Knowledge and Attitudes of Health Professionals toward Dietary Supplements and Herbal Foods

Öz

Dietary supplements are vitamins, minerals, amino acids, fatty acids, fiber, various plants, and extracts. They enhance nutritional status and immune function, and have a significant impact on disease prevention and health. However, it is important to note that dietary supplements should be used to supplement a diet, not replace it, and only when the diet fails to meet nutritional needs or when individuals suffer from undernourishment. Determining the appropriate dosage of dietary supplements is crucial for ensuring their safety. Overconsumption of dietary supplements may result in toxic side effects. In addition, dietary supplements and herbal foods should be carefully used due to possible drug-nutrient/herbal interactions. Questioning and monitoring patients' use of all dietary supplements, herbal foods, and medications by health professionals is important for the prevention of toxicity or other adverse effects. The attitudes and knowledge levels of health professionals regarding dietary supplements and herbal foods affect their counseling of patients, including questioning and monitoring the use of supplements. Therefore, this study aims to review the literature about the knowledge and attitudes of health professionals toward dietary supplements and herbal foods.

Anahtar Kelimeler

• Health professionals
• dietary supplements
• herbal
• food

Sağlık Profesyonellerinin Besin Destekleri ve Bitkisel Besinlere Yönelik Tutum ve Bilgi Düzeyleri

Öz

Besin destekleri; vitaminler, mineraller, amino asitler, yağ asitleri, posa, çeşitli bitkiler ve bitki özlerinden oluşmaktadır. Beslenme durumunu ve bağışıklık fonksiyonunu iyileştirmekte, hastalıkları önleme ve sağlık üzerinde önemli bir etkiye sahiptir. Ancak, besin destekleri yalnızca diyetin beslenme gereksinimlerini karşılamak için yetersiz olduğu veya bireylerin yetersiz beslendiği durumlarda diyete ek olarak (bir gıda alternatifi olarak değil) önerilir. Besin desteklerinin dozu, güvenilirliklerini belirlemek için oldukça önemlidir. Besin desteklerinin büyük miktarlarda tüketilmesi toksik etkilere neden olabilir. Ayrıca besin destekleri ve bitkisel besinler olası besin-ilaç etkileşimleri nedeniyle dikkatli kullanılmalıdır. Hastaların tüm besin destekleri, bitkisel besin ve ilaç kullanımlarının sağlık profesyonelleri tarafından sorgulanması ve izlenmesi, toksisite veya diğer yan etkilerin önlenmesi açısından önemlidir. Sağlık profesyonellerinin besin destekleri ve bitkisel besinlere ilişkin tutumları ve bilgi düzeyleri, besin desteği kullanımını sorgulama ve izleme de dahil olmak üzere hastalara verdikleri danışmanlık hizmetlerini etkilemektedir. Bu nedenle bu çalışma, sağlık profesyonellerinin besin destekleri ve bitkisel besinlere yönelik tutum ve bilgi düzeyleri ile ilgili çalışmaları derlemeyi amaçlamaktadır.

