, Sydney, NSW, 2109, Australia.
- Nuclear Chemistry and Environmental Research Centre, Ghana Atomic Energy Commission, National Nuclear Research Institute, P.O. Box LG 80, Legon, Accra, Ghana.
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21
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Leung ELH, Wu QB. Concurrent use of herbal products with prescription drugs is a double-edged sword and evidence-based medicine contributes to reshaping the practice. Pharmacol Res 2019; 141:609-610. [PMID: 30660823 DOI: 10.1016/j.phrs.2019.01.033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Elaine Lai-Han Leung
- Faculty of Chinese Medicine, State Key Laboratory of Quality Research in Chinese Medicine, Macau Institute For Applied Research in Medicine and Health, Macau University of Science and Technology, Macau, China.
| | - Qi-Biao Wu
- Faculty of Chinese Medicine, State Key Laboratory of Quality Research in Chinese Medicine, Macau Institute For Applied Research in Medicine and Health, Macau University of Science and Technology, Macau, China.
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Jahan S, Fatima A, Alam I, Ullah A, Rehman H, Afsar T, Almajwal A, Razak S. Effects of dietary supplements on selected hematological and biochemical parameters of Pakistani athletes. BMC Nutr 2018; 4:41. [PMID: 32153902 PMCID: PMC7050892 DOI: 10.1186/s40795-018-0250-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Accepted: 09/28/2018] [Indexed: 11/18/2022] Open
Abstract
Background CDC’s (Centers for Disease Control and Prevention) National Center for Health statistics recent reports have shown that an upsurge has occurred in the use of dietary supplements among age of 20 years since 1994 and this use shown regular increase. The purpose of our study was to investigate the effect of supplements on the reproductive health on male athletes in Pakistan. Methods A total of 150 adult male with mean age of 25.78 ± 0.56 years were included in this study and divided into four groups: Non-athlete control (n = 57), Non supplemental athlete control (n = 40), Supplemental athlete group I (n = 28) and supplemental athlete group II (n = 25). Blood (10 ml) was taken from each subject. Complete blood count was performed and 5 ml of blood was centrifuged to separate plasma and then analyzed for antioxidant enzyme (CAT, POD, GR and GSH) activities, Lipid peroxidation (TBARS), electrolyte, metal (sodium, potassium and zinc) and Luteinizing hormone (LH) concentration. Results Complete blood count results showed normal RBC, WBC, Platelets, Hemoglobin, Hematocrit, Mean corpuscular hemoglobin and Mean corpuscular hemoglobin concentration. Antioxidant enzymes (CAT, POD, GR, GSH) increased significantly in supplemental athletes as compared to control groups. Sodium and potassium showed significant increase (p < 0.001) in supplemental athlete group I, while TBARS also showed significant increase (p < 0.05) in supplemental group I and II as compared to non athlete control while non supplemental athletes showed significant increase (p < 0.05) in TBARS concentration as compared to non athlete control. LH concentration was found to be decreased significantly (p < 0.05) in supplemental group I and II as compared to control groups. Conclusion It is therefore concluded from the present results that oxidative stress was considerably elevated in response to supplement consumption among athletes which may affect their health haematological parameters and reproductive hormones.
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McLay JS, Izzati N, Pallivalapila AR, Shetty A, Pande B, Rore C, Al Hail M, Stewart D. Pregnancy, prescription medicines and the potential risk of herb-drug interactions: a cross-sectional survey. Altern Ther Health Med 2017; 17:543. [PMID: 29258478 PMCID: PMC5738179 DOI: 10.1186/s12906-017-2052-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Accepted: 12/07/2017] [Indexed: 12/27/2022]
Abstract
Background Pregnant women are routinely prescribed medicines while self-medicating with herbal natural products to treat predominantly pregnancy related conditions. The aim of this study was to assess the potential for herb-drug interactions (HDIs) in pregnant women and to explore possible herb-drug interactions and their potential clinical significance. Methods A cross-sectional survey of women during early pregnancy or immediately postpartum in North-East Scotland. Outcome measures included; Prescription medicines use excluding vitamins and potential HDIs assessed using Natural Medicines Comprehensive Database. Results The survey was completed by 889 respondents (73% response rate). 45.3% (403) reported the use of at least one prescription medicine, excluding vitamins. Of those taking prescription medicines, 44.9% (181) also reported concurrent use of at least one HNP (Range 1–12). A total of 91 different prescription medicines were reported by respondents using HNPs. Of those taking prescription medicines, 44.9% (181) also reported concurrent use of at least one HNP (Range 1–12). Thirty-four herb-drug interactions were identified in 23 (12.7%) women with the potential to increase the risk of postpartum haemorrhage, alter maternal haemodynamics, and enhance maternal/fetal CNS depression. Almost all were rated as moderate (93.9%), one as a potentially major (ginger and nifedipine) and only one minor (ondansetron and chamomile). Conclusion Almost half of pregnant women in this study were prescribed medicines excluding vitamins and minerals and almost half of these used HNPs. Potential moderate to severe HDIs were identified in an eighth of the study cohort. Healthcare professionals should be aware that the concurrent use of HNPs and prescription medicines during pregnancy is common and carries potential risks.
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Biggs JM, Morgan JA, Lardieri AB, Kishk OA, Klein-Schwartz W. Abuse and Misuse of Selected Dietary Supplements Among Adolescents: a Look at Poison Center Data. J Pediatr Pharmacol Ther 2017; 22:385-393. [PMID: 29290737 DOI: 10.5863/1551-6776-22.6.385] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVE The use of dietary supplements has increased and is associated with adverse effects. Indications for use include recreation, body image concerns, mood enhancement, or control of medical conditions. The risk of adverse effects may be enhanced if agents are used improperly. The objective of this study was to determine the frequency of abuse and misuse of 4 dietary substances among adolescents reported nationally to poison centers. Secondary outcomes included an assessment of medical outcomes, clinical effects, location of treatments provided, and treatments administered. METHODS This descriptive retrospective review assessed data concerning the use of garcinia (Garcinia cambogia), guarana (Paullinia cupana), salvia (Salvia divinorum), and St John's wort (Hypericum perforatum) among adolescents reported nationally to poison centers from 2003 to 2014. Adolescents with a singlesubstance exposure to one of the substances of interest coded as intentional abuse or misuse were included. Poison center calls for drug information or those with unrelated clinical effects were excluded. Data were collected from the National Poison Data System. RESULTS There were 84 cases: 7 cases of Garcinia cambogia, 28 Paullinia cupana, 23 Salvia divinorum, and 26 Hypericum perforatum. Garcinia cambogia was used more frequently by females (100% versus 0%), and Paullinia cupana and Salvia divinorum were used more frequently by males (61% versus 36% and 91% versus 9%, respectively). Abuse, driven by Salvia divinorum, was more common overall than misuse. Abuse was also more common among males than females (p <0.001). Use of these agents fluctuated over time. Overall, use trended down since 2010, except for Garcinia cambogia use. In 62 cases (73.8%), the medical outcome was minor or had no effect or was judged as nontoxic or minimally toxic. Clinical effects were most common with Paullinia cupana and Salvia divinorum. Treatment sites included emergency department (n = 33; 39.3%), non-healthcare facility (n = 24; 28.6%), admission to a health care facility (n = 8; 9.5%), and other/unknown (n = 19; 22.6%). CONCLUSIONS Abuse and misuse of these dietary supplements was uncommon, and outcomes were mild. Further research should be performed to determine use and outcomes of abuse/misuse of other dietary supplements in this population.
