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1.
Artigo em Alemão | MEDLINE | ID: mdl-31529182

RESUMO

In KiGGS Wave 2, data from 3­ to 17-year-olds were collected from a total of 3462 persons using a standardized interview on the current use of AM/NEM in the last seven days. For trends analysis, data from 14,679 study participants in the same age group from the KiGGS baseline study were used.In KiGGS Wave 2, 36.4% (95% CI 34.1-38.8) of the 3­ to 17-year-olds had used at least one AM/NEM in the last seven days. The prevalence was highest at 46.5% in 14- to 17-year-olds and significantly different between girls and boys (56.4% vs. 37.3%). Only among girls were there significant differences by migrant background with a higher prevalence of use among girls without a migrant background.Most frequently, the preparations used were for treatment of the respiratory tract (girls: 14.2%, boys: 14.9%), followed by "Varia" (girls: 8.7%, boys: 9.3%) and preparations for the treatment of the musculoskeletal system (girls: 8.9%, boys: 5.8%). There was a significant decrease in the overall prevalence of medicine use compared to the KiGGS baseline study (46.4% vs. 36.4%). This decrease was mainly due to lower prevalences of use in the ATC main groups "N Nervous System" (7.5% vs. 5.4%), "J Systemic Anti-infectives" (2.5% vs. 1.4%) and "H Systemic Hormones, excl. Sexual Hormones and Insulins" (2.0% vs. 1.1%).The results describe key points in the use of AM/NEM, including self-medication for children and adolescents in Germany. They illustrate the use behaviour and represent a valuable supplement to prescription data.


Assuntos
Suplementos Nutricionais/estatística & dados numéricos , Automedicação/estatística & dados numéricos , Adolescente , Saúde do Adolescente , Criança , Saúde da Criança , Estudos Transversais , Feminino , Alemanha/epidemiologia , Inquéritos Epidemiológicos , Humanos , Masculino , Prevalência
2.
BMC Public Health ; 19(1): 1119, 2019 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-31416429

RESUMO

BACKGROUND: Vitamin D deficiency has been highlighted as a serious public health problem in the United Kingdom. One in four toddlers are not achieving the recommended intake for their healthy development. This study uses quantitative and qualitative methods to explore parents' perceptions, awareness and behaviours around vitamin D intake, and the acceptability of and factors affecting purchasing of food and drink fortified with Vitamin D in children aged 0-2 years old. METHODS: One hundred and ninety-four parents completed an online questionnaire, advertised to parents with one child aged up to 2 years on popular social media websites. The majority of participants were mothers, White-British ethnic background, aged 25-44 years. Participants provided an email address if they wanted to be contacted about the focus groups. Recruitment posters advertising the focus groups were placed in community centres. Eighteen participated in 5 focus groups (13 parents), and 5 individual interviews. A thematic analysis methodology was applied. RESULTS: Fifty-seven percent (n = 110) of parents reported receiving information about vitamin D during pregnancy and 52% (n = 100) after the birth of their child. Parents reported a low level of satisfaction with vitamin D information: many thought it was limited and recommendations on supplements were unclear. Parents wanted more information about vitamin D requirements for their child (80%, n = 153 out of 192 respondents, 2 non-response), about vitamin D and breastfeeding (56%, n = 108) and vitamin D and pregnancy (49%, n = 94). The recommendations were for simpler, easier to read, with specific and clearer guidelines; delivered regularly during routine appointments, at timely stages throughout pregnancy and after the birth. 23% (n = 45, out of 194 respondents) of parents did not know why vitamin D is important for health. Only 26% (n = 49, out of 192 respondents) of parents reported giving their youngest child a vitamin D supplement on most days of the week. The majority of parents (interview/focus group) wanted more information about foods/drinks fortified with vitamin D. CONCLUSION: Parents were generally not aware of the importance of vitamin D, dietary requirements including supplementation and the availability of vitamin D fortified foods. Major improvements are required for the effective promotion of vitamin D information to parents.


Assuntos
Dieta/psicologia , Pais/psicologia , Deficiência de Vitamina D/psicologia , Vitamina D/análise , Vitaminas/análise , Adulto , Pré-Escolar , Suplementos Nutricionais/estatística & dados numéricos , Feminino , Alimentos Fortificados/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Lactente , Recém-Nascido , Masculino , Necessidades Nutricionais , Gravidez , Pesquisa Qualitativa , Inquéritos e Questionários , Reino Unido
3.
BMC Complement Altern Med ; 19(1): 229, 2019 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-31438941

