Herbal food supplements usage awareness of university students: Example of Echinacea and St. John's Wort

Year 2023, Volume: 7 Issue: 4, 792 - 797, 29.12.2023

Tuğba İduğ

https://doi.org/10.31015/jaefs.2023.4.9

Abstract

In recent years, usage of food supplements (Fs) has increased in order to maintain healthy living, have well-being, and be protected from the diseases. There are many medicinal plants used as herbal food supplements (HFs). Within the scope of this study, Echinacea and St. John’s Wort were selected among the plants that are frequently encountered. This descriptive, cross-sectional study was conducted through completing a self-administered online questionnaire by health students. The questionnaire was filled out by 211 students studying at the faculties of Medicine, Dentistry, Pharmacy and Health Sciences at Istanbul Medipol University. The greatest participation was achieved with Pharmacy students (47.4%), whereas the lowest participation was reached with Dentistry students (5.7%). The most commonly used products as Fs were vitamin D (21.3%) and multivitamins (16.1%), while the use of HFs was 8.5%. St. John’s Wort is commonly preferred for wound and burn treatment and Echinacea is used to boost immunity. In parallel with this use, St. John’s Wort is preferred as olive oil maceration and Echinacea as herbal infusion. While the use of HFs was 58.3%, that of the Fs were 44.5%. Echinacea use was found to be 14.4% and St. John’s Wort was 31.3%. The relationship between the presence of chronic disease and the use of Fs or HFs was not statistically significant. This study is significant to detect the opinions and knowledge levels of health students about Fs, especially HFs, St. John’s Wort and Echinacea, which are available in the market.

Keywords

Herbal food supplements, Food supplements, pharmacy students, Echinacea, St. John’s Wort

Üniversite Öğrencilerinin Bitkisel Gıda Takviyeleri Kullanım Farkındalıkları: Ekinezya ve Sarı Kantaron Örneği

Abstract

Son yıllarda sağlıklı yaşam, zinde olmak ve hastalıklardan korunmak için gıda takviyelerinin (Fs) kullanımı artmıştır. Bitkisel gıda takviyesi (HFs) olarak kullanılan birçok tıbbi bitki vardır. Bu çalışma kapsamında sık rastlanan bitkiler arasından Ekinezya ve Sarı kantaron seçilmiştir. Bu tanımlayıcı, kesitsel çalışma, sağlık öğrencileri tarafından kendi kendine uygulanan çevrimiçi bir anketin doldurulmasıyla gerçekleştirilmiştir. Anket İstanbul Medipol Üniversitesi Tıp, Diş Hekimliği, Eczacılık ve Sağlık Bilimleri Fakültelerinde öğrenim gören 211 öğrenci tarafından doldurulmuştur. En fazla katılım Eczacılık (%47,4) öğrencilerinde gerçekleşirken, en düşük katılım Diş Hekimliği (%5,7) öğrencilerinde gerçekleşmiştir. Fs olarak en sık kullanılan ürünler D vitamini (%21,3) ve multivitaminler (%16,1) olurken, HFs kullanımı %8,5 bulunmuştur. Sarı kantaron genellikle yara ve yanık tedavisinde tercih edilirken, Ekinezya bağışıklığı güçlendirmek için kullanılmaktadır. Bu kullanıma paralel olarak Sarı kantaron zeytinyağı maserasyonu, Ekinezya ise infüzyon olarak tercih edilmektedir. HFs kullanımı %58,3 iken, Fs kullanımı %44,5 olarak bulunmuştur. Ekinezya kullanımı %14,4, Sarı kantaron kullanımı %31,3 olarak bulunmuştur. Kronik hastalık varlığı ile Fs veya HFs kullanımı arasındaki ilişki istatistiksel olarak anlamlı bulunmamıştır. Bu çalışma, Sağlık ile ilişikli fakültelerde okuyan öğrencilerin piyasada bulunan gıda takviyeleri, bitkisel gıda takviyeleri, Sarı kantaron ve Ekinezya hakkındaki görüş ve bilgi düzeylerinin belirlenmesi açısından önemlidir.

