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The Use of Herbal and Other Non-vitamin, Non-mineral Supplements among Pre- and Post-menopausal Women in Ontario

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Abstract

Background

Herbal or other non-vitamin, non-mineral (NVNM) supplements are used by many Canadians, and are of public health significance given potential health effects. The majority of supplement users are women, yet there are limited data on their pattern of use. Ontario women were surveyed about their use of NVNM supplements, including those for women’s health, and characteristics associated with use were examined.

Methods

3,423 randomly selected Ontario households were telephoned to identify eligible women (25–65 years). Of the 1,741 identified, 800 agreed to participate and were mailed a self-administered questionnaire querying NVNM supplement use and healthrelated characteristics. Prevalence of use, duration, and reasons for use were calculated; distributions of respondent characteristics were tabulated and associations with supplement use were assessed.

Results

478 women (27%) completed questionnaires; 64% reported ever, and 34% reported current use of NVNM supplements. Echinacea was the most frequently used, followed by evening primrose, garlic, and camomile; supplements were used for less than one year. Alleviation of symptoms and prevention of illness were two primary reasons for taking NVNM supplements. 49% reported ever, and 37% reported current use of supplements for women’s health, and for reasons similar to other NVNM supplements. High body mass index (≥30.0 kg/m2) was associated with more supplement use, and visiting a physiotherapist in the past year was associated with less.

Conclusion

Findings suggest a high level of NVNM supplement use among Ontario women, possibly associated with certain health-related characteristics. This has important public health implications considering possible benefits and/or interactions with conventional medications.

Résumé

Contexte

De nombreux Canadiens prennent des plantes médicinales et autres compléments nonvitaminiques non-minéraux (CNVNM). Le phénomène est d’importance pour la santé publique en raison des effets possibles de ces suppléments sur la santé. La majorité des consommateurs de suppléments sont des femmes, mais on manque de données sur leurs habitudes de consommation. Nous avons sondé les Ontariennes sur leur consommation de CNVNM, y compris les produits de santé des femmes, et analysé les caractéristiques associées à la prise de ces suppléments.

Méthode

Nous avons téléphoné à 3 423 ménages ontariens sélectionnés au hasard pour repérer des femmes admissibles (de 25 à 65 ans). Sur les 1 741 femmes répertoriées, 800 ont accepté de participer au sondage; nous leur avons posté un questionnaire à remplir soi-même, comportant des questions sur leur consommation de CNVNM et leur état de santé. Nous avons calculé la prévalence, la durée et les raisons de la prise de CNVNM, réparti les répondantes selon leur profil de santé et évalué les associations de ces variables avec la prise de suppléments.

Résultats

Des questionnaires ont été remplis par 478 femmes (27 %); 64 % ont déclaré avoir déjà pris des CNVNM, et 34 % ont dit le faire actuellement. Le supplément le plus populaire était l’échinacée, suivi de l’oenothère, de l’ail et de la camomille, et les suppléments étaient pris sur une période inférieure à un an. Les répondantes prenaient principalement des CNVNM pour soulager des symptômes et pour prévenir des maladies. Quarante-neuf p. cent (49 %) des répondantes ont dit avoir déjà pris des produits de santé des femmes, et 37 % ont dit le faire actuellement. Les raisons invoquées étaient les mêmes que pour les autres CNVNM. Un indice de masse corporelle élevé (≥30 kg/m2) était associé à une forte consommation de suppléments, tandis que la consultation d’un physiothérapeute au cours de l’année antérieure était associée à une consommation plus faible.

Conclusion

Les Ontariennes font une consommation élevée de CNVNM, et ces niveaux de consommation pourraient être associés à certaines caractéristiques de santé. Ceci pourrait avoir d’importantes répercussions de santé publique étant donné les avantages possibles de ces produits et/ou leurs interactions éventuelles avec les médicaments classiques.

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References

  1. Wiles J, Rosenberg, MW. ‘Gentle caring experience’. Seeking alternative health care in Canada. Health & Place 2001;7:209–24.

    Article  CAS  Google Scholar 

  2. Seidl MM, Stewart, DE. Alternative treatments for menopausal symptoms. Systematic review of scientific and lay literature. Can Fam Phys 1998;44:1299–308.

