Dietary Supplement Users Research Articles

Dietary Supplement Perception and Usage Pattern Among the Chinese Older Population: A Pilot Study

ObjectivesThe usage of dietary supplements (DS) is increasingly prevalent in China. The purpose of this pilot study was to examine DS use and the factors that influence the buying and usage.MethodsData is from an anonymous, self-developed, online questionnaire administered to Chinese adults ≥60 years. Statistical analyses were conducted using chi-square, independent t-tests, and single-factor ANOVA to test differences in DS usage among characteristic-based stratified groups.Results75 participants were anonymously recruited (66.7% female). The most popular DS was calcium (74.7%). Participants’ children were the most prevalent source for hearing about and obtaining DS (59%). Participants who completed senior high or higher used more DS than those who completed junior high or lower, P = 0.011. Participants living in the North and Northeast Hukou regions took fewer DS than those in other regions, P = 0.007. No significant differences were found in the prevalence of DS use in relation to chronic disease diagnoses.ConclusionsThe results show the lack of awareness and knowledge of DS use. Appropriate guidance and scientific education about DS, such as the benefits and risks of different types of DS and the effectiveness of DS related to chronic diseases, should be provided to Chinese older people by public health departments, healthcare providers, and even DS companies in the future. Older Chinese adults with higher education and living in the North and Northeast Hukou regions are more likely to use DS.Funding SourcesNone.

Employing an “aging paradox” to uncover effective measures for advancing productive longevity

Data gathered from healthy and non-diabetic volunteers who previously had participated in assorted clinical research trials, reveal that many medical risk factors primarily related to insulin resistance (IR) and the metabolic syndrome (MS) gradually intensify between ages 25 and 70 years. This phase here labeled “Continuum of risks” (CR) is a period whereby the metabolic changes that correlate with health situations adjust unfavorably but never exceed nor fall outside ranges that would diagnose established pathological diseases. The strengths of some of these risk factors unexpectedly reverted in an opposite and beneficial direction. This occurred somewhere beyond age 70 years. This phenomenon is defined as “Aging paradox” (AP). Because comparing data from the CR and AP periods did not reveal any significant differences in the glucose-insulin relationships with other components of MS, the beneficial happenings in AP were attributed to “Survivor bias.” The meaning behind this is that those volunteers possessing the more promising profile of risk factors can contribute to clinical studies, while participants with poorer profiles cannot take part as volunteers in later life due to medical debilities or even death. Health-wise, the average values of the following markers changed in a favorable direction when evaluated in the later AP period: Body weight, fat mass, fat free mass, levels of fasting blood glucose (FBG), triglycerides, HDL-cholesterol, and alanine aminotransferase enzyme. The lowering of FBG levels signifies the lessening of IR, the well accepted driving force behind MS. In contrast, total, LDL-, and non-HDL-cholesterol levels as well as systolic blood pressure essentially did not transform favorably over time. Health parameters associated with active survival should be at the center of attention in any developing schema to extend meaningful longevity. Thus, natural regimens involving nutrition, exercise, and dietary supplement usage exist to carry out necessary therapeutic measures to mitigate IR and its disabling components – thus potentially contributing to a longer healthier lifespan.

The Prevalence of Dietary Supplement Usage in Military Aviators.

Background: The prevalence of dietary supplement (DS) and energy drink (ED) usage in military personnel differs from branch to branch and is between 55% and 76% (higher values in special operations forces). Aviators with highly demanding tasks might be especially interested in using dietary supplements. To date, there are only limited data available for this special profession inside the military. Methods: An internet-based survey was conducted on the prevalence of DS and ED usage, the reasons for their usage and the place of purchase for all wings of the German Armed Forces. Results: Of the 181 pilots who participated in the survey, 34% used DSs and 16% EDs. Usage was linked to sports activities but not to the type of aircraft. DSs were purchased on the internet by 50% of the respondents; mostly protein supplements, magnesium and omega-3fatty acids. Only 42% said they would feel an effect from taking DSs. Conclusions: Although the present study showed that the prevalence of usage was comparable to that of the civilian population, the sources of supply and the range of the substances taken give cause for concern. This calls for education and information campaigns to make the pilots aware of the possible risks to their health.