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Affiliation(s)
- Jessica M Biggs
- Department of Pharmacy (JMB, OAK), University of Maryland Medical Center, Baltimore, Maryland; Department of Pharmacy Practice and Science (JAM, ABL, WKS), University of Maryland School of Pharmacy, Baltimore, Maryland; and (WKS) Maryland Poison Center, Baltimore, Maryland
| | - Jill A Morgan
- Department of Pharmacy (JMB, OAK), University of Maryland Medical Center, Baltimore, Maryland; Department of Pharmacy Practice and Science (JAM, ABL, WKS), University of Maryland School of Pharmacy, Baltimore, Maryland; and (WKS) Maryland Poison Center, Baltimore, Maryland
| | - Allison B Lardieri
- Department of Pharmacy (JMB, OAK), University of Maryland Medical Center, Baltimore, Maryland; Department of Pharmacy Practice and Science (JAM, ABL, WKS), University of Maryland School of Pharmacy, Baltimore, Maryland; and (WKS) Maryland Poison Center, Baltimore, Maryland
| | - Omayma A Kishk
- Department of Pharmacy (JMB, OAK), University of Maryland Medical Center, Baltimore, Maryland; Department of Pharmacy Practice and Science (JAM, ABL, WKS), University of Maryland School of Pharmacy, Baltimore, Maryland; and (WKS) Maryland Poison Center, Baltimore, Maryland
| | - Wendy Klein-Schwartz
- Department of Pharmacy (JMB, OAK), University of Maryland Medical Center, Baltimore, Maryland; Department of Pharmacy Practice and Science (JAM, ABL, WKS), University of Maryland School of Pharmacy, Baltimore, Maryland; and (WKS) Maryland Poison Center, Baltimore, Maryland
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Timbo BB, Chirtel SJ, Ihrie J, Oladipo T, Velez-Suarez L, Brewer V, Mozersky R. Dietary Supplement Adverse Event Report Data From the FDA Center for Food Safety and Applied Nutrition Adverse Event Reporting System (CAERS), 2004-2013. Ann Pharmacother 2017; 52:431-438. [DOI: 10.1177/1060028017744316] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background: The Food and Drug Administration (FDA)’s Center for Food Safety and Applied Nutrition (CFSAN) oversees the safety of the nation’s foods, dietary supplements, and cosmetic products. Objective: To present a descriptive analysis of the 2004-2013 dietary supplement adverse event report (AER) data from CAERS and evaluate the 2006 Dietary Supplements and Nonprescription Drug Consumer Protection Act as pertaining to dietary supplements adverse events reporting. Methods: We queried CAERS for data from the 2004-2013 AERs specifying at least 1 suspected dietary supplement product. We extracted the product name(s), the symptom(s) reported, age, sex, and serious adverse event outcomes. We examined time trends for mandatory and voluntary reporting and performed analysis using SAS v9.4 and R v3.3.0 software. Results: Of the total AERs (n = 15 430) received from January 1, 2004, through December 31, 2013, indicating at least 1 suspected dietary supplement product, 66.9% were mandatory, 32.2% were voluntary, and 0.9% were both mandatory and voluntary. Reported serious outcomes included death, life-threatening conditions, hospitalizations, congenital anomalies/birth defects and events requiring interventions to prevent permanent impairments (5.1%). The dietary supplement adverse event reporting rate in the United States was estimated at ~2% based on CAERS data. Conclusions: This study characterizes CAERS dietary supplement adverse event data for the 2004-2013 period and estimates a reporting rate of 2% for dietary supplement adverse events based on CAERS data. The findings show that the 2006 Dietary Supplements and Nonprescription Drug Consumer Protection Act had a substantial impact on the reporting of adverse events.
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Affiliation(s)
- Babgaleh B. Timbo
- Center for Food Safety and Applied Nutrition, US Food and Drug Administration, College Park, MD, USA
| | - Stuart J. Chirtel
- Center for Food Safety and Applied Nutrition, US Food and Drug Administration, College Park, MD, USA
| | - John Ihrie
- Center for Food Safety and Applied Nutrition, US Food and Drug Administration, College Park, MD, USA
| | - Taiye Oladipo
- Center for Food Safety and Applied Nutrition, US Food and Drug Administration, College Park, MD, USA
| | - Loy Velez-Suarez
- Center for Food Safety and Applied Nutrition, US Food and Drug Administration, College Park, MD, USA
| | - Vickery Brewer
- Center for Food Safety and Applied Nutrition, US Food and Drug Administration, College Park, MD, USA
| | - Robert Mozersky
- Center for Food Safety and Applied Nutrition, US Food and Drug Administration, College Park, MD, USA
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Broman D, Ahmed OH, Tscholl PM, Weiler R. Medication and Supplement Use in Disability Football World Championships. PM R 2017; 9:990-997. [PMID: 28363689 DOI: 10.1016/j.pmrj.2017.02.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 02/16/2017] [Accepted: 02/19/2017] [Indexed: 12/31/2022]
Abstract
BACKGROUND Individuals with an impairment comprise more than 15% of the world's population, many of whom can benefit greatly from participation in sport. The provision of medical services in disability sport is a challenging area with a lack of scientific evidence. Given the positive impact that sport can have on the people with an impairment, it is vital that measures are taken to better understand the medical issues posed by disability sport. It is well established that medications and supplements are overused in sport, particularly within professional football, but there is no current evidence on medication or supplement use in elite disability football. OBJECTIVE To examine and describe the use of medication and supplements in disability football, before and during international tournaments, and to identify the profile of substances used by category. DESIGN Prospective, descriptive, cohort study. SETTING International Blind Sport Association Football World Cup 2015 and the International Federation of Cerebral Palsy Football World Cup 2015. PARTICIPANTS Two hundred forty-two elite-level disability footballers, classified with B1 visual impairment or cerebral palsy. METHODS Team clinicians were asked to document all medication and supplements taken in the 48 hours before each match. RESULTS This study recorded the use of 1648 substances in 242 players, with more than one half (53.1%) classified as supplements. There was an overall rate of 1.26 substances used per player per match and a medication use rate of 0.59 medications per player per match. Seventy percent (170/242) of players reported using at least one substance per tournament, with 57.9% (140/242) using at least one prescribed medication (63.6% of players at International Blind Sports Association World Games and 57.7% of players at International Federation of Cerebral Palsy World Cup). The most commonly prescribed category of medications was nonsteroidal anti-inflammatory drugs, representing 39.3% of all reported medications. CONCLUSION This study highlights the potential overuse of medication and supplements in disability football, particularly in the use of nonsteroidal anti-inflammatory drugs. These trends are comparable to previous research in Fédération Internationale de Football Association World Cup competitions. LEVEL OF EVIDENCE Not applicable.