    CAS  Google Scholar 

  3. Non-prescription Drug Manufacturers Association of Canada and AC Nielsen. Health Vision’98. Ottawa: Non-prescription Drug Manufacturers Association of Canada and AC Nielsen, 1998.

    Google Scholar 

  4. Troppmann L, Johns T, Gray-Donald K. Natural health product use in Canada. Can J Public Health 2002;93:426–30.

    PubMed  Google Scholar 

  5. Health Canada. Baseline Natural Health Products Survey Among Consumers. Final Report. Ipsos-Reid Survey. March 2005. Available online at: https://doi.org/www.hc-sc.gc.ca/dhpmps/ alt_formats/hpfb-dgpsa/pdf/pubs/ eng_cons_survey_e.pdf (Accessed October 19, 2006).

    Google Scholar 

  6. Seidl MM, Stewart, DE. Alternative treatments for menopausal symptoms. Qualitative study of women’s experiences. Can Fam Phys 1998;44:1271–76.

    CAS  Google Scholar 

  7. Singh SR, Levine MAH. Natural health product use in Canada: Analysis of the National Population Health Survey. Can J Clin Pharmacol 2006;13:240–50.

    Google Scholar 

  8. Gunther S, Patterson RE, Kristal AR, Stratton KL, White E. Demographic and health-related correlates of herbal and specialty supplement use. J Am Diet Assoc 2004;104:27–34.

    Article  Google Scholar 

  9. Schaffer DM, Gordon NP, Jensen CD, Avins AL. Nonvitamin, nonmineral supplement use over a 12-month period by adult members of a large health maintenance organization. J Am Diet Assoc 2003;103:1500–5.

    Article  Google Scholar 

  10. Radimer KL, Subar AF, Thompson, FE. Nonvitamin, nonmineral dietary supplements: Issues and findings from NHANES III. J Am Diet Assoc 2000;100:447–54.

    Article  CAS  Google Scholar 

  11. UIC. News Tips: NIH awards UIC $7.9 million to study dietary supplements effectiveness. Available online at: https://doi.org/www.uic.edu/ depts/paff/opa/releases/1999/dietsupp_release (Accessed December 4, 2001).

    Google Scholar 

  12. Douglas S. Premenstrual syndrome: Evidencebased treatment in family practice. Can Fam Phys 2002;48:1789–97.

    Google Scholar 

  13. Wylie-Rosett J. Menopause, micronutrients, and hormone therapy. Am J Clin Nutr 2005;81:1223S-31S.

    Article  CAS  Google Scholar 

  14. Strategic Policy Choices and Canadian Health Food Association. Canadian Health Food Industry Sector Analysis. Ottawa: Strategic Policy Choices and Canadian Health Food Association, 1997.

    Google Scholar 

  15. Go VL, Wong DA, Resnick MS, Heber D. Evaluation of botanicals and dietary supplement therapy in cancer patients. J Nutr 2001;131:179S-80S.

    Article  CAS  Google Scholar 

  16. Liu J, Burdette J, Xu H, Gu C, van Breeman R, Bhat K. Evaluation of estrogenic activity of plant extracts for the potential treatment of menopausal symptoms. J Agric Food Chem 2001;49:2472–79.

    Article  CAS  Google Scholar 

  17. Mar C, Bent S. An evidence-based review of the 10 most commonly used herbs. Western J Med 1999;171:168–71.

    CAS  Google Scholar 

  18. Chan RYK, Chen W, Dong A, Guo D, Wong M. Estrogen-like activity of Ginsenoside Rg1 derived from Panax notoginseng. J Clin Endocrinol Metab 2002;87:3691–95.

    Article  CAS  Google Scholar 

  19. Coldham NG, Sauer, MJ. Identification, quantitation and biological activity of phytoestrogens in a dietary supplement for breast enhancement. Food Chem Toxicol 2001;39:1211–24.

    Article  CAS  Google Scholar 

  20. Glazier MG, Bowman, MA. A review of the evidence for the use of phytoestrogens as a replacement for traditional estrogen replacement therapy. Arch Intern Med 2001;161:1161–72.