Abstract P022: MS #279 - Use Of Dietary Supplements And Risk Of Chronic Kidney Disease In The Hispanic Community Health Study/Study Of Latinos (HCHS/SOL)

Background: Dietary supplements (DS) are often used for their perceived health-promoting and therapeutic properties. Certain supplements can be nephrotoxic, especially among individuals at risk for chronic kidney disease (CKD). Hispanic/Latino populations are users of DS (30-70%) and have a high prevalence of conditions predisposing CKD. The potential contribution of DS use to risk of CKD in this population has not been studied. Objective: To assess whether DS use is associated with higher prevalence and incidence of CKD in Hispanic/Latinos. Methods: DS use was assessed in 16,279 of 16,415 Hispanic/Latinos enrolled in HCHS/SOL in 24-hour recall and 30-day medications inventory. Users of any DS were compared to those reporting no DS use. Prevalent CKD was defined with estimated glomerular filtration rate (eGFR) using the serum creatinine-cystatin C equation or urine albumin-to-creatinine ratio (ACR) ≥ 30 mg/g at baseline. Incident low eGFR and incident albuminuria at follow-up were defined as <60 mL/min/1.73 m 2 and ACR ≥ 30 mg/g, respectively. Incident CKD was defined as no prevalent CKD and incident low eGFR with eGFR decline ≥1ml/min/1.73 m 2 /year or incident albuminuria. We used multivariable logistic regression to estimate odds ratios (OR) for prevalence and Poisson regression for incidence rate ratios (IRR). Analyses accounted for HCHS/SOL complex sampling design. Results: DS users were older (median age 45 vs 35 years) and more likely to be female (57 vs 48%), have health insurance (54 vs 48%) and be born in the United States (26 vs 19%). Of DS users, 13% had prevalent CKD while 12% of non-DS users had prevalent CKD (adjusted OR 0.77 (95% CI 0.66, 0.91)). IRRs for incident CKD, low eGFR and albuminuria between users and non-users of DS were 1.0 (95% CI 0.84, 1.3), 0.87 (95% CI 0.61, 1.3), and 1.2 (95% CI 0.88, 1.6), respectively. Conclusions: DS use was associated with lower prevalent CKD at visit 1 and not associated with incident CKD, low eGFR or albuminuria at visit 2. DS use may be a proxy for health-seeking behavior in this population.

The Total Nutrient Index is a Useful Measure for Assessing Total Micronutrient Exposures Among US Adults

BackgroundMost dietary indices reflect foods and beverages and do not include exposures from dietary supplements (DS) that provide substantial amounts of micronutrients. A nutrient-based approach that captures total intake inclusive of DS can strengthen exposure assessment. ObjectivesWe examined the construct and criterion validity of the Total Nutrient Index (TNI) among US adults (≥19 years; nonpregnant or lactating). MethodsThe TNI includes 8 underconsumed micronutrients identified by the Dietary Guidelines for Americans: calcium; magnesium; potassium; choline; and vitamins A, C, D, and E. The TNI is expressed as a percentage of the RDA or Adequate Intake to compute micronutrient component scores; the mean of the component scores yields the TNI score, ranging from 0–100. Data from exemplary menus and the 2003–2006 (≥19 years; n= 8861) and 2011–2014 NHANES (≥19 years; n= 9954) were employed. Exemplary menus were used to determine whether the TNI yielded high scores from dietary sources (women, 31–50 years; men ≥ 70 years). TNI scores were correlated with Healthy Eating Index (HEI) 2015 overall and component scores for dairy, fruits, and vegetables; TNI component scores for vitamins A, C, D, and E were correlated with respective biomarker data. TNI scores were compared between groups with known differences in nutrient intake based on the literature. ResultsThe TNI yielded high scores on exemplary menus (84.8–93.3/100) and was moderately correlated (r = 0.48) with the HEI-2015. Mean TNI scores were significantly different for DS users (83.5) compared with nonusers (67.1); nonsmokers (76.8) compared with smokers (70.3); and those living with food security (76.6) compared with food insecurity (69.1). Correlations of TNI vitamin component scores with available biomarkers ranged from 0.12 (α-tocopherol) to 0.36 (serum 25-hydroxyvitamin D), and were significantly higher than correlations obtained from the diet alone. ConclusionsThe evaluation of validity supports that the TNI is a useful construct to assess total micronutrient exposures of underconsumed micronutrients among US adults.

