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Koç O, Tosyalı M, Gökçe Ş, Koç F. Use of Dietary Supplements and Influencing Factors in Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:734. [PMID: 38928980 PMCID: PMC11203674 DOI: 10.3390/ijerph21060734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Revised: 06/01/2024] [Accepted: 06/02/2024] [Indexed: 06/28/2024]
Abstract
INTRODUCTION In recent years, the use of dietary supplements has increased in all age groups. Parents may also use these supplements for their children for different reasons. This study aims to determine the use of dietary supplements by children, the factors affecting this use, and the attitudes of parents about these products. METHODS A total of 1038 children aged 2-18 years without any chronic disease who presented to the pediatric outpatient clinics of Ege University Children's Hospital were included in this study. Parents (n = 1000) who agreed to participate in the study were interviewed face-to-face, and a comprehensive questionnaire including questions about children's use of dietary supplements, sociodemographic characteristics, and parents' attitudes towards dietary supplements was administered. Analyses were performed with SPSS 25.0. RESULTS The mean age of the children included in our study was 8.6 ± 4.8 years, and 51% (n = 510) were male. It was found that 32.5% of the children used nutritional supplements, and vitamin-mineral preparations (23.2%) were the most frequently used. Omega-3 (19.3%) and immune support products (9.4%) were the second and third most frequently used supplements, respectively. A significant relationship was found between the use of dietary supplements and the child's age, body weight, body mass index, parents' educational level, being health worker, and economic status (p < 0.05). It was found that most of the families thought that vitamin-mineral and omega-3 products were beneficial for growth and development and that they received information from doctors most frequently before taking these products. However, it was found that families followed the media as the second most frequent source of information for these products. CONCLUSIONS Approximately one-third of the children in our study use dietary supplements. It is very important to raise awareness among families about the use of these products when necessary and with the recommendation of a physician. To prevent families from using dietary supplements that are not necessary for their children, especially due to misinformation in the media, pediatricians should provide correct information to parents about these products at every clinic visit. A concerted effort is needed from policy makers, media organizations, and health care providers to guide the safe use of DS. The results obtained from this study will shed light on future randomized controlled prospective studies.
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Affiliation(s)
| | - Merve Tosyalı
- Department of Pediatrics, Faculty of Medicine, Ege University, Children’s Hospital, 35100 Izmir, Turkey; (O.K.); (Ş.G.); (F.K.)
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Sirois J, Reddy S, Nguyen T, Walker H, Rendall J, Bergen G, Reimers M, Cermak E, Tiwary A, Helmes E, Palmer J, Teo S, Mackle T, Park M, Wang C. Safety considerations for dietary supplement manufacturers in the United States. Regul Toxicol Pharmacol 2024; 147:105544. [PMID: 38158034 DOI: 10.1016/j.yrtph.2023.105544] [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: 08/14/2023] [Revised: 11/22/2023] [Accepted: 12/08/2023] [Indexed: 01/03/2024]
Abstract
Due to significant dietary supplement use in the US, product manufacturers must understand the importance of implementing a robust approach to establishing safety for all ingredients, including dietary ingredients, components, and finished dietary supplement products. Different regulatory pathways exist by which the safety of dietary ingredients can be established, and thus allowed to be marketed in a dietary supplement. For individual dietary ingredients, safety information may come from a variety of sources including history of safe use, presence of the ingredient in foods, and/or non-clinical and clinical data. On occasion safety data gaps are identified for a specific ingredient, particularly those of botanical origin. Modern toxicological methods and models can prove helpful in satisfying data gaps and are presented in this review. For finished dietary supplement products, issues potentially impacting safety to consider include claims, product labeling, overages, contaminants, residual solvents, heavy metals, packaging, and product stability. In addition, a safety assessment does not end once a product is marketed. It is important that manufacturers actively monitor and record the occurrence of adverse events reported in association with the use of their products, in accordance with the law. Herein, we provide a comprehensive overview of considerations for assessing dietary supplement safety.
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Affiliation(s)
- Jay Sirois
- Consumer Healthcare Products Association, Washington, DC, USA.
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- Nestle Health Science, Bridgewater, NJ, USA
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Ma G, Chong W, Qi Y, Lu Z, Zhang Z, Nian B, Hu Y. Can vitamin E ester derivatives be excellent alternatives of vitamin E: state of art. Bioprocess Biosyst Eng 2023; 46:1695-1709. [PMID: 37555945 DOI: 10.1007/s00449-023-02918-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 07/27/2023] [Indexed: 08/10/2023]
Abstract
Vitamin E (VE) is a natural antioxidant which is widely used in the food fields, while the shortcomings of easy oxidative inactivation and poor water solubility limit its application. Vitamin E esters' (VEEs) derivatives, such as vitamin E acetate (VEA), are more stable and easier to be absorbed while have similar biological activities and physiological functions compared with VE. In this systematic review, the digestion, absorption and physiological function of VEEs were summarized. To promote their further industrial applications, the synthesis strategies of VEEs were also summarized in-depth. In particular, as a new generation of green solvents, ionic liquids (ILs) have been widely used in enzymatic reactions due to the stabilization and activation of enzymes. Their applications in enzymatic synthesis of VEEs were summarized and discussed. Finally, several future perspectives for developing more efficiency strategies of VEEs synthesis, such as enzyme engineering and design of novel ILs, were also discussed.
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Affiliation(s)
- Guangzheng Ma
- State Key Laboratory of Materials-Oriented Chemical Engineering, School of Pharmaceutical Sciences, Nanjing Technology University, Nanjing, 210009, Jiangsu Province, People's Republic of China
| | - Wenya Chong
- State Key Laboratory of Materials-Oriented Chemical Engineering, School of Pharmaceutical Sciences, Nanjing Technology University, Nanjing, 210009, Jiangsu Province, People's Republic of China
| | - Yuan Qi
- State Key Laboratory of Materials-Oriented Chemical Engineering, School of Pharmaceutical Sciences, Nanjing Technology University, Nanjing, 210009, Jiangsu Province, People's Republic of China
| | - Zeping Lu
- State Key Laboratory of Materials-Oriented Chemical Engineering, School of Pharmaceutical Sciences, Nanjing Technology University, Nanjing, 210009, Jiangsu Province, People's Republic of China
| | - Zihan Zhang
- State Key Laboratory of Materials-Oriented Chemical Engineering, School of Pharmaceutical Sciences, Nanjing Technology University, Nanjing, 210009, Jiangsu Province, People's Republic of China
| | - Binbin Nian
- State Key Laboratory of Materials-Oriented Chemical Engineering, School of Pharmaceutical Sciences, Nanjing Technology University, Nanjing, 210009, Jiangsu Province, People's Republic of China.
| | - Yi Hu
- State Key Laboratory of Materials-Oriented Chemical Engineering, School of Pharmaceutical Sciences, Nanjing Technology University, Nanjing, 210009, Jiangsu Province, People's Republic of China.
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Azhar W, Al-Otaibi K, Abusudah WF, Azzeh F, Qhadi A, Alhassani WE, Almohmadi NH, Bushnaq T, Tashkandi B, Alharbi NA, Babteen A, Ghabashi M, Kamfar Y, Ghafouri K. The consumption of dietary supplements in Saudi Arabia during the COVID-19 pandemic: A cross-sectional study. Saudi Pharm J 2023; 31:101779. [PMID: 37746046 PMCID: PMC10514549 DOI: 10.1016/j.jsps.2023.101779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 09/02/2023] [Indexed: 09/26/2023] Open
Abstract
Background and Objectives People frequently utilize dietary supplements (DS), notably during the COVID-19 epidemic, despite the lack of data supporting their usefulness and safety in enhancing general health. This study aimed to measure the consumption of DS in Saudi Arabia during COVID-19. Previous studies focused on using dietary supplements for preventing or reducing mental health. Materials and Methods A cross-sectional study was conducted with 1572 participants aged 18-65, from all-over Saudi Arabia who were invited to complete a self-administered questionnaire to measure the consumption of supplements during the pandemic lockdown period. Also, it investigates the factor that effect supplements consumption. Results Around 63% of the participants did not change their consumption patterns during the pandemic, while 16% consumed more and 21.4% consumed fewer supplements during the pandemic. The most commonly used supplements were iron; calcium, especially among pregnant women; omega-3, especially in people older than 65 years; and vitamin D. Females (81%; P < 0.002); age (94.7%; P < 0.002); married people (84%; P < 0.001); those with a higher educational level (83.9%; P = 0.02); those with a higher monthly income (86.1%; P = 0.006); and pregnant women (100%; P < 0.007) reported the highest rates of consumption. Conclusion Dietary supplements have recently become popular in Saudi Arabia, but large differences remain between Saudis in their consumption of supplements. Additional research should be conducted to examine the level of knowledge of dietary supplements among Saudi population.
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Affiliation(s)
- Wedad Azhar
- Clinical Nutrition Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Kholod Al-Otaibi
- Clinical Nutrition Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Wafaa F. Abusudah
- Clinical Nutrition Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Firas Azzeh
- Clinical Nutrition Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Alaa Qhadi
- Clinical Nutrition Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Walaa E. Alhassani
- Clinical Nutrition Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Najlaa H. Almohmadi
- Clinical Nutrition Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Taqwa Bushnaq
- Department of Food Science and Nutrition, College of Sciences, Taif University, Taif, Saudi Arabia
| | - Bayan Tashkandi
- Food and Nutrition Department, King Abdulaziz University, Jeddah 22254, Saudi Arabia
| | - Nouf Abdullah Alharbi
- Department of Nutrition and Food Sciences, Northern Border University, P.O. Box 1321, Arar 91431, Saudi Arabia
| | - Abrar Babteen
- Clinical Nutrition Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Mai Ghabashi
- Clinical Nutrition Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Yara Kamfar
- Pharamcy Department, King Abdullah Medical City, P.O. Box 57657, Makkah 21955, Saudi Arabia
| | - Khloud Ghafouri
- Clinical Nutrition Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
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Christensen C, Matthiessen J, Fagt S, Biltoft-Jensen A. Dietary supplements increase the risk of excessive micronutrient intakes in Danish children. Eur J Nutr 2023; 62:2449-2462. [PMID: 37127694 PMCID: PMC10421806 DOI: 10.1007/s00394-023-03153-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 04/13/2023] [Indexed: 05/03/2023]
Abstract
PURPOSE Dietary supplement use is common in Northern Europe. Many dietary supplements contain 100% of nutrient reference values (NRV) of micronutrients. This study investigates the contribution of dietary supplements to micronutrient intake, the prevalence of excess intake of micronutrients, and parental characteristics of dietary supplement use in Danish children. METHODS Data on 499 4-10-year-old children from the Danish National Survey of Diet and Physical Activity 2011-2013 were analysed using non-parametric statistics to compare micronutrient intake from the diet and dietary supplements to the reference intake (RI), and to the tolerable Upper Intake Level (UL) for users and non-users of dietary supplements. Furthermore, characteristics of the parents of users and non-users of dietary supplements were examined by logistic regression analysis. RESULTS Sixty-four percent of the children were dietary supplement users. Multivitamin-mineral supplements were the most frequently used type of supplement (60%). Children of never-smokers were more likely to use supplements than children of smokers. Users had significantly higher total intakes of 15 micronutrients compared to non-users. Intakes of vitamin A, zinc, and iodine from the diet alone exceeded ULs in 12-30% of the children. Use of dietary supplements gave rise to 21-73% of children in exceedance of the aforementioned three ULs as well as the UL for iron (6-45%). CONCLUSION Dietary supplement use was common among 4-10-year-old Danish children and resulted in a considerable proportion of users exceeding the ULs for vitamin A, zinc, iodine, and iron. The long-term health consequences of exceeding these ULs for children are unknown.