Anahtar Kelimeler

• Sağlık profesyonelleri
• besin destekleri
• bitkisel
• besin

Kaynakça

1. Alsaleem, S. A., Asiri, M. M., Alsaleem, M. A., AlShahrani, A. N., Alamer, K. A., & Mahfouz, A. A. (2021). Dietary supplement use among primary health care attendants in Abha city, southwestern Saudi Arabia. Nutrients, 13(9), 2968. https://doi.org/10.3390/nu13092968
2. Altamimi, M., Hamdan, M., Badrasawi, M., & Allahham, S. (2021). Knowledge, attitudes and practices related to dietary supplements among a group of Palestinian pharmacists. Sultan Qaboos University Medical Journal, 21(4), 613-620. https://doi.org/10.18295/squmj.4.2021.029
3. Bailey, R. L., Dodd, K. W., Gahche, J. J., Dwyer, J. T., Cowan, A. E., Jun, S., Eicher-Miller, H. A., Guenther, P. M., Bhadra, A.,Thomas, P. R., Potischman, N., Carroll, R. J., & Tooze, J. A. (2019). Best practices for dietary supplement assessment and estimation of total usual nutrient intakes in population-level research and monitoring. The Journal of Nutrition, 149(2), 181-197. https://doi.org/10.1093/jn/nxy264
4. Bjerså, K., Stener Victorin, E., & Fagevik Olsén, M. (2012). Knowledge about complementary, alternative and integrative medicine (CAM) among registered health care providers in Swedish surgical care: A national survey among university hospitals. BMC Complementary and Alternative Medicine, 12, 42. https://doi.org/10.1186/1472-6882-12-42
5. Buckinx, F., Reginster, J. Y., Cavalier, E., Petermans, J., Ricour, C., Dardenne, C., & Bruyère, O. (2016). Determinants of vitamin D supplementation prescription in nursing homes: A survey among general practitioners. Osteoporosis International, 27(3), 881-886. https://doi.org/10.1007/s00198-015-3469-3
6. 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, 35-40. https://doi.org/10.1016/j.ctim.2018.09.005
7. Cawood, A. L., Walters, E. R., Smith, T. R., Sipaul, R. H., & Stratton, R. J. (2020). A review of nutrition support guidelines for individuals with or recovering from COVID-19 in the community. Nutrients, 12(11), 3230.https://doi.org/10.3390/nu12113230
8. Chen, F., Du, M., Blumberg, J. B., Ho Chui, K. K., Ruan, M., Rogers, G., Shan, Z., Zeng, L., & Zhang, F. F. (2019). Association among dietary supplement use, nutrient intake, and mortality among U.S. Adults: A cohort study. Annals of Internal Medicine, 170(9), 604-613. https://doi.org/10.7326/m18-2478

