Assessing the Use of Prescription Drugs in Obese Respondents in the National Health and Nutrition Examination Survey

Introduction: Obesity is a common disease and a known risk factor for many other conditions such as hypertension, type 2 diabetes, and cancer. Treatment options for obesity include lifestyle changes, pharmacotherapy, and surgical interventions such as bariatric surgery. In this study, we examine the use of prescription drugs and dietary supplements by the individuals with obesity. Methods: We conducted a cross-sectional analysis of the National Health and Nutrition Examination Survey (NHANES) data 2003-2014. We used multivariate logistic regression to analyze the correlations of demographics and obesity status with the use of prescription drugs and dietary supplement use. We also built machine learning models to predict prescription drug and dietary supplement use using demographic data and obesity status. Results: Individuals with obesity are more likely to take cardiovascular agents (OR=1.265, 95% CI 1.222-1.311) and metabolic agents (OR=1.398, 95% CI 1.343-1.456) than individuals without obesity. The best performing prediction model for predicting prescription drugs had the accuracy of 74.5% and the AUROC of 0.817. Conclusions: This study can inform clinical practice and patient education of the use of prescription drugs and dietary supplements and their correlation with obesity.

Dietary Supplement Use and Interactions with Tamoxifen and Aromatase Inhibitors in Breast Cancer Survivors Enrolled in Lifestyle Interventions

The use of dietary supplements is common in the general population and even more prevalent among cancer survivors. The World Cancer Research Fund/American Institute for Cancer Research specifies that dietary supplements should not be used for cancer prevention. Several dietary supplements have potential pharmacokinetic and pharmacodynamic interactions that may change their clinical efficacy or potentiate adverse effects of the adjuvant endocrine therapy prescribed for breast cancer treatment. This analysis examined the prevalence of self-reported dietary supplement use and the potential interactions with tamoxifen and aromatase inhibitors (AIs) among breast cancer survivors enrolled in three randomized controlled trials of lifestyle interventions conducted between 2010 and 2017. The potential interactions with tamoxifen and AIs were identified using the Natural Medicine Database. Among 475 breast cancer survivors (2.9 (mean) or 2.5 (standard deviation) years from diagnosis), 393 (83%) reported using dietary supplements. A total of 108 different types of dietary supplements were reported and 36 potential adverse interactions with tamoxifen or AIs were identified. Among the 353 women taking tamoxifen or AIs, 38% were taking dietary supplements with a potential risk of interactions. We observed a high prevalence of dietary supplement use among breast cancer survivors and the potential for adverse interactions between the prescribed endocrine therapy and dietary supplements was common.

Oral Dietary Supplements Use among Healthcare Workers during the COVID-19 Pandemic in Malaysia

Healthcare workers (HCWs) must be aware of the latest data supporting or refuting the use of oral dietary supplements (ODS) in order to disseminate evidence-based health information and help patients make informed decisions. Nevertheless, there is relatively scant data on the prevalence of dietary supplement use among HCWs, the types of dietary supplements recommended to patients by HCWs, and their reasons for recommending these products, particularly during the COVID-19 outbreak. This study examined the prevalence of ODS use among surveyed HCWs, considered the types of ODS used and recommended by those HCWs, identified the reasons given by those HCWs for using or not using ODS, and determined whether those HCWs were recommending or not recommending ODS to their patients during the COVID-19 pandemic. This cross-sectional study targeted all HCWs working at a district hospital in Malaysia and was conducted via a self-administered online survey. The survey revealed that 67.3% of HCWs did not recommend ODS for patient use during the pandemic, despite 55.3% of HCWs reported personal use of ODS during the pandemic. Type of HCWs (P=0.001), monthly household income (P=0.019), prior ODS use (P<0.001) and recommendation of ODS to patients (P<0.001) were significantly associated with personal ODS use during the pandemic. Vitamin C was the most commonly used (81.3%) and recommended (95.0%) ODS. “To maintain overall health and wellness” was the most common reason for personal ODS use and recommendation to patients (83.3% & 79.2%). Given the increasing rate of ODS use during the pandemic, further research should be done so that evidence-based recommendations can be formulated to ensure patient safety.

Dietary supplement use and knowledge among students from a health science faculty in a Turkish University

Dietary supplements are concentrated sources of nutrients used as an addition to a normal diet with a nutritional or physiological effect. In this cross-sectional study, it was aimed to determine the factors of dietary supplement use, the related knowledge, and their relationship with supplement use in a faculty of health sciences among university students. This cross-sectional study was carried out with 333 voluntary university students from Ankara Yıldırım Beyazıt University, the Faculty of Health Sciences. A questionnaire form consisting of 5 sections was applied to the students by face-to-face interview method. The most remarked purposes of supplement use were to improve health (44.2%) and boost immunity (22.1%). There was no difference between age, gender, department, coexistent disease, tobacco smoking and alcohol consumption in terms of dietary supplement use (p = 0.611, p = 0.720, p = 0.682, p = 0.062, p = 0.491, and p = 0.658, respectively). No significant difference was observed between physical activity status, the duration of physical activity, dieting status, the source of diet program, daily frequency of main meals and snacks, body mass index (BMI) groups, and the reason for meal skipping among students according to dietary supplement use (p = 0.180, p = 0.205, p = 0.686, p = 0.226, p = 0.533, p = 0.449, p = 0.976, and p = 0.758, respectively). There was not any significant difference between physical activity status, the duration of physical activity, dietary supplement use, dieting status, the frequency of main meals and snacks and BMI in terms of total knowledge score of dietary supplements (p = 0.245, p = 0.713, p = 0.278, p = 0.067, p = 0.466, p = 0.647, and p = 0.851, respectively). Scientific attention should be paid to the use of dietary supplements. Arbitrary approaches can lead to unwanted interactions. Therefore, in order for health and government policies to be established related to dietary supplements, it is essential to determine the factors related to their use.

Self-Reported Health Indicators in the US Army: Longitudinal Analysis From a Population Surveillance System, 2014‒2018

Objectives. To describe health-related behaviors or indicators associated with overall health and well-being using the Global Assessment Tool (GAT), a health behavior and psychosocial questionnaire completed annually by US Army personnel. Methods. We analyzed GAT responses from 2014 to 2018, consisting of 367 000 to 449 000 respondents per year. We used generalized estimating equations to predict the presence of each health behavior or indicator, aggregated by year and stratified on various demographics. Results. Key findings included decreases from 2014 to 2018 in risky health behaviors such as hazardous drinking (7.5% decrease) and tobacco use (7.9% decrease), dietary supplement use (5.0% to 10.6% decrease, depending on type), self-reported musculoskeletal injury (5.1% decrease), and pain interference (3.6% decrease). Physical activity, sleep, and nutritional habits largely remained consistent over time. Conclusions. In the Army, tobacco, alcohol, and risky dietary supplement usage appears to be declining, whereas lifestyle health behaviors have been stable. Whether these trends reflect responses to health education is unknown. The GAT provides useful insights into the health of the Army, which can be leveraged when developing health-related educational programs and policies. Public Health Implications. Health behaviors that have changed less over time (e.g., nutrition, sleep) may require novel approaches compared with those that changed more (e.g., dietary supplement use, drinking). (Am J Public Health. Published online ahead of print September 9, 2021: e1–e11. https://doi.org/10.2105/AJPH.2021.306456 )