Variety Of Dietary Supplements Research Articles

Nutrition, Training, Supplementation, and Performance-Enhancing Drug Practices of Male and Female Physique Athletes Peaking for Competition.

Escalante, G, Barakat, C, Tinsley, GM, and Schoenfeld, BJ. Nutrition, training, supplementation, and performance-enhancing drug practices of male and female physique athletes peaking for competition. J Strength Cond Res 37(8): e444-e454, 2023-The purpose of this descriptive investigation was threefold: (a) to assess the nutrition, training, supplement, and performance-enhancement drug practices of male and female physique competitors 30 days before competition; (b) to examine the specific water and macronutrient manipulation performed by competitors during the last 3 days before competition; and (c) to assess physiological responses to precontest preparation including body composition, body fluids, resting heart rate, and blood pressure. Competitors reported performing moderately high volume, moderate to high repetition, split-body resistance training programs performed on most days of the week; the programs included the use of a variety of advanced training methods. A majority of competitors included cardio to expedite fat loss, and most reported performing cardio in a fasted state despite a lack of objective evidentiary support for the practice. Competitors substantially restricted calories and consumed protein in amounts well above research-based guidelines (>3 g·kg -1 ·d -1 ); carbohydrate and lipid intake were highly variable. Water was substantially reduced in the final 3 days before competition. Competitors used a variety of dietary supplements throughout the study period, many of which are not supported by research. Both male and female competitors reported using performance enhancing drugs (∼48 and ∼38%, respectively) including testosterone derivatives, selective androgen receptor modulators, and human growth hormone. More research is warranted to elucidate safer and more effective peak week practices for physique competitors.

Potential protective function of green tea polyphenol EGCG against high glucose-induced cardiac injury and aging

Green tea and its active extracts have been widely used in a variety of dietary supplements. However, to date, the interaction of these bioactive compounds in green tea and their protein targets are not well studied. We first used the bioinformatics analysis of the relevant diabetes-related targets with the green tea bioactive compounds target proteins to construct a protein interaction (PPI) network to screen the core targets. The results of in vitro experiments showed that EGCG, a major polyphenolic component of green tea, inhibited HG-induced cardiomyocyte hypertrophy, inflammation, oxidative stress response, and cellular senescence. It was found that the PPARG-dependent pathways were involved in the protective effects of EGCG against HG-induced myocardial injury and senescence. This study comprehensively explored the role of EGCG in high glucose-induced myocardial cell injury and aging.

Chapter 13 - Currently available therapies in mitochondrial disease

Mitochondrial diseases are a heterogeneous group of multisystem disorders caused by impaired mitochondrial function. These disorders occur at any age and involve any tissue, typically affecting organs highly dependent on aerobic metabolism. Diagnosis and management are extremely difficult due to various underlying genetic defects and a wide range of clinical symptoms. Preventive care and active surveillance are strategies to try to reduce morbidity and mortality by timely treatment of organ-specific complications. More specific interventional therapies are in early phases of development and no effective treatment or cure currently exists. A variety of dietary supplements have been utilized based on biological logic. For several reasons, few randomized controlled trials have been completed to assess the efficacy of these supplements. The majority of the literature on supplement efficacy represents case reports, retrospective analyses and open-label studies. We briefly review selected supplements that have some degree of clinical research support. In mitochondrial diseases, potential triggers of metabolic decompensation or medications that are potentially toxic to mitochondrial function should be avoided. We shortly summarize current recommendations on safe medication in mitochondrial diseases. Finally, we focus on the frequent and debilitating symptoms of exercise intolerance and fatigue and their management including physical training strategies.

Sampling Plan for a Study of Cranberry Dietary Supplements (DS) for the Dietary Supplement Ingredient Database (DSID)