RESUMO

BACKGROUND: Use of complementary and alternative medicine (CAM), including vitamins, minerals, herbals, and other dietary supplements, is widespread in the United States (ranging from 24% in Hispanics to 50% in American Indians). Pharmacists are an accessible source for healthcare information, but little is known about their use of CAM products and to whom they would recommend these products. METHODS: A cross-sectional survey was sent via email to pharmacists licensed in one state in the United States in 2015. The survey included items about their use of 10 vitamins and minerals, and 21 herbal or other dietary supplements, as well as reasons for use, conditions used to treat, if they would recommend the product to patients, family, or friends, their perception of CAM safety and effectiveness, and four demographic questions. Descriptive statistics were used to summarize the data, and a chi-square test was used to determine differences between pharmacists' use of vitamins/minerals and herbals/other dietary supplements. The a priori alpha level was 0.05. RESULTS: A total of 639 pharmacists completed the survey. Female pharmacists used vitamins/minerals (p = 0.031) and herbals/others (p = 0.039) more than male pharmacists. Older pharmacists used herbals/others more than younger pharmacists (p < 0.001). Fifty-nine percent thought the dietary supplements in the survey were safe while 32% reported they were effective. Seventy-eight percent of respondents reported use of any vitamin or mineral product versus 42% who reported use of any herbal or other dietary supplement. Commonly used products included: multivitamins (91%), vitamin C (71%), fish oil (65%), probiotics (53%), and fiber (53%). The most commonly reported reason for use was general health and wellness (17-90%). Pharmacists most commonly recommend fiber/psyllium (94%) and calcium (90%) to patients, family, and friends. CONCLUSIONS: Pharmacists in this survey selectively used vitamins, minerals, herbals and other dietary supplements, and recommended some of the more commonly used products to patients, family and friends. This is valuable information given that pharmacists are frontline healthcare professionals who may be asked to provide advice about these products.


Assuntos
Micronutrientes/uso terapêutico , Educação de Pacientes como Assunto/estatística & dados numéricos , Farmacêuticos/estatística & dados numéricos , Preparações de Plantas/uso terapêutico , Adulto , Atitude do Pessoal de Saúde , Terapias Complementares/estatística & dados numéricos , Estudos Transversais , Suplementos Nutricionais/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Educação de Pacientes como Assunto/métodos , Farmácia , Estados Unidos/epidemiologia , Adulto Jovem
4.
BMC Complement Altern Med ; 19(1): 196, 2019 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-31375101

RESUMO

BACKGROUND: The rise in use of food supplements based on botanical ingredients (herbal supplements) is depicted as part of a trend empowering consumers to manage their day-to-day health needs, which presupposes access to clear and accurate information to make effective choices. Evidence regarding herbal supplement efficacy is extremely variable so recent regulations eliminating unsubstantiated claims about potential effects leave producers able to provide very little information about their products. Medical practitioners are rarely educated about herbal supplements and most users learn about them via word-of-mouth, allowing dangerous misconceptions to thrive, chief among them the assumption that natural products are inherently safe. Print media is prolific among the information channels still able to freely discuss herbal supplements. METHOD: This study thematically analyses how 76 newspaper/magazine articles from the UK, Romania and Italy portray the potential risks and benefits of herbal supplements. RESULTS: Most articles referenced both risks and benefits and were factually accurate but often lacked context and impartiality. More telling was how the risks and benefits were framed in service of a chosen narrative, the paucity of authoritative information allowing journalists leeway to recontextualise herbal supplements in ways that serviced the goals and values of their specific publications and readerships. CONCLUSION: Providing sufficient information to empower consumers should not be the responsibility of print media, instead an accessible source of objective information is required.


Assuntos
Suplementos Nutricionais/estatística & dados numéricos , Comunicação , Informática Aplicada à Saúde dos Consumidores , Suplementos Nutricionais/análise , Humanos , Itália , Publicações Periódicas como Assunto , Medição de Risco , Romênia , Reino Unido
5.
J Strength Cond Res ; 33(9): 2308-2320, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31343547

RESUMO

Winwood, PW, Pritchard, HJ, Wilson, D, Dudson, M, and Keogh, JWL. The competition-day preparation strategies of strongman athletes. J Strength Cond Res 33(9): 2308-2320, 2019-This study provides the first empirical evidence of the competition-day preparation strategies used by strongman athletes. Strongman athletes (n = 132) (mean ± SD: 33.7 ± 8.1 years, 178.2 ± 11.1 cm, 107.0 ± 28.6 kg, 12.8 ± 8.0 years general resistance training, 5.9 ± 4.8 years strongman implement training) completed a self-reported 4-page internet survey on their usual competition-day preparation strategies. Analysis of the overall group and by sex, age, body mass, and competitive standard was conducted. Ninety-four percent of strongman athletes used warm-ups in competition, which were generally self-directed. The typical warm-up length was 16.0 ± 8.9 minutes, and 8.5 ± 4.3 minutes was the perceived optimal rest time before the start of an event. The main reasons for warming up were injury prevention, to increase activation, and increase blood flow/circulation, temperature, and heart rate. Athletes generally stated that competition warm-ups were practiced in training. Dynamic stretching, foam rolling, and myofascial release work were performed during warm-ups. Warm-up intensity was monitored using the rate of perceived exertion, perceived speed of movement, and training load (as a percentage of 1 repetition maximum). Cognitive strategies were used to improve competition performance, and psychological arousal levels needed to increase or be maintained in competition. Electrolyte drinks, caffeine, and preworkout supplements were the commonly used supplements. These data will provide strongman athletes and coaches some insight into common competition-day preparation strategies, which may enhance competition performances. Future research could compare different competition-day preparation strategies in an attempt to further improve strongman competition performance and injury prevention.