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Affiliation(s)
- Camilla Christensen
- Research Group for Nutrition, Sustainability and Health Promotion, National Food Institute, Technical University of Denmark, Kgs. Lyngby, Denmark.
| | - Jeppe Matthiessen
- Research Group for Nutrition, Sustainability and Health Promotion, National Food Institute, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Sisse Fagt
- Research Group for Nutrition, Sustainability and Health Promotion, National Food Institute, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Anja Biltoft-Jensen
- Research Group for Nutrition, Sustainability and Health Promotion, National Food Institute, Technical University of Denmark, Kgs. Lyngby, Denmark
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Amin MB, Aktarujjaman M, Meem AE, Hossain E, Islam MN, Roy N. Prevalence, correlates and common conditions associated with adolescent dietary supplement use: a cross-sectional survey in Bangladesh. Public Health Nutr 2023; 26:1143-1151. [PMID: 36535744 PMCID: PMC10346021 DOI: 10.1017/s1368980022002634] [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: 05/27/2022] [Revised: 11/13/2022] [Accepted: 11/24/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE There is a broad spectrum of dietary supplements (DS) and their accessibility worldwide. However, little is known about the prevalence of DS use among Bangladeshi adolescents. This study estimates the prevalence, correlates and common conditions related to DS use. DESIGN A cross-sectional, convenient sampling strategy was adopted using an interviewer-administered, structured questionnaire. SETTING Kurigram and Patuakhali districts of Bangladesh. PARTICIPANTS 702 adolescents aged 10-19 years. RESULTS The overall prevalence of DS use was 83 %. The majority of participants (93·4 %) agreed that DS were good for health, and 28·3 % reported general health and well-being as the reason for using DS. The most frequently used supplements were multivitamins (38·6 %) and Ca (37 %). DS use was more common among adolescents who had ≤5 siblings, good health status, no chronic diseases, a positive impression that DS are good for health and who had the tendency to encourage DS to others. DS use was also higher among those who received DS information from healthcare providers, professional literature, friends, family and relatives. CONCLUSIONS The prevalence of DS use is relatively higher among Bangladeshi adolescents compared to Bangladeshi adults and adolescents from other countries, highlighting the inclination towards DS use. Guidelines for safe DS use for adolescents are warranted to control DS use and prevent adverse effects.
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Affiliation(s)
- Md. Bony Amin
- Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, Bangladesh
| | - Md. Aktarujjaman
- Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, Bangladesh
| | - Amatul Elah Meem
- Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, Bangladesh
| | - Ekhtear Hossain
- Department of Biological Sciences and Chemistry, Southern University, A&M College, Baton Rouge, LA, USA
| | - Md. Nazrul Islam
- Department of Post-Harvest Technology and Marketing, Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, Bangladesh
| | - Nitai Roy
- Department of Biochemistry and Food Analysis, Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali8602, Bangladesh
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Hafiz NM, El-Readi MZ, Esheba G, Althubiti M, Ayoub N, Alzahrani AR, Al-Ghamdi SS, Eid SY. The use of the nutritional supplements during the covid-19 outbreak in Saudi Arabia: A cross-sectional study. Complement Ther Med 2023; 72:102917. [PMID: 36632904 PMCID: PMC9827747 DOI: 10.1016/j.ctim.2023.102917] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 12/31/2022] [Accepted: 01/04/2023] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND COVID-19 causes moderate to severe illness and is spreading globally. During a pandemic, vitamins and minerals are vital to health. Therefore, the prevalence and epidemiology of supplement use in Saudi Arabia during the COVID-19 pandemic must be known. METHODS This cross-sectional study was conducted in Saudi Arabia using an online survey. The study was conducted from June to March 2022 on both adults and children. The link to the survey was shared on social media platforms. The survey included questions on participants' demographics, vaccination status, supplements they used, and side effects of supplements. Participation in this study was optional, and there was no obligation to participate. There was a declaration about the aim of the study and different objectives before starting the survey. RESULTS The present study reported that most of the participants reported that they used vitamin C (64.6 %), zinc (51.9 %), multivitamins (46.1 %), black seeds (26.7 %), garlic (Allium sativum) (15.4 %), omega-3 (22.1 %), vitamin D (22.2 %), echinacea (10.1 %), manuka honey (26.0 %), curcumin (13.6 %), ginger (22.5 %), royal jelly (12.9 %), and propolis (7.5 %) before and during the COVID-19 pandemic period. These supplements were used more frequently by subjects during the pandemic than before. DISCUSSION AND CONCLUSION The respondents' risk of these supplements' use may partially reflect the public's behavioral response during a pandemic. Future studies can document the health beliefs and motivations of nutritional supplement users.
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Affiliation(s)
- Nada Mohammed Hafiz
- Department of Pharmacology and Toxicology, Faculty of Medicine, Umm Al-Qura University, Al Abdeyah, Makkah 24381, Saudi Arabia; Saudi Toxicology Society, Umm Al-Qura University, Makkah, Saudi Arabia; Nahdi Medical Company, Saudi Arabia
| | - Mahmoud Zaki El-Readi
- Department of Biochemistry, Faculty of Medicine, Umm Al-Qura University, Al Abdeyah, Makkah 24381, Saudi Arabia; Biochemistry Department, Faculty of Pharmacy, Al-Azhar University, Assuit 71524, Egypt.
| | - Ghada Esheba
- Department of Pathology, Faculty of Medicine, Umm Al-Qura University, Al Abdeyah, Makkah 24381, Saudi Arabia; Department of Pathology, Faculty of Medicine, Tanta University, Egypt
| | - Mohammad Althubiti
- Department of Biochemistry, Faculty of Medicine, Umm Al-Qura University, Al Abdeyah, Makkah 24381, Saudi Arabia
| | - Nahla Ayoub
- Department of Pharmacology and Toxicology, Faculty of Medicine, Umm Al-Qura University, Al Abdeyah, Makkah 24381, Saudi Arabia; Saudi Toxicology Society, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Abdullah R Alzahrani
- Department of Pharmacology and Toxicology, Faculty of Medicine, Umm Al-Qura University, Al Abdeyah, Makkah 24381, Saudi Arabia; Saudi Toxicology Society, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Saeed S Al-Ghamdi
- Department of Pharmacology and Toxicology, Faculty of Medicine, Umm Al-Qura University, Al Abdeyah, Makkah 24381, Saudi Arabia; Saudi Toxicology Society, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Safaa Yehia Eid
- Department of Biochemistry, Faculty of Medicine, Umm Al-Qura University, Al Abdeyah, Makkah 24381, Saudi Arabia.
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Wiedeman AM, Dhillon AK, Wu BT, Innis SM, Elango R, Devlin AM. Children Aged 5-6 Years in Vancouver, Canada Meet Dietary Recommendations for Folate and Vitamin B12 but not Choline. J Nutr 2023; 153:197-207. [PMID: 36913454 DOI: 10.1016/j.tjnut.2022.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 10/17/2022] [Accepted: 11/14/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Choline, folate, and vitamin B12 are required for growth and development, but there is limited information on the intakes and relationships to biomarkers of status in children. OBJECTIVES The objective of this study was to determine the choline and B-vitamin intakes and relationship to biomarkers of status in children. METHODS A cross-sectional study was conducted in children (n = 285, aged 5-6 y) recruited from Metro Vancouver, Canada. Dietary information was collected by using 3 24-h recalls. Nutrient intakes were estimated by using the Canadian Nutrient File and United States Department of Agriculture database for choline. Supplement information was collected by using questionnaires. Plasma biomarkers were quantified by using mass spectrometry and commercial immunoassays, and relationships to dietary and supplement intake were determined by using linear models. RESULTS Daily dietary intakes of choline, folate, and vitamin B12 were [mean (SD)] 249 (94.3) mg, 330 (120) DFE μg, and 3.60 (1.54) μg, respectively. Top food sources of choline and vitamin B12 were dairy, meats, and eggs (63%-84%) and for folate, were grains, fruits, and vegetables (67%). More than half of the children (60%) were consuming a supplement containing B-vitamins, but not choline. Only 40% of children met the choline adequate intake (AI) recommendation for North America (≥250 mg/d); 82% met the European AI (≥170 mg/d). Less than 3% of children had inadequate folate and vitamin B12 total intakes. Some children (5%) had total folic acid intakes above the North American tolerable upper intake level (UL; >400 μg/d); 10% had intakes above the European UL (>300 μg/d). Dietary choline intake was positively associated with plasma dimethylglycine, and total vitamin B12 intake was positively associated with plasma B12 (adjusted models; P < 0.001). CONCLUSIONS These findings suggest that many children are not meeting the dietary choline recommendations, and some children may have excessive folic acid intakes. The impact of imbalanced one-carbon nutrient intakes during this active period of growth and development requires further investigation.
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Affiliation(s)
- Alejandra M Wiedeman
- Department of Pediatrics, The University of British Columbia and BC Children's Hospital Research Institute, Vancouver, Canada
| | - Amneet K Dhillon
- Department of Pediatrics, The University of British Columbia and BC Children's Hospital Research Institute, Vancouver, Canada
| | - Brian T Wu
- Department of Pediatrics, The University of British Columbia and BC Children's Hospital Research Institute, Vancouver, Canada
| | - Sheila M Innis
- Department of Pediatrics, The University of British Columbia and BC Children's Hospital Research Institute, Vancouver, Canada
| | - Rajavel Elango
- Department of Pediatrics, The University of British Columbia and BC Children's Hospital Research Institute, Vancouver, Canada
| | - Angela M Devlin
- Department of Pediatrics, The University of British Columbia and BC Children's Hospital Research Institute, Vancouver, Canada.
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Parmenter BH, Bumrungpert A, Thouas GA. Sociodemographic factors and parental views associated with use of an omega-3 supplement for their children. PHARMANUTRITION 2022. [DOI: 10.1016/j.phanu.2022.100289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Pilot study of dietary supplement consumption by kindergarten and elementary school children. HERBA POLONICA 2021. [DOI: 10.2478/hepo-2021-0017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Summary
Introduction: The use of dietary supplements has been increasing globally, especially among children. A lot of parents are influenced by advertising. In addition, in Poland a trend to self-medication has been observed. Parents often do not distinguish dietary supplements, medicinal products and non-prescription drugs. These are the most common reasons for the increase in sales of dietary supplements in Poland. Until a few years ago, many products containing vitamins and minerals intended for children were sold as medicines. Today, a product with the same formulation is sold as a dietary supplement. However, a few studies have been conducted to assess the use of dietary supplements among Polish children.
Objective: The aim of the study was to analyse the use of dietary supplements provided by parents and the study of the awareness of the risks associated with supplements intake among preschool and elementary school students.
Methods: The study was conducted by questionnaire method among 316 parents/legal guardians of children attending elementary schools and preschools in three provinces.
Results: The questionnaire was completed by 88.3% mothers and 11.7% fathers. The age of the respondents was as follows: 64.5% aged 31–40, 18.3% aged 41–45, 9.5% aged 26–30, 7.2% above 46 years and only 0.3% younger than 25. About 80% of parents administered their children with dietary supplements in specific situations. Vitamin and mineral supplements were predominant. A statistical analysis showed the effect of the education level as well as having many children on the administration of dietary supplements.
Conclusion: The questionnaire shows that the vast majority of parents/legal guardians administer their children with dietary supplements. There is a need to educate parents/legal guardians about the use of supplements and the risks involved.
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Beneficial Effects of Plant Extracts and Bioactive Food Components in Childhood Supplementation. Nutrients 2021; 13:nu13093157. [PMID: 34579034 PMCID: PMC8464764 DOI: 10.3390/nu13093157] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/06/2021] [Accepted: 09/07/2021] [Indexed: 02/07/2023] Open
Abstract
The pivotal role of childhood nutrition has always roused a growing interest from the scientific community. Plant extracts and bioactive dietary components play a significant role in the maintenance of human health and wellness, with the potential to modulate risk factors and manage symptoms for a large number of common childhood disorders such as memory impairment, respiratory illnesses, gastrointestinal disorders, metabolic derangements, and pathologies related to the oral cavity. This review is designed to highlight the health benefits of botanical extracts and bioactive dietary components in children as evidenced by clinical trials, considering their safety with regards to childhood sensibilities. The supplementation of children with the herbal extracts or bioactive components mentioned in this review leads to the conclusion that they are useful for treating various ailments, with no serious adverse events being reported. However, for the limited number of investigations specifically focused on the safety of such products in children, time is needed to expand the literature data covering the safety of childhood supplementation with botanical extract and bioactive food components.