9. Chiba, T., Sato, Y., Nakanishi, T., Yokotani, K., Suzuki, S., & Umegaki, K. (2014). Inappropriate usage of dietary supplements in patients by miscommunication with physicians in Japan. Nutrients, 6(12), 5392-5404. https://doi.org/10.3390/nu6125392
10. Cordina, C., Shaikh, I., Shrestha, S., & Camilleri-Brennan, J. (2011). Probiotics in the management of gastrointestinal disease: Analysis of the attitudes and prescribing practices of gastroenterologists and surgeons. Journal of Digestive Diseases, 12(6), 489-496. https://doi.org/10.1111/j.1751-2980.2011.00534.x
11. da Silva, L., Brody, R., Byham-Gray, L., & Parrott, J. S. (2014). Online education improves Canadian dietitians' attitudes and knowledge regarding recommending and ordering multivitamin/mineral supplements. Canadian Journal of Dietetic Practice and Research, 75(3), 111-117. https://doi.org/10.3148/cjdpr-2014-001
12. de Kruijk, J. R., & Notermans, N. C. (2005). Sensory disturbances caused by multivitamin preparations. Nederlands Tijdschrift voor Geneeskunde, 149(46), 2541-2544.
13. Dickinson, A., Boyon, N., & Shao, A. (2009). Physicians and nurses use and recommend dietary supplements: Report of a survey. Nutrition Journal, 8, 29. https://doi.org/10.1186/1475-2891-8-29
14. Dickinson, A., & MacKay, D. (2014). Health habits and other characteristics of dietary supplement users: A review. Nutrition Journal, 13, 14. https://doi.org/10.1186/1475-2891-13-14
15. Dwyer, J. T., Coates, P. M., & Smith, M. J. (2018). Dietary supplements: Regulatory challenges and research resources. Nutrients, 10(1), 41. https://doi.org/10.3390/nu10010041
16. Fijan, S., Frauwallner, A., Varga, L., Langerholc, T., Rogelj, I., Lorber, M., Lewis, P., & Povalej Bržan, P. (2019). Health professionals' knowledge of probiotics: An international survey. International Journal of Environmental Research and Public Health, 16(17), 3128. https://doi.org/10.3390/ijerph16173128
17. Gardiner, P., Woods, C., & Kemper, K. J. (2006). Dietary supplement use among health care professionals enrolled in an online curriculum on herbs and dietary supplements. BMC Complementary and Alternative Medicine, 6, 21. https://doi.org/10.1186/1472-6882-6-21
18. Guess, K., Malek, L., Anderson, A., Makrides, M., & Zhou, S. J. (2017). Knowledge and practices regarding iodine supplementation: A national survey of healthcare providers. Women and Birth, 30(1), e56-e60. https://doi.org/10.1016/j.wombi.2016.08.007
19. Harnett, J., Le, T. Q., Smith, L., & Krass, I. (2018). Perceptions, opinions and knowledge of pharmacists towards the use of complementary medicines by people living with cancer. International Journal of Clinical Pharmacy, 40(5), 1272-1280. https://doi.org/10.1007/s11096-018-0645-5
20. Hilleman, D. E., Wiggins, B. S., & Bottorff, M. B. (2020). Critical differences between dietary supplement and prescription omega-3 fatty acids: A narrative review. Advances in Therapy, 37(2), 656-670. https://doi.org/10.1007/s12325-019-01211-1
21. Hussain, S., Malik, F., Hameed, A., Ahmed, S., Riaz, H., Abbasi, N., & Malik, M. (2012). Pakistani pharmacy students' perception about complementary and alternative medicine. American Journal of Pharmaceutical Education, 76(2), 21. https://doi.org/10.5688/ajpe76221
22. Jong, M., Lundqvist, V., & Jong, M. C. (2015). A cross-sectional study on swedish licensed nurses' use, practice, perception and knowledge about complementary and alternative medicine. Scandinavian Journal of Caring Sciences, 29(4), 642-650. https://doi.org/10.1111/scs.12192
23. Kamarli Altun, H., Karacil Ermumcu, M. S., & Seremet Kurklu, N. (2021). Evaluation of dietary supplement, functional food and herbal medicine use by dietitians during the COVID-19 pandemic. Public Health Nutrition, 24(5), 861-869. https://doi.org/10.1017/s1368980020005297
24. Kemper, K. J., Amata-Kynvi, A., Sanghavi, D., Whelan, J. S., Dvorkin, L., Woolf, A., Samuels, R. C., & Hibberd, P. (2002). Randomized trial of an internet curriculum on herbs and other dietary supplements for health care professionals. Academic Medicine, 77(9), 882-889. https://doi.org/10.1097/00001888-200209000-00014
25. Kemper, K. J., Gardiner, P., Gobble, J., & Woods, C. (2006). Expertise about herbs and dietary supplements among diverse health professionals. BMC Complementary and Alternative Medicine, 6, 15. https://doi.org/10.1186/1472-6882-6-15
26. Kemper, K. J., Gardiner, P., & Woods, C. (2007). Changes in use of herbs and dietary supplements (HDS) among clinicians enrolled in an online curriculum. BMC Complementary and Alternative Medicine, 7, 21. https://doi.org/10.1186/1472-6882-7-21