Assuntos
Comportamento Competitivo , Esportes , Exercício de Aquecimento , Adulto , Nível de Alerta , Bebidas/estatística & dados numéricos , Cafeína/administração & dosagem , Suplementos Nutricionais/estatística & dados numéricos , Eletrólitos/administração & dosagem , Feminino , Frequência Cardíaca , Humanos , Masculino , Massagem , Exercícios de Alongamento Muscular , Esforço Físico , Treinamento de Resistência , Descanso , Esportes/fisiologia , Esportes/psicologia , Inquéritos e Questionários , Adulto Jovem
6.
J Int Soc Sports Nutr ; 16(1): 30, 2019 Jul 18.
Artigo em Inglês | MEDLINE | ID: mdl-31319850

RESUMO

BACKGROUND: Dietary supplementation is a common strategy to achieve a specific health status or performance benefit. Several investigations have focused on the prevalence of dietary supplement use by athletes. However, information on how athletes manage the use and purchase of dietary supplements is scarce. METHODS: Five hundred and twenty-seven high-performance athletes (346 males and 181 females), participating in individual and team sports, completed a validated questionnaire about use and purchase patterns of dietary supplements. The dietary supplements were categorized according to the International Olympic Committee (IOC) consensus. RESULTS: Sixty four percent of the athletes (n = 337) used dietary supplements (median = 3; range 1 to 12). Age, sex, type of sport, level of competition, and professionalism influenced the prevalence of dietary supplement use (all p < 0.05). The most prevalent dietary supplement consumed was proteins (41%; n = 137), followed by amino acids/BCAA-based supplements (37%; n = 124). Additionally, as per group of supplements according to IOC consensus, 18% of the supplements were rated as having a low level of scientific evidence (e.g., glutamine, HMB, L-carnitine, etc). Most athletes (45%, n = 152) purchased dietary supplements in a store and 24% (n = 81) obtained them from a sponsor. Most athletes also (42%, n = 141) reported a self-organization of supplementation and did not consult with any professional. Last, 81% (n = 273) of athletes consuming supplements did not know any platform to check supplement safety/quality. For those who do not use dietary supplements (36% of the total sample, n = 190), most reported that they do not consider supplements necessary (72%, n = 137). CONCLUSION: Dietary supplementation appears to be widely used in sport with a considerable proportion of athletes consuming supplements with low level of scientific evidence. Additionally, athletes seem to rely on inadequate sources of information and may be largely unaware of sources to detect supplement contamination.


Assuntos
Atletas , Suplementos Nutricionais/estatística & dados numéricos , Fenômenos Fisiológicos da Nutrição Esportiva , Adolescente , Adulto , Feminino , Humanos , Masculino , Prevalência , Esportes , Inquéritos e Questionários , Adulto Jovem
7.
BMC Pregnancy Childbirth ; 19(1): 218, 2019 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-31253114

RESUMO

BACKGROUND: The importance of vitamin D in bone health and calcium homeostasis has been well documented. However, emerging evidence supports the role of vitamin D beyond its recognised traditional roles. In pregnancy, vitamin D levels are crucial in sustaining both the maternal stores and optimal growth of the foetus. In Southern Africa, there is paucity of data on vitamin D in pregnancy and related outcomes. To expand this body of knowledge, we assessed vitamin D levels in late pregnancy and (if any) associated maternal determinants in Harare, Zimbabwe. METHODS: Study participants comprised of 138 pregnant Zimbabwean women in their third trimester. These were stratified by HIV status; sampling median (IQR) gestation for HIV negative study participants was 34 weeks (26-41) and 31 weeks (20-40) in the HIV positive participants. Maternal plasma 25 hydroxyvitamin (OH) Dlevels were measured using the ClinPrepHigh Pressure Liquid Chromatography (HPLC) kit. Statistical analysis was carried out using the STATA statistical package version 13. A p-value of < 0.05was considered to be statistically significant. RESULTS: HIV infected participants had significantly higher mean 25 (OH) D concentration (112 ± 33.4 nmol/L) compared to the HIV uninfected (100 ± 27.1 nmol/L), p = 0.032.Participants whose samples were collected during summer had higher maternal 25 (OH) D levels than those cART duration and maternal 25 (OH) D levels (p = 0.031, Spearman correlation =0.28). CONCLUSIONS: Our findings show high mean levels of maternal 25 (OH) D in late pregnancy in our setting and in the absence of vitamin D supplementation. Both HIV infection and season are significant determinants of maternal vitamin D levels. Summer season is associated with higher maternal plasma 25 (OH) D levels. HIV infection is associated with increased maternal vitamin D levels. Prolonged use of cART, Tenolam E is associated with improved maternal 25(OH) D levels.


Assuntos
Infecções por HIV/sangue , Complicações na Gravidez/epidemiologia , Terceiro Trimestre da Gravidez/sangue , Deficiência de Vitamina D/epidemiologia , Vitamina D/análogos & derivados , Adulto , Estudos Transversais , Suplementos Nutricionais/estatística & dados numéricos , Feminino , Infecções por HIV/complicações , Humanos , Gravidez , Complicações na Gravidez/sangue , Complicações na Gravidez/virologia , Fatores de Risco , Estações do Ano , Estatísticas não Paramétricas , Vitamina D/sangue , Vitamina D/uso terapêutico , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/virologia , Vitaminas/uso terapêutico , Zimbábue/epidemiologia
8.
Wien Klin Wochenschr ; 131(19-20): 462-467, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31098837