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Barrack MT, Sassone J, Dizon F, Wu AC, DeLuca S, Ackerman KE, Tenforde AS. Dietary Supplement Intake and Factors Associated with Increased Use in Preadolescent Endurance Runners. J Acad Nutr Diet 2021; 122:573-582. [DOI: 10.1016/j.jand.2021.07.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 07/23/2021] [Accepted: 07/26/2021] [Indexed: 01/09/2023]
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Finch SL, Rosenberg AM, Kusalik AJ, Maleki F, Rezaei E, Baxter-Jones A, Benseler S, Boire G, Cabral D, Campillo S, Chédeville G, Chetaille AL, Dancey P, Duffy C, Duffy KW, Guzman J, Houghton K, Huber AM, Jurencak R, Lang B, Laxer RM, Morishita K, Oen KG, Petty RE, Ramsey SE, Roth J, Schneider R, Scuccimarri R, Stringer E, Tse SML, Tucker LB, Turvey SE, Szafron M, Whiting S, Yeung RS, Vatanparast H. Higher concentrations of vitamin D in Canadian children with juvenile idiopathic arthritis compared to healthy controls are associated with more frequent use of vitamin D supplements and season of birth. Nutr Res 2021; 92:139-149. [PMID: 34311227 DOI: 10.1016/j.nutres.2021.05.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 05/05/2021] [Accepted: 05/23/2021] [Indexed: 10/21/2022]
Abstract
A number of studies have demonstrated that patients with autoimmune disease have lower levels of vitamin D prompting speculation that vitamin D might suppress inflammation and immune responses in children with juvenile idiopathic arthritis (JIA). The objective of this study was to compare vitamin D levels in children with JIA at disease onset with healthy children. We hypothesized that children and adolescents with JIA have lower vitamin D levels than healthy children and adolescents. Data from a Canadian cohort of children with new-onset JIA (n= 164, data collection 2007-2012) were compared to Canadian Health Measures Survey (CHMS) data (n=4027, data collection 2007-2011). We compared 25-hydroxy vitamin D (25(OH)D) concentrations with measures of inflammation, vitamin D supplement use, milk intake, and season of birth. Mean 25(OH)D level was significantly higher in patients with JIA (79 ± 3.1 nmol/L) than in healthy controls (68 ± 1.8 nmol/L P <.05). Patients with JIA more often used vitamin D containing supplements (50% vs. 7%; P <.05). The prevalence of 25(OH)D deficiency (<30 nmol/L) was 6% for both groups. Children with JIA with 25(OH)D deficiency or insufficiency (<50 nmol/L) had higher C-reactive protein levels. Children with JIA were more often born in the fall and winter compared to healthy children. In contrast to earlier studies, we found vitamin D levels in Canadian children with JIA were higher compared to healthy children and associated with more frequent use of vitamin D supplements. Among children with JIA, low vitamin D levels were associated with indicators of greater inflammation.
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Affiliation(s)
- Sarah L Finch
- University of Saskatchewan, Saskatoon, Canada; University of Prince Edward Island, Charlottetown, Canada
| | | | | | | | | | | | - Susanne Benseler
- Alberta Children's Hospital, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | | | - David Cabral
- BC Children's Hospital and The University of British Columbia, Vancouver, Canada
| | | | | | | | - Paul Dancey
- Janeway Children's Health and Rehabilitation Centre, St. John's, Canada
| | - Ciaran Duffy
- Children's Hospital of Eastern Ontario, Ottawa, Canada
| | | | - Jaime Guzman
- BC Children's Hospital and The University of British Columbia, Vancouver, Canada
| | - Kristin Houghton
- BC Children's Hospital and The University of British Columbia, Vancouver, Canada
| | - Adam M Huber
- IWK Health Centre and Dalhousie University, Halifax, Canada
| | | | - Bianca Lang
- IWK Health Centre and Dalhousie University, Halifax, Canada
| | - Ron M Laxer
- The University of Toronto and The Hospital for Sick Children, Toronto, Canada
| | - Kimberly Morishita
- BC Children's Hospital and The University of British Columbia, Vancouver, Canada
| | - Kiem G Oen
- University of Manitoba, Winnipeg, Canada
| | - Ross E Petty
- BC Children's Hospital and The University of British Columbia, Vancouver, Canada
| | | | - Johannes Roth
- Children's Hospital of Eastern Ontario, Ottawa, Canada
| | - Rayfel Schneider
- The University of Toronto and The Hospital for Sick Children, Toronto, Canada
| | | | | | - Shirley M L Tse
- The University of Toronto and The Hospital for Sick Children, Toronto, Canada
| | - Lori B Tucker
- BC Children's Hospital and The University of British Columbia, Vancouver, Canada
| | - Stuart E Turvey
- BC Children's Hospital and The University of British Columbia, Vancouver, Canada
| | | | | | - Rae Sm Yeung
- The University of Toronto and The Hospital for Sick Children, Toronto, Canada
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14
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Ishitsuka K, Sasaki S, Mezawa H, Konishi M, Igarashi M, Yamamoto-Hanada K, Nakayama SF, Ohya Y. Dietary supplement use in elementary school children: a Japanese web-based survey. Environ Health Prev Med 2021; 26:63. [PMID: 34090343 PMCID: PMC8180069 DOI: 10.1186/s12199-021-00985-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 05/26/2021] [Indexed: 11/13/2022] Open
Abstract
Background A variety of dietary supplements are commercially available. However, the efficacy and safety of dietary supplement use in children are not well established. Understanding dietary supplement use is important for developing public health policy regarding dietary supplements. This study aimed to investigate the types of dietary supplements used and characteristics of dietary supplement users among Japanese elementary school children. Method We conducted a cross-sectional web-based questionnaire study. Dietary supplement use, socio-demographics, and health-related behaviors were assessed through mother-reported questionnaire. Types of dietary supplements were identified based on ingredient using product barcodes and brand names. Multivariate logistic regression analysis was conducted to investigate the socio-demographics and health-related behaviors associated with supplement use. Results Among 4933 children, 333 (6.8%) were identified as dietary supplement users. The most common supplement was amino acids or protein (1.4%), followed by n–3 fatty acids or fish oil (1.0%), probiotics (1.0%), multivitamins (0.9%), multivitamin-minerals (0.8%), and botanicals (0.8%). Overall, any dietary supplement use was significantly associated with the highest frequency of sports participation (odds ratio [OR], 2.58; 95% confidence interval [CI], 1.65–4.02), highest household income (OR, 1.87; 95% CI, 1.13–3.10), highest maternal educational level (OR, 1.82; 95% CI, 1.31–2.52), and male sex (OR, 1.38; 95% CI, 1.09–1.75). The highest frequency of sports participation was significantly associated with higher odds of use of amino acids or protein (OR, 6.06; 95% CI, 1.78–20.6) and multivitamins (OR, 3.56; 95% CI, 1.11–11.5), compared to the lowest frequency of sports participation. Conclusion This study showed that Japanese children primarily use non-vitamin, non-mineral supplements. Non-vitamin, non-mineral supplements should thus be included in future studies aimed at monitoring dietary supplement use. We also found that dietary supplement use in children was associated with sports participation. Guidelines for dietary supplement use for children, in particular sport participants, are needed. Supplementary Information The online version contains supplementary material available at 10.1186/s12199-021-00985-7.
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Affiliation(s)
- Kazue Ishitsuka
- Medical Support Center for the Japan Environment and Children's Study, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan. .,Department of Social and Preventive Epidemiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8654, Japan.
| | - Satoshi Sasaki
- Department of Social and Preventive Epidemiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8654, Japan.,Department of Social and Preventive Epidemiology, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8654, Japan
| | - Hidetoshi Mezawa
- Medical Support Center for the Japan Environment and Children's Study, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan
| | - Mizuho Konishi
- Medical Support Center for the Japan Environment and Children's Study, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan
| | - Maki Igarashi
- Department of Molecular Endocrinology, National Research Institute for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan
| | - Kiwako Yamamoto-Hanada
- Medical Support Center for the Japan Environment and Children's Study, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan
| | - Shoji F Nakayama
- Centre for Health and Environmental Risk Research, National Institute for Environmental Studies, 16-2 Onogawa, Tsukuba, 305-8506, Japan
| | - Yukihiro Ohya
- Medical Support Center for the Japan Environment and Children's Study, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan
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15
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Panjwani AA, Cowan AE, Jun S, Bailey RL. Trends in Nutrient- and Non-Nutrient-Containing Dietary Supplement Use among US Children from 1999 to 2016. J Pediatr 2021; 231:131-140.e2. [PMID: 33340548 PMCID: PMC8005463 DOI: 10.1016/j.jpeds.2020.12.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 10/20/2020] [Accepted: 12/11/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVES To characterize dietary supplement use among US children, including product type, motivations, user characteristics, and trends over time with a primary focus on non-vitamin/non-mineral dietary supplements (NVNM). STUDY DESIGN Overall, NVNM, and vitamin and/or mineral dietary supplement only (VM-only) use; motivations for use; and trends in use over time were examined in children (≤19 years of age) using the National Health and Nutrition Examination Survey 1999-2016 data (n = 42 510). RESULTS Between 1999 and 2016, overall dietary supplement and VM-only dietary supplement use among all children remained relatively stable at ∼30%; yet, NVNM dietary supplement use increased from 2.9% to 6.4%, mainly due to increased use of omega-3 polyunsaturated fatty acids. NVNM use was greater in boys than in girls (3.9% vs 3.3%), and greater in older children than in younger children (Ptrend < .0001), the opposite of what was observed with VM-only dietary supplement use. Although both user groups shared 2 primary motivations, both motivations were reported by a significantly greater percent of vitamin and/or mineral dietary supplement users vs NVNM users: to maintain health (38.7% vs 23.1%) and to improve health (33.1% vs 22.6%). NVNM users were much more likely to use dietary supplement for relaxation, stress, and sleep; for mental health; and for colon and bowel health. CONCLUSIONS Although the prevalence of any dietary supplement and VM-only dietary supplement use among US children has both remained stable, the prevalence of NVNM use has increased substantially over time. Yet, NVNM use remains relatively low overall. NVNM use exhibited different patterns by sex, age, and motivations when compared with vitamin and/or mineral dietary supplement use. Despite increasing NVNM use, high-quality evidence supporting their use is lacking, especially in children.
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Affiliation(s)
- Anita A. Panjwani
- Department of Nutrition Science, Purdue University, West Lafayette, IN 47907, USA
| | - Alexandra E. Cowan
- Department of Nutrition Science, Purdue University, West Lafayette, IN 47907, USA
| | - Shinyoung Jun
- Department of Nutrition Science, Purdue University, West Lafayette, IN 47907, USA
| | - Regan L. Bailey
- Department of Nutrition Science, Purdue University, West Lafayette, IN 47907, USA
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Zisman CR, Patti MA, Kalb LG, Stapp EK, Van Eck K, Volk H, Holingue C. Complementary and Alternative Medicine Use in Children with a Developmental Disability and Co-occurring Medical Conditions. Complement Ther Med 2020; 53:102527. [PMID: 33066848 DOI: 10.1016/j.ctim.2020.102527] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 07/20/2020] [Accepted: 07/20/2020] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE The primary aim of this study was to evaluate differences in the prevalence of complementary and alternative medicine (CAM) usage among children with and without developmental disabilities (DD). Secondarily, the association between CAM usage and comorbid chronic medical conditions was explored among children with DD. DESIGN Data come from the 2012 Child Complementary and Alternative Medicine Supplement of the National Health Interview Survey, a nationally representative sample of children in the United States between the ages of 4 and 17 (n = 10,218).Main outcome measures Multiple logistical regression models provided insight into the relationships between parent-report CAM usage, DD, and chronic medical conditions. RESULTS Children with developmental disabilities were more likely to use CAMs compared to their typically developing peers (21% vs 16%). Children with DDs and comorbid chronic medical conditions used CAMs at even higher rates (23% vs 18%). CONCLUSIONS Results indicated that children with DD, especially those with a co-occurring chronic medical condition, use CAMs more often that typically developing children. Given scarcity of information on safety and effectiveness, clinical providers need to be alert to which children may be more likely to be exposed to CAMs. Communication between parents and providers needs to include discussion of CAM treatments.
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Affiliation(s)
- Corina R Zisman
- Section on the Neurobiology of Fear and Anxiety, National Institute of Mental Health, 9000 Rockville Pike, Bethesda, MD, 20892, United States.
| | - Marisa A Patti
- Department of Epidemiology, Brown University School of Public Health, 121 S Main St, Providence, RI 02903, United States
| | - Luther G Kalb
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, 624 N Broadway, Baltimore, MD, 21205, United States; Wendy Klag Center for Autism and Developmental Disabilities, Bloomberg School of Public Health, Johns Hopkins University, 615 N Wolfe St, Baltimore, MD, 21205, United States; Department of Neuropsychology, Kennedy Krieger Institute, 1750 E Fairmount Ave, Baltimore, MD, 21231, United States
| | - Emma K Stapp
- Genetic Epidemiology Branch, Intramural Research Program, National Institute of Mental Health, 35 Convent Drive MSC 3720, Bldg. 35A, Bethesda, MD 20892-3720, United States
| | - Kathryn Van Eck
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, 1800 Orleans Street, Baltimore, MD 21287, United States; Department of Psychiatry, Kennedy Krieger Institute, 1741 Ashland Ave, Baltimore, MD, 21205, United States
| | - Heather Volk
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, 624 N Broadway, Baltimore, MD, 21205, United States; Wendy Klag Center for Autism and Developmental Disabilities, Bloomberg School of Public Health, Johns Hopkins University, 615 N Wolfe St, Baltimore, MD, 21205, United States
| | - Calliope Holingue
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, 624 N Broadway, Baltimore, MD, 21205, United States; Wendy Klag Center for Autism and Developmental Disabilities, Bloomberg School of Public Health, Johns Hopkins University, 615 N Wolfe St, Baltimore, MD, 21205, United States; Department of Neuropsychology, Kennedy Krieger Institute, 1750 E Fairmount Ave, Baltimore, MD, 21231, United States
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17
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What Do Polish Parents and Caregivers Think ofDietary Supplements for Children Aged 3-12? Nutrients 2020; 12:nu12103076. [PMID: 33050235 PMCID: PMC7600402 DOI: 10.3390/nu12103076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 10/02/2020] [Accepted: 10/03/2020] [Indexed: 12/19/2022] Open
Abstract
Background: The aim of this study was to specify the amounts and the types of dietary supplements (DS) taken by children and define the attitudes of caregivers towards DS and towards administering them to children aged 3–12. An analysis of the reasons for using DSs, and of expected benefits and awareness of health risks associated with administering DSs, was conducted. Methods: The online questionnaire collected information on sociodemographic characteristics and use of dietary supplements. Multiple analyses were used to describe the relationship between demographic factors and dietary supplement intake. In particular cases, strength and correlation were also calculated. Results: In total, 54.89% of participants were administering dietary supplements to children at the time of completing the questionnaire—a weak linear relationship (Cramer’s V = 0.21) between child’s age and the child taking dietary supplements. Respondents for whom DSs are equivalents of medicines tend not to see that dietary supplements may cause side-effects and interact. Conclusions: Parents who administer dietary supplements to children show a tendency to have more trust in this type of product than the people who do not do so. It was also confirmed that the people who take dietary supplements transfer their behavioral patterns by also administering them to their children.