Abstract P5-15-08: Dietary supplement use among BRCA1/2mutation carriers

Abstract INTRODUCTIONWomen who carry BRCA1/2 mutations are at significantly increased risk of breast, ovarian, pancreatic and other cancer. Little is known regarding the use of dietary supplements among women harboring BRCA1/2 mutations. This study aims to characterize the utilization of and attitudes toward dietary supplement use in women who carry BRCA1/2 mutations. METHODSPatients identified through a cancer genetics clinic as harboring a BRCA1/2 mutation were invited to complete an electronic survey focused on their use of nutritional supplements. Inclusion criteria included female sex, age 21 years or older, confirmed BRCA1/2 mutation status, and no active cancer treatment. Participants answered questions regarding type of supplement, extent of physician involvement with dietary supplement usage, and perceptions toward dietary supplement use. A 10-point Likert-scale was used to measure the motivations for supplement use. RESULTSA total of 208 BRCA1/2 mutation carriers were invited to participate, and 68 surveys were completed. Patient characteristics are depicted in Table 1 and include high education level, active participation in exercise, and a significant uptake of risk-reducing surgery. Forty-nine participants (84%) reported using some type of dietary supplement including B vitamins, multivitamins, magnesium, zinc, fish oil, and turmeric being the most commonly reported. Twenty-seven patients (59%) reported that the supplements were not prescribed by a physician, however, 38 patients (70%) reported that their physician was aware of their supplement use. All respondents indicated that it is important for physicians to know what types of supplements they are taking, and the majority felt comfortable discussing this topic with their doctors. Patients reported that the motivating factors included enhancing the body’s immune system, reducing inflammation, and improving mood, stamina, and energy. Lastly, participants expressed an awareness that dietary supplements could be harmful and interact with other medications. CONCLUSIONOur results show a high utilization of dietary supplement use in women who carry a BRCA1/2 mutation, and while the majority of these supplements were not prescribed by a physician, patients placed high value on physician involvement with their supplement use. The primary motivators for use of dietary supplements in this high-risk population include benefit to the body’s immune system, and positive impact on mood, stamina, and energy. The results of this study underscore the significant interest in nutritional supplements in this high-risk population, but also reveal that there is room to improve upon physician engagement. Table 1.Participant Demographic Information (N = 68)CharacteristicNo. (%)Age 18-25 26-34 35-39 40-49 50+3 (5.0%)12 (20.0%)7 (11.7%)10 (16.7%)28 (46.7%)Education Level High School or GED Some College College Degree Graduate/Professional Degree (PhD, MD)2 (3.3%)11 (18.3%)23 (38.3%)24 (40.0%)Past Breast Cancer/Ovarian Cancer Diagnosis Breast Cancer Ovarian Cancer22 (36.7%)2 (3.3%)Risk-Reducing Surgery Mastectomy Salpingo-Oophorectomy32 (53.3%)34 (56.7%)Moderate Exercise Every Day 2-3 Times per Week Once a Week Once or Twice a Month Rarely/Never15 (25.9%)26 (44.8%)10 (17.2%)2 (3.5%)5 (8.6%) Citation Format: Ryan Rogers, Tara Rangarajan, Virginia Uhley, Kristina Ivan, Dana Zakalik. Dietary supplement use among BRCA1/2mutation carriers [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P5-15-08.