ObjectivesThe intake of cranberry juice or supplements has been found in several, but not all, clinical studies to reduce the recurrence of urinary tract infections (UTIs). Several studies indicate that cranberry proanthocyanidins (PACs) may have a role in UTI prevention due to their ability to inhibit bacterial adhesion. For cranberry DS products on the US market, the relationship between PAC content and the cranberry source (e.g., powder, juice, extract) used in formulations is largely unknown. Therefore, a sampling plan was developed to identify and purchase DS for PAC testing as part of the Dietary Supplement Ingredient Database project. This will include popular cranberry DS, those used in clinical trials, and products with a variety of label claims and source ingredients. MethodsDS usage data from the National Health and Nutrition Examination Survey and retail sales data were used to identify the most popular cranberry DS in the natural health (NH), mass market (MM), and direct distribution sales channels. Other sources of information were the Dietary Supplement Label Database and web-based DS sellers. Three DS label categories were identified: those with a trademarked cranberry ingredient, those without a trademarked cranberry ingredient, and those with a numeric PAC claim. Some products may fall into two categories. Most products chosen for the study had cranberry as the primary ingredient by weight. Popular products with D-mannose and vitamin C were also included. ResultsIn the first phase of this study, we purchased 41 DSs (18 MM, 11 NH, and 12 direct). Our sample included caplets, capsules, soft gels, tablets, and liquid DSs. Cranberry source materials for the DSs included extracts, concentrates, powder, juice, and whole fruit. Fifteen (15) supplements had trademarked cranberry ingredients and 9 had a specific voluntary claim for PAC content. ConclusionsIn 2020, cranberries were the 6th ranked herbal ingredient sold in the US, according to the Nutrition Business Journal. The range of PAC content in the diverse cranberry DSs on the market is currently not known, since there is no requirement for this information on labels. This study will answer questions about the PAC content in a variety of DSs and whether multiple laboratories testing using the dimethylaminocinnamaldehyde (DMAC) method will yield similar results. Funding SourcesNIH ODS and the USDA.

Diagnosis and Therapy of Iron Deficiency Anemia During Pregnancy: Recommendation of the Austrian Society for Gynecology and Obstetrics (OEGGG).

This overview analyzes the data on the controversial therapy of iron substitution during pregnancy, the diagnosis of iron deficiency anemia and the indication-related therapy, and is the first recommendation issued by the OEGGG on the appropriate therapy. The effects of anemia during pregnancy on postnatal outcomes have been intensively investigated with heterogeneous results. A final scientific conclusion with regards to the “optimal” maternal hemoglobin level is limited by the heterogeneous results of various studies, many of which were conducted in emerging nations (with different dietary habits and structural differences in the respective healthcare systems). The current literature even suggests that there may be a connection between both decreased and increased maternal serum hemoglobin concentrations and unfavorable short-term and long-term neonatal outcomes. In Austria, 67 percent of pregnant women take pharmacological supplements or use a variety of dietary supplements. Clinically, the prevalence of maternal anemia is often overestimated, leading to overtreatment of pregnant women (iron substitution without a medical indication). To obtain a differential diagnosis, a workup of the indications for treatment should be carried out prior to initiating any form of iron substitution during pregnancy. If treatment is medically indicated, oral iron substitution is usually sufficient. Because of the restricted approval and potential side effects, medical indications for intravenous iron substitution should be limited. Intravenous iron substitution without a prior detailed diagnostic workup is an off-label use and should only be used in very limited cases, and women should be advised accordingly.

Dietary supplement use in elementary school children: a Japanese web-based survey

BackgroundA 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.MethodWe 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.ResultsAmong 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.ConclusionThis 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.

Dietary Supplements Intended for Children–—Proposed Classification of Products Available on the Market

Lately, it has been observed that the variety of dietary supplements is rapidly growing. The aim of the study is to extend the classification of dietary supplements (DSs) intended for children above the age of 3, as well as to categorize the ingredients used to manufacture such products. Three hundred fifteen dietary supplements intended for children from 3 to 12 years old, available on the Polish market, were chosen. Evaluation of product specifications provided by the producers, which included lists of ingredients as well as health and nutrition claims found on labels or online, was conducted. Among the available products, one can distinguish supplements with overall health effects used to supplement the diet (such as multivitamin supplements) as well as products for specific conditions, which can be divided into a total of 10 groups of products. Substances that can be found in dietary supplements were also systematized and divided into eight categories, which constitute a division of DSs active ingredients. The results of this research are an extension to the already existing Polish and European classification, which can be applied to classify products intended for children as well as for adults.

Vitamin D in migraine headache: a comprehensive review on literature.