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Reliability of Self-Administered Questionnaire on Dietary Supplement Consumption in Malaysian Adolescents. Nutrients 2020; 12:nu12092853. [PMID: 32957625 PMCID: PMC7551120 DOI: 10.3390/nu12092853] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 09/15/2020] [Accepted: 09/16/2020] [Indexed: 11/20/2022] Open
Abstract
The repeatability of most questionnaires utilized in previous studies related to the consumption of dietary supplements (DS) among youth has not been well documented. Thus, a simple and easy-to-administer questionnaire to capture the habitual use of DS in the past one year known as the dietary supplement questionnaire (DiSQ) was developed and supported with external reliability evaluation. Analyses were done based on a convenience sample of 46 secondary school students. To elicit information regarding the intake of DS, the questionnaire was partitioned into two domains. The first domain was used to identify vitamin/mineral (VM) supplements, while the second domain was utilized to identify non-vitamin/non-mineral (NVNM) supplements. Cohen’s kappa coefficient (k) was used to evaluate the test–retest reliability of the questionnaire. Questionnaire administration to the respondents was done twice whereby a retest was given two weeks after the first test. Between test and retest, the reliability of individual items ranged from moderate to almost perfect for the VM (k = 0.53–1.00) and NVNM (k = 0.63–1.00) domains. None of the items had “fair” or ”poor” agreement. Various correlation coefficients can be obtained for the DiSQ but are generally reliable over time for assessing information on the consumption of supplements among the adolescent population.
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Babinska K, Celusakova H, Belica I, Szapuova Z, Waczulikova I, Nemcsicsova D, Tomova A, Ostatnikova D. Gastrointestinal Symptoms and Feeding Problems and Their Associations with Dietary Interventions, Food Supplement Use, and Behavioral Characteristics in a Sample of Children and Adolescents with Autism Spectrum Disorders. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E6372. [PMID: 32882981 PMCID: PMC7503400 DOI: 10.3390/ijerph17176372] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 08/21/2020] [Accepted: 08/28/2020] [Indexed: 12/12/2022]
Abstract
Autism spectrum disorders (ASD) are characterized by impairments in social interaction, communication, and restricted, stereotyped behavior. Gastrointestinal (GI), nutritional, and feeding problems are often reported in ASD. We investigated the prevalence of GI symptoms, food selectivity, and mealtime difficulties, and their associations with dietary interventions, food supplement use, and behavioral characteristics in a sample involving 247 participants with ASD and 267 controls aged 2-18 years. Data were collected by a questionnaire. GI symptoms were observed in 88.9% of children and adolescents with ASD, more often in girls than in boys. High rates of food selectivity (69.1%) and mealtime problems (64.3%) were found. Food supplements were used by 66.7% of individuals, mainly vitamins/minerals, probiotics, and omega-3 fatty acids. In the ASD sample, 21.2% of subjects followed a diet, mostly based on gluten and milk restriction, including individuals exhibiting food selectivity. Frequency of GI symptoms, food selectivity, and mealtime problems correlated weakly, but significantly with behavioral characteristics in the ASD group, but not with food supplement use. The study demonstrated that higher frequency of GI symptoms, food selectivity, and mealtime problems are a common problem in pre-schoolers, schoolchildren, and adolescents with ASD, and together with dietary modification, they are significantly associated with ASD.
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Affiliation(s)
- Katarina Babinska
- Academic Research Centre for Autism, Institute of Physiology, Faculty of Medicine in Bratislava, Comenius University, 813 72 Bratislava, Slovakia; (H.C.); (I.B.); (Z.S.); (D.N.); (A.T.); (D.O.)
| | - Hana Celusakova
- Academic Research Centre for Autism, Institute of Physiology, Faculty of Medicine in Bratislava, Comenius University, 813 72 Bratislava, Slovakia; (H.C.); (I.B.); (Z.S.); (D.N.); (A.T.); (D.O.)
| | - Ivan Belica
- Academic Research Centre for Autism, Institute of Physiology, Faculty of Medicine in Bratislava, Comenius University, 813 72 Bratislava, Slovakia; (H.C.); (I.B.); (Z.S.); (D.N.); (A.T.); (D.O.)
| | - Zofia Szapuova
- Academic Research Centre for Autism, Institute of Physiology, Faculty of Medicine in Bratislava, Comenius University, 813 72 Bratislava, Slovakia; (H.C.); (I.B.); (Z.S.); (D.N.); (A.T.); (D.O.)
| | - Iveta Waczulikova
- Department of Nuclear Physics and Biophysics, Faculty of Mathematics, Physics and Informatics, Comenius University, 842 48 Bratislava, Slovakia;
| | - Dagmar Nemcsicsova
- Academic Research Centre for Autism, Institute of Physiology, Faculty of Medicine in Bratislava, Comenius University, 813 72 Bratislava, Slovakia; (H.C.); (I.B.); (Z.S.); (D.N.); (A.T.); (D.O.)
- Gastroenterology Centre ASSIDUO, 811 08 Bratislava, Slovakia
| | - Aleksandra Tomova
- Academic Research Centre for Autism, Institute of Physiology, Faculty of Medicine in Bratislava, Comenius University, 813 72 Bratislava, Slovakia; (H.C.); (I.B.); (Z.S.); (D.N.); (A.T.); (D.O.)
| | - Daniela Ostatnikova
- Academic Research Centre for Autism, Institute of Physiology, Faculty of Medicine in Bratislava, Comenius University, 813 72 Bratislava, Slovakia; (H.C.); (I.B.); (Z.S.); (D.N.); (A.T.); (D.O.)
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Sweetening Agents and Sweeteners in Dietary Supplements for Children-Analysis of the Polish Market. Nutrients 2020; 12:nu12082387. [PMID: 32784924 PMCID: PMC7468995 DOI: 10.3390/nu12082387] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 07/31/2020] [Accepted: 08/06/2020] [Indexed: 12/31/2022] Open
Abstract
Sweetening agents (SA) and sweeteners are major additives used in the production of dietary supplements (DS), they fulfill both technological and organoleptic functions. The aim of this study is to identify the types of SA and sweeteners found in DS intended for children and to determine the secondary role of them. The study was performed on data from the documentation of representative samples of DS (N = 315) available on the Polish market. The results show that 75.24% of the products contained at least one SA or sweetener. Sucrose is the SA most frequently used in DS production. The empirical findings show that the type of sweetening ingredient correlates closely with the formulation of products, which in turn has to be suited to consumption abilities of the target group as well as to the children's taste requirements. The crucial need for analysis of the composition of DS is emphasized in the light of high consumption rates of these products as well as limited regulations and policy.
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Alfawaz H, Khan N, Almarshad A, Wani K, Aljumah MA, Khattak MNK, Al-Daghri NM. The Prevalence and Awareness Concerning Dietary Supplement Use among Saudi Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103515. [PMID: 32443434 PMCID: PMC7277864 DOI: 10.3390/ijerph17103515] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 05/13/2020] [Accepted: 05/15/2020] [Indexed: 12/13/2022]
Abstract
Current dietary supplement (DS) use among Saudi school students is not well described. In this study, we aim to investigate the prevalence and predictors of DS use among adolescents. This cross-sectional study collected data via self-administered questionnaire from 1221 students (12 to 18 years). The overall prevalence of DS use was 26.2%, significantly higher in females than males (33% vs. 17.9%, p < 0.001). High proportion of female DS users demonstrated normal BMI than males (84% vs. 56.5%, p < 0.001). High percentage of male DS users were engaged in vigorous and/or high physical activity (PA) levels than female DS users (58.2% vs. 43%, p = 0.022; and 57.1% vs. 20.7%, p < 0.001, respectively). The main reasons for DS use among females were vitamin deficiency (63.3%), hair condition (37.6%) and nail health (23.5%) while in males, the main reasons were vitamin deficiency (58.4%) and body building (34.4%). The predictors of DS use in Saudi adolescents included being female, having high family income and being physically active. In conclusion, the overall prevalence and preference of DS use, though low among Saudi adolescents, was driven mostly by gender, physical activity levels and socioeconomic factors like family income. DS use guidelines and counselling among Saudi adolescents are warranted to improve public health.
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Affiliation(s)
- Hanan Alfawaz
- College of Food Science & Agriculture, Department of Food Science & Nutrition, King Saud University, Riyadh 11495, Saudi Arabia;
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, King Saud University, Riyadh 11451, Saudi Arabia; (K.W.); (M.N.K.K.); (N.M.A.-D.)
- Correspondence: ; Tel.: +966-8055890
| | - Nasiruddin Khan
- College of Applied and Health Sciences, Department of Food Science and Human Nutrition, A’ Sharqiyah University, Ibra 400, Oman;
| | - Alwateen Almarshad
- College of Food Science & Agriculture, Department of Food Science & Nutrition, King Saud University, Riyadh 11495, Saudi Arabia;
| | - Kaiser Wani
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, King Saud University, Riyadh 11451, Saudi Arabia; (K.W.); (M.N.K.K.); (N.M.A.-D.)
| | - Muneerah A. Aljumah
- College of Medicine Medical Student, Almaarefa University, Riyadh 11597, Saudi Arabia;
| | - Malak Nawaz Khan Khattak
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, King Saud University, Riyadh 11451, Saudi Arabia; (K.W.); (M.N.K.K.); (N.M.A.-D.)
| | - Nasser M. Al-Daghri
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, King Saud University, Riyadh 11451, Saudi Arabia; (K.W.); (M.N.K.K.); (N.M.A.-D.)
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Szajewska H, Hojsak I. Health benefits of Lactobacillus rhamnosus GG and Bifidobacterium animalis subspecies lactis BB-12 in children. Postgrad Med 2020; 132:441-451. [DOI: 10.1080/00325481.2020.1731214] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Hania Szajewska
- Department of Paediatrics, The Medical University of Warsaw, Warsaw, Poland
| | - Iva Hojsak
- Referral Center for Pediatric Gastroenterology and Nutrition, Children’s Hospital Zagreb, Zagreb, Croatia
- Department of Pediatrics, School of Medicine, University of Zagreb, Zagreb, Croatia
- Department of Pediatrics, School of Medicine, University J.J. Strossmayer, Osijek, Croatia
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Kobayashi E, Sato Y, Nishijima C, Chiba T. Concomitant Use of Dietary Supplements and Medicines among Preschool and School-Aged Children in Japan. Nutrients 2019; 11:nu11122960. [PMID: 31817183 PMCID: PMC6950417 DOI: 10.3390/nu11122960] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 11/19/2019] [Accepted: 11/29/2019] [Indexed: 01/16/2023] Open
Abstract
Dietary supplement use is widespread amongst the general population including in children and adolescents. The ingredients in dietary supplements can interact with medicines when patients take them concomitantly. However, the prevalence of the concomitant use of dietary supplements and medicines in Japan among children remains unclear. To clarify this issue, a nationwide internet survey was administered to 55,038 mothers (25 to 60 years old) of preschool- or school-aged children in Japan. Among them, 7.6% currently provide dietary supplements and 3.2% concomitantly provide dietary supplements and prescription or over-the-counter medicines to their children. The prevalence of concomitant use increased with the children's grade. Among 1057 mothers with 1154 children who were concomitantly using dietary supplements and medicines, 69.1% provided dietary supplements without physician consultation because they considered dietary supplements as only foods and therefore safe. Although the purpose of the use and types of dietary supplement differed between boys and girls, the most popular product was probiotics in both boys and girls. Among concomitant users, 8.3% of mothers gave dietary supplements for treatment of diseases and 4.9% mothers recognized the adverse events of dietary supplements in their child. The findings of this study suggest that mothers' knowledge about the risk of using dietary supplement with medicines is insufficient. Parental education about the safety of dietary supplements and potential risk of drug-supplement interaction is needed.