Adverse Effects Associated with Multiple Categories of Dietary Supplements: The Military Dietary Supplement Use Study

BackgroundAbout 50% of Americans and 70% of US military service members (SMs) regularly use dietary supplements (DSs) and some are associated with adverse effects (AEs). SMs are more likely to use unsafe DSs than civilians. ObjectiveThe aim of this investigation was to examine the prevalence of, and factors associated with, AEs. DesignCross-sectional. ParticipantsA stratified random sample of 200,000 US SMs from the Air Force, Army, Marine Corps, and Navy were obtained from military workforce records. Eighteen percent (n = 26,681) of successfully contacted SMs (n = 146,365) volunteered to participate between December 2018 and August 2019. Participants completed a detailed online questionnaire on demographic characteristics, lifestyle factors, and AEs associated with DS use. Main outcome measurePrevalence of, and factors associated with, AEs among DS users. Statistical analysisPrevalence of AEs was calculated by DS categories. Linear trends, χ2 statistics, and multivariable logistic regression examined associations between AEs and demographic characteristics, lifestyle factors, and number DSs consumed. ResultsProportion of DS users (≥ 1 time /week) reporting ≥1 AE was 18% overall, 20% for combination products (ie, weight loss, muscle building, and before/after workout supplements), 8% for purported prohormones, 6% for protein/amino acid products, 6% for multivitamin/multiminerals, 6% for individual vitamins/minerals, 4% for herbal products, and 2% for joint health products. Combination products are very popular in military personnel with nearly half of SMs regularly taking them. In multivariable analysis, reporting AEs were independently associated with female gender, younger age, higher body mass index, smoking, higher alcohol intake, service in the Army, Navy, or Marine Corps (compared with Air Force), and consumption of a greater number of DSs. ConclusionsA large proportion of SMs report experiencing AEs, especially users of combination products and purported prohormone supplements. This study presents contemporary data collected from a very large at-risk population on potentially hazardous categories of DSs.

Physically inactive adults are the main users of sports dietary supplements in the capital of Brazil

PurposeThis cross-sectional study aimed to provide estimates of dietary supplements (DS) use and to examine the relationship between sports dietary supplements (SDS) use and sociodemographic and lifestyle characteristic, body mass index and total daily physical activity (PA) in the adult population of Brasília, Brazil.MethodsDS use was collected from 506 adults via a Food Frequency Questionnaire. DS were divided into multivitamin-minerals, electrolyte drinks, energy, protein, partial meal replacements, creatine, caffeine, and others. Electrolyte drinks, energy, and protein supplements were considered as SDS. PA was estimated from a 24-h PA recall, and total MET (metabolic equivalents)/day and MET-h/day were calculated. Participants were categorized as physically inactive or active according to MET-h/day.ResultsDS were used by 68% of adults; multivitamin-minerals (38%) and protein supplements (29%) were the most commonly used products. SDS use was associated with the highest socioeconomic level, younger age, and male gender, but not with PA. Also, most SDS users were physically inactive.ConclusionThese findings indicate that SDS may be used unnecessarily by adults in Brasília. Specific recommendations and control procedures for the use of SDS are warranted.

Dietary Supplement Use in Middle-aged and Older Adults.

Despite limited evidence of clinical benefits, dietary supplement use is increasingly common among older adults. The aim of this study was to characterise the prevalence of dietary supplement use in a national sample of community-dwelling middle-aged and older adults and investigate factors associated with its use. This was a cross-sectional study using data from the Health and Retirement Study (HRS), a biennial, nationally representative survey of individuals aged 50 years and older in the United States. This study combined data from the 2013/14 Health Care and Nutrition Survey (HCNS) and 2012 Core Survey. The primary outcome was the use of any dietary supplement at least once a week. Secondary outcomes were the use of multivitamins and specific vitamin and supplement types. Multivariable regression models were used to identify factors associated with any dietary supplement use. A total of 6045 participants (weighted n = 71,268,015) were included in the final analytical sample (mean age 67.7 years, 59.3% female). Of these, 84.6% (n=60,292,704) were regular dietary supplement users, with participants taking a mean of 3.2±0.1 different dietary supplements and 41.9% taking four or more. Multivitamins were the most common, used by 57.5% (n=41,147,146) of participants. Other commonly used dietary supplements were vitamin D, fish oil, calcium, vitamin C, and vitamin B12. Older age (75+ years), female sex, higher education, daily alcohol use, vigorous physical activity, regular medication use, and arthritis were associated with higher odds of dietary supplement use. In this sample of middle-aged and older Americans, more than 4 out of 5 used a dietary supplement. Certain demographic, behavioural, and clinical factors were associated with their use. Given the lack of evidence for improving health outcomes, our findings suggest potential overuse of dietary supplements in people over the age of 50.

