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Vol. LXVII, No. 7
March 27, 2015
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Complementary Health
Survey Reveals New Trends in Use of Natural Products

On the front page...

Kids of NIH staff and their friends do the downward-facing dog pose as they try out yoga together.

Kids of NIH staff and their friends do the downward-facing dog pose as they try out yoga together.

Photo: Bryan Ewsichek

Holding that lotus pose? Reaching for certain dietary supplements while pushing others to the back of the medicine cabinet? Then you’re among the growing number of Americans using complementary health products and therapies—from mind and body practices such as yoga to taking natural products such as fish oil pills—in addition to conventional care. And, you’re likely paying attention to the research on what products may or may not be effective. Results from a recent national survey show certain supplements and therapies are becoming more popular than others, trends that seem to correspond with the latest research results.

Continued...

The National Center for Complementary and Integrative Health recently released findings from a 2012 complementary health questionnaire, developed in conjunction with the Centers for Disease Control and Prevention’s National Center for Health Statistics. This nationally representative survey, conducted in 5-year intervals, is the third among adults and the second to study complementary health among children. Nearly 90,000 adults were surveyed in 2002, 2007 and 2012 cumulatively, and another 17,000 adults knowledgeable about children ages 4-17 were interviewed in 2007 and 2012.

“In terms of natural products, what’s interesting to us is that the changes over time in children and adults, from 2007 to 2012, seem to mirror research findings,” said Dr. Richard Nahin, NCCIH senior advisor for scientific coordination and outreach and a co-author of the surveys’ reports. “Since the data coincides with changes in use, we’re thinking perhaps the public is paying attention to research findings.”

Data from the 2012 survey showed fish oil and melatonin topped the list of natural products used among adults and children, while the use of echinacea declined dramatically since 2007. Among adults, the use of probiotics increased while glucosamine/chondroitin became less popular.

These findings are in line with recent research about dietary supplements, some of which shows negative or inconclusive evidence on health benefits. For example, the decrease in echinacea use coincided with research trials that could not prove the supplement boosts the immune system or helps prevent colds. In fact, several NCCIH-funded studies on echinacea found no health benefit at all, said Nahin. Other formerly popular supplements had a similar fate in research studies. Recent large NIH trials found glucosamine/chondroitin ineffective at relieving arthritis pain.

“In terms of natural products, what’s interesting to us is that the changes over time in children and adults, from 2007 to 2012, seem to mirror research findings,” said Dr. Richard Nahin, NCCIH senior advisor.

“In terms of natural products, what’s interesting to us is that the changes over time in children and adults, from 2007 to 2012, seem to mirror research findings,” said Dr. Richard Nahin, NCCIH senior advisor.

Such survey results help inform NIH research. “The major impetus in doing these surveys, going back to our first one in 2002, was really to guide the NIH research agenda so that NCCIH and the other institutes interested in these interventions will know what the public is using and help guide whether we should be putting dollars into trials of glucosamine or trials of acupuncture or trials of echinacea,” said Nahin. “If there’s very little use of these products by the U.S. population, it doesn’t make sense for the NIH to be putting a lot of money into studying them.”

The survey revealed a growing trend among adults toward yoga, tai chi, deep-breathing exercises, meditation, chiropractic care, acupuncture and massage. Results from the children’s survey showed that such complementary therapies—particularly chiropractic care and yoga, tai chi or qi gong—were often used to manage head or chest colds, anxiety, back or neck pain and other musculoskeletal conditions.

Most people turn to complementary health approaches to improve their health and well-being, alleviate stress and to help manage pain and other symptoms associated with chronic conditions or the side effects of prescribed medicines. Whatever complementary medicine you use or consider using, it’s important to discuss it with your doctor.

“If you’re going to use supplements or if you’re going to see an acupuncturist or use massage, you should always let your conventional care provider know,” said Nahin. “There’s always the potential for some interactions with your conventional therapy.”

If you’re taking warfarin, for example, also taking ginkgo could affect the blood thinner’s ability to work and may even harm you. That’s why it’s important for patients and their health practitioners to communicate. That’s integrative health. “With any complementary practices, your health plan should incorporate all of these factors in a systematic way with the full knowledge of all participants,” said Nahin.

More scientific research is needed on popular products and therapies, from dietary supplements to acupuncture, yoga and massage. It’s an ongoing cycle. Product-use trends inform NIH research and investment into safety and efficacy studies. And the resulting research informs the public on what supplements and therapies may or may not work best for most people.

NCCIH continues to work collaboratively on this research with other institutes, including NCI, NHLBI and NIAMS. Said Nahin, “By working together both financially and intellectually, we can produce the best available evidence for the public and the clinicians.”


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