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Determinants of taking dietary supplements in Iranian children and adolescents: the CASPIAN-V study. J Diabetes Metab Disord 2019; 18:409-417. [PMID: 31890666 DOI: 10.1007/s40200-019-00432-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Accepted: 08/08/2019] [Indexed: 12/31/2022]
Abstract
Aim Tendency for taking dietary supplements is dramatically increasing. However, limited studies exist in this regard. We aimed to assess the frequency and determinants of dietary supplement use among a nationally-representative sample of Iranian children and adolescents. Methods This population-based cross-sectional study (the CASPIAN V) was conducted in students aged 7 to 18 years old in 2015. Multistage, stratified cluster sampling method was used to select participants from thirty provinces in Iran. Data regarding taking vitamin and mineral supplements were collected. Demographic information, anthropometric indices, physical activity, screen time and body image were also evaluated. Multivariate logistic regression model was used for analyses. Results The prevalence of dietary supplements use was 34.1% and the most popular dietary supplement was Iron (12.9%). Multivariate logistic regression showed that boys (0.84, 95%CI: 0.78, 0.91) and body image perception (OR: 0.84, 95%CI: 0.75, 0.94) used less dietary supplements compared to others. Children aged 11 to 14 years (OR: 1.15, 95%CI: 1.06, 1.26) and those with moderate family socioeconomic status (OR: 1.12, 95%CI: 1.007, 1.25) used more supplement compared to other groups. Moreover, those with higher paternal educational level (OR: 0.77, 95%CI: 0.64, 0.93) used less supplements. However, living area, family size, paternal occupation, children BMI, Intended weight loss, and body image by student did not indicate any significant association. Conclusion Our findings indicated that about one-third of Iranian children and adolescents used dietary supplements; iron supplements were the most frequent ones. Children aged 11 to 14 years, those with higher educated mothers and moderate family socioeconomic status used more supplements compared to others. However, boys, children with excess weight and those with high-educated parents used less supplements compared to others. More studies are needed to clarify the efficacy and safety of dietary supplements in different age groups in various societies.
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Nishijima C, Kobayashi E, Sato Y, Chiba T. A Nationwide Survey of the Attitudes toward the Use of Dietary Supplements among Japanese High-School Students. Nutrients 2019; 11:E1469. [PMID: 31261616 PMCID: PMC6683252 DOI: 10.3390/nu11071469] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 06/25/2019] [Accepted: 06/26/2019] [Indexed: 12/15/2022] Open
Abstract
We previously studied the prevalence of dietary supplement use in Japanese high-school students by conducting a study on mothers. However, there is often a discrepancy between mothers' understanding and children's attitudes. Thus, we conducted an internet survey of high-school students to clarify their attitudes toward the use of dietary supplements. An invitation to the internet survey was e-mailed to registrants of a research company aged 15 to 18 years. A total of 1031 students (276 male, 755 female) answered the questionnaire on a first come, first served basis. The participants were classified according to the purchasers of their supplements: students who purchased supplements themselves were defined as active users, and others were defined as passive users. The prevalence of dietary supplement use was 30.8% in males and 26.7% in females. Among the users, 42.4% of males and 43.8% of females were active users. Males used supplements for health regardless of active or passive use. However, in females, more active users (40.9%) used supplements for weight loss than passive users (20.4%); the corresponding prevalence was 2.3% in our previous report on mothers' understanding of their daughters. The most frequently used source of information for active users was the internet, whereas for passive users it was family. The frequency of adverse events was 9.4% in males and 14.4% in females, with gastrointestinal symptoms being the most commonly experienced events. Our results suggest that dietary education, including healthy eating and the appropriate use of dietary supplements, should be provided to high-school students.
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Affiliation(s)
- Chiharu Nishijima
- 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
| | - Yoko Sato
- 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
| | - 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.
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Perlitz H, Mensink GBM, Lage Barbosa C, Richter A, Brettschneider AK, Lehmann F, Patelakis E, Frank M, Heide K, Haftenberger M. Use of vitamin and mineral supplements among adolescents living in Germany-Results from EsKiMo II. Nutrients 2019; 11:E1208. [PMID: 31141966 PMCID: PMC6627803 DOI: 10.3390/nu11061208] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 05/21/2019] [Accepted: 05/24/2019] [Indexed: 12/26/2022] Open
Abstract
Dietary supplements may contribute to nutrient intake; however, actual data on dietary supplement use among adolescents living in Germany are rare. The aim of this analysis was to describe the current use of dietary supplements, its determinants, and reasons of use. Changes in supplement use over time were evaluated by comparing the results with those from EsKiMo I (2006). Data from the Eating Study as a KiGGS Module EsKiMo II (2015-2017) were used to analyze supplement intake according to sociodemographic, health characteristics, and physical exercise behavior of 12-17-year-olds (n = 1356). Supplement use during the past four weeks was assessed by a standardized computer assisted personal interview. Multivariable logistic regression was used to identify the association between supplement use and its determinants. Between 2015-2017, 16.4% (95%-CI: 13.0-19.7%) of the adolescents used dietary supplements, and its use decreased with lower levels of physical exercise and overweight. Most supplement users used only one supplement, often containing both vitamins and minerals. The most frequently supplemented nutrients were vitamin C and magnesium. The main reported reason to use supplements was 'to improve health'. Prevalence of supplement use was slightly lower in 2015-2017 than in 2006 (18.5%; 95%-CI: 15.8-21.2%). The results underline the importance of including nutrient intake through dietary supplements in nutrition surveys.
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Affiliation(s)
- Hanna Perlitz
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, 12101 Berlin, Germany.
| | - Gert B M Mensink
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, 12101 Berlin, Germany.
| | - Clarissa Lage Barbosa
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, 12101 Berlin, Germany.
| | - Almut Richter
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, 12101 Berlin, Germany.
| | | | - Franziska Lehmann
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, 12101 Berlin, Germany.
| | - Eleni Patelakis
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, 12101 Berlin, Germany.
| | - Melanie Frank
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, 12101 Berlin, Germany.
| | - Karoline Heide
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, 12101 Berlin, Germany.
| | - Marjolein Haftenberger
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, 12101 Berlin, Germany.
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Awareness of the Consumption of Dietary Supplements among Students in a University in Saudi Arabia. J Nutr Metab 2019; 2019:4641768. [PMID: 31192009 PMCID: PMC6525940 DOI: 10.1155/2019/4641768] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 03/09/2019] [Accepted: 03/28/2019] [Indexed: 12/13/2022] Open
Abstract
The dietary supplement market in Saudi Arabia is growing alongside the number of Saudis consuming dietary supplements. It is therefore increasingly important for healthcare personnel to understand the consumption rate of dietary supplements, whether they are used wisely, and the know-how concerning their use and dosage. The purpose of this study was to clarify the overall awareness of dietary supplement consumption among female students of Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia. Using a descriptive approach, data were collected from 759 female students (mean age = 22.1 ± 1.7 years) via an electronic survey. All participants reported having consumed dietary supplements at some point, and 32.3% were taking them at the time of the survey. They took supplements primarily for aesthetic reasons (e.g., hair and skin health) and preferred purchasing supplements at pharmacies. Nearly all (89.9%) participants could define supplements correctly, and 43.6% reported that supplements improved health. More than half the sample believed that supplements are safe. While a large proportion of participants correctly identified the recommended number of daily servings of fruits and vegetables, relatively few actually consumed that recommended amount. More than one-third of participants consumed more than one type of supplement simultaneously, and more than half reported that they would use supplements when necessary in the future. The results of this study suggest a need for long-term studies on the consumption of nutritional supplements among Saudis and its impact on health.
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Different Socio-Demographic and Lifestyle Factors Can Determine the Dietary Supplement Use in Children and Adolescents in Central-Eastern Poland. Nutrients 2019; 11:nu11030658. [PMID: 30889923 PMCID: PMC6470763 DOI: 10.3390/nu11030658] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 03/12/2019] [Accepted: 03/13/2019] [Indexed: 12/31/2022] Open
Abstract
Vitamin/mineral supplement (VMS) use has become increasingly popular in children and adolescents; however, different predictors may be associated with their usage. Therefore, the aim of this study was to compare determinants of VMS use in 1578 children and adolescents. Data was collected among parents of children (≤12 years old) and among adolescents (>12 years old) who attended public schools by a self-administered questionnaire. Multivariate-adjusted logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs) for determining the predictors of VMS use. In children, the following determinants of VMS use were indicated: socioeconomic status (average vs. very good/good; OR: 1.69, 95% CI: 1.16–2.48), physical activity (1–5 vs. <1 h/week; OR: 1.44, 95% CI: 1.02–2.04), BMI (≥25 vs. 18.5–24.9 kg/m2; OR: 0.67, 95% CI: 0.46–0.98), and presence of chronic diseases (yes vs. no; OR: 2.32, 95% CI: 1.46–3.69). In adolescents, gender (male vs. female; OR: 0.56, 95% CI: 0.37–0.87), residential area (rural vs. urban; OR: 0.63, 95% CI: 0.40–0.99), BMI (<18.5 vs. 18.5–24.9 kg/m2; OR: 0.35, 95% CI: 0.17–0.73), and health status (average/poor vs. at least good; OR: 1.96, 95% CI: 1.13–3.39) were factors of VMS use. In both groups, the mother’s higher educational level, fortified food consumption and diet modification towards better food choices were predictors of VMS use. In conclusion, most of the predictors of VMS use were different in children and adolescents.
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Bailey RL, Dodd KW, Gahche JJ, Dwyer JT, Cowan AE, Jun S, Eicher-Miller HA, Guenther PM, Bhadra A, Thomas PR, Potischman N, Carroll RJ, Tooze JA. Best Practices for Dietary Supplement Assessment and Estimation of Total Usual Nutrient Intakes in Population-Level Research and Monitoring. J Nutr 2019; 149:181-197. [PMID: 30753685 PMCID: PMC6374152 DOI: 10.1093/jn/nxy264] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Revised: 09/12/2018] [Accepted: 09/20/2018] [Indexed: 12/14/2022] Open
Abstract
The use of dietary supplements (DS) is pervasive and can provide substantial amounts of micronutrients to those who use them. Therefore when characterizing dietary intakes, describing the prevalence of inadequacy or excess, or assessing relations between nutrients and health outcomes, it is critical to incorporate DS intakes to improve exposure estimates. Unfortunately, little is known about the best methods to assess DS, and the structure of measurement error in DS reporting. Several characteristics of nutrients from DS are salient to understand when comparing to those in foods. First, DS can be consumed daily or episodically, in bolus form and can deliver discrete and often very high doses of nutrients that are not limited by energy intakes. These characteristics contribute to bimodal distributions and distributions severely skewed to the right. Labels on DS often provide nutrient forms that differ from those found in conventional foods, and underestimate analytically derived values. Finally, the bioavailability of many nutrient-containing DS is not known and it may not be the same as the nutrients in a food matrix. Current methods to estimate usual intakes are not designed specifically to handle DS. Two temporal procedures are described to refer to the order that nutrient intakes are combined relative to usual intake procedures, referred to as a "shrinking" the distribution to remove random error. The "shrink then add" approach is preferable to the "add then shrink" approach when users and nonusers are combined for most research questions. Stratifying by DS before usual intake methods is another defensible option. This review describes how to incorporate nutrient intakes from DS to usual intakes from foods, and describes the available methods and fit-for-purpose of different analytical strategies to address research questions where total usual intakes are of interest at the group level for use in nutrition research and to inform policy decisions. Clinical Trial Registry: NCT03400436.
