Natural Health Product Use in Canada

Leticia Troppmann1, Timothy Johns1, Katherine Gray-Donald1
1School of Dietetics and Human Nutrition, McGill University, Ste Anne de Bellevue, Canada

Tóm tắt

Objective: To quantify patterns of Natural Health Product (NHP) use in Canada. Methods: The Food Habits of Canadians surveyed 1,543 Canadian adults using a 24-hour recall to record dietary supplements. Prevalence of use by user profile was examined. Results: Forty-six percent of women and 33% of men reported taking at least one Natural Health Product with a mean of 2.3 among users. The highest prevalence of supplement use, 57%, occurred among women aged 50–65. Supplement users were older, less likely to smoke and perceived their health as better than non-users. Among supplement users, men had higher rates of use of garlic and vitamin C while women used iron, calcium, B complex, evening primrose oil and glucosamine sulfate. Discussion: Supplement use by Canadians, at 38% for nutrients and 15% for herbal products, was similar to the rate of uses in the U.S., although differences in the reporting of types of supplements underline aspects of consumer behaviour as well as methodological issues specific to NHPs. Investigation of the use of NHPs in the healthcare setting is important given the widespread use and the potential health care consequences associated with supplement use.

Từ khóa


Tài liệu tham khảo

Health Canada. Office of Natural Health Products: Frequently Asked Questions. Available at: http://www.hc-sc.gc.ca/hpb/onhp/faq2_e.html. Site Accessed: February, 2001.

Balluz LS, Kieszak SM, Philen RM, Mulinare J. Vitamin and mineral supplement use in the United States: Results from the Third National Health and Nutrition Examination Survey. Arch Fam Med 2000;9:258–62.

Dickinson VA, Block G, Russek-Cohen E. Supplement use, other dietary and demographic variables and serum vitamin C in NHANESII. J Am Coll Nutr 1994;13:22–32.

United States Department of Agriculture. Continuing survey of food intakes by individuals: Table 28-Vitamin and mineral supplements: Percentages of individuals using and type, by sex and age, 1994–1996. Available at: http://www.barc.usda.gov/bhnrc/foodsurvey/pdf/ supp.pdf Site Accessed: April, 2002.

Eisenberg DM, Davis RB, Ettner SL, Appel A, Wilkey S, Van Rompay M, Kieszak SM. Trends in alternative medicine use in the United States, 1990–1997. JAMA 1998;280:1569–75.

Foster DF, Phillips RS, Hamel MB, Eisenberg DM. Alternative medicine use in older Americans. J Am Geriatr Soc 2000;48:1560–65.

Sandler RS, Halabi S, Kaplan EB, Baron JA, Paskett E, Petrelli NJ. Use of vitamins, minerals and nutritional supplements by participants in a chemoprevention trial. Cancer 2001;91:1040–45.

Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin and Choline. Washington, DC: National Academy Press, 2000.

Herb sales up 101% in mainstream market. HerbalGram 1998;43:61.

Blumenthal M. Herb Market Levels After Five years of Boom: 1999 Sales in Mainstream Market up Only 11% in First Half of 1999 After 55% Increase in 1998. HerbalGram 1999;47:64–65.

Gallo M, Sarkar M, Au W, Pietrak K, Comas B, Smith M, et al. Pregnancy outcome following gestational exposure to echinacea: A prospective controlled study. Arch Intern Med 2000;160:3141–43.

Troppmann LA, Gray-Donald K, Johns T. Supplement use: Is there any nutritional benefit? J Am Diet Assoc 2002;102:818–25.

Gray-Donald K, Jacobs-Starkey L, Johnson-Down L. Food habits of Canadians: Reduction in fat intake over a generation. Can J Public Health 2000;91:381–85.

Frank E, Bendich A, Denniston M. Use of vitamin-mineral supplements by female physicians in the United States. Am J Clin Nutr 2000;72:969–75.

Patterson RE, Neuhouser ML, White E, Kristal AR, Potter JD. Measurement error from assessing use of vitamin supplements at one point in time. Epidemiology 1998;9:567–69.

Giovannucci E, Stampfer MJ, Colditz GA, Hunter DJ, Fuchs C, Rosner BA, et al. Multivitamin use, folate and colon cancer in women in Nurses’ Health Study. Ann Intern Med 1998;129:517–24.

Medeiros DM, Bock MA, Carpenter K, Ortiz M, Raab C, Read M, et al. Long-term supplement users and dosages among adult westerners. J Am Diet Assoc 1991;980–82.

Top ten herb sales in selected health food stores. Whole Foods Magazine 1995.

Top selling herbs supplements in mass market–1997. HerbalGram 1998;42:65.

Richman A, Wright JD. Echinacea #1 in natural food trade. HerbalGram 1997;41:53.

Searle GF. Stigma and depression: A double whammy. Int J Clin Pract 1999;53:473–75.

Stoehr GP, Ganguli M, Seaberg EC, Echement DA, Belle S. Over-the-counter medication use in an older rural community: The MoVIES project. J Am Geriatric Society 1997;45:158–65.

Juhn MS. Oral creatine supplementation: Separating fact from hype. The Physician and Sports Medicine 1999;27(5):47–61.

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

Brevoort P. Top Selling Herbs in U.S. Commerce. East Earth Herb Inc. 1994.

Reader’s Digest. The Healing Power of Vitamins, Minerals and Herbs. Montreal, Canada: Books and Home Entertainment, 1999.

Lininger SW, Gaby AR, Austin S, Brown DJ, Wright JV, Duncan A. The Natural Pharmacy. United States: Prima Publishing, 1999.

Tarasuk VS, Beaton GH. Women’s dietary intakes in the context of household food insecurity. J Nutr 1999;129:672–79.

MacQueen K. The best of both worlds: British Columbia aids the merger of traditional Chinese practice with western medicine. Maclean’s 2001;44–47.

Cupp MJ. Herbal remedies: Adverse effects and drug interactions. Am Fam Phys 1999;59:1239–44.

Food and Nutrition Board Institute of Medicine. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium and Zinc. Washington, DC: National Academy Press, 2001.

Haller CA, Benowitz NL. Adverse cardiovascular and central nervous system events associated with dietary supplements containing ephedra alkaloids. N Engl J Med 2000;343:1833–38.

Health Canada. Advisory not to use products containing Ephedra or ephedrine. Available at: http://www.hc-sc.gc.ca/english/archives/warnings/2001/2001_67e.htm. Site Accessed: July, 2001.

Nightingale SL. New safety measures are proposed for dietary supplements containing ephedrine alkaloids. JAMA 1997;278:15.

Theoharides TC. Sudden death of a healthy college student related to ephedrine toxicity from a Ma Huang-containing drink. J Clin Psychopharmacology 1997;17:437–39.

White LM, Gardner SF, Gurley BJ, Marx MA, Wang P-L, Estes M. Pharmacokinetics and cardiovascular effects of Ma-Huang (Ephedra sinica) in normotensive adults. J Clin Pharmacol 1997;37:116–22.