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Affiliation(s)
- Daniel Broman
- The FA Centre for Disability Football Research, St. George's Park, Burton-upon-Trent, DE13 9PD, United Kingdom; Institute of Sport, Exercise & Health, University College London, London, United Kingdom(∗).
| | - Osman Hassan Ahmed
- The FA Centre for Disability Football Research, St. George's Park, Burton-upon-Trent, United Kingdom; Department of Physiotherapy, Poole Hospital NHS Foundation Trust, Poole, Dorset, United Kingdom(†)
| | - Philippe M Tscholl
- Division of Orthopedics and Trauma Surgery, Geneva University Hospital, Geneva, Switzerland; FIFA Medical Assessment and Research Center (F-MARC), Schulthess Clinic, Zurich, Switzerland(‡)
| | - Richard Weiler
- The FA Centre for Disability Football Research, St. George's Park, Burton-upon-Trent, United Kingdom; Institute of Sport, Exercise & Health, University College London, London, United Kingdom; Fortius Clinic, London, United Kingdom(§)
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Abstract
Integrative oncology helps support the health of patients with cancer and their caregivers through an evidence-informed approach to lifestyle and behavior modification and the use of complementary health therapies as part of conventional cancer care. Integrative approaches can provide patients relief from cancer and cancer treatment-related symptoms, leading to improvements in their physical and psychosocial health. An evidence-informed approach is important when recommending an integrative cancer plan. Efforts at enhancing communication between patients and health care providers, as well as between integrative practitioners and conventional health care teams, are critical to achieving optimal health and healing for patients with cancer.
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Affiliation(s)
- Gabriel Lopez
- Section of Integrative Medicine, Department of Palliative, Rehabilitation and Integrative Medicine, Integrative Medicine Center, University of Texas, MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1414, Houston, TX 77030, USA.
| | - Jun J Mao
- Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, 1429 First Avenue, New York, NY 10021, USA
| | - Lorenzo Cohen
- Integrative Medicine, Integrative Medicine Program, Department of Palliative, Rehabilitation and Integrative Medicine, University of Texas, MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA
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Rao N, Spiller HA, Hodges NL, Chounthirath T, Casavant MJ, Kamboj AK, Smith GA. An Increase in Dietary Supplement Exposures Reported to US Poison Control Centers. J Med Toxicol 2017; 13:227-237. [PMID: 28741126 PMCID: PMC5570731 DOI: 10.1007/s13181-017-0623-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2017] [Revised: 06/13/2017] [Accepted: 06/21/2017] [Indexed: 02/02/2023] Open
Abstract
INTRODUCTION The objective of this study was to investigate the epidemiology of dietary supplement exposures in the USA. METHODS A retrospective analysis was conducted of out-of-hospital dietary supplement exposures reported to the National Poison Data System from 2000 through 2012. RESULTS There were 274,998 dietary supplement exposures from 2000 through 2012. The annual rate of dietary supplement exposures per 100,000 population increased by 46.1% during 2000-2002, decreased 8.8% during 2002-2005, and then increased again by 49.3% from 2005 to 2012. These trends were influenced by the decrease in ma huang exposures starting in 2002. Miscellaneous dietary supplements accounted for 43.9% of all exposures, followed by botanicals (31.9%), hormonal products (15.1%), and other supplements (5.1%). The majority of dietary supplement exposures (70.0%) occurred among children younger than 6 years old and were acute (94.0%) and unintentional (82.9%). Serious medical outcomes accounted for 4.5% of exposures and most (95.0%) occurred among individuals 6 years and older. Ma huang products, yohimbe, and energy products were the categories associated with the greatest toxicity. CONCLUSIONS There was an overall increase in the rate of dietary supplement exposures from 2000 through 2012. Although the majority of these exposures did not require treatment at a health care facility or result in serious medical outcomes, exposures to yohimbe and energy products were associated with considerable toxicity. Our results demonstrate the success of the FDA ban on ma huang products and the need for FDA regulation of yohimbe and energy products in the USA.
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Affiliation(s)
- Nisha Rao
- Center for Injury Research and Policy of the Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - Henry A Spiller
- The Ohio State University College of Medicine, Columbus, OH, USA
- Central Ohio Poison Center, Columbus, OH, USA
| | - Nichole L Hodges
- Center for Injury Research and Policy of the Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - Thiphalak Chounthirath
- Center for Injury Research and Policy of the Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA
| | - Marcel J Casavant
- Center for Injury Research and Policy of the Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA
- The Ohio State University College of Medicine, Columbus, OH, USA
- Central Ohio Poison Center, Columbus, OH, USA
| | - Amrit K Kamboj
- Center for Injury Research and Policy of the Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA
- Mayo Clinic, Division of General Internal Medicine, Rochester, MN, USA
| | - Gary A Smith
- Center for Injury Research and Policy of the Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA.
- The Ohio State University College of Medicine, Columbus, OH, USA.
- Child Injury Prevention Alliance, Columbus, OH, USA.