RESUMO

BACKGROUND: Iron deficiency anemia is common in pregnancy with a prevalence of approximately 16% in Austria; however, international guideline recommendations on screening and subsequent treatment with iron preparations are inconsistent. The aim of this study was to find out how often pregnant women take iron-containing supplements, and who recommended them. As hemoglobin data were available for a sub-group of women, hemoglobin status during pregnancy and associated consumption of iron-containing medications were also recorded. METHODS: This cross-sectional study was conducted at the Mother-Child-Booklet service center of the Styrian Health Insurance Fund in Graz, Austria. A questionnaire containing seven questions was developed. Absolute and relative numbers were determined, and corresponding 95% confidence intervals calculated using bootstrapping techniques. RESULTS: A total of 325 women completed the questionnaire, 11% had been diagnosed with anemia before becoming pregnant, 67% reported taking iron-containing compounds. The women reported taking 45 different products but 61% took 1 of 3 different supplements. Overall, 185 (57%) women had not been diagnosed with anemia before becoming pregnant but reported taking an iron-containing supplement and 89% of the women took supplements on the recommendation of their physician. Of the 202 women whose hemoglobin status was assessed, 92% were found not to be anemic. CONCLUSION: Overall, 67% of pregnant women took iron-containing compounds, irrespective of whether they were deficient in iron. Physicians were generally responsible for advising them to take them. No standardized procedure is available on which to base the decision whether to take iron during pregnancy, even in guidelines. As most guidelines only recommend taking iron supplements in cases of anemia, the high percentage of women taking them in Austria is incomprehensible.


Assuntos
Anemia Ferropriva , Suplementos Nutricionais/estatística & dados numéricos , Ferro/uso terapêutico , Complicações na Gravidez/terapia , Anemia Ferropriva/terapia , Áustria , Estudos Transversais , Feminino , Humanos , Gravidez
9.
BMC Pregnancy Childbirth ; 19(1): 113, 2019 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-30940114

RESUMO

BACKGROUND: Iron-deficiency anemia during pregnancy is an underlying cause of maternal deaths, and reducing risk through routine iron supplementation is a key component of antenatal care (ANC) programs in most low- and middle income countries. Supplementation coverage during pregnancy is estimated from maternal self-reports in population-based household surveys, yet recall bias and social desirability bias lead to errors of unknown magnitude. METHODS: We linked data from household and health facility surveys from 16 countries to estimate input-adjusted coverage of iron supplementation during pregnancy. We assessed the validity of reported receipt of iron supplements in client exit interviews using direct observation as the gold standard across 9 countries with a recent Service Provision Assessment (SPA). Using a sample of 227 women who participated in the Nepal Oil Massage Study (NOMS), we also assessed the validity of self-reported receipt of iron folic acid (IFA) supplements. We used Poisson regression models to explore the association between client and health facility characteristics and agreement of self-reported receipt of iron supplements compared to direct observation. RESULTS: Across the 16 countries, iron supplements were in supply at most of the 9215 sampled health facilities offering ANC services (91%). We estimated that between 48 and 93% of women attended at least one ANC visit at a health facility with iron supplements available. The specificity of recall of receipt of iron supplementation immediately following a visit was 79.3% and the sensitivity was 88.7% for the entire sample. Individual-level accuracy was high (Area under the curve > 0.7) and population bias low (0.75 < inflation factor < 1.25) across all countries. By contrast, in the NOMS sub-study, the accuracy of self-reported receipt of IFA supplements after 1-2 years was poor (sensitivity 86.1%, specificity 34.3%). Adjusted regression analyses indicated that older age and higher level of education were associated with poorer agreement between self-reports and direct observation. CONCLUSIONS: These findings suggest the need for caution when using self-reported measures with an extended recall period. Further validation studies using conditions similar to widely used population-based household surveys are warranted.


Assuntos
Confiabilidade dos Dados , Suplementos Nutricionais/estatística & dados numéricos , Ferro/uso terapêutico , Cuidado Pré-Natal/estatística & dados numéricos , Autorrelato/estatística & dados numéricos , Adulto , Feminino , Humanos , Gravidez , Análise de Regressão , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
10.
Monaldi Arch Chest Dis ; 89(1)2019 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-30985095

RESUMO

It is important, in our opinion, to provide physicians with a brief update of scientifically-sound evidence in preventive nutrition, to be employed in their everyday practice, since the latest scientific and clinical advances in this area are generally not well known. Here, we review the most recent evidence in support of an optimal cardio-protective diet, and we identify the need to focus mainly on protective food which should be part of such diet, rather than on nutrients with negative effects to be limited (salt, saturated fats, simple sugars). We conclude that, to favor patient compliance, it is also necessary to underscore indications on the topics for which there is convincing and coherent literature, leaving other less-explored aspects to individual preferences.


Assuntos
Doenças Cardiovasculares/dietoterapia , Dieta/métodos , Cooperação do Paciente/psicologia , Consumo de Bebidas Alcoólicas/efeitos adversos , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/prevenção & controle , Dieta/normas , Dieta Hipossódica/efeitos adversos , Dieta Hipossódica/estatística & dados numéricos , Carboidratos da Dieta/administração & dosagem , Carboidratos da Dieta/efeitos adversos , Gorduras na Dieta/administração & dosagem , Gorduras na Dieta/efeitos adversos , Fibras na Dieta/administração & dosagem , Fibras na Dieta/efeitos adversos , Fibras na Dieta/estatística & dados numéricos , Suplementos Nutricionais/efeitos adversos , Suplementos Nutricionais/estatística & dados numéricos , Medicina Baseada em Evidências/educação , Medicina Baseada em Evidências/métodos , Feminino , Humanos , Lipoproteínas LDL/administração & dosagem , Lipoproteínas LDL/efeitos adversos , Masculino , Médicos , Guias de Prática Clínica como Assunto , Ensaios Clínicos Controlados Aleatórios como Assunto/métodos , Comportamento de Redução do Risco
11.
Complement Ther Med ; 43: 196-200, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30935530