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Affiliation(s)
- Regan L Bailey
- Department of Nutrition Science, Purdue University, West Lafayette, IN,Address correspondence to RLB (e-mail: )
| | - Kevin W Dodd
- National Institutes of Health, National Cancer Institute, Rockville, MD
| | - Jaime J Gahche
- National Institutes of Health, Office of Dietary Supplements, Bethesda, MD
| | - Johanna T Dwyer
- National Institutes of Health, Office of Dietary Supplements, Bethesda, MD
| | - Alexandra E Cowan
- Department of Nutrition Science, Purdue University, West Lafayette, IN
| | - Shinyoung Jun
- Department of Nutrition Science, Purdue University, West Lafayette, IN
| | | | - Patricia M Guenther
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT
| | - Anindya Bhadra
- Department of Statistics, Purdue University, West Lafayette, IN
| | - Paul R Thomas
- National Institutes of Health, Office of Dietary Supplements, Bethesda, MD
| | - Nancy Potischman
- National Institutes of Health, Office of Dietary Supplements, Bethesda, MD
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Liu H, Zhang S, Zou H, Pan Y, Yang Q, Ouyang Y, Luo J, Lin Q. Dietary Supplement Use Among Chinese Primary School Students: A Cross-Sectional Study in Hunan Province. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16030374. [PMID: 30699949 PMCID: PMC6388182 DOI: 10.3390/ijerph16030374] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 01/25/2019] [Accepted: 01/27/2019] [Indexed: 12/20/2022]
Abstract
Dietary supplement use is increasing globally, especially among children. However, few studies have been conducted to examine dietary supplement use among Chinese children. The aim of this study was to examine the prevalence of dietary supplement use and the associated factors in primary school students. A cross-sectional study was conducted in four primary schools in Hunan province, China. A total of 706 Chinese parents/caregivers of school children aged 6–12 years old were enrolled. Self-administrated questionnaires were used to collect information about the children’s dietary supplement use, and their socio-demographic characteristics. The prevalence of dietary supplement use in primary school students was 20.4%. Calcium (16.7%), vitamin C (9.2%), and vitamin D (8.5%) were the most commonly used types of dietary supplement. The main reasons for parents/caregivers to purchase dietary supplements for their children were immunity improvement (43.6%), and for growth promotion (36.5%). Some caregivers (26.4%) purchased dietary supplements online, including from dubious or unknown sellers. However, 37.5% of caregivers did not receive formal guidance on supplementation even if they purchased their supplements through formal channels. Parents/caregivers were unclear about the appropriate choices for children’s dietary supplement use. Guidelines and counseling regarding dietary supplements for children may be helpful in public health work.
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Affiliation(s)
- Hanmei Liu
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Rd, Changsha 410078, China.
| | - Shiya Zhang
- Xiangya School of Public Health, Central South University, 110 Xiangya Rd, Changsha 410078, China.
| | - Hanshuang Zou
- Xiangya School of Public Health, Central South University, 110 Xiangya Rd, Changsha 410078, China.
| | - Yuanlin Pan
- Xiangya School of Public Health, Central South University, 110 Xiangya Rd, Changsha 410078, China.
| | - Qiping Yang
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Rd, Changsha 410078, China.
| | - Yufeng Ouyang
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Rd, Changsha 410078, China.
| | - Jing Luo
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Rd, Changsha 410078, China.
| | - Qian Lin
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 110 Xiangya Rd, Changsha 410078, China.
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Dietary Supplement Use among U.S. Children by Family Income, Food Security Level, and Nutrition Assistance Program Participation Status in 2011⁻2014. Nutrients 2018; 10:nu10091212. [PMID: 30200511 PMCID: PMC6163871 DOI: 10.3390/nu10091212] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 08/27/2018] [Accepted: 08/30/2018] [Indexed: 12/31/2022] Open
Abstract
This analysis characterizes use of dietary supplements (DS) and motivations for DS use among U.S. children (≤18 years) by family income level, food security status, and federal nutrition assistance program participation using the 2011⁻2014 National Health and Nutrition Examination Survey data. About one-third (32%) of children used DS, mostly multivitamin-minerals (MVM; 24%). DS and MVM use were associated with higher family income and higher household food security level. DS use was lowest among children in households participating in the Supplemental Nutrition Assistance Program (SNAP; 20%) and those participating in the Special Supplemental Nutrition Assistance Program for Women, Infants, and Children (WIC; 26%) compared to both income-eligible and income-ineligible nonparticipants. Most children who used DS took only one (83%) or two (12%) products; although children in low-income families took fewer products than those in higher income families. The most common motivations for DS and MVM use were to "improve (42% or 46%)" or "maintain (34 or 38%)" health, followed by "to supplement the diet (23 or 24%)" for DS or MVM, respectively. High-income children were more likely to use DS and MVM "to supplement the diet" than middle- or low-income children. Only 18% of child DS users took DS based on a health practitioner's recommendation. In conclusion, DS use was lower among children who were in low-income or food-insecure families, or families participating in nutrition assistance programs.
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Kobayashi E, Nishijima C, Sato Y, Umegaki K, Chiba T. The Prevalence of Dietary Supplement Use Among Elementary, Junior High, and High School Students: A Nationwide Survey in Japan. Nutrients 2018; 10:nu10091176. [PMID: 30154316 PMCID: PMC6164982 DOI: 10.3390/nu10091176] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 08/18/2018] [Accepted: 08/25/2018] [Indexed: 01/05/2023] Open
Abstract
The prevalence of dietary supplement use, such as vitamins, minerals, or fish oil, has increased among children in Japan; however, whether children are using dietary supplements appropriately remains unclear. This study aimed to determine dietary supplement use among children. In August 2017, a nationwide internet preliminary survey of 265,629 mothers aged from 25 to 59 years old was undertaken. Of these, 19,041 mothers of children attending either elementary school, junior high school, or high school were selected. Among them, 16.4% were currently providing their children with dietary supplements and 5.2% had previously given dietary supplements to their children. The prevalence of dietary supplement use was higher in boys than in girls, and the prevalence increased according to their grade. A total of 2439 participants were eligible to undertake a targeted survey on dietary supplement use. Dietary supplements were being taken to maintain health, supplement nutrients, and enhance growth in both boys and girls, and many children (37.5%) were provided with vitamin and mineral supplements. Mothers mainly obtained information concerning dietary supplements via the internet, and supplements were purchased in drug stores or via the internet. The prevalence of dietary supplement use in mothers was 65.4% and may be associated with the prevalence rates in children. Some mothers reported adverse events (3.6%) in their children, such as stomachache, diarrhea, nausea and vomiting, and constipation. The cause-and-effect relationships for adverse events were not clear, but some children were given products for adults. Children are more influenced by dietary supplements compared to adults. To prevent adverse events due to inappropriate use, parental education concerning dietary supplements is essential.
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Affiliation(s)
- 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.
| | - Chiharu Nishijima
- 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.
- Laboratory of Medical Chemistry, Graduate School of Nutrition Sciences, Kagawa Nutrition University, 3-9-21 Chiyoda, Sakado, Saitama 350-0288, Japan.
| | - Yoko Sato
- 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.
| | - Keizo Umegaki
- Department of Food Safety and Management, Showa Women's University; 1-7-57 Taishido, Setagaya-ku, Tokyo 154-8533, Japan.
| | - 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.
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Social determinants affecting the use of complementary and alternative medicine in Japan: An analysis using the conceptual framework of social determinants of health. PLoS One 2018; 13:e0200578. [PMID: 30011303 PMCID: PMC6047791 DOI: 10.1371/journal.pone.0200578] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 07/01/2018] [Indexed: 11/19/2022] Open
Abstract
This study aims to use the conceptual framework of social determinants of health (SDH) to elucidate the social determinants that affect the use of complementary and alternative medicine (CAM) from the perspectives of both intermediary and structural determinants. Data were derived from a survey mailed to 1,500 randomly selected residents (20–69 years old; May–July 2009) of Sendai city in Japan. A generalized linear model was used in the analysis, with CAM use over the past one month as the dependent variable, SDH structural and intermediary determinants as independent variables, and demographic characteristics, indicators of health status, and the evaluation of health or healthcare systems as control variables. The prevalence of CAM usage was 62.1%. The generalized linear model showed that middle subjective social status (OR = 1.47; 95% CI: 1.04–2.07) as structural determinants was significantly associated with CAM usage. Adding the intermediary determinants, the same effect was observed. When demographic characteristics, indicators of health status, and the evaluation of health or healthcare systems were introduced as control variables, the associations of the structural determinants disappeared, revealing that hope (OR = 1.25; 95%CI: 1.04–1.50) as intermediary determinants was associated with the use of CAM. Female sex (OR = 1.47; 95% CI: 1.02–2.12) and health anxiety (OR = 1.68; 95% CI: 1.20–2.34) were associated with CAM usage. We found that intermediary rather than structural determinants were associated with CAM usage. Hope as an intermediary determinant was particularly associated with CAM usage.
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Tsarouhas K, Kioukia-Fougia N, Papalexis P, Tsatsakis A, Kouretas D, Bacopoulou F, Tsitsimpikou C. Use of nutritional supplements contaminated with banned doping substances by recreational adolescent athletes in Athens, Greece. Food Chem Toxicol 2018; 115:447-450. [PMID: 29621580 DOI: 10.1016/j.fct.2018.03.043] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 03/29/2018] [Accepted: 03/30/2018] [Indexed: 01/03/2023]
Abstract
Although the use of nutritional supplements by adult athletes has been extensively studied, information on supplements consumption by adolescent athletes is still limited. The present study reports on the use of nutritional supplements contaminated with banned doping substances among 170 recreational adolescent athletes from eleven, randomly selected, gym centres, in Athens, Greece. Nutritional supplements consumption was reported by almost 60% of the study population, with proteins/amino acids and vitamins being the most popular. Nine per cent of the users were found to consume nutritional supplements contaminated with anabolic steroids, prohormones, selective androgen receptor modulators (SARMs) and aromatase inhibitors, all pharmacological substances with endocrine modulating properties not stated on the label. None of these individuals had previously consulted a physician or a nutritionist. A representative sample (ca 15%) of the protein/aminoacids and creatine preparations used by the study population were also tested and found free from doping substances. The majority (63%) of adolescents purchased products from the internet. In conclusion, exercising adolescents can have easy access to contaminated nutritional supplements and "black market" products, which could constitute a risk for public health. Low level of awareness and low involvement of medical care professionals among recreational adolescent athletes is also observed.
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Affiliation(s)
- Konstantinos Tsarouhas
- Department of Cardiology, University Hospital of Larissa, Mezourlo, Larissa 41110, Greece
| | - Nassia Kioukia-Fougia
- Doping Control Laboratory of Athens, OAKA "Sp.Louis", Kiffisias 37, Maroussi 15223, Greece
| | - Petros Papalexis
- Spiliopoulio General Hospital "Agia Eleni", 21st Dim. Soutsou Str., Ampelokipi, Athens 11521, Greece
| | - Aristidis Tsatsakis
- Department of Forensic Sciences and Toxicology, Faculty of Medicine, University of Crete, Heraklion 71003, Greece
| | - Dimitrios Kouretas
- Department of Biochemistry and Biotechnology, University of Thessaly, Larissa, Greece
| | - Flora Bacopoulou
- Center for Adolescent Medicine and UNESCO Chair on Adolescent Health Care, First Department of Pediatrics, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, Athens 11527, Greece
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Abstract
The published literature supports the high prevalence of supplement use in children and adolescents in the United States. Pediatricians today are faced with questions from parents and patients about the benefits, safety, efficacy, and correct dose of vitamins and minerals. In this article, we review 7 vitamins with the most clinical relevance as judged by abundance in food, risks and symptoms of deficiency, and potential for toxicity. Specifically, we focus on possible clinical scenarios that can be indicative of nutritional deficiency. We synthesize and summarize guidelines from nutrition experts, various medical societies, the World Health Organization, and the American Academy of Pediatrics.
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Affiliation(s)
- Liliane Diab
- Section of Nutrition, Department of Pediatrics, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO
| | - Nancy F Krebs
- Section of Nutrition, Department of Pediatrics, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO
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Ren. J, Brann. LS, Bruening. KS, Scerpella. TA, Dowthwaite. JN. Relationships among diet, physical activity, and dual plane dual-energy X-ray absorptiometry bone outcomes in pre-pubertalgirls. Arch Osteoporos 2017; 12:19. [PMID: 28197890 PMCID: PMC6376963 DOI: 10.1007/s11657-017-0312-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 01/13/2017] [Indexed: 02/03/2023]
Abstract
UNLABELLED In pre-pubertal girls, nutrient intakes and non-aquatic organized activity were evaluated as factors in vertebral body bone mass, structure, and strength. Activity, vitamin B12, and dietary fiber predicted bone outcomes most consistently. Exercise and vitamin B12 appear beneficial, whereas high fiber intake appears to be adverse for vertebral body development. PURPOSE Childhood development sets the baseline for adult fracture risk. Most studies evaluate development using postero-anterior (PA) dual-energy X-ray absorptiometry (DXA) areal bone mineral density, bone mineral content, and bone mineral apparent density. In a prior analysis, we demonstrated that PA DXA reflects posterior element properties, rather than vertebral body fracture sites, such that loading is associated with subtle differences in vertebral body geometry, not 3D density. The current analysis is restricted to pre-pubertal girls, for a focused exploration of key nutrient intakes and physical activity as factors in dual plane indices of vertebral body geometry, density, and strength. METHODS This cross-sectional analysis used paired PA and supine lateral (LAT) lumbar spine DXA scans to assess "3D" vertebral body bone mineral apparent density (PALATBMAD), "3D" index of structural strength in axial compression (PALATIBS), and fracture risk index (PALATFRI). Diet data were collected using the Youth/Adolescent Questionnaire (YAQ, 1995); organized physical activity was recorded via calendar-based form. Pearson correlations and backward stepwise multiple linear regression analyzed associations among key nutrients, physical activity, and bone outcomes. RESULTS After accounting for activity and key covariates, fiber, unsupplemented vitamin B12, zinc, carbohydrate, vitamin C, unsupplemented magnesium, and unsupplemented calcium intake explained significant variance for one or more bone outcomes (p < 0.05). After adjustment for influential key nutrients and covariates, activity exposure was associated with postero-anterior (PA) areal bone mineral density, PA bone mineral content, PA width, lateral (LAT) BMC, "3D" bone cross-sectional area (coronal plane), "3D" PALATIBS, and PALATFRI benefits (p < 0.05). CONCLUSIONS Physical activity, fiber intake, and unsupplemented B12 intake appear to influence vertebral body bone mass, density, geometry, and strength in well-nourished pre-pubertal girls; high fiber intakes may adversely affect childhood vertebral body growth.