    Article  CAS  Google Scholar 

  21. Schellenberg R. Treatment for the premenstrual syndrome with agnus castus fruit extract: Prospective, randomised, placebo controlled study. BMJ 2001;322:134–37.

    Article  CAS  Google Scholar 

  22. Setchell KDR, Brown NM, Desai P, Zimmer- Nechemias L, Wolfe BE, Brashear, WT. Bioavailability of nutrients and other bioactive components from dietary supplements. J Nutr 2001;131:1362S-75S.

  23. Zava DT, Dollbaum CM, Blen M. Estrogen and progestin bioactivity of foods, herbs, and spices. Exp Biol Med (Maywood) 1998;217:369–78.

    Article  CAS  Google Scholar 

  24. SAS Institute Inc., Cary, NC: SAS Institute Inc., 1999–2001.

  25. Archer SL, Stamler J, Moag-Stahlberg A, Van Horn L, Garside D, Chan Q, et al. Association of dietary supplement use with specific micronutrient intakes among middle-aged American men and women: The INTERMAP study. J Am Diet Assoc 2005;105:1106–14.

    Article  Google Scholar 

  26. Kaufman DW, Kelly JP, Rosenberg L, Anderson TE, Mitchell, AA. Recent patterns of medication use in the ambulatory adult population of the United States: The Slone Survey. JAMA 2002;287:337–44.

    Article  Google Scholar 

  27. Ness J, Cirillo DJ, Weir DR, Nisly NL, Wallace RB. Use of complementary medicine in older Americans: Results from the health and retirement study. Gerontologist 2005;45:516–24.

    Article  Google Scholar 

  28. Newton KM, Buist DSM, Keenan NL, Anderson LA, LaCroix, AZ. Use of alternative therapies for menopause symptoms: Results of a populationbased survey. Obstet Gynecol 2002;100:18–25.

    PubMed  Google Scholar 

  29. Bair YA, Gold EB, Greendale GA, Sternfeld B, Adler SR, Azari R, et al. Ethnic differences in use of complementary and alternative medicine at midlife: Longitudinal results from SWAN participants. Am J Public Health 2002;92:1832–40.

    Article  Google Scholar 

  30. Raiten DJ, Picciano F, Coates, PM. Dietary supplement use in women: Current status and future directions: Introduction and conference summary. J Nutr 2003;133:1957S-60S.

    Article  Google Scholar 

  31. Messerer M, Wolk A. Sensitivity and specificity of self-reported use of dietary supplements. Eur J Clin Nutr 2004;58:1669–71.

    Article  CAS  Google Scholar 

  32. Dwyer J, Picciano MF, Raiten DJ and Members of the Steering Committee. Future directions for what we eat in America-NHANES: The integrated CSFII-NHANES. J Nutr 2003;133:590S- 600S.

  33. Messerer M, Johansson SE, Wolk A. The validity of questionnaire-based micronutrient intake estimates is increased by including dietary supplement use in Swedish men. J Nutr 2004;134:1800–5.

    Article  CAS  Google Scholar 

  34. Millen AE, Dodd KW, Subar, AF. Use of vitamin, mineral, nonvitamin, and nonmineral supplements in the United States: The 1987, 1992. and 2000 National Health Interview Survey results. J Am Diet Assoc 2004;104:942–50.

    Article  Google Scholar 

  35. Pittler MH, Ernst E. Complementary therapies for reducing body weight: A systematic review. Int J Obes 2005;29:1030–38.

    Article  CAS  Google Scholar 

  36. Goggs R, Vaughan-Thomas A, Clegg PD, Carter SD, Innes JF, Mobasheri A. Nutraceutical therapies for degenerative joint disease: A critical review. Crit Rev Food Sci Nutr 2005;45:145–64.

    Article  CAS  Google Scholar 

  37. Keenan NL, Mark S, Fugh-Berman A, Browne D, Kaczmarczyk J, Hunter C. Severity of menopausal symptoms and use of both conventional and complementary/alternative therapies. Menopause 2003;10:507–15.

    Article  Google Scholar 

  38. Neuhouser, ML. Dietary supplement use by American women: Challenges in assessing patterns of use, motives and costs. J Nutr 2003;133:1992S-96S.