Knowledge, awareness and practices regarding dietary supplements in Jordan


 
 
 
 Purpose: To investigative the knowledge, attitudes and beliefs pertaining to dietary supplements (DS) use in Jordan.
 Methods: Participants were enrolled from four main cities in Jordan, viz, Amman, Zarqa, Irbid, and Mafraq, to fill a self-administered questionnaire which explored the objectives of the study.
 Results: Most participants (80 %) knew what DS are. The prevalence of DS use was high (62.1 %) and significantly higher among females (p = 0.004). The most commonly consumed DS among users were in the form of multivitamins (93.0 %), vitamin D (65.8 %) and vitamin C (57.6 %). About half of the participants (46.2 %) believed that DS have no side effects. The most frequent source of information for participants about DS was from non-reliable references, such as social media. Self-prescription was the most common approach by DS users for supplement intake. Finally, the common hypothesis of associating healthy habits with DS use was not found to be true among Jordanians.
 Conclusion: These results highlight the need to implement appropriate awareness programs for the public regarding DS benefits and hazards, and especially to advise the public not to initiate DS use without first consulting an appropriate healthcare professional.
 
 
 

Food and nutrient intake in dietary supplement users: a nationwide school-based study in Japan.

Dietary supplements can be used to compensate for an inadequate diet. However, some studies indicate that supplement users consume healthier diets than non-users, although such data are lacking in Japanese children. The aim of the present study was to investigate the food and nutrient intake of dietary supplement users among school-aged children in Japan. A nationwide school dietary survey was conducted at fourteen elementary schools and thirteen junior high schools in twelve prefectures in Japan. Three-day non-consecutive semi-weighed dietary records were obtained on two weekdays and one weekend day. Analysis of covariance was performed to investigate differences in food and nutrient intake from meals consumed at school and outside of school between dietary supplement users and non-users, adjusted for socio-demographic and health-related characteristics. Of the 910 children included in this analysis, 80 (8⋅8 %) reported supplement use. Based on 3-d dietary records, dietary supplement users consumed higher mean amounts of oils and lower amounts of fruits and vegetables than non-users. In school lunches, users consumed significantly higher amounts of oils and lower amounts of protein than non-users. In meals consumed outside of school, dietary supplement users consumed significantly higher amounts of confectioneries and lower amounts of fruits and vegetables, folate, vitamin C and dietary fibre than non-users. Collectively, our findings indicate that dietary supplement users consumed less healthy diets than non-users. Additional studies are warranted to confirm these results and identify factors contributing to poorer dietary habits in supplement users.

Interprofessional Osteoarthritis Care: A Pilot for Interprofessional Care and Education

Background: An osteoarthritis (OA) pilot was initiated in an interprofessional clinic to provide a learning opportunity for practitioners to provide integrated care in the setting of OA to improve health outcomes and quality of life in patients living with osteoarthritis. This study was a qualitative analysis performed following the completion of the pilot. Purpose: To determine effective processes that support integrated care to best serve those living with osteoarthritis. Methods: Flyers and neighborhood mailers were provided to the community to inform patients of the OA pilot. Patients were screened by the nurse practitioner and physical therapists to ensure they met osteoarthritis criteria (> 45 years, were experiencing activity-related joint pain, and had no morning joint-related stiffness, or > 30 minutes of morning stiffness). The interventions included one integrated care visit (in-person) followed by telehealth care thereafter. Telehealth visits obtained patient feedback, provided further patient guidance based on patient-response to care plans, and to evaluate change in function, medication usage, and pain management from baseline. The following questions aided researchers to organize our findings following the 3-month pilot: (1) What methods were utilized to aid in patient function and mobility improvement? (2) What was done to ensure safe and effective medication use? (3) How best to utilize each practitioner so that (a) methods for pilot duplication were determined and (b) integrated care best practices were established? Results: Function and mobility improvement were exhibited in 100% of the patients. Mental health services were utilized to overcome fear of movement and fear of pain barriers to mobility. Half of the patients were originally performing movement exercises that were harmful to their condition prior to obtaining a consult with the physical therapist. The pharmacist-driven medication review during the initial consult identified 88% of the patients were utilizing suboptimal medications for the management of their OA, and 25% were using unsafe dietary supplements. All unsafe medication and dietary-supplement usage was resolved. Establishing care with a team visit supported integrated healthcare engagement. Telehealth and incorporation of healthcare students for follow-up calls were effective for utilization of all practitioners, patient engagement, and supported improved patient outcomes. Conclusion: The findings of this study outline best practices that support integrated care, integrated education, and improved patient outcomes.