Keywords

Bitkisel gıda takviyeleri, Gıda takviyeleri, Eczacılık öğrencileri, Ekinezya, St. John’s Wort

References

• Agbabiaka, T. B., Wider, B., Watson, L. K. & Goodman, C. (2017). Concurrent Use of Prescription Drugs and Herbal Medicinal Products in Older Adults: A Systematic Review. Drugs & Aging, 34(12), 891–905. https://doi.org/10.1007/s40266-017-0501-7
• Aina, B. & Ojedokun, O. (2014). Knowledge and use of dietary supplements by students of College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria. Journal Of Basic and Clinical Pharmacy, 5(2), 34. https://doi.org/10.4103/0976-0105.134952
• Arslan, D., Aydın, M. & Türker, S. (2021). Tıbbi ve Aromatik Bitkilerin Ekstraksiyon Yöntemleri, Gıdalarda Kullanımı ve Takviye Edici Gıda Alanında Değerlendirilmesi. Turkish Journal of Agriculture-Food Science and Technology, 9(5), 926–936 (in Turkish). https://doi.org/10.24925/turjaf.v9i5.926-936.4399
• Axon, D. R., Vanova, J., Edel, C. & Slack, M. (2017). Dietary Supplement Use, Knowledge, and Perceptions Among Student Pharmacists. American Journal of Pharmaceutical Education, 81(5), 92. https:// doi.org/10.5688/ajpe81592
• Bardia, A., Nisly, N. L., Zimmerman, M. B., Gryzlak, B. M. & Wallace, R. B. (2007). Use of herbs among adults based on evidence-based indications: Findings from the National Health Interview Survey. Mayo Clinical Proceed, 82(5), 561–566. https://doi.org/10.4065/82.5.561
• Biagi, M., Pecorari, R., Appendino, G., Miraldi, E., Magnano, A. R., Governa, P., Cettolin, G. & Giachetti, D. (2016). Herbal products in Italy: The thin line between Phytotherapy, nutrition and Parapharmaceuticals; a normative overview of the fastest growing market in Europe. Pharmaceuticals, 9(4). https://doi.org/10.3390/ph9040065
• Bukic, J., Rusic, D., Bozic, J., Zekan, L., Leskur, D., Seselja Perisin, A. & Modun, D. (2018). Differences among health care students’ attitudes, knowledge and use of dietary supplements: a cross-sectional study. Complementary Therapies in. Medicine, 41(July), 35–40. https://doi.org/10.1016/j.ctim.2018.09.005
• Catanzaro, M., Corsini, E., Rosini, M., Racchi, M. & Lanni, C. (2018). Immunomodulators inspired by nature: A review on curcumin and Echinacea. Molecules, 23(11), 1–17. https:// doi.org/10.3390/molecules23112778
• Chrubasik-Hausmann, S., Vlachojannis, J. & McLachlan, A. J. (2019). Understanding drug interactions with St John’s wort (Hypericum perforatum L.): impact of hyperforin content. Journal of Pharmacy and Pharmacology, 71(1), 129–138. https://doi. org/10.1111/jphp.12858
• Dickinson, A., Blatman, J., El-Dash, N., & Franco, J. C. (2014). Consumer Usage and Reasons for Using Dietary Supplements: Report of a Series of Surveys. Journal of the American Collage of Nutrition, 33(2), 176–182. https://doi.org/10.1080/07315724.2013.875423
• Erarslan, Z. B., & Kültür, Ş. (2021). A cross-sectional survey of herbal remedy taking to prevent Covid-19 in Turkey. Journal of Research in Pharmacy, 25(6), 920–936. https://doi.org/10.29228/JRP.89
• Food supplements. (n.d). Retrieved November 11, (2022), from https://food.ec.europa.eu/safety/labelling-and-nutrition/ food-supplements_en
• Freeman, C. & Spelman, K. 2008. A critical evaluation of drug interactions with Echinacea spp. Moleculer Nutrition and Food Research, 52(7), 789–798. https://doi.org/10.1002/mnfr.200700113
• Galeotti, N. (2017). Hypericum perforatum (St John’s wort) beyond depression: A therapeutic perspective for pain conditions. Journal of Ethnopharmacology, 200(February), 136–146. https://doi.org/10.1016/j.jep.2017.02.016