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Affiliation(s)
- Jie Ren.
- Nutrition Science and Dietetics Program. Syracuse University. Address: 1645 Belleville Way #B, Sunnyvale, CA. 94087. Telephone number: (804)-432-2582.
| | - Lynn S. Brann.
- Nutrition Science and Dietetics Program. Syracuse University. Address: 550L White Hall, Syracuse, NY 13244. Telephone number: (315) 443-4805. Fax number: 315-443-9807
| | - Kay S. Bruening.
- Nutrition Science and Dietetics Program. Syracuse University. Address: 550L White Hall, Syracuse, NY 13244. Telephone number: (315) 443-9326. Fax number: 315-443-9807
| | - Tamara A. Scerpella.
- Department of Orthopedics and Rehabilitation. University of Wisconsin-Madison. Address: 1685 Highland Ave., 6 floor, Madison, WI 53705. Telephone number: (608) 263-5636.
| | - Jodi N. Dowthwaite.
- Department of Orthopedic Surgery, Upstate Medical University. Address: 750 East Adams Street, Syracuse, NY 13210. Telephone number: (315) 464-9981. Fax number: (315) 464-6638.
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O'Brien SK, Malacova E, Sherriff JL, Black LJ. The Prevalence and Predictors of Dietary Supplement Use in the Australian Population. Nutrients 2017; 9:E1154. [PMID: 29065492 PMCID: PMC5691770 DOI: 10.3390/nu9101154] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 10/12/2017] [Accepted: 10/18/2017] [Indexed: 12/31/2022] Open
Abstract
Current dietary supplement use in Australia is not well described. We investigated the prevalence and predictors of supplement use in the Australian population (n = 19,257) using data from the 2014-2015 National Health Survey. We reported the prevalence of supplement use by sex and age group and investigated the independent predictors of supplement use in adults, adolescents, and children using multiple logistic regression models. A total of 43.2% of adults (34.9% of males, 50.3% of females), 20.1% of adolescents (19.7% of males, 20.6% of females), and 23.5% of children (24.4% of males, 22.5% of females) used at least one dietary supplement in the previous two weeks. The most commonly used supplements were multivitamins and/or multiminerals and fish oil preparations. In adults, independent predictors of supplement use included being female, increasing age, being born outside Australia and other main English-speaking countries, having a higher education level, having a healthy BMI compared to those who were obese, being physically active, and being a non-smoker. To our knowledge, this is the first detailed investigation of dietary supplement use in a nationally-representative sample of the Australian population. Future studies investigating the contribution of supplements to overall dietary intakes of vitamins, minerals, and omega-3 fatty acids are warranted.
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Affiliation(s)
- Stacey K O'Brien
- School of Public Health, Curtin University, Bentley 6102, WA, Australia.
| | - Eva Malacova
- School of Public Health, Curtin University, Bentley 6102, WA, Australia.
| | - Jill L Sherriff
- School of Public Health, Curtin University, Bentley 6102, WA, Australia.
| | - Lucinda J Black
- School of Public Health, Curtin University, Bentley 6102, WA, Australia.
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Dwyer JT. The Best of Times. Annu Rev Nutr 2017; 37:33-49. [PMID: 28574804 DOI: 10.1146/annurev-nutr-071816-064932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
I came of age as a nutrition scientist during the best of times-years that spanned a rapidly changing world of food and nutrition science, politics, and policy that greatly broadened the specialty and its influence on public affairs. I followed the conventional route in academe, working my way up the academic ladder in Boston from a base first in a school of public health and later in a teaching hospital and medical school, interspersed with stints in Washington, DC. Thus I tell a tale of two cities. Those were the best of times because nutrition science and policy converged and led to important policies and programs that shaped the field for the next 50 years.
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Affiliation(s)
- Johanna T Dwyer
- Office of Dietary Supplements, National Institutes of Health, Bethesda, Maryland 20892; .,Schools of Medicine, Friedman School of Nutrition Science and Policy, and the Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts 02111
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Bieszczad B, Gilheany DG. Highly stereoselective construction of the C2 stereocentre of α-tocopherol (vitamin E) by asymmetric addition of Grignard reagents to ketones. Org Biomol Chem 2017; 15:6483-6492. [PMID: 28741644 DOI: 10.1039/c7ob00751e] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Tertiary alcohol precursors of both C2 diastereoisomers of α-tocopherol were prepared in three ways by our recently reported asymmetric Grignard synthesis. The versatility of Grignard chemistry inherent in its three-way disconnection was exploited to allow the synthesis of three product grades: 77 : 23 dr (5 steps), 81 : 19 dr (5 steps) and 96 : 4 dr (7 steps, one gram scale) from readily available and abundant starting materials. The products were converted to their respective α-tocopherols in 3 steps, which allowed a definitive re-assignment of their absolute configurations.
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Affiliation(s)
- Bartosz Bieszczad
- Centre for Synthesis and Chemical Biology, School of Chemistry, University College Dublin, Belfield, Dublin 4, Ireland.
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Frawley JE, Anheyer D, Davidson S, Jackson D. Prevalence and characteristics of complementary and alternative medicine use by Australian children. J Paediatr Child Health 2017; 53:782-787. [PMID: 28475224 DOI: 10.1111/jpc.13555] [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: 11/01/2016] [Revised: 12/21/2016] [Accepted: 02/28/2017] [Indexed: 12/27/2022]
Abstract
AIM This study was conducted to evaluate the use of complementary and alternative medicine (CAM) among Australian children within the previous 12 months. METHODS Parents with children up to the age of 18 years were recruited from online parenting groups. Questions addressed demographic factors, socio-economic status, conventional health service use, including vaccination status and use of CAM. RESULTS A total of 149 parents responded to the study of which 73.8% (n = 110) had taken their child to visit a CAM practitioner or given their child a CAM product in the previous 12 months. The two most frequently visited CAM practitioners were naturopath/herbalist (30.4%) and chiropractor (18.4%). The most commonly used products were vitamins/minerals (61.7%), and herbal medicine (38.8%). Children had also consulted with a general practitioner (89.8%), community health nurse (31.29%) and paediatrician (30.3%) over the same period. A total of 52% of parents did not disclose their child's use of CAM to their medical provider. Children's vaccination status was less likely to be up-to-date if they visited a CAM practitioner (OR 0.16; CI 0.07, 0.36; P < 0.001) or used a CAM product (OR 0.25; CI 0.09, 0.64; P = 0.004). CONCLUSION Despite a lack of high quality research for efficacy and safety, many children are using CAM products and practices in parallel with conventional health services, often without disclosure. This highlights the need to initiate conversations with parents about their child's use of CAM in order to ensure safe, coordinated patient care. The association between vaccine uptake and CAM use requires further investigation.
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Affiliation(s)
- Jane E Frawley
- Australian Centre for Public and Population Health Research, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Dennis Anheyer
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University Duisburg-Essen, Essen, Germany
| | - Sandy Davidson
- Endeavour College of Natural Health, Sydney, New South Wales, Australia
| | - Debra Jackson
- Oxford Institute of Nursing and Allied Health Research, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, United Kingdom
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Datta M, Vitolins MZ. Food Fortification and Supplement Use-Are There Health Implications? Crit Rev Food Sci Nutr 2017; 56:2149-59. [PMID: 25036360 DOI: 10.1080/10408398.2013.818527] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
UNLABELLED Dietary supplements are a multi-billion dollar industry in the U.S., and their use is increasing exponentially. Additionally, many foods and beverages are increasingly being fortified with single or multiple vitamins and minerals. Consequently, nutrient intakes are exceeding the safe limits established by the Institute of Medicine. In this paper, we examine the benefits and drawbacks of vitamin and mineral supplements and increasing consumption of fortified foods (in addition to dietary intake) in the U.S. POPULATION The pros and cons are illustrated using population estimates of folic acid, calcium, and vitamin D intake, highlighting concerns related to overconsumption of nutrients that should be addressed by regulatory agencies.
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Affiliation(s)
- Mridul Datta
- a Department of Nutrition Science , Purdue University , West Lafayette , Indiana , USA
| | - Mara Z Vitolins
- b Wake Forest School of Medicine , Department of Epidemiology and Prevention , Winston-Salem , North Carolina , USA
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Oren-Amit A, Berkovitch M, Bahat H, Goldman M, Kozer E, Ziv-Baran T, Abu-Kishk I. Complementary and alternative medicine among hospitalized pediatric patients. Complement Ther Med 2017; 31:49-52. [PMID: 28434470 DOI: 10.1016/j.ctim.2017.02.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 02/06/2017] [Accepted: 02/06/2017] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES To estimate the prevalence and describe the characteristics of complementary and alternative medicine (CAM) use among hospitalized children, and to discover the awareness of medical staff regarding CAM use. DESIGN/SETTING Parents of children aged 0-18 years admitted to the Pediatric Division at Assaf Harofeh Medical Center in Israel between January and July of 2015 (n=146) were provided a questionnaire regarding socio-economic status and evaluating the CAM use. The medical charts of the participants were reviewed in order to establish whether or not CAM use was documented. RESULTS Of those who completed the questionnaire, 78 (54.3%) were using CAM. The major indications for CAM use were colic and teething. CAM use was advised by the family in 44.9%, physician 34.6%, pharmacist 34.6%, friends 30.8%, previous experience 23.1, advertisements 18%, nurses 6.4%, and homeopaths 2.6%. The family physician was aware of CAM use was in 42%. During the admission, only 5 patients were asked about CAM use (3.4%) by the medical staff. Reviewing the medical charts revealed there was no documentation of CAM use in any of the participants. Socio-demographic analysis of our population revealed no differences between users and non users of CAM, but significant differences in belief in CAM (p=0.018) were found. CAM use was age related; the older the child the less the use (p=0.010). CONCLUSION CAM use is common among hospitalized pediatric patients and is often overlooked by the medical staff. CAM use should be included in the medical history.
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Affiliation(s)
- Adi Oren-Amit
- Pediatric Division, Assaf Harofeh Medical Center, Zerifin, Affiliated to the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Matitiahu Berkovitch
- Pharmacology Unit, Assaf Harofeh Medical Center, Zerifin, Affiliated to the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Hilla Bahat
- Pediatric Division, Assaf Harofeh Medical Center, Zerifin, Affiliated to the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Michael Goldman
- Pediatric Division, Assaf Harofeh Medical Center, Zerifin, Affiliated to the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Eran Kozer
- Pediatric Division, Assaf Harofeh Medical Center, Zerifin, Affiliated to the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Tomer Ziv-Baran
- School of Public Health, Department of Epidemiology and Preventive Medicine, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Ibrahim Abu-Kishk
- Pediatric Division, Assaf Harofeh Medical Center, Zerifin, Affiliated to the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
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Galli F, Azzi A, Birringer M, Cook-Mills JM, Eggersdorfer M, Frank J, Cruciani G, Lorkowski S, Özer NK. Vitamin E: Emerging aspects and new directions. Free Radic Biol Med 2017; 102:16-36. [PMID: 27816611 DOI: 10.1016/j.freeradbiomed.2016.09.017] [Citation(s) in RCA: 246] [Impact Index Per Article: 35.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 09/11/2016] [Accepted: 09/22/2016] [Indexed: 12/30/2022]
Abstract
The discovery of vitamin E will have its 100th anniversary in 2022, but we still have more questions than answers regarding the biological functions and the essentiality of vitamin E for human health. Discovered as a factor essential for rat fertility and soon after characterized for its properties of fat-soluble antioxidant, vitamin E was identified to have signaling and gene regulation effects in the 1980s. In the same years the cytochrome P-450 dependent metabolism of vitamin E was characterized and a first series of studies on short-chain carboxyethyl metabolites in the 1990s paved the way to the hypothesis of a biological role for this metabolism alternative to vitamin E catabolism. In the last decade other physiological metabolites of vitamin E have been identified, such as α-tocopheryl phosphate and the long-chain metabolites formed by the ω-hydroxylase activity of cytochrome P-450. Recent findings are consistent with gene regulation and homeostatic roles of these metabolites in different experimental models, such as inflammatory, neuronal and hepatic cells, and in vivo in animal models of acute inflammation. Molecular mechanisms underlying these responses are under investigation in several laboratories and side-glances to research on other fat soluble vitamins may help to move faster in this direction. Other emerging aspects presented in this review paper include novel insights on the mechanisms of reduction of the cardiovascular risk, immunomodulation and antiallergic effects, neuroprotection properties in models of glutamate excitotoxicity and spino-cerebellar damage, hepatoprotection and prevention of liver toxicity by different causes and even therapeutic applications in non-alcoholic steatohepatitis. We here discuss these topics with the aim of stimulating the interest of the scientific community and further research activities that may help to celebrate this anniversary of vitamin E with an in-depth knowledge of its action as vitamin.