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Mert KU, Ilgüy S, Dural M, Mert GÖ, Özakin E. Effects of creatine supplementation on cardiac autonomic functions in bodybuilders. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2017; 40:721-727. [PMID: 28436092 DOI: 10.1111/pace.13096] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 03/23/2017] [Accepted: 04/13/2017] [Indexed: 01/28/2023]
Abstract
Bodybuilder-type workouts may affect heart rate variability (HRV), which has considerable potential to assess the role of autonomic nervous system (ANS). A scientifically designed approach is necessary for bodybuilders to achieve better results while protecting their health. In this study, we aimed to investigate HRV parameters in bodybuilders compared to healthy control subjects and effects of creatine supplementation. A total of 48 male participants (16 controls, 16 supplement (-), 16 supplement (+)) were evaluated in our study. Bodybuilders who were taking creatine supplementation were enrolled in supplement (+) group. HRV parameters were measured from 24-hour Holter recordings of all participants. When mean heart rates were compared with control group (71.5 ± 12.6 beats/min), statistically significant difference was revealed in supplement (-) group (61.8 ± 6.8 beats/min; P = 0.022) unlike supplement (+) group (69.63 ± 14.1 beats/min; P = 0.650). HRV analyses revealed significant parasympathetic shift in supplement (-) group. No significant difference was demonstrated on HRV parameters, except high frequency (P = 0.029) in supplement (+) group. Conclusively, elevated parasympathetic modulation, which is favorable cardiovascular outcome of exercise, was demonstrated in bodybuilders. However, our study also revealed that creatine supplementation attenuates this favorable effect in ANS by limiting elevation of parasympathetic modulation. Although the sympathetic slight shift is attributed to creatine supplementation, it cannot be discriminated from the effects of over training.
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Affiliation(s)
- Kadir Uğur Mert
- Department of Cardiology, Faculty of Medicine, Eskişehir Osmangazi University, Eskişehir, Turkey
| | - Serdar Ilgüy
- Department of Cardiology, Faculty of Medicine, Eskişehir Osmangazi University, Eskişehir, Turkey
| | - Muhammet Dural
- Department of Cardiology, Faculty of Medicine, Eskişehir Osmangazi University, Eskişehir, Turkey
| | - Gurbet Özge Mert
- Department of Cardiology, Yunus Emre State Hospital, Eskişehir, Turkey
| | - Engin Özakin
- Department of Emergency Medicine, Faculty of Medicine, Eskişehir Osmangazi University, Eskişehir, Turkey
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Avery RJ, Eisenberg MD, Cantor JH. An examination of structure-function claims in dietary supplement advertising in the U.S.: 2003-2009. Prev Med 2017; 97:86-92. [PMID: 28115209 DOI: 10.1016/j.ypmed.2017.01.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Revised: 01/16/2017] [Accepted: 01/17/2017] [Indexed: 12/31/2022]
Abstract
Dietary supplement advertising cannot claim a causal link between the product and the treatment, prevention, or cure of a disease unless manufacturers seek approval from the FDA for a health claim. Manufacturers can make structure-function (S-F) claims without FDA approval linking a supplement to a body function or system using words such as "may help" or "promotes." These S-F claims are examined in this study in order to determine whether they mimic health claims for which the FDA requires stricter scientific evidence. Data include S-F claims in supplement advertisements (N=6179) appearing in US nationally circulated magazines (N=137) from 2003 to 2009. All advertisements were comprehensively coded for S-F claims, seals of approval, and other claims of guarantee. S-F claims associate supplements with a wide variety of health conditions, many of which are serious diseases and/or ailments. A significant number of the specific verbs used in these S-F claims are indicative of disease treatment/cure effects, thereby possibly mimicking health claims to the average consumer. The strength of the clinical associations made are largely unsubstantiated in the medical literature. Claims that a product is "scientifically proven" or "guaranteed" were largely unsubstantiated by clinical literature. Ads carrying externally validating seals of approval were highly prevalent. S-F claims that strongly mimic FDA-prohibited health claims are likely to create confusion in interpretation and possible public health concerns are discussed.
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Affiliation(s)
- Rosemary J Avery
- Department of Policy Analysis and Management, Cornell University, Ithaca, NY 14853, United States.
| | - Matthew D Eisenberg
- Department of Health Policy and Management, Johns Hopkins University, Baltimore, MD 21205, United States.
| | - Jonathan H Cantor
- Wagner School of Public Service, New York University, New York, NY 10012, United States.
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Deshpande P, Mohan V, Ingavale D, Mane J, Pore M, Thakurdesai, PhD P. Preclinical Safety Assessment of Furostanol Glycoside-Based Standardized Fenugreek Seed Extract in Laboratory Rats. J Diet Suppl 2017; 14:521-541. [DOI: 10.1080/19390211.2016.1272659] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Pallavi Deshpande
- Department of Scientific Affairs, Indus Biotech Private Limited, Pune, India
| | - Vishwaraman Mohan
- Department of Scientific Affairs, Indus Biotech Private Limited, Pune, India
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Zaorsky NG, Churilla TM, Ruth K, Hayes SB, Sobczak ML, Hallman MA, Smaldone MC, Chen DY, Horwitz EM. Men's health supplement use and outcomes in men receiving definitive intensity-modulated radiation therapy for localized prostate cancer. Am J Clin Nutr 2016; 104:1583-1593. [PMID: 27797706 PMCID: PMC5118729 DOI: 10.3945/ajcn.115.119958] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Accepted: 09/19/2016] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Approximately 50% of newly diagnosed cancer patients start taking dietary supplements. Men's health supplements (MHSs), which we define as supplements that are specifically marketed with the terms men's health and prostate health (or similar permutations), are often mislabeled as having potential anticancer benefits. OBJECTIVE We evaluated the effects of MHSs on patient outcomes and toxicities in patients who were undergoing definitive intensity-modulated radiation therapy (IMRT) for localized prostate cancer. DESIGN This retrospective analysis included patients who were being treated at a National Cancer Institute-designated comprehensive cancer center and consented to have information stored in a prospective database. MHSs were queried online. Outcome measures were freedom from biochemical failure (FFBF) (biochemical failure was defined with the use of the prostate-specific antigen nadir + 2-ng/mL definition), freedom from distant metastasis (FFDM), cancer-specific survival (CSS), and overall survival (OS) as well as toxicities. Kaplan-Meier analysis, log-rank tests, Fine and Gray competing-risk regression (to adjust for patient and lifestyle factors), and Cox models were used. RESULTS From 2001 to 2012, 2207 patients were treated with IMRT with a median dose of 78 Gy, and a median follow-up of 46 mo. Of these patients, 43% were low risk, 37% were intermediate risk, and 20% were high risk; 10% used MHSs. MHSs contained a median of 3 identifiable ingredients (range: 0-78 ingredients). Patients who were taking an MHS compared with those who were not had improved 5-y OS (97% compared with 92%, respectively; P = 0.01), but there were no differences in the FFBF (94% compared with 89%, respectively; P = 0.12), FFDM (96% compared with 97%, respectively; P = 0.32), or CSS (100% compared with 99%, respectively; P = 0.22). The unadjusted association between MHS use and improved OS was attenuated after adjustment for patient lifestyle factors and comorbidities. There was no difference in toxicities between the 2 groups (late-grade 3-4 genitourinary <3%; gastrointestinal <4%). CONCLUSION The use of MHSs is not associated with outcomes or toxicities.