• Gardiner, P., Kemper, K. J., Legedza, A. & Phillips, R. S. (2007). Factors associated with herb and dietary supplement use by young adults in the United States. BMC Complementary and Alternative Medicine, 7, 1–7. https://doi.org/10.1186/1472-6882-7- 39
• Gazibara, T., Pekmezović, T., Popović, A., Paunić, M., & Kisić- Tepavčević, D. (2018). Chronic diseases among university students: Prevalence, patterns and impact on health- related quality of life. Vojnosanit Pregled, 75(12), 1178–1184. https://doi.org/10.2298/VSP160920050G
• Gıda Güvenliği Bilgi Sistemi-Food Safety Information System. (n.d). Retrieved August 10, (2023), from https://ggbs. tarim.gov.tr/
• Herts, K. L., Wallis, E., & Maslow, G. (2014). College freshmen with chronic illness: A comparison with healthy first-year students. Journal of College Student Development, 55(5), 475–480. https://doi. org/10.1353/csd.2014.0052
• Karelakis, C., Zevgitis, P., Galanopoulos, K., & Mattas, K. (2020). Consumer Trends and Attitudes to Functional Foods. Journal of International Food & Agribusiness Marketing, 32(3), 266–294. https://doi.org/10.1080/08974438.2019.1599760
• Khampang, R., Kloyiam, S. & Butchon, R. (2022). Relationship between socioeconomic, demographic, health and social characteristics and ability to access reliable information on herbal and food supplements: analysis of Thai Health Literacy Survey 2019. BMC Public Health, 22(1), 1–10. https://doi.org/10.1186/s12889-022-13454-9
• Kim, H. & Calderón, A. I. (2022). Rational and Safe Use of the Top Two Botanical Dietary Supplements to Enhance the Immune System. Combinatorial Chemistry & High Throughput Screening, 25(7), 1129–1130. https://doi.org/10.2174/1386207325666220207112937
• Klemenc-Ketis, Z., Kersnik, J., Eder, K. & Colarič, D. (2011). Factors associated with health-related quality of life among university students. Srpski arhiv za celokupno lekarstvo, 139(3–4), 197–202. https://doi.org/10.2298/SARH1104197K
• Knapik, J. J., Trone, D. W., Steelman, R. A., Farina, E. K., & Lieberman, H. R. (2021). Prevalence of and Factors Associated with Dietary Supplement Use in a Stratified, Random Sample of US Military Personnel: The US Military Dietary Supplement Use Study. The Journal of Nutrition, 151(11), 3495–3506. https://doi.org/10.1093/jn/nxab239
• Knudsen, V. K., Rasmussen, L. B., Hanna Haraldsdó Ttir, J., Ovesen, L., Bülow, I., Knudsen, N., Jørgensen, T., Laurberg, P. & Perrild, H. (2002). Use of dietary supplements in Denmark is associated with health and former smoking. Public Health Nutrition, 5(3), 463–468. https://doi.org/10.1079/PHN2001276
• Lam, M., Khoshkhat, P., Chamani, M., Shahsavari, S., Dorkoosh, F. A., Rajabi, A., Maniruzzaman, M. & Nokhodchi, A. (2022). In-depth multidisciplinary review of the usage, manufacturing, regulations & market of dietary supplements. Journal of Drug Delivery Science and Technology, 67. 102985. https://doi.org/10.1016/j. jddst.2021.102985
• Mannel, M. (2004). Drug interactions with St John’s Wort: Mechanisms and clinical implications. Drug Safety, 27(11), 773–797. https://doi.org/10.2165/00002018-200427110-00003
• Moore, J., McClain, A. & Hong, M. Y. (2020). Dietary Supplement Use in the United States: Prevalence, Trends, Pros, and Cons. Nutrition Today, 55(4), 174–181. https://doi.org/10.1097/ NT.0000000000000402
• Nakhal, S. A., Domiati, S. A., Amin, M. E. K. & El-Lakany, A. M. (2022). Assessment of pharmacy students’ knowledge, attitude, and practice toward herbal dietary supplements. Journal of American College Health, 70(6), 1826-1830. https://doi.org/10.10 80/07448481.2020.1825226