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Affiliation(s)
- Francesco Galli
- Department of Pharmaceutical Sciences, University of Perugia, Laboratory of Clinical Biochemistry and Nutrition, Via del Giochetto, 06126 Perugia, Italy.
| | - Angelo Azzi
- USDA-HNRCA at Tufts University, 711 Washington St., Boston, MA 02111, United States.
| | - Marc Birringer
- Department of Nutritional, Food and Consumer Sciences, Fulda University of Applied Sciences, Leipziger Straße 123, 36037 Fulda, Germany.
| | - Joan M Cook-Mills
- Allergy/Immunology Division, Northwestern University, 240 E Huron, Chicago, IL 60611, United States.
| | | | - Jan Frank
- Institute of Biological Chemistry and Nutrition, University of Hohenheim, Garbenstr. 28, 70599 Stuttgart, Germany.
| | - Gabriele Cruciani
- Department of Chemistry, Biology and Biotechnology, University of Perugia, Italy.
| | - Stefan Lorkowski
- Institute of Nutrition, Friedrich Schiller University Jena, Dornburger Str. 25, 07743 Jena, Germany; Competence Cluster for Nutrition and Cardiovascular Health (nutriCARD), Halle-Jena-Leipzig, Germany.
| | - Nesrin Kartal Özer
- Department of Biochemistry, Faculty of Medicine, Genetic and Metabolic Diseases Research Center (GEMHAM), Marmara University, 34854 Maltepe, Istanbul, Turkey.
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Can B, Akan H, Topaloglu Demir F, Zindanci I, Cebeci F, Turkoglu Z, Kavala M. Complementary and Alternative Therapies Used by Patients of Pediatric Dermatology Outpatient Clinics in Turkey: A Multicenter Study. Pediatr Dermatol 2017; 34:72-77. [PMID: 27874216 DOI: 10.1111/pde.13039] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND The aim of this study was to determine the frequency of complementary and alternative medicine (CAM) methods used in children and adolescents with chronic skin diseases, which methods parents prefer, and to what extent these methods are useful. MATERIAL AND METHODS This cross-sectional study was conducted between June and November 2014 in patients with chronic skin diseases attending the outpatient pediatric dermatology clinics of three hospitals in Turkey. Data were collected using self-administered questionnaires from the parents of the patients. RESULTS A total of 307 patients were included in the study, 168 (54.7%) of whom were female and 139 (45.3%) male. The mean age was 12.3 ± 4.3 years. Eighty of the children (26.1%) had used CAM methods in the previous year. Longer disease duration and having a father with at least a university degree were highly associated with CAM use (p < 0.05). The most used method was herbal remedies available at home. Most patients used CAM methods to support the primary treatment given by their dermatologists. Only eight CAM users (2.6%) reported any side effects. Thirty-nine (48.8%) did not mention CAM use to their doctors. The overall satisfaction rate was 4.5 ± 3.1 on a 10-point rating scale. CONCLUSION CAM use rates are high in children with chronic skin problems, and parents generally prefer herbal treatments. Satisfaction with the results of CAM use is moderate. Parents generally do not share CAM use information with their doctors unless they are asked.
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Affiliation(s)
- Burce Can
- Department of Dermatology, School of Medicine, Medeniyet University, Goztepe Research and Training Hospital, Istanbul, Turkey
| | - Hülya Akan
- Department of Family Medicine, School of Medicine, Yeditepe University, Istanbul, Turkey
| | | | - Ilkin Zindanci
- Department of Dermatology, School of Medicine, Medeniyet University, Goztepe Research and Training Hospital, Istanbul, Turkey
| | - Filiz Cebeci
- Department of Dermatology, School of Medicine, Medeniyet University, Goztepe Research and Training Hospital, Istanbul, Turkey
| | - Zafer Turkoglu
- Department of Dermatology, School of Medicine, Medeniyet University, Goztepe Research and Training Hospital, Istanbul, Turkey
| | - Mukaddes Kavala
- Department of Dermatology, School of Medicine, Medeniyet University, Goztepe Research and Training Hospital, Istanbul, Turkey
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46
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Dietary Supplement Use and Nutrient Intake among Children in South Korea. J Acad Nutr Diet 2016; 116:1316-22. [DOI: 10.1016/j.jand.2016.02.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Accepted: 02/18/2016] [Indexed: 11/19/2022]
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Lopez-Cepero A, Torres R, Elias A, Rosal MC, Palacios C. Micronutrient Intake among Children in Puerto Rico: Dietary and Multivitamin-Multimineral Supplement Sources. INT J VITAM NUTR RES 2016; 85:329-339. [PMID: 27439655 DOI: 10.1024/0300-9831/a000252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Micronutrients are critical for healthy growth and development of children. Micronutrient intake from dietary sources is inadequate among some children and may be improved by use of multivitamin and multimineral (MVMM) supplements. OBJECTIVE To assess micronutrient intake from dietary and MVMM supplement sources among 12-year-old children in Puerto Rico. METHODS A representative sample of 732 children enrolled in an oral health study in Puerto Rico, who completed dietary and MVMM assessments through one 24-h recall, were included in this analysis. Micronutrient intake sources were described and compared to the Dietary Reference Intakes (DRIs) using the Estimated Average Requirement when available (used Adequate Intake for vitamin K and pantothenic acid). Micronutrient profiles of MVMM users and non-users were compared using t-tests. RESULTS Mean intakes of vitamins A, D, E, and K, pantothenic acid, calcium, and magnesium from food and beverage sources were below the DRIs. From food and beverage sources, MVMM users had higher intakes of riboflavin and folate compared to non-users (p < 0.05). When MVMM supplements were taken into account, users had higher intakes of all nutrients except vitamin K. With the help of MVMM, users increased intake of vitamins E, A, D, and pantothenic acid to IOM-recommended levels but calcium, magnesium, and vitamin K remained below guidelines. CONCLUSION Micronutrient intake from diet was below the IOM-recommended levels in the total sample. MVMM use improved intake of selected micronutrients and facilitated meeting recommendations for some nutrients. Public health measures to improve micronutrient intake among children in Puerto Rico are needed.
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Affiliation(s)
- Andrea Lopez-Cepero
- 1 Nutrition Program, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, Puerto Rico
| | - Roxana Torres
- 1 Nutrition Program, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, Puerto Rico
| | - Augusto Elias
- 2 School of Dental Medicine, Medical Sciences Campus, University of Puerto Rico, Puerto Rico
| | - Milagros C Rosal
- 3 Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Cristina Palacios
- 1 Nutrition Program, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, Puerto Rico
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Benavides S, Madzhidova S, Hernandez A, Le T, Palma SM, Stephen S. Establishment of Pediatric Medication Therapy Management: A Proposed Model. PHARMACY 2016; 4:E5. [PMID: 28970378 PMCID: PMC5419360 DOI: 10.3390/pharmacy4010005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 01/08/2016] [Accepted: 01/14/2016] [Indexed: 11/29/2022] Open
Abstract
Ongoing healthcare reform calls for increased accessibility, enhanced delivery, and improved quality of healthcare. Children and adolescents are experiencing a rise in the prevalence in chronic diseases leading to an increased utilization of medications. The increased use of chronic medications can lead to more medication errors or adverse drug events, particularly in children and adolescents using multiple chronic medications. These ongoing changes expand opportunities for a pharmacist to become further integrated in the inter-professional healthcare delivery for pediatric patients, particularly in an ambulatory or community setting. To date, a systemic process for the provision of medication therapy management (MTM) services in pediatric patients has not been elucidated. The purpose of this paper is to describe a proposed model for delivering pediatric MTM. Furthermore, based on the available literature related to pediatric patients at risk for medication errors, adverse drug reactions, and subsequently-increased utilization of emergency departments and hospitalizations, a set of criteria is proposed for further research investigation.
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Affiliation(s)
- Sandra Benavides
- Larkin Health Sciences Institute, College of Pharmacy, 18301 N. Miami Avenue, Suite 1, Miami, FL 33169, USA.
| | - Shirin Madzhidova
- College of Pharmacy, Nova Southeastern University, Davie, FL 33328, USA.
| | - Anihara Hernandez
- College of Pharmacy, Nova Southeastern University, Davie, FL 33328, USA.
| | - Thao Le
- College of Pharmacy, Nova Southeastern University, Davie, FL 33328, USA.
| | - Stephanie M Palma
- College of Pharmacy, Nova Southeastern University, Davie, FL 33328, USA.
| | - Steffi Stephen
- College of Pharmacy, Nova Southeastern University, Davie, FL 33328, USA.
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Akabas SR, Vannice G, Atwater JB, Cooperman T, Cotter R, Thomas L. Quality Certification Programs for Dietary Supplements. J Acad Nutr Diet 2016; 116:1370-1379. [PMID: 26795259 DOI: 10.1016/j.jand.2015.11.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Indexed: 11/16/2022]
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Péter S, Saris WHM, Mathers JC, Feskens E, Schols A, Navis G, Kuipers F, Weber P, Eggersdorfer M. Nutrient Status Assessment in Individuals and Populations for Healthy Aging-Statement from an Expert Workshop. Nutrients 2015; 7:10491-500. [PMID: 26694458 PMCID: PMC4690099 DOI: 10.3390/nu7125547] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2015] [Accepted: 12/10/2015] [Indexed: 11/17/2022] Open
Abstract
A workshop organized by the University Medical Center Groningen addressed various current issues regarding nutrient status of individuals and populations, tools and strategies for its assessment, and opportunities to intervene. The importance of nutrient deficiencies and information on nutrient status for health has been illustrated, in particular for elderly and specific patient groups. The nutrient profile of individuals can be connected to phenotypes, like hypertension or obesity, as well as to socio-economic data. This approach provides information on the relationship between nutrition (nutrient intake and status) and health outcomes and, for instance, allows us to use the findings to communicate and advocate a healthy lifestyle. Nutrition is complex: a broader profile of nutrients should be considered rather than focusing solely on a single nutrient. Evaluating food patterns instead of intake of individual nutrients provides better insight into relationships between nutrition and health and disease. This approach would allow us to provide feedback to individuals about their status and ways to improve their nutritional habits. In addition, it would provide tools for scientists and health authorities to update and develop public health recommendations.
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Affiliation(s)
- Szabolcs Péter
- Nutrition Science & Advocacy, DSM Nutritional Products Ltd., Wurmisweg 576, Kaiseraugst 4303, Switzerland.
| | - Wim H M Saris
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Universiteitssingel 40, Maastricht 6229 ER, The Netherlands.
| | - John C Mathers
- Human Nutrition Research Centre, Institute of Cellular Medicine, Campus for Aging and Vitality, Newcastle University, Newcastle upon Tyne NE4 5PL, UK.
| | - Edith Feskens
- Division of Human Nutrition, Wageningen University, Bomenweg 4, Wageningen 6703 HD, The Netherlands.
| | - Annemie Schols
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Universiteitssingel 40, Maastricht 6229 ER, The Netherlands.
| | - Gerjan Navis
- University Medical Center Groningen, University of Groningen, Hanzeplein 1, Groningen 9700 RB, The Netherlands.
| | - Folkert Kuipers
- University Medical Center Groningen, University of Groningen, Hanzeplein 1, Groningen 9700 RB, The Netherlands.
| | - Peter Weber
- Nutrition Science & Advocacy, DSM Nutritional Products Ltd., Wurmisweg 576, Kaiseraugst 4303, Switzerland.
- University Hohenheim, Schloß Hohenheim 1, Stuttgart 70599, Germany.
| | - Manfred Eggersdorfer
- Nutrition Science & Advocacy, DSM Nutritional Products Ltd., Wurmisweg 576, Kaiseraugst 4303, Switzerland.
- University Medical Center Groningen, University of Groningen, Hanzeplein 1, Groningen 9700 RB, The Netherlands.
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