RESUMO

OBJECTIVES: To assess chiropractic (DC) and naturopathic doctors' (ND) pediatric care natural health product (NHP) recommendations. DESIGN: Surveys were developed in collaboration with DC and ND educators, and delivered as an on-line national survey. NHP dose, form of delivery, and indications across pediatric age ranges (from newborn to 16 years) for each practitioner's top five NHPs were assessed. Data were analyzed using descriptive statistics, t-tests, and non-parametric tests. RESULTS: Of the 421 respondents seeing one or more pediatric patients per week, 172 (41%, 107 DCs, 65 NDs) provided 440 NHP recommendations, categorized as: vitamins and minerals (89 practitioners, 127 recommendations), probiotics (110 practitioners, 110 recommendations), essential fatty acids (EFAs: 72 practitioners, 72 recommendations), homeopathics (56 practitioners, 66 recommendations), botanicals (29 practitioners, 31 recommendations), and other NHPs (33 practitioners, 34 recommendations). Indications for the NHP recommendations were tabulated for NHPs with 10 or more recommendations in any age category: 596 total indications for probiotics, 318 indications for essential fatty acids, 138 indications for vitamin D, and 71 indications for multi-vitamins. CONCLUSIONS: This is the first study documenting the pediatric NHP recommendations of two popular complementary medicine professions. Common NHPs at standard doses are the most frequently recommended products, with use and doses adjusted according to age. High-quality evidence regarding the efficacy, safety, and dosing for NHP use in children is scarce; development of evidence-informed pediatric guidelines is recommended, particularly for the most commonly used and recommended NHPs.


Assuntos
Produtos Biológicos/uso terapêutico , Quiroprática/estatística & dados numéricos , Suplementos Nutricionais/estatística & dados numéricos , Naturopatia/estatística & dados numéricos , Adolescente , Atitude do Pessoal de Saúde , Canadá , Criança , Pré-Escolar , Terapias Complementares/estatística & dados numéricos , Feminino , Pesquisas sobre Serviços de Saúde/estatística & dados numéricos , Humanos , Lactente , Recém-Nascido , Masculino
12.
Complement Ther Med ; 43: 277-282, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30935543

RESUMO

OBJECTIVES: The purpose of this study was to determine if participant diagnosis, as determined by a health care provider, is associated with dietary supplement (DS) use. DESIGN/SETTING: Surveys from 1255 study participants aged 34-84, part of the Midlife in the US Study (MIDUS 2 Survey) Biomarker Project, were reviewed. Participant data included pharmaceutical use (prescription and over-the-counter medications (OTC)), clinical symptoms and diagnosis, and laboratory results. Associations were calculated between the above participant characteristics and DS use. MAIN OUTCOME MEASURES: Frequency of DS use for physician-reported diagnoses. RESULTS: Overall prevalence of DS use was 32.4%. Participants taking DS were more often female (p = .048), white (p < 0.001), and older (mean age 57 years, p < 0.001). Participants taking DS reported taking more OTC (p < .001) and prescription medications (p = .024), and had an increased number of chronic conditions (p = .004). Participants reporting physician-diagnosed diabetes were significantly less likely to be taking DS (p = .0066), while participants with eye disease (p = .001), high cholesterol (p = 0.041), cancer (p = 0.042), and arthritis (p = 0.044) were more likely to be taking DS than those without those conditions. No difference in DS use was found between patients with and without other identified medical conditions. After adjusting for age, race/ethnicity, and gender, only diabetes remained a significant predictor of decreased DS use (OR 0.588, CI 0.388-0.873, p = .01). CONCLUSIONS: Some physician-reported participant diagnoses were associated, positively or negatively, with DS use.


Assuntos
Suplementos Nutricionais/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Doença Crônica/tratamento farmacológico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medicamentos sem Prescrição/uso terapêutico , Medicamentos sob Prescrição/uso terapêutico , Prevalência , Inquéritos e Questionários
13.
Yakugaku Zasshi ; 139(3): 483-490, 2019.
Artigo em Japonês | MEDLINE | ID: mdl-30828026

RESUMO

This study aimed to clarify the situation of use of health foods by patients and the level of satisfaction of patients in order to make use of information on cases where patients undergoing cancer medication therapy use health foods. Between May 7, 2018 and June 29, 2018, we conducted a questionnaire survey of patients with progressive cancer who were undergoing cancer chemotherapy at Ogaki Municipal Hospital. In addition, we conducted a multivariate analysis of patients who were using health foods and those who were not. The questionnaire items included the objectives of use, product effectiveness and satisfaction, and QOL. The rate of health food use was 81/281 (29.5%). The primary objectives of use were, "to maintain health" (29.8%) and "to alleviate symptoms" (24.0%). The primary sources of information about health foods were "a friend" (50.6%) and "TV" (13.5%). The satisfaction level was 0-3 points in 8.3% of patients, 4-6 points in 38.1% of patients, and 7-10 points in 53.6% of patients. For "stage of illness (recurrence)," the odds ratio was 1.810 (95% CI, 1.040-3.150; p=0.035), and for "QOL value," the odds ratio was 2.210 (95% CI, 1.220-4.020; p=0.009), indicating that these factors had a significant influence on health food use. Health foods tended to be used in patients who had recurring cancer with low QOL and various symptoms, and friends and other people close to the patient had a large influence on the patient's decision. It was clear that the patients' satisfaction level was high.