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Affiliation(s)
| | | | - Karen Ruth
- Biostatistics and Bioinformatics Facility, and
| | | | | | | | - Marc C Smaldone
- Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA
| | - David Yt Chen
- Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA
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Nakamura A, Tagami T, Kajimura K, Yamasaki K, Sawabe Y, Obana H. Simultaneous analysis of highly polar pharmaceutical adulterants in slimming products by hydrophilic interaction liquid chromatography. J LIQ CHROMATOGR R T 2016. [DOI: 10.1080/10826076.2016.1231691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
| | - Takaomi Tagami
- Osaka Prefectural Institute of Public Health, Osaka, Japan
| | - Keiji Kajimura
- Osaka Prefectural Institute of Public Health, Osaka, Japan
| | | | | | - Hirotaka Obana
- Osaka Prefectural Institute of Public Health, Osaka, Japan
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Alhomoud FK, Basil M, Bondarev A. Knowledge, Attitudes and Practices (KAP) Relating to Dietary Supplements Among Health Sciences and Non-Health Sciences Students in One of The Universities of United Arab Emirates (UAE). J Clin Diagn Res 2016; 10:JC05-JC09. [PMID: 27790468 DOI: 10.7860/jcdr/2016/19300.8439] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 04/16/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The use of Dietary Supplements (DS) has increased substantially in the United Arab Emirates (UAE) in recent years, despite the fact that the efficacy and safety of these supplements are not proven yet. In addition, the practices of supplement users in the UAE remain undocumented. AIM To determine the usage of DS in health sciences and non-health sciences students; and to determine their knowledge, attitudes and practices (KAP) regarding these supplements. MATERIALS AND METHODS A descriptive, cross-sectional, questionnaire-based study was conducted among university students. Based on the Raosoft online calculator, it was anticipated that the sample of 383 students would enable us to achieve the study objectives. Students were recruited from Ajman University of Science and Technology and identified by the academic staff through students' records. All students who were registered at Ajman University of Science and Technology - including medical (i.e. dental, pharmacy and health sciences) and non-medical colleges (i.e. engineering, business administration, law, information technology, mass communications and humanities) - were invited to participate, after obtaining the approval of the Institutional Ethics Committee (IEC), (during the period of January-February 2015). This study used quantitative method approach. Therefore, data were analysed quantitatively using SPSS version 22.0. RESULTS More than one-third of participants (39%) were found to consume DS. The most common reasons for consuming supplements were to maintain good health (58,21%) and ensure adequate nutrition (43,15%). Almost two-thirds of participants (65%) perceived that the best way to obtain nutrients is through food and DS together (49%), or DS alone (16%). Therefore, there was a relatively high amount of DS intake among participants in this study. With regard to medical and non-medical students' use of DS, there were no significant differences in the use (p=0.139). However, other findings suggest that there are significant differences in the knowledge of health sciences and non-health sciences students pertaining to the health benefits and safety of these supplements (p<0.001), what they are (p=0.040) and the source of help that should be sought when using them (p<0.001). CONCLUSION There is a relatively high prevalence of DS consumption among students, which they reported as using to maintain good health and ensure adequate nutrition. However, findings suggest that there are significant differences in the knowledge of health sciences and non-health sciences students pertaining to the health benefits and safety of these supplements. Therefore, awareness of DS usage and information should be integrated into everyday practice.
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Affiliation(s)
- Farah Kais Alhomoud
- Faculty of Pharmacy, Department of Clinical Pharmacy and Pharmacy Practice, Umm Al-Qura University , Saudi Arabia
| | - Mohammed Basil
- Faculty of Pharmacy, Ajman University of Science and Technology , United Arab Emirates
| | - Andrey Bondarev
- Faculty of Pharmacy, Ajman University of Science and Technology , United Arab Emirates
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Bouwmeester CJ. Surveying Physicians' Attitudes about Herbal Supplements, Resources, and Pharmacy Consultations. J Pharm Technol 2016. [DOI: 10.1177/875512250502100502] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective: To investigate whether physicians discuss herbal supplement use with their patients and document this information in the medical record, to determine the perceived barriers to discussing herbal supplement use, and to assess all resources currently available to physicians in their office setting and additional resources needed to answer questions about herbal supplements. Methods: An electronic survey was conducted of physicians enrolled in a managed care electronic network as of November 2002; data were collected from December 2002 through March 2003. Results: Of the 203 physicians who responded to the survey, 18% always discussed herbal supplements with their patients, 57% sometimes carried on these discussions, 21% rarely did, and 4% never asked. These responses correlated roughly with how often herbal supplement use was documented in the medical chart (always 27%, sometimes 51%, rarely 20%, never 2%). The strongest barriers to discussing herbal supplements were lack of resources and lack of time. The largest number of physicians used Web sites or print resources for information on herbal supplements. The most preferred resources were Web sites, computer databases, and pharmacy consultations. Conclusions: Awareness of herbal supplement use is vital for the healthcare practitioner to deliver comprehensive health services. Physicians' attitudes regarding herbal supplements are influenced by the resources available and by personal bias. Pharmacists can play a pivotal role in providing consultation services, educational materials, and screening for drug–herb interactions.
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Affiliation(s)
- Carla J Bouwmeester
- CARLA J BOUWMEESTER PharmD BCPS, Educational Affairs Program Manager, American Society of Consultant Pharmacists, 1320 Duke St., Alexandria, VA 22314-3563, fax 703/739-1500
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Abstract
Herbal poisoning exposures reported to poison centers increased by 344% after passage of the Dietary Supplement Health and Education Act, with 24412 exposures reported in 2003. Increased toxicity is speculated to be related to lack of child-resistant packaging, new issues of contamination, proliferation of multiple ingredient products, excessive concentration of active ingredients, and discovery of new drug-herb interactions. This review addresses contamination issues such as heavy metals, pharmaceuticals, homeopathic remedies, microbes, insects, environmental chemicals, and mis-identification of one plant for another. Toxicity issues covered include carcinogenicity, delay in seeking medical treatment when using herbs to treat serious illness, toxic components, hypersensitivity reactions, hepatotoxins, nephrotoxins, epileptogenic compounds, cardiac toxins, gastrointestinal toxins, and hematologic toxins. Common drug-herb interactions are discussed. The pharmacist plays an important role in patient education and evaluation of potential toxicities related to herbal supplements.
