CHICAGO – After a rise in the popularity of dietary supplements in the 1990s, their use seems to have plateaued, although exposure may continue to increase with the addition of herbal supplements to mainstream multivitamin products, according to an article in the February 14 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.
During the last decade the use of alternative medicines, particularly herbal products, has increased considerably, according to background information in the article. Americans spent $4.2 billion on herbs and other botanical remedies in 2001, and their benefits are being cited more and more in the media.
Judith P. Kelly, M.S., from Boston University School of Public Health, and colleagues examined data from phone interviews conducted from 1998 through 2002 in order to determine which dietary supplements Americans were using. The 8,470 study participants were asked to identify all over-the-counter and prescription drugs, along with dietary supplements taken during the preceding seven days.
The percentage of people using dietary supplements increased from 14.2 percent in 1998 – 1999 to 18.8 percent 2002, with a low of 12.3 percent in 2000 and a high of 19.8 percent in 2001. The percentage of people aged 45 to 64 years who took supplements increased by about half between 1998-1999 and 2001-2002. However, the use of Ginko biloba and Panax ginseng declined during the study period. Overall, supplement users were older, more likely to be female (59.9 vs. 55.5 percent) and white (80.7 vs. 75.6 percent). The use of lutein, a component of multivitamin products, increased in both men and women, with a prevalence of 0.3 percent, 0.5 percent, 6.6 percent, and 8.4 percent, respectively, in 1998-1999, 2000, 2001, and 2002.
"Our observations regarding lutein use were unexpected," the authors noted. This carotenoid antioxidant which it has been suggested may be protective against macular degeneration (an important cause of blindness in adults), was first added to many popular multivitamins in late 1999 and 2000. Another antioxidant, lycopene, was added to major multivitamins in 2003 as a cancer preventative. "The addition of these supplements to multivitamin products has signaled two subtle, but important, changes in recent years," the researchers suggest. "First, the acceptance of herbal supplements and other dietary supplements as part of the mainstream health milieu has apparently increased. Second, the marketing strategy for multivitamin products appears to have broadened from supplying recommended daily allowances of vitamins and minerals that may be lacking in the diet to preventing chronic disease, such as macular degeneration and cancer."
"Approximately one quarter of adults in the United States use multivitamins, and this prevalence may increase following the recent recommendation that all adults take a multivitamin daily," the authors write. "Although the deliberate use of herbal products may have reached a plateau in the last few years, exposure to individual herbal ingredients may continue to rise as more of them are added to mainstream multivitamin products."
(Arch Intern Med. 2005; 165: 281 – 286. Available post-embargo at www.archinternmed.com.)
Editor's Note: The Slone Survey was supported by Slone Epidemiology Center funds.
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