Assuntos
Suplementos Nutricionais , Alimento Funcional , Neoplasias/tratamento farmacológico , Neoplasias/psicologia , Pacientes/psicologia , Satisfação Pessoal , Adulto , Idoso , Idoso de 80 Anos ou mais , Suplementos Nutricionais/estatística & dados numéricos , Feminino , Alimento Funcional/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Recidiva Local de Neoplasia , Qualidade de Vida , Inquéritos e Questionários , Fatores de Tempo
14.
Rev Bras Epidemiol ; 22: e190007, 2019 Mar 14.
Artigo em Português, Inglês | MEDLINE | ID: mdl-30892470

RESUMO

INTRODUCTION: Exclusive breastfeeding (BF), after the sixth month of life, as a single food source is not recommended. It is believed that it is not possible to supply the caloric needs of protein, iron and vitamin without adequate food supplementation. OBJECTIVE: To comparethe nutritional statusof children withexclusive breastfeeding(BF)for more than 6monthsversuschildren with otherbreastfeeding practices. METHOD: Cross-sectionalexploratory studywith685children(39BF >6months and646with otherbreastfeeding practices).Situations ofanthropometricdeficit were considered by values< -2 in Z score, anemia evaluated by hemoglobin < 11 g/dL,and deficient/lowlevels ofvitamin A by serumretinol < 1.05 µmol/L. RESULTS: There were nocases ofdeficitin the anthropometric ratios of weight/height, weight/age andbody mass index(BMI)among childrenBF > 6months,while the comparison group was approximately 0.5%. In theheight/ageratio,the deficitwasaround 2.6% in both groups.Inthe weight/height ratioand BMI,the resultsranged from28.7 to 31.9% foroverweight in group comparisson. TheaverageHb, serumretinol, weightand heightwere similarbetween thegroups. DISCUSSION: The low prevalence (≤ 0.6%) of protein energy malnutrition in both groups represents a surprising finding, below the values found in reference to normal international reference, WHO standard. CONCLUSION: Children who maintained BF after six months exhibited equivalent nutritional status to those of children with other breastfeeding practices.


Assuntos
Aleitamento Materno/estatística & dados numéricos , Suplementos Nutricionais/estatística & dados numéricos , Estado Nutricional , Adulto , Antropometria , Brasil , Desenvolvimento Infantil , Saúde da Criança , Estudos Transversais , Feminino , Humanos , Lactente , Fenômenos Fisiológicos da Nutrição do Lactente , Masculino , Fatores Socioeconômicos , Adulto Jovem
15.
BMC Public Health ; 19(1): 282, 2019 Mar 08.
Artigo em Inglês | MEDLINE | ID: mdl-30849959

RESUMO

BACKGROUND: Vitamin A deficiency (VAD) is of major public health significance; it is a risk factor for childhood deaths from diarrhoea and measles in low and middle-income countries and an important cause of preventable childhood blindness in low income countries. Vitamin A supplementation (VAS) is being implemented in many LMICs and high coverage reduces the prevalence of blinding corneal diseases in children. However, national estimates of coverage may not reveal any inequities in intra country coverage. The aim of this study is to assess factors influencing VAS coverage and also assess the relationship between VAS coverage and childhood corneal blindness in Nigeria. METHODS: Data were collected from the Nigeria Demographic and Health Survey (NDHS) 2013 and the published literature on population-based childhood blindness surveys in Nigeria. The main outcome measure was the proportion of eligible children who received VAS in the last 6 months preceding the survey. Study factors comprised a range of socioeconomic, and individual factors. Data were analysed using STATA V.12.1 (Statcorp, Texas). To explore the effects of the independent variables on VAS coverage, bivariate and multivariate regression was done. Variables with p < 0.05 in the final multivariable model were considered as independent factors. For the population-based childhood blindness surveys, aggregated and disaggregated data were used. Causes of blindness were stratified into corneal blindness and 'others'. Odds ratios were computed to determine the odds of developing corneal blindness in each geopolitical region. Tests of significance were set at the 95% level. RESULTS: The total VAS coverage in 2013 was 41.5%. VAS coverage was inequitable. Children with very educated mothers (OR 3.27 p < 0.001), from the south-south region (OR 2.38 p < 0.001) or in the highest wealth quintile (OR 2.81 p < 0.001) had higher odds of receiving VAS. The northwest zone had the lowest VAS coverage and the highest prevalence of corneal blindness. CONCLUSION: Regional and socioeconomic inequities in VAS exist in Nigeria and these may have grave implications for the causes of childhood blindness. The development and implementation of context specific and effective strategies are needed to reduce these inequities in VAS.