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Affiliation(s)
- Susan C. Smolinske
- Children’s Hospital of Michigan Regional Poison Control Center, Wayne State University, College of Medicine, Department of Pediatrics, Detroit, Michigan
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Lüde S, Vecchio S, Sinno-Tellier S, Dopter A, Mustonen H, Vucinic S, Jonsson B, Müller D, Veras Gimenez Fruchtengarten L, Hruby K, De Souza Nascimento E, Di Lorenzo C, Restani P, Kupferschmidt H, Ceschi A. Adverse Effects of Plant Food Supplements and Plants Consumed as Food: Results from the Poisons Centres-Based PlantLIBRA Study. Phytother Res 2016; 30:988-96. [PMID: 26948409 DOI: 10.1002/ptr.5604] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 02/09/2016] [Accepted: 02/11/2016] [Indexed: 12/19/2022]
Abstract
Plant food supplements (PFS) are products of increasing popularity and wide-spread distribution. Nevertheless, information about their risks is limited. To fill this gap, a poisons centres-based study was performed as part of the EU project PlantLIBRA. Multicentre retrospective review of data from selected European and Brazilian poisons centres, involving human cases of adverse effects due to plants consumed as food or as ingredients of food supplements recorded between 2006 and 2010. Ten poisons centres provided a total of 75 cases. In 57 cases (76%) a PFS was involved; in 18 (24%) a plant was ingested as food. The 10 most frequently reported plants were Valeriana officinalis, Camellia sinensis, Paullinia cupana, Melissa officinalis, Passiflora incarnata, Mentha piperita, Glycyrrhiza glabra, Ilex paraguariensis, Panax ginseng, and Citrus aurantium. The most frequently observed clinical effects were neurotoxicity and gastro-intestinal symptoms. Most cases showed a benign clinical course; however, five cases were severe. PFS-related adverse effects seem to be relatively infrequent issues for poisons centres. Most cases showed mild symptoms. Nevertheless, the occurrence of some severe adverse effects and the increasing popularity of PFS require continuous active surveillance, and further research is warranted. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Saskia Lüde
- National Poisons Centre, Tox Info Suisse, Associated Institute of the University of Zurich, Zurich, Switzerland
| | - Sarah Vecchio
- Pavia Poison Center and National Toxicology Information Centre-Toxicology Unit IRCCS Maugeri Foundation and University of Pavia, Pavia, Italy
| | | | - Aymeric Dopter
- Nutrivigilance, Agence Nationale de Sécurité Sanitaire de l'Alimentation, de l'Environnement et du Travail, Maisons-Alfort, France
| | - Harriet Mustonen
- Poison Information Centre, Helsinki University Central Hospital, Helsinki, Finland
| | - Slavica Vucinic
- National Poison Control Centre, Military Medical Academy, Belgrade, Serbia
| | | | - Dieter Müller
- GIZ-Nord Poisons Center Göttingen, Göttingen, Germany
| | | | - Karl Hruby
- Austrian Poisons Information Centre, Vienna, Austria
| | | | - Chiara Di Lorenzo
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Milan, Italy
| | - Patrizia Restani
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Milan, Italy
| | - Hugo Kupferschmidt
- National Poisons Centre, Tox Info Suisse, Associated Institute of the University of Zurich, Zurich, Switzerland
| | - Alessandro Ceschi
- National Poisons Centre, Tox Info Suisse, Associated Institute of the University of Zurich, Zurich, Switzerland.,Department of Clinical Pharmacology and Toxicology, University Hospital Zurich, Zurich, Switzerland.,Division of Clinical Pharmacology and Toxicology, Department of Internal Medicine, Ente Ospedaliero Cantonale, Lugano, Switzerland
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Meamar R, Maracy M, Nematollahi S, Yeroshalmi S, Zamani-Moghaddam A, Ghazvini MRA. Effect of taking dietary supplement on hematological and biochemical parameters in male bodybuilders an equation model. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2016; 20:681-8. [PMID: 26793253 PMCID: PMC4700687 DOI: 10.4103/1735-9066.170004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Background: The improved physical action following administration of supplements to bodybuilders was supported by changes in laboratory parameters. Despite the fact that these supplements are sometimes associated both advantage and side effects, this study were conducted for the purpose of evaluating the possible effects of some commonly used supplements in bodybuilders on the hematological and biochemical parameters. Materials and Methods: In this study, we included 40 male bodybuilders as cases and 40 controls in the age group of 20-40 years. They used different kinds of supplements for 1 year. In general, all the supplements used were classified into two groups: hormonal and non-hormonal. Laboratory tests were requested for evaluation of hematological and biochemical parameters. Results: In an equation model, we found that weight (P = 0.024), duration of bodybuilding (P < 0.001), and duration of hormone supplement consumption (P < 0.001) were loaded significantly on the latent variables, demographic and dietary supplement, respectively. The relationship between dietary supplement and biochemical and hematological parameters was significant (P = 0.01) and some of these parameters including creatinine (P = 0.023), blood aspartate aminotransferase (AST) (P < 0.001), alanine aminotransferase (ALT) (P < 0.001), and red blood cell distribution (RDW) (P = 0.046) had a significant role than others. In a multivariate regression model, we found that WBC (P < 0.001), platelets (P < 0.001), blood urea nitrogen (BUN; P < 0.001), creatinine (P < 0.001), AST (P = 0.005), and ALT (P = 0.001) were higher in athletes than in controls. Conclusions: It is strongly advised that there should be some concerns about possible supplement-induced changes in the laboratory exams for bodybuilders. The available supplements are unchecked and not approved by the US Food and Drug Administration (FDA). More studies should be designed for a better and precise administration of each supplement in athletes.
