Herbal and dietary supplement use in Bangkok: a survey

Optimization of water-based ultrasonic-microwave assisted extraction (UMAE) of bioactive compounds from Garcinia mangostana pericarp

OBJECTIVES

Garcinia mangostana (GM) pericarp extract recognizes for relieving skin disorders. It becomes a household fruit juice due to its high concentration of antioxidant compounds, including phenolic and α-mangostin. The purpose of this study was to optimize the conditions of Ultrasonic-Microwave Assisted Extraction (UMAE) of GM pericarp.

METHODS

GM pericarp was extracted by UMAE and conventional decoction extraction. UMAE was created in nine different individuals and combined ultrasonic and microwave power. The amount of phenolic compound, "caffeic acid, ferulic acid", α-mangostin, and total phenolic content (TPC) were compared. The optimized parameters were particle size of grounded raw material, microwave power, and ultrasonic power during water extraction.

RESULTS

The optimized UMAE conditions combined 200 W microwave power and 200 W ultrasonic power to extract raw material grounded to 22.6 μm diameter particles (p≤0.05). The synergistic effect of ultrasonic and microwave-assisted extraction significantly (p≤0.05) impacted on the TPC, the yield of caffeic acid, ferulic acid, and α-mangostin.

CONCLUSIONS

Overall, the synergistic effect of ultrasonic and microwave extraction resulted in a significantly higher amount of bioactive compounds when compared to conventional decoction extraction (p≤0.001). These results demonstrated the advantages of UMAE for preparing GM pericarp extract for the food, cosmetic and pharmaceutical industries.

Prevalence of complementary and alternative medicine (CAM) use in Brazil

Background

The use of medicinal plants or other alternative practices can be the only therapeutic resources for many communities and ethnic groups, especially in developing countries. In Brazil, the Ministry of Health incorporated Complementary and Alternative Medicine (CAM) as a public health policy since 2006. The aim of this study was to evaluate the prevalence of CAM use in Brazil.

Methods

This was a cross-sectional study performed as an epidemiological survey, with data from the National Health Survey, 2013 that evaluated a sample of adult Brazilians (18+ years old). The outcome was the use of CAM therapies, such as acupuncture, homeopathy, medicinal plants and herbal medicines in the last 12 months. We employed a logistic regression model (CI 95%) to evaluate the chances of CAM use.

Results

The prevalence of CAM use in Brazil was 4.5%. The subjects with higher chances to use CAM were: women (AOR = 1.42), aged > 40 years (AOR = 1.64), with higher educational levels (AOR = 2.35), and residents at North (AOR = 2.02) and South (AOR = 1.67) regions of Brazil, all with p-value < 0.001. According to the socioeconomic status, subjects from upper classes had higher chances to use acupuncture and homeopathy when compared to the other classes, and individuals from lower classes had higher chances to use medicinal plants and herbal medicines. Almost half of all individuals reporting CAM use did so outside the health care system. The Brazilian Unified Health System (SUS) was the least used funding for CAM when compared to other types of funding.

Conclusions

We recommend that the Ministry of Health invests in capacity building for health professionals who work with CAM, providing structure for those practices in health services, increasing the access of CAM therapies for SUS users, and improving the registering of information about those therapies, encouraging the use of CAM by the Brazilian population.

Herbal or traditional medicine consumption in a Thai worker population: pattern of use and therapeutic control in chronic diseases

BACKGROUND

Herbal and traditional medicines (HTM) are widely used in Asian countries. Specific data on prevalent of HTM usage and association with chronic diseases in the Thai population is currently lacking. We examined the prevalence and factors associated with HTM use in a Thai worker population. In addition, we explored the relationship between HTM use and therapeutic control of cardiovascular risk factors and documented the most common types of HTM used in various chronic diseases.

METHODS

Employees of EGAT (The Electric Generating Authority of Thailand) who had participated in a health examination were studied. Each participant documented their HTM consumption and self-reported chronic diseases in a questionnaire. Clinical disease and therapeutic control were also defined by concomitant laboratory tests.

RESULTS

Of a total of 6592 subjects, 32.6% were HTM-users. Age < 50 years, female gender, self-reported history of diabetes, liver disease, cancer, dyslipidemia, and alcohol use were independently associated with HTM use. HTM consumption increased in proportion to the numbers of self-reported chronic diseases. There were no differences in the therapeutic control of cardiovascular risk factors between HTM users and non-users. Liver and kidney function were not different. The most commonly used HTM was turmeric.

CONCLUSIONS

HTM consumption is common in community-based Thai subjects, with higher use among those with chronic diseases. Although there were no differences in control of cardiovascular risk factors between HTM users and non-users, many of the commonly used herbs have relevant biological activities for chronic disease prevention or treatment.

The use of herbal medicines among chronic disease patients in Thailand: a cross-sectional survey

Background

The study aimed to assess the prevalence and correlates of herbal medicine use among chronic disease patients in health care settings in Thailand.

Methods

In a cross-sectional study, 1374 adult chronic disease patients (median age 60 years) were consecutively sampled from health care facilities in Thailand. Logistic regression was used to estimate the independent predictors of herbal medicine use in the past 12 months.

Results

The prevalence of herbal medicine use in the past 12 months was 35.9%. Of participants who were using herbal medicine in the past 12 month, 53.7% used it for treating a long-term health condition, 40.0% used herbal medicine in order to improve well-being and 6.3% for treating an acute illness. More than half of the herbal medicine users (57.2%) rated their herbal medicine use as very helpful, 33.3% as somewhat helpful and 6.5% not at all helpful or do not know. In adjusted logistic regression analysis, having Grade 6 to 12 education (Odds Ratio-OR: 1.71, Confidence Interval-CI: 1.04, 2.82), rural residence (OR: 0.76, CI: 0.60, 0.97), other religion (OR: 0.57, CI: 0.35, 0.97), anxiety (OR: 1.64, CI: 1.25, 2.16), low quality of life (OR: 0.42, CI: 0.31, 0.56) and having multiple chronic conditions (OR: 1.82, CI: 1.30, 2.56) were associated with past 12-month herbal medicine use. Further, in adjusted logistic regression analysis, having arthritis, asthma, cancer, cardiovascular disease, dyslipidaemia, gastrointestinal disease, dyslipidaemia were positively and hypertension negatively associated with past 12-month herbal medicine use.

Conclusions

The study found a high prevalence of herbal medicine use among chronic disease patients in Thailand. Several factors (education, rural residence, anxiety, low quality of life and multiple chronic conditions) associated with herbal medicine use were identified. This knowledge will support health care providers and policy makers in decision making on the use of herbal medicine.