As a primary headache, migraine has been established as the first leading disability cause worldwide in the subjects who aged less than 50years. A variety of dietary supplements have been introduced for migraine complementary treatment. As an anti-inflammatory and antioxidant agent, vitamin D is one of these agents which has been of interest in recent years. Although higher prevalence of vitamin D deficiency/insufficiency has been highlighted among migraineurs compared to controls, there is not any consensus in prescribing vitamin D in clinical practice. Therefore, in the current review, in addition to observational and case-control studies, we also included clinical trials concerning the effects of vitamin D supplementation on migraine/headache. Based on a PubMed/MEDLINE and ScienceDirect database search, this review study includes published articles up to June 2019 concerning the association between migraine/headache and vitamin D status or supplementation. The percentage of subjects with vitamin D deficiency and insufficiency among migraineurs and headache patients has been reported to vary between 45 and 100%. In a number of studies, vitamin D level was negatively correlated with frequency of headaches. The present findings show that supplementation with this vitamin in a dose of 1000-4000IU/d could reduce the frequency of attacks in migraineurs. It seems a high proportion of migraine patients might suffer from vitamin D deficiency/insufficiency. Further, the current evidence shows that in addition to routine drug therapy, vitamin D administration might reduce the frequency of attacks in migraineurs. However, these results have yet to be confirmed.

Design and methods for the Ranger Resilience and Improved Performance on Phospholipid bound Omega-3's (RRIPP-3 study)

Intake of nutrients fundamental for optimal neuronal function is of increasing interest. The potential importance of omega-3 highly unsaturated fatty acids (HUFAs) for optimizing emotional states, cognitive function, and mental health has been demonstrated in observational studies and randomized controlled trials. Omega-3 (HUFAs), specifically EPA (eicosapentaenoic acid) and docosahexaenoic acid (DHA), are concentrated in neural tissues and are essential for neural function, normative neurodevelopment, neurotransmitter, and neural immune functions. Omega-3 HUFAs must be obtained from the diet, predominantly from marine sources such as fish and other seafood. HUFAs also can be found in a variety of dietary supplements (omega-3 fatty acid esters, fish oil and krill oil). As dietary supplements, omega-3 HUFAs (fatty acid esters, fish and krill oils) differ substantially in their physicochemical properties and nutrient content. Here we present the design and methods for the Ranger Resilience and Improved Performance on Phospholipid bound Omega-3's (RRIPP-3) study. RRIPP-3 was a double blind, randomized, controlled trial among individuals in the United States (US) Army Infantry Basic Officer Leaders Course (IBOLC) and following US Ranger School training (RC) at Fort Benning, GA of omega-3 HUFA on krill oil versus placebo supplementation. The RRIPP-3 study sought to determine if krill oil supplementation with omega-3 HUFAs supports aspects of cognitive functioning critical to battlefield success when measured immediately after an intense combat simulation. Sub-analyses addressed basic improvements in IBOLC performance. We also describe additional outcome measures critical for interpretation of the study results, such as diet and other dietary supplement use.

Prevalence and Characteristic of Dietary Supplement Users in Malaysia: Data From the Malaysian Adult Nutrition Survey (MANS) 2014

BACKGROUND: There has been an increase trend of dietary supplements intake among Malaysians over the last decade. The aim of this study was to determine the prevalence and characteristic of dietary supplements users among adults in Malaysia. METHODS: Data of 3000 respondents aged 18–59 years from the Malaysian Adult Nutrition Survey (MANS) 2014 were utilized. A multi-stage stratified sampling method was employed and eligible respondent from each household was selected using Kish method. Validated questionnaire was used to gather information on vitamin/mineral supplements (VMS) and food supplements (FS). Descriptive analysis and multiple logistic regressions were conducted using SPSS version 20.0. RESULTS: The prevalence of VMS and FS intakes among adults in Malaysian were 28.1% and 34.0% respectively. Women, older aged adults with higher education level and monthly income were more likely to consume dietary supplements. Vitamin C and multivitamin/ multimineral, were the commonest VMS consumed by the respondents. The most common FS taken were fish oil and royal jelly. The main causes for dietary supplements intake include for health reasons, doctor’s prescription, to increase energy level and for beauty. CONCLUSIONS: About one third of the Malaysian adults took variety of dietary supplements. Thus, information based on the scientific evidences of health benefits for each type of the dietary supplements is needed to enable consumers to make informed choices on the dietary supplements.