Evaluation of Knowledge, Attitudes, and Practices Related to Dietary Supplements Intake among College Students: A Cross-sectional Study

Introduction: Food intake has been connected to health status for a long time. There are some products that are used to boost the nutrient density of the food intake, such as dietary supplements (DS). DS can defined as a concentrated source of nutrients with a nutritional or physiological effect that adds further nutritional value to the normal diet. Aim: This study investigated the intake of DS among students at the University of Jordan (JU) in Amman, as well as consumer’s Knowledge, Attitudes and Practices (KAP) regarding DS according to gender, Body Mass Index (BMI), science and humanities, and academic year streams. Materials and Methods: A descriptive cross-sectional questionnaire-based study was conducted over three months on 381 students selected by using convenient sampling method from the JU from different faculties including freshmen students and senior students between April and May 2018. The KAP was used to assess awareness of the study group on the topic. The questionnaire was divided into two parts, part I included questions related to participant’s socio-demographic characteristics and part II included 11 questions for assessing KAP related to DS. Face to face interview technique was used for data collection. Statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS) program (version 22.0). Pearson’s chi-square test for independence was used for the qualitative variables to detect the relationship between gender, BMI, faculty (humanities or science) and academic year and the corresponding KAP toward DS. p-value less than 0.05 was considered as statistically significant. Results: The results showed that the overall percentage of student’s knowledge of DS is only 13.65%, which indicates lack of knowledge in regard to DS. It was found that the percentage of intake of DS at least one per week among students was approximately 42%, which is considered relatively high. Regarding the results of the present study, there were statistically significant differences in faculty (p=0.001**) and BMI subdivisions (p=0.03*) in term of previous knowledge. Science facultie’s students had more information than humanities about the risks of DS (p=0.008*). Nearly (80%) of science and humanities faculties’ students have not received any training or attended in any health campaign about DS. Most of the students trusted the information that comes from health care professionals (65%). One third of DS users consumed them for no certain purpose (34%). Pharmacies were the most common source to buy supplements (87%). Furthermore, vitamin D and iron were the most frequently reported DS type used, while herbal supplements, omega 6, omega 9, multi minerals were the least common DS among participants. Conclusion: It can be concluded from results of this study that there was a relative high prevalence of DS consumption among JU students and students in general lacked knowledge about DS.

Use of Dietary Supplements and Perceived Knowledge among Adults Living with Fibromyalgia in Norway: A Cross-Sectional Study.

Fibromyalgia syndrome (FMS) is a complex medical condition characterized by widespread musculoskeletal pain. To date, no gold standard treatment has been developed, and persons with FMS often seek alternative methods to control their symptoms, such as dietary supplements (DS). This study aimed to describe the use of DS in persons living with FMS and examine the associations between the use of DS and its potential predictors. We recruited a convenience sample of 504 participants (≥18 years) living with FMS. The main outcome variables included estimated expenditure on DS in the last 12 months in Norwegian kroner (NOK) and the differences between the groups of users and non-users of DS. Of the 504 participants, 430 reported having used DS, and the mean amount of money spent in the previous year was determined to be NOK 2300. The most common DS reported were vitamin D, magnesium, and omega-3 fatty acids. The predictors of being a DS user were high education, high self-reported knowledge of DS but low overall knowledge of health claims. Users of DS marketed for muscles/joints appear to spend more money on DS. The increasing availability of DS and aggressive advertising in the media through health claims stipulate the need for interventions that lead to informed decisions about DS.

