CONTEXT: Iodine-induced hyperthyroidism has been reported in the early phases of almost all iodine fortification programs, depending on prior iodine intake in the population, the amount of fortification, and the rate of change. OBJECTIVE: The aim of the study was to monitor the effect of the Danish iodine fortification program on incidence of hyperthyroidism as measured by the incident use of antithyroid medication. DESIGN: We conducted a register study. Using the unique identification number of all Danes, we linked data from the Register of Medicinal Product Statistics and the Civil Registration register on an individual level. All dispensing of antithyroid medication from 1995 to 2007 was studied. The place of residency was used to divide patients into mildly and moderately iodine-deficient groups. MAIN OUTCOME MEASURE: We measured the incident use of antithyroid medication. RESULTS: In the region with moderate iodine deficiency, the number of incident users of antithyroid medication increased 46% in the first 4 yr of iodine fortification. The use increased the most among the youngest age group (younger than 40 yr) and the oldest age group (older than 75 yr). In the mildly iodine-deficient region, the number of incident users increased only 18%, and only in the youngest age groups (below 40 and 40-59 yr). After 4 yr of fortification, the incidence rates started to fall and reached baseline, for most groups, 6 yr after onset of fortification. CONCLUSIONS: This study shows that iodine fortification induced a temporary, modest increase in the incidence of hyperthyroidism as measured by use of antithyroid medication. A new steady state has not yet evolved.
The use of complementary and alternative medicine (CAM) is becoming more common, particularly among cancer patients. We sought to define the frequency of CAM use among general surgery, hepatobiliary and surgical oncology patients and to define some of the determinants of CAM use in patients with benign and malignant disease.
We asked all patients attending the clinics of 3 hepatobiliary/surgical oncology surgeons from 2002 to 2005 to voluntarily respond on first and subsequent visits to a questionnaire related to the use of CAM. We randomly selected patients for review.
We reviewed a total of 490 surveys from 357 patients. Overall CAM use was 27%. There was significantly more CAM use among cancer (34%) versus noncancer patients (21%; p = 0.008), and the use of CAM was more common in patients with unresectable cancer (51%) than resectable cancer (22%; p
The use of complementary alternative medicine (CAM) is potentially prevalent among paediatric patients with chronic diseases but with variable rates among different age groups, diseases and countries. There are no recent reports on CAM use among paediatric patients with inflammatory bowel disease (IBD) and juvenile idiopathic arthritis (JIA) in Europe. We hypothesized that CAM use associates with a more severe disease in paediatric IBD and JIA.
A cross-sectional questionnaire study among adolescent outpatients with IBD and JIA addressing the frequency and type of CAM use during the past year. The patients were recruited at the Children's Hospital, University of Helsinki, Finland.
Of the 147 respondents, 97 had IBD (Crohn's disease: n?=?46; median age 15.5, disease duration 3.4 years) and 50 had JIA (median age 13.8, disease duration 6.9 years). During the past 12 months, 48% regularly used CAM while 81% reported occasional CAM use. Compared to patients with JIA, the use of CAM in IBD patients tended to be more frequent. The most commonly used CAM included probiotics, multivitamins, and mineral and trace element supplements. Self-imposed dietary restrictions were common, involving 27.6% of the non-CAM users but 64.8% of all CAM users. Disease activity was associated with CAM use in JIA but not in IBD.
CAM use is frequent among adolescents with IBD and JIA and associates with self-imposed dietary restrictions. Reassuringly, adherence to disease modifying drugs is good in young CAM users. In JIA, patients with active disease used more frequently CAM than patients with inactive disease. As CAM use is frequent, physicians should familiarise themselves with the basic concepts of CAM. The potential pharmacological interaction or the toxicity of certain CAM products warrants awareness and hence physicians should actively ask their patients about CAM use.
This study aimed to assess the compliance with fluoride supplements provided at home by a dental hygienist to mothers of at-risk preschool children.
Participants were recruited during pregnancy of low-income women. On the first visit, the mothers of 60 infants aged 6 to 9 months were handed free fluoride supplements. A questionnaire was administered at that time and after 6 and 12 months to assess compliance during the preceding week.
At the beginning of the study, none of the mothers reported having given fluoride supplements, in comparison with 73 percent of mothers of 44 infants who received all three visits at the end of follow-up; 48 percent reported fluoride supplement use on a daily basis.
Removal of financial and physical barriers and personal professional involvement are good strategies to achieve compliance with fluoride supplements. Further assessment regarding the possible application of this intervention to other professional or cultural contexts is warranted.