Moderate Intake of Flavonoid-Rich Tea, Green or Black, Confers Cardiovascular Protection

A variety of dietary supplements have been proposed for the management of hypertension and other cardiovascular diseases, but the evidence for their efficacy is meagre. 1 However, over the last few years, there is growing interest in the potential benefit of tea in cardiovascular protection. 2-4 Tea is the extract of Camellia sinensis , and one of the most widely enjoyed drinks. 2,3 The leaves of the plant are rich in flavonoids, containing several phytochemicals including phenols and catechins, to which potent antioxidant, free radical scavenging, appetite-modifying and hypolipidemic effects have been ascribed. 2-7 Long-term consumption of beverages containing catechins inhibits the formation of oxidized lipids and decreases body fat. 5-9 Over 70% of flavonoids in green tea are catechins. Epigallocatechin-3-gallate (EGCG) is the cardinal (65%) catechin in green tea. In-vitro studies have shown that the epigallocatechins in green tea have angiotensin converting enzyme inhibitor properties, 10 and vasodilatory actions. 11 Molecular and animal studies have demonstrated that green tea catechins enhance processes, thought to stimulate bile acid production, decrease cholesterol concentration in the hepatocytes, inhibit intestinal absorption of lipids and upregulate low-density lipoprotein (LDL) receptors in the liver, mechanisms all leading to favorable blood lipid profile. 2-4,12,13 Black tea also contains small amounts of catechins. However, due to the fermentation process of black tea, its primary antioxidant polyphenols are theaflavins and thearubigins, equally effective antioxidants to catechins. 14... (excerpt)

Individuals at risk of metabolic syndrome are more likely to use a variety of dietary supplements

BackgroundIt has been suggested that users of dietary supplements are likely to be people who are more health conscious. It is therefore conceivable that developing a metabolic disorder, such as diabetes, insulin resistance or hypertension, may make an individual more receptive to dietary supplement use. The aim of this study was to determine whether individuals with self-reported features of metabolic syndrome (FeMS) were more likely to use different dietary supplements compared with individuals without self-reported FeMS. MethodIn this cross sectional survey a total of 300 individuals working or studying in a UK university were invited to participate in the study. A self-administered questionnaire was used to collect data on demographics, health status, use of dietary supplements and lifestyle. ResultsA total o the 210 individuals completing the questionnaire, 32% (n=66) were currently using or had used dietary supplements in the past 12 months. The five most common dietary supplements used were; multi vitamins (38%), fish oils (35%), calcium (26%), different herbal supplements (24%) and omega 3 oils (24%). Individuals with FeMS (defined as at least 1 self reported condition of; diabetes, hypertension, dyslipidaemia or obesity), (n=54; 28%) were more likely (P<0.05) to use different types of dietary supplements and less likely to report or discuss the use of dietary supplements with their general practitioner (P=0.043) than those without FeMS. DiscussionFeMS may be an independent predictor of dietary supplement use. Dietary supplement use is more common in older individuals and those with higher educational status.

Determination of Total Iodine in Foods and Dietary Supplements Using Inductively Coupled Plasma–Mass Spectrometry

A method was developed and validated for the determination of total iodine in a wide variety of food products and dietary supplements. The method involves a unique sample digestion with a KOH solution in an oven or by using an open-vessel microwave system. After digestion, a stabilizer is added and the solution is taken to volume, then filtered and analyzed either directly or after dilution. The amount of iodine is determined with inductively coupled plasma-mass spectrometry (ICP-MS). The method was validated by experiments to determine its precision, accuracy, linearity, specificity, ruggedness, and robustness. The LOQ of this method is 25-50 microg/kg. The method demonstrated an average RSD of 2.27% during analysis of milk powder and 4.30% during analysis of a dietary supplement tablet reference material. The accuracy of the method as determined with these same reference materials was 100 and 94.2%, respectively. The method has been used successfully on commodity foods, processed foods, dairy products, pet food, infant formula, animal feed, mineral premixes, and a variety of dietary supplements.

Analysis and Confirmation of 1,3-DMAA and 1,4-DMAA in Geranium Plants Using High Performance Liquid Chromatography with Tandem Mass Spectrometry at ng/g Concentrations

1,3-Dimethylamylamine (1,3-DMAA) is a stimulant commercially sold in a variety of dietary supplements as a chemical species derived from geranium plants (Pelargonium graveolens). Whether 1,3-DMAA naturally occurs in geranium plants or other dietary ingredients, it has important regulatory and commercial ramifications. However, the analysis of 1,3-DMAA in geranium plants is not trivial due to low concentrations and a complex environmental matrix, requiring high selectivity and sensitivity. An extraction method combined with high performance liquid chromatography and tandem mass spectrometry is used to determine 1,3-DMAA and 1,4-dimethylamylamine (1,4-DMAA) concentrations in geranium plants with both external calibration and standard addition method. Samples from the Changzhou, Kunming, and Guiyang regions of China during both winter and summer were analyzed for 1,3-DMAA and 1,4-DMAA. The diastereomer ratios of the 1,3-DMAA stereoisomers of a racemic standard and the extracted plant were also quantified.