Dietary Supplements: A Survey Use, Attitudes and Knowledge Among IIUM Kuantan Students

Objectives: Dietary supplements have been recognized as products that are globally used, especially among university students due to its effectiveness and benefits towards health. In order to determine the efficiency of the supplements, the users must equip themselves with knowledge on the usage of dietary supplements. Hence, this study mainly aims to assess the usage, attitude and knowledge on dietary supplements among IIUM Kuantan students. Method: This study used a descriptive cross-sectional with stratified random sampling study among 349 undergraduate students at the International Islamic University Malaysia (IIUM), Kuantan campus. Data was collected using online questionnaires and shared with students from IIUM Kuantan campus. The data was analyzed by using IBM Statistical Package Social Science (SPSS) version 25.0. Results: The overall prevalence of dietary supplements used by the students in the university was 31.8%. On the other hand, students show to have positive attitude and good knowledge, 70.8% and 84.0%, respectively. There was an association between course study and presence of illness with the level of attitudes based on Fisher exact test with p-values of <0.05 representing statistical significance. The same test was used resulting in age and BMI were associated with the level of knowledge. Conclusion: Prevalence of dietary supplements used was lower than other local findings and most of the students depict a good level of knowledge and positive attitudes towards dietary supplements. nevertheless, educational information regarding dietary supplements still needs to be provided to university students as the number of consumers keeps rising.

Dietary vitamin D intake among university students and their habits concerning daily sunlight exposure – a cross-sectional study

Aim: To evaluate students’ dietary vitamin D intake according to characteristics and habits concerning daily sunlight exposure. Methods: The study included 403 students of the University of Rijeka, Croatia that fulfilled questionnaire about their characteristics, habits, physical activity, supplement use, diet, and their daily sunlight exposure. For assessing diet quality, the Dietary inflammatory index (DII®) was used. Results: Average dietary vitamin D intake was 2.76 μg/day, statistically highest among men (p<0.01), medical sciences universities’ students (p<0.01), students with obesity (p=0.03), highly physically active (p=0.02) and smokers (p=0.01). Major dietary vitamin D sources were fish (42%, p<0.01) and meat and meat products (31%). Students that more frequently expose themselves to the sunlight were mostly men, overweight, moderately physically active, dietary supplements users, and had a diet with more anti-inflammatory potential, higher dietary vitamin D intake and its major dietary sources. Those who rarely and never used a sunscreen had a more anti-inflammatory diet and higher vitamin D and its major food sources intakes. Diet with more pro-inflammatory potential had students that rarely or never directly expose themselves to the sunlight, likewise the students that frequently used sunscreen. Those subgroups also had the lowest dietary vitamin D intake. Conclusions: The average dietary vitamin D intake by investigated university students satisfied only the fifth of the recommended daily vitamin D intake. Students with habits that can influence the lower synthesis of vitamin D may increase the risk of diseases related to bone health, immunity and inflammation in their future life. Provided results about students’ habits of their exposure to the sunlight might be useful for public health messages toward sufficient sunlight exposure, diet quality with more anti-inflammatory potential, vitamin D supplements use, and vitamin D deficiency prevention.

Consumer Acceptance and Market Potential of Iodine-Biofortified Fruit and Vegetables in Germany.

Biofortification of food crops with iodine is a novel approach to preventing iodine deficiency in humans. The present study analyses the consumer target groups and the market potential of iodine-biofortified fruit and vegetables in Germany. For this purpose, an online survey of 1016 German fruit and vegetable consumers was conducted to investigate the acceptance of different product categories as well as relevant criteria for the market launch. The results show that iodine-biofortified fruit and vegetables are particularly attractive to consumers who purchase at farmers’ markets, organic food shops, and farm stores. Out of this group, 39% of consumers rate such iodine-rich foods as very appealing. They attach importance to food that naturally contains iodine and prefer produce from integrated domestic cultivation. With their focus on sustainability and naturalness, this group of consumers clearly differs from typical users of dietary supplements, who are primarily concerned with health benefits. However, overall about 85% of respondents would prefer biofortified fruits and vegetables to supplements to improve their iodine supply. The greatest market potential for iodine-biofortified fruit and vegetables is to be expected in supermarkets, as this is the preferred food shopping location for most consumers. A total of 28% of those who buy here rate the biofortified foods presented as very appealing. Nevertheless, a successful market launch requires that the benefits of the new products are communicated according to the potential consumer group needs.