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Affiliation(s)
- Rokhsareh Meamar
- Department of Medical Science, School of Medicine, Najafabad Branch, Islamic Azad University and Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Maracy
- Department of Biostatistics and Epidemiology, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shahrzad Nematollahi
- Department of Biostatistics and Epidemiology, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shemouil Yeroshalmi
- Department of Medical Sciences, Najafabad Branch, Islamic Azad University, Isfahan, Iran
| | - Ali Zamani-Moghaddam
- Sayyd-Al-Shohada Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Reza Aghaye Ghazvini
- Isfahan Center of Health Research, National Institute of Health Research, Tehran University of Medical Sciences, Tehran, Iran
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Hutková J, Kántor A, Terentjeva M, Petrová J, Puchalski C, Kluz M, Kordiaka R, Kunová S, Kačániová M. Indicience of bacteria nad antibacterial activity of selected types of tea. POTRAVINARSTVO 2016. [DOI: 10.5219/552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The purpose of this study was to determine in vitro antibacterial activity of selected teas (Assam: Indian black tea from Camellia sinensis, Pu-erh: darkpu-erh (shu) from Camellia sinensis, Sencha: Japanese green tea from Camellia sinensis) against five species of pathogenic microorganisms. In our study, we determined the total viable count (TVC), yeasts (Y) andEnterobacteriaceae counts (E). MALDI-TOF MS Biotyper was used for identification of colonies after cultivation. Evaluation of the antimicrobial activity was performed by disc diffusion method, well diffusion method and detection of minimum inhibitory concentration (MIC). For antibacterial activity against Escherichia coli CCM 2024, Yersinia enterocolitica CCM 5671, Klebsiella pneumonie CCM 2318, Staphylococus aureus CCM 2461 and Bacillus thurigiensis CCM19 were detected. The inhibition zones were measured in mm in disc diffusion method and well diffusion method. The MIC of the individual extracts was measured spectrophotometrically. The high number of total viable count was found in Pu-erh tea (2.1 log CFU.g-1) and lowest number was found in Assam tea (0.7 log CFU.g-1). The high number of Enterobacteriacea was found in Pu-erh tea (2.03 log CFU.g-1) and lowest in Assam tea (0 log CFU.g-1). The higher number of yeasts was found in Pu-erh tea (1.83 log CFU.g-1) and lowest in Assam tea (0.3 log CFU.g-1). Mass spectrometry revealed the presence of seven Gram positive bacteria Bacillus cereus, B. mycoides, B. pumilus, Enterococcus durans, Staphylococcus epidermis, S. hominis, S. warneri, four Gram negative bacteriaAcinetobacter junii, Hafnia alvei, Klebsiella pneumoniae, Sphingomonas spp. and two yeast - Candida glabrata, Cryptococcus albidus. The results show that certain tea extracts are particularly active against various pathogenic bacteria. Tea extracts (Sencha, Rooibos, Mate, Assam) were found to have the strongest antibacterial activity against Staphylococcus aureus CCM 2461.
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Han CT, Kim MJ, Moon SH, Jeon YR, Hwang JS, Nam C, Park CW, Lee SH, Na JB, Park CS, Park HW, Lee JM, Jang HS, Park SH, Han KG, Choi YW, Lee HY, Kang JK. Acute and 28-Day Subacute Toxicity Studies of Hexane Extracts of the Roots of Lithospermum erythrorhizon in Sprague-Dawley Rats. Toxicol Res 2015; 31:403-14. [PMID: 26877842 PMCID: PMC4751449 DOI: 10.5487/tr.2015.31.4.403] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Revised: 05/07/2015] [Accepted: 07/03/2015] [Indexed: 11/20/2022] Open
Abstract
Lithospermum erythrorhizon has long been used as a traditional oriental medicine. In this study, the acute and 28-day subacute oral dose toxicity studies of hexane extracts of the roots of L. erythrorhizon (LEH) were performed in Sprague-Dawley rats. In the acute toxicity study, LEH was administered once orally to 5 male and 5 female rats at dose levels of 500, 1,000, and 2,000 mg/kg. Mortality, clinical signs, and body weight changes were monitored for 14 days. Salivation, soft stool, soiled perineal region, compound-colored stool, chromaturia and a decrease in body weight were observed in the extract-treated groups, and no deaths occurred during the study. Therefore, the approximate lethal dose (ALD) of LEH in male and female rats was higher than 2,000 mg/kg. In the subacute toxicity study, LEH was administered orally to male and female rats for 28 days at dose levels of 25, 100, and 400 mg/kg/day. There was no LEH-related toxic effect in the body weight, food consumption, ophthalmology, hematology, clinical chemistry and organ weights. Compound-colored (black) stool, chromaturia and increased protein, ketone bodies, bilirubin and occult blood in urine were observed in the male and female rats treated with the test substance. In addition, the necropsy revealed dark red discoloration of the kidneys, and the histopathological examination showed presence of red brown pigment or increased hyaline droplets in the renal tubules of the renal cortex. However, there were no test substance-related toxic effects in the hematology and clinical chemistry, and no morphological changes were observed in the histopathological examination of the kidneys. Therefore, it was determined that there was no significant toxicity because the changes observed were caused by the intrinsic color of the test substance. These results suggest that the no-observed-adverse-effect Level (NOAEL) of LEH is greater than 400 mg/kg/day in both sexes.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Young Whan Choi
- Department of Horticultural Bioscience, Pusan National University, Miryang, Korea
| | | | - Jong-Koo Kang
- Biotoxtech Co., Ltd., Cheongju, Korea
- Department of Laboratory Animal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Korea
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Lieberman HR, Marriott BP, Williams C, Judelson DA, Glickman EL, Geiselman PJ, Dotson L, Mahoney CR. Patterns of dietary supplement use among college students. Clin Nutr 2015; 34:976-85. [DOI: 10.1016/j.clnu.2014.10.010] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Revised: 10/16/2014] [Accepted: 10/29/2014] [Indexed: 02/07/2023]
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Farias MM, Gajardo C, Alvarez V, Cuevas A, Perez-Cotapos ML. Short-term skin reactions associated to sleeve gastrectomy in eight patients. Obes Surg 2015; 24:1826-9. [PMID: 25078509 DOI: 10.1007/s11695-014-1381-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Bariatric procedures have beneficial effects on metabolic disturbances, including dermatological conditions. Short-term skin reactions associated with sleeve gastrectomy are not described in the literature. METHODS We reviewed our database for patients who underwent bariatric surgery between May and October 2013 who reported a cutaneous rash during the short-term post-surgical period. RESULTS Of a total of 195 patients, 8 (0.02 %) developed acute skin reactions during the first 3 months. Case 1 was compatible with reticulated papillomatosis. Case 2 was diagnosed as recurrent angioedema. Cases 3, 4, and 7 presented a cutaneous drug reaction to vitamin supplementation. Cases 5, 6, and 8 seemed to be secondary to xerosis and responded to lubrication. CONCLUSION Acute cutaneous skin reactions after bariatric surgery are unusual. When they do occur, they appear to be benign conditions.