27. Klein, E., Beckmann, M. W., Bader, W., Brucker, C., Dobos, G., Fischer, D., Hanf, V., Hasenburg, A., Jud, S. M., Kalder, M., Kiechle, M., Kümmel, S., Müller, A., Müller, M. T., Paepke, D., Rotmann, A. R., Schütz, F., Scharl, A., Voiss, P., Wallwiener, M., Witt, C., & Hack, C. C. (2017). Gynecologic oncologists' attitudes and practices relating to integrative medicine: Results of a nationwide ago survey. Archives of Gynecology and Obstetrics, 296(2), 295-301. https://doi.org/10.1007/s00404-017-4420-y
28. Kwan, D., Hirschkorn, K., & Boon, H. (2006). U.S. and Canadian pharmacists' attitudes, knowledge, and professional practice behaviors toward dietary supplements: A systematic review. BMC Complementary and Alternative Medicine, 6, 31. https://doi.org/10.1186/1472-6882-6-31
29. Lederman, V. G., Huffman, F. G., & Enrione, E. B. (2009a). Knowledge of Florida nurses and dietitians regarding dietary supplements. Complementary Therapies in Clinical Practice, 15(1), 38-43. https://doi.org/10.1016/j.ctcp.2008.10.006
30. Lederman, V. G., Huffman, F. G., & Enrione, E. B. (2009b). Practices, attitudes, and beliefs regarding dietary supplements among Florida's dietitians and nurses. Journal of Dietary Supplements, 6(2), 124-142. https://doi.org/10.1080/19390210902861833
31. Marupuru, S., Axon, D. R., & Slack, M. K. (2019). How do pharmacists use and recommend vitamins, minerals, herbals and other dietary supplements? BMC Complementary and Alternative Medicine, 19(1), 229. https://doi.org/10.1186/s12906-019-2637-y
32. Marx, W., Kiss, N., McKavanagh, D., & Isenring, E. (2016). Attitudes, beliefs and behaviours of Australia dietitians regarding dietary supplements: A cross-sectional survey. Complementary Therapies in Clinical Practice, 25, 87-91. https://doi.org/10.1016/j.ctcp.2016.09.002
33. Owen, K. N., & Dewald, O. (2022). Vitamin E toxicity. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK564373/
34. Pitkälä, K. H., Suominen, M. H., Bell, J. S., & Strandberg, T. E. (2016). Herbal medications and other dietary supplements. A clinical review for physicians caring for older people. Annals of Medicine, 48(8), 586-602. https://doi.org/10.1080/07853890.2016.1197414
35. Rittenhouse, M., Scott, J., & Deuster, P. (2020). Dietary supplements: Knowledge and adverse event reporting practices of Department of Defense health care providers. Military Medicine, 185(11-12), 2076-2081. https://doi.org/10.1093/milmed/usaa157
36. Stanojević-Ristić, Z., Mrkić, I., Ćorac, A., Dejanović, M., Mitić, R., Vitković, L., Rašić, J., Valjarević, D., & Valjarević, A. (2022). Healthcare professionals' knowledge and behaviors regarding drug-dietary supplement and drug-herbal product interactions. International Journal of Environmental Research and Public Health, 19(7), 4290. https://doi.org/10.3390/ijerph19074290
37. Steyn, N. P., Labadarios, D., Nel, J. H., & Heidi-Lee, R. (2005). Development and validation of a questionnaire to test knowledge and practices of dietitians regarding dietary supplements. Nutrition, 21(1), 51-58. https://doi.org/10.1016/j.nut.2004.09.008
38. Tarı Selçuk, K., & Çevik, C. (2020). Use of dietary supplements among nursing students in turkey in the last 12 months and its relation with orthorexia nervosa. Perspectives in Psychiatric Care, 56(4), 885-893. https://doi.org/10.1111/ppc.12507
39. Umhau, J. C., Garg, K., & Woodward, A. M. (2012). Dietary supplements and their future in health care: Commentary on draft guidelines proposed by the food and drug administration. Antioxidants & Redox Signaling, 16(5), 461-462. https://doi.org/10.1089/ars.2011.4402
40. Valdovinos-García, L. R., Abreu, A. T., & Valdovinos-Díaz, M. A. (2019). Probiotic use in clinical practice: Results of a national survey of gastroenterologists and nutritionists. Revista de Gastroenterología de México, 84(3), 303-309. https://doi.org/10.1016/j.rgmx.2018.05.004.
41. Waddington, F., Naunton, M., Kyle, G., Thomas, J., Cooper, G., & Waddington, A. (2015). A systematic review of community pharmacist therapeutic knowledge of dietary supplements. International Journal of Clinical Pharmacy, 37(3), 439-446. https://doi.org/10.1007/s11096-015-0092-5
42. Wheeler, K. E., Cook, D. J., Mehta, S., Calce, A., Guenette, M., Perreault, M. M., Thiboutot, Z., Duffett, M., & Burry, L. (2016). Use of probiotics to prevent ventilator-associated pneumonia: A survey of pharmacists' attitudes. Journal of Critical Care, 31(1), 221-226. https://doi.org/10.1016/j.jcrc.2015.10.016
43. Wilson, Z., & Whitehead, K. (2019). A cross sectional survey to assess healthcare professionals' attitudes to and understanding of probiotics. Clinical Nutrition ESPEN, 34, 104-109. https://doi.org/10.1016/j.clnesp.2019.08.004
44. Zgliczyński, W. S., Rostkowska, O. M., & Sarecka-Hujar, B. (2021). Vitamin D knowledge, attitudes and practices of Polish medical doctors. Nutrients, 13(7), 2443. https://doi.org/10.3390/nu13072443