    Article  Google Scholar 

  39. Beal, MW. Women’s use of complementary and alternative therapies in reproductive health care. J Nurse-Midwifery 1998;43:224–34.

    Article  CAS  Google Scholar 

  40. Kurzer, MS. Phytoestrogen supplement use by women. J Nutr 2003;133:1983S-86S.

    Article  Google Scholar 

  41. Palaniappan U, Starkey LJ, O’Loughlin J, Gray- Donald K. Fruit and vegetable consumption is lower and saturated fat intake is higher among Canadians reporting smoking. J Nutr 2001;131:1952–58.

    Article  CAS  Google Scholar 

  42. Beland Y. Canadian Community Health Survey: Methodological overview. Health Reports 2002;13:9–14.

    PubMed  Google Scholar 

  43. Allen M. Telephone Refusal Rates Continue to Rise. Available online at: https://doi.org/www.pmrsaprm. com/SpecialResponse/article02.html (Accessed March 15, 2006).

    Google Scholar 

  44. Kjoller M, Thoning H. Characteristics of nonresponse in the Danish Health Interview Surveys, 1987–1994. Eur J Public Health 2005;15:528–35.

    Article  Google Scholar 

  45. Moorman PG, Newman B, Millikan RC, Tse CKJ, Sandler, DP. Participation rates in a casecontrol study: The impact of age, race, and race of interviewer. Ann Epidemiol 1999;9:188–95.

    Article  CAS  Google Scholar 

  46. Statistics Canada. 2001 Census: Analysis series. Canada’s Ethnocultural Portrait: The Changing Mosaic. 2003. Available online at: https://doi.org/www.fin.gov.on.ca/english/demographics/ cenhi6.html (Accessed October 29, 2006).

    Google Scholar 

  47. Statistics Canada. Census of Population, Population 15 Years and Over by Highest Degree, Certificate or Diploma (1986–2001 Censuses). Available online at: https://doi.org/www.statcan.ca/english/Pgdb/educ42.htm. (Accessed October 29, 2006).

    Google Scholar 

  48. Laeeque H, Charrois TL, Vohra S. Adverse effects and drug interactions relating to use of St. John’s wort. Can Pharm J 2006;139:30–33.

    Article  Google Scholar 

  49. Dergal JM, Gold JL, Laxer DA, Lee MSW, Binns MA, Lanctot KL, et al. Potential interactions between herbal medicines and conventional drug therapies used by older adults attending a memory clinic. Drugs Aging 2002;19:879–86.

    Article  CAS  Google Scholar 

  50. Health Canada. Drugs and Health Products. Single Ingredient Monographs. Available online at: https://doi.org/hc-sc.gc.ca/dhp-mps/prodnatur/applications/ licen-prod/monograph/mono_list_e.html (Accessed October 19, 2006).

    Google Scholar 

  51. Health Canada. Canadian Guidelines for Body Weight Classification in Adults. Ottawa: Health Canada, 2003.

    Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada

    Katayoon Pakzad MSc & Nancy Kreiger MPH, PhD

  2. Division of Preventive Oncology, Cancer Care Ontario, 620 University Avenue, Toronto, ON, M5G 2L7, Canada

    Beatrice A. Boucher MHSc, Nancy Kreiger MPH, PhD & Michelle Cotterchio MS, MPH, PhD

  3. Department of Public Health Sciences, University of Toronto, Canada

    Nancy Kreiger MPH, PhD & Michelle Cotterchio MS, MPH, PhD

Authors
  1. Katayoon Pakzad MSc
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  2. Beatrice A. Boucher MHSc
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  3. Nancy Kreiger MPH, PhD
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  4. Michelle Cotterchio MS, MPH, PhD
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Corresponding author

Correspondence to Beatrice A. Boucher MHSc.

Additional information

Acknowledgements: This project was funded by Canadian Cancer Etiology Research Network (CCERN). The authors wish to thank Margaret Sloan for statistical advice and Eva D’souza for manuscript assistance.

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Pakzad, K., Boucher, B.A., Kreiger, N. et al. The Use of Herbal and Other Non-vitamin, Non-mineral Supplements among Pre- and Post-menopausal Women in Ontario. Can J Public Health 98, 383–388 (2007). https://doi.org/10.1007/BF03405424

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