Zyflamend suppresses growth and sensitizes human pancreatic tumors to gemcitabine in an orthotopic mouse model through modulation of multiple targets

Agents that can potentiate the efficacy of standard chemotherapy against pancreatic cancer are of great interest. Because of their low cost and safety, patients commonly use a variety of dietary supplements, although evidence of their efficacy is often lacking. One such commonly used food supplement is Zyflamend, a polyherbal preparation with potent anti-inflammatory activities and preclinical efficacy against prostate and oral cancer. Whether Zyflamend has any efficacy against human pancreatic cancer alone or in combination with gemcitibine, a commonly used agent, was examined in cell cultures and in an orthotopic mouse model. In vitro, Zyflamend inhibited the proliferation of pancreatic cancer cell lines regardless of p53 status and also enhanced gemcitabine-induced apoptosis. This finding correlated with inhibition of NF-κB activation by Zyflamend and suppression of cyclin D1, c-myc, COX-2, Bcl-2, IAP, survivin, VEGF, ICAM-1 and CXCR4. In nude mice, oral administration of Zyflamend alone significantly inhibited the growth of orthotopically transplanted human pancreatic tumors, and when combined with gemcitabine, further enhanced the antitumor effects. Immunohistochemical and Western blot analyses of tumor tissue showed that the suppression of pancreatic cancer growth correlated with inhibition of proliferation index marker (Ki-67), COX-2, MMP-9, NF-κB and VEGF. Overall, these results suggest that the concentrated multiherb product Zyflamend alone can inhibit the growth of human pancreatic tumors and, in addition, can sensitize pancreatic cancers to gemcitabine through the suppression of multiple targets linked to tumorigenesis.

Abstract ED04-02: Update on COX-2 inhibitors in cancer prevention

Abstract ED04-02: Update on COX-2 inhibitors in cancer prevention

The efficacy of Phaseolus vulgaris as a weight-loss supplement: a systematic review and meta-analysis of randomised clinical trials

A variety of dietary supplements are presently available as slimming aids, but their efficacy has not been proven. One such slimming aid is the bean extract, Phaseolus vulgaris. The aim of the present systematic review is to evaluate the evidence for or against the efficacy of P. vulgaris. Electronic and non-electronic searches were conducted to identify relevant human randomised clinical trials (RCT). Hand searches of bibliographies were also conducted. No age, time or language restrictions were imposed. The eligibility of studies was determined by two reviewers independently, and the methodological quality of the included studies was assessed. We identified eleven eligible trials, and six were included. All the included RCT had serious methodological flaws. A meta-analysis revealed a statistically non-significant difference in weight loss between P. vulgaris and placebo groups (mean difference (MD) − 1.77 kg, 95 % CI − 3.33, 0.33). A further meta-analysis revealed a statistically significant reduction in body fat favouring P. vulgaris over placebo (MD − 1.86 kg, 95 % CI − 3.39, − 0.32). Heterogeneity was evident in both analyses. The poor quality of the included RCT prevents us from drawing any firm conclusions about the effects of P. vulgaris supplementation on body weight. Larger and more rigorous trials are needed to objectively assess the effects of this herbal supplement.

Method for the Determination of Lycopene in Supplements and Raw Material by Reversed-Phase Liquid Chromatography: Single-Laboratory Validation