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Affiliation(s)
- Maria M Farias
- Department of Nutrition, Clinica Las Condes, Lo Fontecilla 441, Santiago, Chile,
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Starr RR. Starr Responds. Am J Public Health 2015; 105:e3-4. [PMID: 25973821 PMCID: PMC4463378 DOI: 10.2105/ajph.2015.302754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2015] [Indexed: 03/24/2024]
Affiliation(s)
- Ranjani R Starr
- Ranjani R. Starr is with the Office of Public Health Studies, Department of Public Health Sciences, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu
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Acute and repeated doses (28 days) oral toxicity study of glycosides based standardized fenugreek seed extract in laboratory mice. Regul Toxicol Pharmacol 2015; 72:323-34. [DOI: 10.1016/j.yrtph.2015.05.003] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Revised: 04/05/2015] [Accepted: 05/05/2015] [Indexed: 11/19/2022]
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Choi JY, Heo S, Yoo GJ, Park SK, Yoon CY, Baek SY. Development and validation of an LC-MS/MS method for the simultaneous analysis of 28 specific narcotic adulterants used in dietary supplements. Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2015; 32:1029-39. [DOI: 10.1080/19440049.2015.1040080] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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The effect of flaxseed dose on circulating concentrations of alpha-linolenic acid and secoisolariciresinol diglucoside derived enterolignans in young, healthy adults. Eur J Nutr 2015; 55:651-663. [PMID: 25808116 DOI: 10.1007/s00394-015-0885-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Accepted: 03/14/2015] [Indexed: 01/24/2023]
Abstract
PURPOSE The primary endpoint was to determine the plasma concentration of alpha-linolenic acid (ALA), and its metabolites, following milled flaxseed consumption at four doses. Secondary outcomes focused on plasma enterolignan concentrations and the effects on tolerability, platelet aggregation, plasma lipids and urinary thromboxane levels. METHODS Healthy, younger adults (n = 34; 18-49 years old) were randomized into four groups consuming one muffin daily for 30 days fortified with 10, 20, 30 or 40 g of milled flaxseed. Blood and urine were collected at baseline and 4 weeks. RESULTS Plasma ALA concentrations increased with all flaxseed doses (P < 0.01), except the 20 g/day dose (P = 0.10), yet there was no significant dose-dependent response (P = 0.81). Only with the 30 g/day diet were n-3 polyunsaturated fatty acids (P = 0.007), and eicosapentaenoic acid (EPA) (P = 0.047) increased from baseline values. Docosapentaenoic acid and docosahexaenoic acid were not detected at any dose. Plasma total enterolignan concentrations significantly increased over time in all treatment groups, yet despite a dose-dependent tendency, no between-group differences were detected (P = 0.22). Flaxseed was well tolerated, even at the highest dose, as there were no reported adverse events, changes in cholesterol, platelet aggregation or urinary 11-dehydro-thromboxane B2. CONCLUSIONS In healthy, younger adults, 10 g/day of milled flaxseed consumption is sufficient to significantly increase circulating ALA and total enterolignan concentrations; however, 30 g/day is required to convert ALA to EPA. Although all doses were well tolerated, 40 g/day is too low to attenuate cholesterol in this population.
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Starr RR. Too little, too late: ineffective regulation of dietary supplements in the United States. Am J Public Health 2015; 105:478-85. [PMID: 25602879 DOI: 10.2105/ajph.2014.302348] [Citation(s) in RCA: 94] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Millions of people in the United States consume dietary supplements hoping to maintain or improve their health; however, extensive research has failed to demonstrate the efficacy of numerous supplements in disease prevention. In addition, concerns about the safety of routine and high-dose supplementation have been raised. The Food and Drug Administration regulates dietary supplement quality, safety, and labeling, and the Federal Trade Commission monitors advertisements and marketing; still, vast enforcement challenges remain, and optimal governmental oversight has not been achieved. If the composition and quality of ingredients cannot be reliably ensured, the validity of research on dietary supplements is questionable. Moreover, the health of the US public is put at risk.
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Affiliation(s)
- Ranjani R Starr
- Ranjani R. Starr, MPH, is with the Office of Public Health Studies, Department of Public Health Sciences, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu
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Yong PW, Tan LB, Loh YH. Consumption of dietary health supplements among hospitalized patients at an acute tertiary Hospital. PHARMANUTRITION 2014. [DOI: 10.1016/j.phanu.2014.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Amariles P, González LI, Giraldo NA. Prevalence of self-treatment with complementary products and therapies for weight loss: A randomized, cross-sectional Study in Overweight and Obese Patients in Colombia. Curr Ther Res Clin Exp 2014; 67:66-78. [PMID: 24678084 DOI: 10.1016/j.curtheres.2006.02.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2005] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The use of complementary and alternative medicine for weight loss is becoming increasingly common worldwide. In overweight or obese patients, this practice could be harmful. Available data concerning the use of complementary therapies and products (CTPs) for weight loss in these patients in Colombia are limited. OBJECTIVES The aims of this study were to determine the prevalence of self-treatment with CTPs in overweight or obese patients in Colombia and to explore the relationship between CTP use and demographic, anthropometric, and biochemical parameters. METHODS This randomized, cross-sectional study was conducted at a registered dieticians' office located at the Center for Nutritional Care, School of Nutrition and Dietetics, University of Antioquia, Medellín, Colombia, and at an outpatient clinic attended by a registered dietician located at the Pablo Tobón Uribe Hospital, Medellín, Colombia. The study enrolled a random sample of overweight (body mass index [BMI], 25-30 kg/m(2)) or obese (BMI, >30 kg/m(2)) male and female patients aged 20 to 50 years received nutritional treatment in Colombia in 2002. Data concerning the use of weight-loss CTPs were gathered, and their possible association with demographic, anthropometric, and biochemical data was explored. RESULTS This randomized study comprised 94 patients (70 women, 24 men; mean [SD] age, 36.5 [9.7] years; mean [SD] BMI, 28.4 [4.2] kg/m(2)). Forty-nine (52.1%) patients reported self-treatment with weight-loss CTPs; 40 (42.6%) patients used complementary products, and 21 (22.3%) used complementary therapies. Among the products, inadequately identified herbal medicines (ie, absence of available information concerning the composition of the products or information could not be obtained from the patient [many of the products used were not authorized for distribution in Colombia]), folkloric or home remedies, and commercial diets were most commonly used (40.0%, 40.0%, and 27.5%, respectively). The use of CTPs was more prevalent in women compared with men (P < 0.001; odds ratio [OR] = 6.43). In women, CTP use was significantly higher in patients with a higher educational level (P = 0.008; OR = 3.82) and in those who were single (P = 0.038; OR = 2.97). The use of CTPs was also more frequent in patients with a negative view of their current nutritional therapy (P = 0.002; OR = 6.8). CONCLUSIONS In the small group of overweight and obese patients in this study, 52.1% used CTPs. In obese women, those with a higher educational level and/or who were single were more likely to use CTPs. Patients were also more likely to use CTPs if they had a negative view of their current nutritional therapy.
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Affiliation(s)
- Pedro Amariles
- Faculty of Pharmaceutical Chemistry, University of Antioquia, Medellin, Colombia ; Research Group on Pharmaceutical Care, University of Granada, Granada, Spain
| | - Laura I González
- School of Nutrition and Dietetics, University of Antioquia, Medellin, Colombia ; Research Group on Human Nutrition, University of Antioquia, Medellin, Colombia
| | - Nubia A Giraldo
- School of Nutrition and Dietetics, University of Antioquia, Medellin, Colombia
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