• Neuhouser, M. L., Patterson, R. E. & Levy, L. (1999). Motivations for using vitamin and mineral supplements. Journal of the Academy of Nutrition and Dietetics, Am. Diet. Assoc. 99(7). 851–854. https://doi.org/10.1016/S0002-8223(99)00202-3
• Niva, M. & Mäkelä, J. (2007). Finns and functional foods: Socio-demographics, health efforts, notions of technology and the acceptability of health-promoting foods. International Journal of Consumer Studies, 31(1), 34–45. https://doi.org/10.1111/ j.1470-6431.2005.00482.x
• Percival, S. S. (2000). Use of echinacea in medicine. Biochemical Pharmacololgy, 60(2), 155–158. https://doi.org/10.1016/ S0006-2952(99)00413-X
• Regulatory Information | FDA. (n.d). Retrieved November 11, (2022), from https://www.fda.gov/regulatory-information
• Schepetkin, I. A., Özek, G., Özek, T., Kirpotina, L. N., Khlebnikov, A. I. & Quinn, M. T. (2021). Chemical composition and immunomodulatory activity of essential oils from Rhododendron albiflorum. Molecules, 26(12), 1–20. https:// doi.org/10.3390/molecules26123652
• Serdarevic, N., Katana, B., Jaganjac, A., Bojicic, S., Brankovic, S. & Mahmutovic, J. (2019). The Cigarette Smoking, Coffee and Supplements Intake at Students of Sarajevo University. Medical Archives, 73(2), 104. https://doi.org/10.5455/ MEDARH.2019.73.104-108
• Shahwan, M. & Al Abdin, S. M. Z. (2018). Knowledge and practice of dietary supplement and micronutrients among medical students at Ajman university. Journal of Pharmaceutical Sciences and Research, 10(1), 85– 90. Retrieved from https://www.proquest.com/scholarly-journals/knowledge-practice-dietary-supplement/docview/2001049299/se-2
• Smith, T., Resetar, H. & Morton, C. (2022). US Sales of herbal supplements increase by 9.7% in 2021. American Botanical Council, Market Report, 136, 42-68.
• Stanojević-Ristić, Z., Stević, S., Rašić, J., Valjarević, D., Dejanović, M. & Valjarević, A. (2017). Influence of pharmacological education on perceptions, attitudes and use of dietary supplements by medical students. BMC Complementary and Alternative Medicine, 17(1), 527. https://doi.org/10.1186/s12906-017-2031-6
• Thakkar, S., Anklam, E., Xu, A., Ulberth, F., Li, J., Li, B., Hugas, M., Sarma, N., Crerar, S., Swift, S., Hakamatsuka, T., Curtui, V., Yan, W., Geng, X., Slikker, W. & Tong, W. (2020). Regulatory landscape of dietary supplements and herbal medicines from a global perspective. Regulatory Toxicology and Pharmacology, 114. https://doi.org/10.1016/j.yrtph.2020.104647
• Tuğut, N. & Bekar, M. (2008). Üniversite Öğrencilerinin Sağlığı Algılama Durumları ile Sağlıklı Yaşam Biçimi Davranışları Arasındaki İlişki. Atatürk Üniversitesi Hemşirelik Yüksekokulu Dergisi, 11(3), 17–26 (in Turkish).
• Welz, A. N., Emberger-Klein, A. & Menrad, K. (2019). The importance of herbal medicine use in the German health- care system: Prevalence, usage pattern, and influencing factors. BMC Health Services Research, 19(1), 1–11. https://doi. org/10.1186/s12913-019-4739-0
• Xiong, Y., Gao, M., van Duijn, B., Choi, H., van Horssen, F. & Wang, M. (2021). International policies and challenges on the legalization of traditional medicine/herbal medicines in the fight against COVID-19. Pharmacological Reserach, 166. https:// doi.org/10.1016/j.phrs.2021.105472
• Yılmaz, U., Kaya, H., Turan, M., Bir, F. & Şahin, B. (2019). Investigation the effect of Hypericum perforatum on corneal alkali burns. Cutaneous and Ocular Toxicology, 38(4), 356–359. https://doi.org/ 10.1080/15569527.2019.1622560
• Zhang, R., Ji, Y., Zhang, X., Kennelly, E. J., & Long, C. (2020). Ethnopharmacology of Hypericum species in China: A comprehensive review on ethnobotany, phytochemistry and pharmacology. Journal of Ethnopharmacology, 254. https://doi. org/10.1016/j.jep.2020.112686