A single laboratory validation (SLV) study was conducted for a liquid chromatography (LC) method for the determination of total and all-trans-beta-carotene in a variety of dietary supplements, including multivitamin tablets, softgels, capsules, and beadlet raw materials. Extraction variants were developed for the different types of supplements tested based upon the supplement type and level of beta-carotene. Water dispersible formulations such as powders, emulsions, tablets, and capsules were enzymatically digested with protease and extracted with dichloromethane-ethanol. Oily suspensions were directly dissolved in dichloromethane-ethanol. After appropriate dilution or concentration, the extracts were chromatographed by using either a reversed-phase C18 column or, in products containing high amounts of alpha-carotene, a reversed-phase C30 column. The LC systems provided linear responses in the range of 0.1-50 microg beta-carotene/mL. The main geometrical isomers of beta-carotene (all-trans, 9-cis, 13-cis, and 15-cis) were well separated from each other and from other carotenoids such as a-carotene, cryptoxanthin, lutein, lycopene, and zeaxanthin. Duplicate determinations of total beta-carotene performed by 2 technicians in 8 different test materials on 5 different days resulted in relative standard deviations of 1.2-4.4%. Recoveries determined for supplements and beadlet raw material spiked with beta-carotene levels of 10 microg to 100 mg/test portion and 0.2-40%, respectively, ranged from 97.5 to 102.1%. On the basis of the accuracy, precision, and recovery results from the SLV study, the method is suggested for a collaborative study on the determination of total and all-trans-beta-carotene in dietary supplements.

Method for the Determination of Aconitum Alkaloids in Dietary Supplements and Raw Materials by Reversed-Phase Liquid Chromatography with Ultraviolet Detection and Confirmation by Tandem Mass Spectrometry: Single-Laboratory Validation

A study of single-laboratory validation (SLV) of a reversed-phase liquid chromatography (RP-LC) method was conducted for the determination of diester-diterpene Aconitum alkaloids, viz., aconitine, mesaconitine, and hypaconitine, in a variety of dietary supplements, including single- and multiple-ingredient dry powder extracts, pills, capsules, and raw materials. The Aconitum alkaloids in the samples were extracted by diethyl ether in the presence of ammonia. After cleanup with solid-phase extraction to remove the matrix interferences, the alkaloids were determined by RP-LC with UV detection at 235 nm, and the results were confirmed by tandem mass spectrometry. The linear responses for aconitine, mesaconitine, and hypaconitine based on the present LC system ranged from 0.5 to 200 microg/mL. Relative standard deviations of 2.0 to 6.9% were obtained from duplicate analysis of 6 test materials of different matrixes for the 3 Aconitum alkaloids performed by 2 analysts on 5 different days. The recoveries determined for supplements and raw materials spiked with 3 Aconitum alkaloids at levels of 2.5-10 microg/g were in the range of 86-99%. In view of the attainment of satisfactory results for accuracy, precision, and recovery in the SLV study, it is recommended that the method validation process proceed to a collaborative study.

Perceived Efficacy, Indications, and Information Sources for Medically Indigent Patients and Their Healthcare Providers Regarding Dietary Supplements

Evidence exists that medically indigent and minority patients use dietary supplements at rates as high or higher than that of the general population. Safety concerns regarding the use of dietary supplements are further exacerbated by a suboptimal level of patient disclosure and provider inquiry. To determine dietary supplement use, indications, perceived efficacy, and information sources of patients and providers using a pilot study in a clinic for the medically indigent. Five hundred self-administered patient surveys and 50 healthcare provider surveys were made available to any patient at a free health clinic in Kansas City, MO. Surveys were collected and descriptive analyses were performed. Three hundred eleven patient surveys were returned. Of the 37.3% (116/311) of respondents who had used dietary supplements, 13.8% (n = 16) had 10 comorbid conditions. Ninety-six dietary supplements were used for 8 medical condition categories. The 9 agents most frequently reported used were garlic (n = 32), aloe/green tea (n = 27 each), chamomile/echinacea (n = 24 each), St. John's wort (n = 22), ginseng (n = 18), and cranberry/Ginkgo biloba (n = 17 each). Patients reported a broad range of indications for taking dietary supplements. Patients reported (mean +/- SD) 2.37 +/- 4.23 agents as effective and 0.78 +/- 1.73 as ineffective or harmful. Provider surveys revealed that 60% (21/35) and 74% (26/35) were currently or had ever used dietary supplements, respectively. Fifty-seven percent (20/35) of providers reported attending educational programs on dietary supplements, and providers perceived patient supplement use to be most influenced by advertisements (40%) and friends (40%). The medically indigent population uses a wide variety of dietary supplements. There is little consistency in perceived indications, which may prevent clinicians from accurately predicting specific herbal use rationale given any individual's or population's set of comorbid conditions. Clinicians are encouraged to accurately determine their individual practice setting's use pattern.