Assuntos
Cegueira/prevenção & controle , Suplementos Nutricionais/estatística & dados numéricos , Deficiência de Vitamina A/prevenção & controle , Vitamina A/administração & dosagem , Vitaminas/administração & dosagem , Cegueira/epidemiologia , Cegueira/etiologia , Pré-Escolar , Feminino , Inquéritos Epidemiológicos , Humanos , Lactente , Masculino , Mães , Nigéria/epidemiologia , Razão de Chances , Prevalência , Fatores de Risco , Fatores Socioeconômicos , Deficiência de Vitamina A/complicações
16.
Environ Res ; 172: 437-443, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30826666

RESUMO

BACKGROUND: Research suggests that dietary supplements may be a source of exposure to phthalates, given that diethyl phthalate (DEP) or di-n-butyl phthalate (DBP) can be components of coatings that facilitate extended release or encapsulate dietary supplements. METHODS: Using nationally representative data on a population of 12,281 adults ages 20 y + surveyed between 1999 and 2014 from the National Health and Nutrition Examination Survey (NHANES), we evaluated the association between dietary supplement use in relation to urinary phthalate metabolites of DEP (monoethyl phthalate, MEP) and DBP (mono-n-butyl phthalate, MBP). We examined associations pertaining to regular use of multivitamin/multimineral (MVMM) supplements, as well as regular use of any other non-MVMM supplement products, the number of non-MVMM supplement products used, as well as individual supplements potentially containing phthalates (exclusive of MVMM). For each urinary phthalate metabolite, results are presented as the minimally-adjusted and multivariable-adjusted ratio, comparing the geometric mean among users to non-users. RESULTS: In multivariable models, we observed a significant positive association between regular use of MVMM use and MEP, with persons using MVMM supplements having 11% higher geometric mean MEP than non-users (Ratio: 1.11; 95% CI: 1.04-1.20); no association was observed for MVMM in relation to MBP. No other significant multivariable-adjusted associations were observed, although power was limited in analyses of individual supplements. Associations did not markedly vary by gender; however, the associations of garlic supplement use with MEP and MBP varied by calendar time, with statistically significant positive associations observed in later years. CONCLUSIONS: A modest significant association was observed between MVMM use and MEP. No other significant associations were observed in our overall multivariable models. Follow-up on the positive association observed between garlic and urinary phthalate metabolite concentrations observed in later years in a well-powered, prospective study would further clarify study findings.


Assuntos
Suplementos Nutricionais , Poluentes Ambientais , Inquéritos Nutricionais , Ácidos Ftálicos , Adulto , Suplementos Nutricionais/análise , Suplementos Nutricionais/estatística & dados numéricos , Exposição Ambiental , Poluentes Ambientais/efeitos adversos , Poluentes Ambientais/análise , Poluentes Ambientais/urina , Feminino , Humanos , Masculino , Inquéritos Nutricionais/estatística & dados numéricos , Ácidos Ftálicos/efeitos adversos , Ácidos Ftálicos/análise , Ácidos Ftálicos/urina , Estudos Prospectivos , Adulto Jovem
17.
Int J Sport Nutr Exerc Metab ; 29(5): 518-525, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-30859854

RESUMO

The authors aimed to update knowledge of the use of supplements among Australian athletes at a state-based sports institute. The authors conducted a cross-sectional survey using an online questionnaire to assess the influence of age, sports category, and scholarship category on supplement use. Of 94 completed questionnaires, 82 (87%) indicated supplements in the previous 12 months (mean = 4.9 ± 3.3). No significant difference in supplement usage rate was identified when considering age, scholarship category, or sport category. The most frequently used supplements were sports drinks (70%), caffeine (48%), protein powder (42%), and sports bars (42%). Recovery (63%), health maintenance (59%), and improved energy (50%) were the most frequently reported rationale to use supplements. Allied health professionals and credible online resources were the predominant sources of influence regarding use. However, athletes from lower scholarship categories were more likely to have social media, parents, and siblings influence usage, and age was inversely related to increased influence from parents, social media, physicians not associated with the institute, the Internet, and siblings. Older athletes and those on higher scholarships were more likely to source supplements from training facilities and sports nutrition staff outside of the institute or direct from a supplier, whereas those on lower scholarships tended to rely more on family and friends for their supplements. Findings from this study show a high prevalence of supplement use and are the first to show an influence of social media, particularly in younger athletes. Opportunities exist to optimize how athletes are informed regarding supplement use and organizational and supplement policy.


Assuntos
Atletas , Suplementos Nutricionais/estatística & dados numéricos , Adolescente , Adulto , Austrália , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Esportes , Inquéritos e Questionários , Adulto Jovem
18.
BMC Res Notes ; 12(1): 127, 2019 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-30867036

RESUMO

OBJECTIVES: Our study aimed to assess local data for compliance with IFA supplementation and prevalence of anaemia among the pregnant mothers visiting government health facilities of eastern Nepal. RESULTS: In our study samples, IFA compliance rate was 58% during pregnancy and 42% were anaemic. Anemia was 24 times more likely to occur in IFA noncompliant women during pregnancy than their counterparts (aOR = 24.2, 95% CI 10.1-58.3), and anemia was three times less likely to be found in those taking foods rich in heme-iron than their counterparts (aOR = 3.3, 95% CI 1.4-8.1).


