Complementary and Alternative Medicine Use Among Rural Older Adults

Little research has investigated Complementary and Alternative Medicine (CAM) use prevalence and its determinants among older adults. We examined ethnic and gender variation in CAM use among rural older adults who reside in two North Carolina counties. Home and folk remedies, and vitamin and mineral supplements, were used by most participants. Men and women did not differ. African and Native American elders used home and folk remedies more than European Americans; European and Native Americans used vitamin and mineral supplements more than African Americans. Health care providers should be aware that their patients use CAM and may need counseling to minimize CAM-drug interactions.

Use and safety perceptions regarding herbal supplements: a study of older persons in southeast Idaho

Herbal supplements (HS) are used by older persons and are often perceived as safe, although there is limited research that examines why this perception exists. A questionnaire was developed and pilot tested to investigate the use and perceived safety of HS among a convenience sample of 112 adults aged 60 to 92 in southeast Idaho. Fifty-five percent of the participants (n = 62) reported using HS in the past. Ninety-five percent (n = 59) of those using HS and 75% (n = 37) of nonusers reported they believed most or some HS were safe. Perception of herbal supplement safety was greatly influenced by family and friends, and HS users had a greater perception of safety than nonusers (p < or = .001). The top reasons for perceived safety given by HS users were that HS: (1) can be purchased without a prescription, (2) can be purchased in many locations, and (3) are natural.

Differences in Fruit and Vegetable Intake among Categories of Dietary Supplement Users

BACKGROUND

People who choose to take dietary supplements are often classified as having a healthful lifestyle; however, it is probable that several health behavior patterns exist among users.

OBJECTIVE

Data from the North Carolina Strategies to Improve Diet, Exercise, and Screening study (N = 727) were used to identify and describe five different categories of dietary supplement use and evaluate how these categories are associated with both quantity and quality of fruit and vegetable consumption.

DESIGN

Five nonoverlapping dietary supplement use categories were created and descriptive demographic statistics were compared. Least-squares means were calculated for knowledge and fruit and vegetable quality and quantity measures. Logistic regression was performed to calculate adjusted odds ratios to examine associations among the dietary supplement use categories and the fruit and vegetable measures, using nonusers as the reference category.

RESULTS

Demographic profiles and dietary intake varied among the dietary supplement categories. People reporting both a multivitamin/multimineral and a single supplement (Multi Plus category) and any nonvitamin/nonmineral products (Herbals category) were more likely to be consuming more vegetables and higher-quality fruits and vegetables than those not taking any dietary supplements (Nonusers category), whereas people taking multivitamins/multiminerals only (Multis category) had patterns that were more consistently similar to those not taking any dietary supplements (Nonusers).

CONCLUSIONS

Study participants exhibited dietary supplement use patterns that were associated with differences in fruit and vegetable consumption. Simply characterizing people as users and nonusers will not capture critical demographic and dietary differences and will likely further cloud investigations of diet-disease relationships.

Herbal and Vitamin/Mineral Supplement Use by Retirement Community Residents

A survey questionnaire assessed supplement use by free-living residents of a retirement community. Of the 318 respondents (mean age 82.2 years), 20% of women and 20% of men reported using herbal supplements, with 62% of these using them at least once per week. Most herbal supplements users (97%) also used vitamin/mineral supplements. Sixty-eight percent of herbal supplement users felt very much/somewhat informed about taking the supplements. Forty-four percent, however, were not sure whether there was testing before marketing; 33% were not sure about side effects. Half (52%) relied "very much/somewhat" on doctors/nurses as information sources; 40% relied on dietitians.

Bone and nutrition in elderly women: protein, energy, and calcium as main determinants of bone mineral density

OBJECTIVE

Nutrition is an important factor in the prevention and treatment of osteoporosis. Our goal was to examine the relationship between various nutrients and bone mass of several skeletal sites in elderly women, taking into account possible confounding variables.

DESIGN/METHODS

A cross-sectional study in 136 healthy Caucasian, postmenopausal women, free of medications known to affect bone was carried out. Bone mineral density (BMD) and body composition (lean and fat tissue) were measured by dual X-ray absorptiometry using specialized software for different skeletal sites. Parathyroid hormone (PTH) and vitamin D, 25(OH)D, as possible confounders, were determined in serum samples. Dietary intake, including all supplements, was assessed by 3-day dietary record and analyzed using Food Processor. Past physical activity and present walking were examined as well and accounted for as potential confounders. Simple and multiple regression models were created to assess the relationships between nutrients and BMD. To examine the co-linear variables and their possible independent association with bone, subgroup analyses were performed.

RESULTS

: Showed independent influence of calcium, energy, and protein, examined separately and in multiple regression models on BMD of several skeletal sites. Magnesium, zinc and vitamin C were significantly related to BMD of several skeletal sites in multiple regression models (controlled for age, fat and lean tissue, physical activity and energy intake), each contributing more than 1% of variance. Serum PTH and 25(OH)D did not show significant association with bone mass.

CONCLUSIONS

Despite the cross-sectional nature of our study we were able to show a significant relationship between BMD and several critical nutrients: energy, protein, calcium, magnesium, zinc and vitamin C. The exact involvement of these nutrients and their clinical significance in bone health need to be further elucidated in humans and conclusions about the effects of a single nutrient on bone mass must be given cautiously, taking into account its interaction and co-linearity with others. Understanding relationships among nutrients, not just limited to calcium and vitamin D, but others that have not been investigated to such extent, is an important step toward identifying preventive measures for bone loss and prevention of osteoporosis.