Metabolic Activation of the Toxic Natural Products From Herbal and Dietary Supplements Leading to Toxicities.

Currently, herbal and dietary supplements have been widely applied to prevent and treat various diseases. However, the potential toxicities and adverse reactions of herbal and dietary supplements have been increasingly reported, and have gradually attracted widespread attention from clinical pharmacists and physicians. Metabolic activation of specific natural products from herbal and dietary supplements is mediated by hepatic cytochrome P450 or intestinal bacteria, and generates chemical reactive/toxic metabolites that bind to cellular reduced glutathione or macromolecules, and form reactive metabolites-glutathione/protein/DNA adducts, and these protein/DNA adducts can result in toxicities. The present review focuses on the relation between metabolic activation and toxicities of natural products, and provides updated, comprehensive and critical comment on the toxic mechanisms of reactive metabolites. The key inductive role of metabolic activation in toxicity is highlighted, and frequently toxic functional groups of toxic natural products were summarized. The biotransformation of drug cytochrome P450 or intestinal bacteria involved in metabolic activation were clarified, the reactive metabolites-protein adducts were selected as biomarkers for predicting toxicity. And finally, further perspectives between metabolic activation and toxicities of natural products from herbal and dietary supplements are discussed, to provide a reference for the reasonable and safe usage of herbal and dietary supplements.

Use of Nutritional Supplements Among Gym Clubs Participants in Sulaymaniyah City, Kurdistan Region of Iraq

Introduction: Using dietary supplements has gained interest amongst people who desire to enhance their body composition. However, there are scant published data regarding the use of nutritional supplements and gym users. This study is to assess the intake of nutritional and dietary supplements among gym members in Sulaymaniyah city, Iraqi Kurdistan.
 Methods: The results of this study are based on the responses of one hundred gym members (aged over 18 years) to a self-manage questionnaire.
 Results: Almost half of the sample reported taking nutritional supplements and hormones. Thirty percent of the participants were consuming different protein powders. Most dietary supplement users noticed some side effects. Supplement users should always consult their physicians and been under the supervision of professional trainers and medical practitioners. In this manner, dietary supplements should not cause any side effects such as hypertension, hepatic disturbance, kidney disorders, hepatic, kidney disturbance, and muscle pain. However, some people (gym participants) may experience allergies, upset stomach/abdominal pain, and frequent urination.
 Conclusion: The usage rate of fitness supplements is very high, and the users are not aware of the potential consequences or dangers of unsupervised practice or unprescribed products. Therefore, there is an immediate need to promote consumers’ awareness of this issue, and the latest scientific data must be provided to users and coaches concerning consuming supplements.

Assessment of Dietary Supplements Use among American University of Beirut Students: Prevalence, Knowledge, and Reasons for Supplementation

The purpose of this study was to evaluate the prevalence and type of supplements used among university students, level of knowledge in this respect, reasons to supplement their diet, and the sources for information about dietary supplements. A sample of 100 students at the American University of Beirut were surveyed through a questionnaire composed of 22 questions and divided into four sections: socio-demographic, anthropometric, dietary supplement (DS) knowledge, DS intake and reasons. Descriptive statistics were conducted to determine the frequency of respondents for each variable and appropriate statistical tests were used for associations according to variable type and data. A total of 100 participants were included in the study of which 49 (49.0%) were males and 51 (51.0%) were females. Sixty-eight participants were dietary supplement users, of which 27 (39.7%) were males and 41 (60.3%) were females. Supplementation reasons differed: 53 consumed supplements to improve energy and vitality, 22 to enhance cognitive performance, 22 to promote hair, skin and health, and 13 to prevent or treat cold. A significant association was observed between dietary supplements use and female gender (OR = 5.66, 95% CI: 1.60-20.10). No significance was found between consuming dietary supplements and smoking status, BMI, living conditions, medical condition, age, exercise, major, dietary knowledge, and side effects. More than half of the participants are dietary supplements users with females being more likely to use them. The main reason for both genders to resort to dietary supplement use is to improve their energy and vitality.