Assuntos
Anemia/prevenção & controle , Dieta/estatística & dados numéricos , Suplementos Nutricionais/estatística & dados numéricos , Ácido Fólico/administração & dosagem , Hospitais Públicos/estatística & dados numéricos , Ferro/administração & dosagem , Adesão à Medicação/estatística & dados numéricos , Complicações Hematológicas na Gravidez/prevenção & controle , Oligoelementos/administração & dosagem , Complexo Vitamínico B/administração & dosagem , Adolescente , Adulto , Anemia/epidemiologia , Estudos Transversais , Feminino , Humanos , Nepal/epidemiologia , Gravidez , Complicações Hematológicas na Gravidez/epidemiologia , Adulto Jovem
19.
J Obstet Gynaecol ; 39(4): 498-503, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30773966

RESUMO

The aim of this study is to investigate vitamin D deficiency and the associated risk factors in pregnant women and their infants in the Black Sea region of Turkey. One hundred and twenty healthy pregnant women in the last trimester and their healthy newborn pairs were observed between June and August 2017 in Giresun province. The serum 25(OH)D3 and calcium levels were measured through the samples collected from maternal and neonatal cord blood. The effects of maternal lifestyle on the maternal vitamin D levels were assessed by multiple regression analysis. The mean concentrations of 25(OH)D3 were found to be 9.54 ± 6.35 ng/mL and 11.16 ± 6.52 ng/mL in the maternal and neonatal cord blood sera, respectively. Vitamin D deficiency (≤20 ng/mL) and severe vitamin D deficiency (≤5 ng/mL) were observed in between 94.2% and 24.2% of mothers and 90% and 10% of infants, respectively. The clothing style, the consumption of milk/dairy products and antenatal multivitamin supplement usage were found as significant factors on the serum vitamin D levels. Even during the Summer months, the vitamin D deficiency in mothers and infants was observed at high rates in the Eastern Black Sea region of Turkey. As a result, it has been concluded that routine maternal serum 25(OH)D3 measurements for clinical follow-up, vitamin D supplementation and regular consumption of dairy products should be recommended. Impact Statement What is already known on this subject? Vitamin D deficiency is a very important risk factor to be considered for maternal and infant health. In a large number of studies, it has been observed that the risk of a vitamin D deficiency in women during their pregnancy was found to be higher, depending on the various strong influences such as the demographic and maternal lifestyles. What the results of this study add? A vitamin D deficiency associated with the demographic and lifestyle factors of pregnant women and their infants was investigated in Giresun province, located in the Eastern Black Sea region of Turkey. The results of this study add that a vitamin D deficiency in the maternal and in the infants may be observed at high rates in regions with mostly rainy weather, even during the Summer months. What the implications are of these findings for clinical practice and/or further research? The vitamin D levels in infants can be determined indirectly by looking at the vitamin D levels in third trimester pregnancies. Furthermore, it is suggested as a non-invasive method to determine vitamin D levels by taking advantage of the maternal level, without measuring the vitamin D levels of infants. Thus, this will be effective to reduce health costs and to prevent the possible diseases affecting the future life of infants. Routine maternal serum 25(OH)D3 measurements for clinical follow-up, vitamin D supplementation and the regular consumption of dairy products should be recommended to pregnant women with risk factors, even in the Summer in the Black Sea Region of Turkey. In addition, further studies are needed to investigate the vitamin D deficiency associated with the demographic and lifestyle factors of pregnant women and their infants, especially for the different locations of Turkey.


Assuntos
Complicações na Gravidez/epidemiologia , Deficiência de Vitamina D/epidemiologia , Adulto , Mar Negro/epidemiologia , Calcifediol/sangue , Laticínios/análise , Suplementos Nutricionais/estatística & dados numéricos , Feminino , Sangue Fetal/química , Humanos , Lactente , Recém-Nascido , Gravidez , Complicações na Gravidez/etiologia , Cuidado Pré-Natal/estatística & dados numéricos , Análise de Regressão , Fatores de Risco , Estações do Ano , Turquia/epidemiologia , Deficiência de Vitamina D/etiologia
20.
Indian Pediatr ; 56(1): 33-36, 2019 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-30806358

RESUMO

OBJECTIVE: To estimate incidence of side effects after weekly iron and folic acid supplementation (WIFS) in Delhi and Haryana. METHODS: In this cross-sectional school-based study, data were collected from 4,183 adolescents on WIFS consumption and side effects experienced first time of receipt of WIFS (week 1), and in last two consecutive weeks (week 2,3). Week 3 was 48 hours preceding the survey. RESULTS: WIFS consumption in week 1, 2 and 3 was 85%, 63% and 52%, respectively. Side effects reported were highest in first week (25%) and reduced to 7% (week 2) and 5% (week 3). Side effects most reported were abdominal pain (80%) and nausea (10%). Adolescents (45%) who faced a side-effect in week 1 did not consume WIFS in subsequent week. CONCLUSIONS: Incidence of side effects was low, but it affected compliance. Positive reinforcement to students who face side effects requires strengthening by teachers.


Assuntos
Suplementos Nutricionais/efeitos adversos , Ácido Fólico/efeitos adversos , Ferro/efeitos adversos , Dor Abdominal/epidemiologia , Dor Abdominal/etiologia , Adolescente , Anemia Ferropriva/tratamento farmacológico , Estudos Transversais , Suplementos Nutricionais/estatística & dados numéricos , Feminino , Ácido Fólico/administração & dosagem , Ácido Fólico/uso terapêutico , Humanos , Incidência , Índia/epidemiologia , Ferro/administração & dosagem , Ferro/uso terapêutico , Masculino , Náusea/epidemiologia , Náusea/etiologia , Cooperação do Paciente/estatística & dados numéricos , Estudantes
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