OBJECTIVES: Existing studies on the use of complementary and alternative medicine (CAM) have produced diverse results regarding the types and prevalence of CAM use due, in part, to variations in the measurement of CAM modalities. A questionnaire that can be adapted for use in a variety of populations will improve CAM utilization measurement. The purposes of this article are to (1) articulate the need for such a common questionnaire; (2) describe the process of questionnaire development; (3) present a model questionnaire with core questions; and (4) suggest standard techniques for adapting the questionnaire to different languages and populations. METHODS: An international workshop sponsored by the National Research Center in Complementary and Alternative Medicine (NAFKAM) of the University of Tromsø, Norway, brought CAM researchers and practitioners together to design an international CAM questionnaire (I-CAM-Q). Existing questionnaires were critiqued, and working groups drafted content for a new questionnaire. A smaller working group completed, tested, and revised this self-administered questionnaire. RESULTS: The questionnaire that was developed contains four sections concerned with visits to health care providers, complementary treatments received from physicians, use of herbal medicine and dietary supplements, and self-help practices. A priori-specified practitioners, therapies, supplements, and practices are included, as well as places for researcher-specified and respondent-specified additions. Core questions are designed to elicit frequency of use, purpose (treatment of acute or chronic conditions, and health maintenance), and satisfaction. A penultimate version underwent pretesting with "think-aloud" techniques to identify problems related to meaning and format. The final questionnaire is presented, with suggestions for testing and translating. CONCLUSIONS: Once validated in English and non-English speaking populations, the I-CAM-Q will provide an opportunity for researchers to gather comparable data in studies conducted in different populations. Such data will increase knowledge about the epidemiology of CAM use and provide the foundation for evidence-based comparisons at an international level.
OBJECTIVE: To compare the diet and lifestyle in breast cancer survivors and healthy women. DESIGN: Cross-sectional study in the population-based Norwegian Women and Cancer cohort study, using a postal questionnaire on diet, lifestyle and health. SETTING: Nation-wide, population-based study. SUBJECTS: Women aged 41-70 years. Prevalent breast cancer cases (314 short-term with 1-5 years since diagnosis, 352 long-term with >5 years since diagnosis) were identified by linkage to the Norwegian Cancer Registry. The comparison group consisted of 54,314 women. INTERVENTIONS: Analyses of variance, with post hoc Bonferroni tests when significant differences were found. RESULTS: Overall there were few differences in the diet of the three groups. Short-term survivors ate more fruits and vegetables than healthy women (P
To determine dietary supplementation practices and opinions, preferred means for dietary supplement (DS) education, and antidoping opinions among elite Canadian athletes varying in age and gender.
A descriptive, cross-sectional survey.
Elite athlete training centers in Calgary, Canada and surrounding area.
A total of 582 high-performance athletes (314 male, 268 female).
High-performance athletes representing 27 sports with a mean age of 19.96+/-3.91 years completed a validated questionnaire assessing DS practices and opinions by recall. Sport categories included varsity, Canadian Sport Centre Calgary (CSCC), and National Sport School (NSS).
There was extensive DS use, with 88.4% of participants taking>or=1 DS (mean of 3.08+/-1.87 DS per user) during the previous 6 months. Overall, sport drinks (22.4%), sport bars (14.0%), multivitamins and minerals (13.5%), protein supplements (9.0%), and vitamin C (6.4%) were most frequently reported. Older athletes were significantly more likely to report greater DS usage; to be advised by teammates, health food store retailers, and magazines; to prefer supplementation education via individual interviews; to claim awareness of anti-doping rules; and to perceive anti-doping compliance. Relative to gender, significant differences were observed for the types of DS reported; supplementation advisors; justifications for DS use; and awareness of anti-doping regulations.
Utilization of this validated and reliable questionnaire has the potential for broad use and provides insight into the factors that influence DS use in elite athletes.
In 2006, 20 % of adolescents aged 12-17 years used dietary supplements. Persons with high physical activity levels as well as those with high education levels consumed dietary supplements more often than others. Many supplement users used only one single-nutrient supplement. A similarly large proportion of users consumed one supplement with multiple nutrients. Most often supplements containing vitamin C, magnesium, B-vitamins, vitamin E and calcium were used.
We examined the dietary intake of iron, zinc and folate, estimated from both food and supplement sources, in 2019 pregnant women who participated in the Prenatal Health Project (PHP). The PHP recruited pregnant women from ultrasound clinics in London, Ontario, in the years 2002-2005.
Participants completed a telephone survey, which included a food frequency questionnaire and questions on dietary supplement use. Frequencies of use of dietary supplements were generated. Nutrient intake values were estimated from food and supplement sources, and summed to calculate total daily intake values.
Most women took a multivitamin supplement, and many women took folic acid and iron supplements; however, one-fifth of the sample did not take any supplements providing any of the three micronutrients. Despite being of a higher socio-economic status overall, significant proportions of the cohort ranked below the recommended dietary allowance values for iron, zinc, and folate. This suggests there may be other barriers that impact dietary practices.
Further research is required on how to better promote supplement use and a healthy diet during pregnancy.