Academic journal article Canadian Journal of Public Health

Natural Health Product Use in Canada

Academic journal article Canadian Journal of Public Health

Natural Health Product Use in Canada

Article excerpt


Objective: To quantify patterns of Natural Health Product (NHP) use in Canada.

Methods: The Food Habits of Canadians surveyed 1,543 Canadian adults using a 24-hour recall to record dietary supplements. Prevalence of use by user profile was examined.

Results: Forty-six percent of women and 33% of men reported taking at least one Natural Health Product with a mean of 2.3 among users. The highest prevalence of supplement use, 57%, occurred among women aged 50-65. Supplement users were older, less likely to smoke and perceived their health as better than non-users. Among supplement users, men had higher rates of use of garlic and vitamin C while women used iron, calcium, B complex, evening primrose oil and glucosamine sulfate.

Discussion: Supplement use by Canadians, at 38% for nutrients and 15% for herbal products, was similar to the rate of uses in the U.S., although differences in the reporting of types of supplements underline aspects of consumer behaviour as well as methodological issues specific to NHPs. Investigation of the use of NHPs in the healthcare setting is important given the widespread use and the potential health care consequences associated with supplement use.

Natural Health Products (NHPs) include "traditional herbal medicines; traditional Chinese, Ayurvedic and Native North American medicine; homeopathic preparations; and vitamin and mineral supplements".1 While U.S. studies consistently report that 40% of adults use some form of vitamin or mineral supplement2-4 and 13% use herbal preparations,5-7 data concerning the prevalence of use in Canada are lacking.

Dietary supplements may be used to enhance dietary quality, prevent disease or as a natural remedy for health problems. The new Dietary Reference Intakes (DRIs) recognize both the role of diet and of supplemental forms of nutrients in health promotion (e.g., synthetic folic acid used prior to and during early pregnancy to prevent neural tube defects (NTDs)).8 Within the context of DRIs promoting synthetic nutrients and a booming herbal supplement market, 9,10 obtaining information on supplement use presents a practical challenge to healthcare professionals.

Currently there is limited government regulation of supplements and few scientific reports on the efficacy and outcomes of NHPs used in Canada. Moreover, consumers lack knowledge concerning appropriate use, with even the most common herbal supplements such as Echinacea being used at inappropriate levels.11 The Natural Health Products Directorate (NHPD) has been mandated to address these issues, yet there is limited background available on current NHP use in Canada. The following report offers the first insight into the usage habits and characteristics of Canadian users.


Sample design

The Food Habits of Canadians randomly selected and interviewed 1,543 (572 men, 971 women) Canadian adults aged 18-65. Eighty sample areas, representative of the Canadian population, were randomly selected using a probability of selection based on population size, from each of 5 regions, 4 census divisions, then 2 subdivisions and finally 2 enumeration areas. Using a telephone listing, the adult in the household with the next birthday was invited to participate in the study. Fifteen percent of the population isolated from major population centres and Aboriginal communities were excluded, as were pregnant and lactating women. Low-income individuals and young males had lower response rates. Twenty-four hour recalls were conducted in the home by a dietitianinterviewer, inquiring about the use of any dietary supplements on the recalled day. Full sampling methods and dietary intakes with and without nutritive supplements have been described previously.lz.12,13


Data were analyzed in mutually exclusive categories of NHP use: non-users (NU), nutritive supplement only users (N), nutritive and herbal supplement users (NH), and herbal supplement only users (H), as well as by specific supplement user types (e. …

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