Natural Foods Merchandiser

CAM booming among older people

Mick Jagger of the Rolling Stones once lamented, "Oh, what a drag it is growing old," in one of the band's signature songs. Now 64 and still rockin', Jagger epitomizes the spirit that Americans don't have to book a room in a retirement home when they get their first issue of AARP The Magazine.

People are obviously living longer and better as the decades roll by. Based on the sheer number of people using alternative therapies such as dietary supplements and herbal medicines, you can't discount these products as a factor in this trend. A survey released earlier this year by the National Center for Complementary and Alternative Medicine, conducted in association with AARP, found that more than two-thirds of Americans over age 50 use some form of CAM therapy, from massages to herbal remedies and dietary supplements to energy healing.

Additionally, mainstream scientific studies are now finding some supplements and herbals, such as echinacea and flaxseed, show promise in treating various diseases, including cancer. Despite the overt use of products outside the mainstream, the NCCAM and AARP survey discovered that few users discuss their use with a physician.

"Well, the primary reason that people are not telling their providers is that the providers don't ask," explains Dr. Margaret Chesney, deputy director of NCCAM. "That's what 42 percent of the people have told us. … And actually, there's a small number of people who said that they were afraid that their doctor would be dismissive or even say, ?I don't want you to do that.'"

Science surges ahead
NCCAM-supported research published in the March/April issue of Alternative Therapies in Health and Medicine found that Americans ages 45 to 64 are the most likely segment of the population to use herbal products. Topping their list are echinacea (41 percent), ginseng (25 percent), gingko (22 percent) and garlic (20 percent). The most frequent conditions for herb use were head or chest cold, musculoskeletal conditions and stomach or intestinal illness, the study found.

At the Botanicals Research Center for Age-Related Diseases, run by Purdue University in association with the University of Alabama-Birmingham, scientists are studying the efficacy and safety of herbals for age-related ailments like osteoporosis, cataracts and cardiovascular disease. The NCCAM-supported research center also has pilot grants to research herbals and their effects on cancer and diabetes, according to Connie Weaver, director of the center and a principal investigator for several projects.

"We generally study commercially available herbal dietary supplements that claim to have functions," Weaver explains. One study that she published in the Journal of Clinical Endocrinology and Metabolism reviewed the effect of soy on bone density in post-menopausal women. The verdict: Have the soy milk with your granola cereal only if you like the taste, not for stronger bones.

But researchers studying a link between green tea extract with in vitro and animal models are seeing some promising results, according to Weaver. "Green tea extracts, particularly in combination with other plant-derived constituents, will inhibit all sorts of cancer tumors," Weaver says. Those findings have spurred clinical trials of green tea extract at the Indiana School of Medicine, she adds.

Weaver says herbs have played a central role in medicine for centuries, so it's unlikely research will necessarily lead to more use. "I don't know if you can say they'll play a bigger role than they have throughout history, but hopefully we'll understand them better and know which ones do something," she says. "The fact that [National Institutes of Health] is sponsoring randomized, controlled trials of some of the supplements brings a higher level of research, and it will change the reception of them if there are positive trials."

Drawing a line on health
Dietary supplement manufacturers now market products directly for older adults. Some even offer full lines of products targeted to those older than 50. Bluebonnet Nutrition lists 17 products under seniors' health on its Web site, from glucosamine to omega-3 joint and brain formulas.

The herbal company Herb Pharm, in Williams, Ore., doesn't market its products directly for use by older people, though some naturally fall into that category, according to the company's founder and co-owner Ed Smith.

For example, older customers are typically drawn to the brain and memory formulas, though they're meant for adults of any age. "Memory tends to be more of a problem as you get older," Smith notes. He says Herb Pharm has considered branding a line dedicated to that segment of the population but hasn't done so yet.

The baby boomers are getting older, so there is more of a market and more of a need, says 62-year-old Smith.

Dr. Judith S. Stern, a distinguished professor of nutrition and internal medicine at the University of California, Davis, says there's nothing magical about the age of 50 in terms of health and nutrient needs, though our physiology certainly changes and certain supplements become valuable. For women, post-menopause is the threshold, while age 50-plus works well for men in terms of deciding what sorts of dietary aids to take.

At the top of the list are multi?vitamins without iron. And older people definitely need more vitamin D, according to Stern. "For some reason … we're not getting enough sunshine, and it's clear that vitamin D is critical," she says.

Stern also recommends supplementing diets with calcium (men and women), magnesium and potassium, particularly to help lower blood pressure. "I think it's very hard for people to get all they need from food," she says, particularly for older people, as we tend to eat less as we age. "I think to make sure [older people get enough nutrients], I would take them as supplements, and that's not usually what nutritionists say."

Consumers need information
Zedrick Clark, owner of Nature's Food Market in Berlin, Ohio, says he believes there are good products out there that address the needs of older customers, but marketing sometimes overshadows efficacy. "You have to search through the hype," he says.

And you need to read through a product's literature, according to Stern. "I think you have to be a good label reader," she says, particularly because many conventionally trained physicians are not talking about supplements with their patients, as evidenced by the AARP-NCCAM survey. "Doctors don't know much about nutrition and supplements," she says.

Smith puts it more bluntly: "Going to a doctor to get information about herbs is like going to a car mechanic to get information about your TV." He says his company fields a growing number of questions about how certain herbs might interact with a drug.

It's certainly a valid concern, especially because older people may be on multiple medications, Stern says. She notes that something as seemingly innocuous as herbal tea or grapefruit can enhance a drug or decrease its effectiveness. For example, grapefruit affects an enzyme that helps metabolize certain drugs.

The key group to educate is women because they buy about 75 percent of supplements for their families, Stern notes. "They are the key people we should be talking to about supplements."

Clark hits on the same theme at Nature's Food Market.

"I try to educate my customers on how to buy; that way they don't get suckered when they're not at our store," he says. Supplements containing lutein for macular health are popular with the older crowd, as are multivitamins, progesterone creams and what Clark calls "libido formulas." Wrinkle creams are also a favorite.

In fact, he says, body care, not necessarily health, is on the minds of consumers, something evidenced by the variety of products on his store's shelves. "The baby boomer generation doesn't want to let go of its youth," Clark says.

Natural Foods Merchandiser volume XXVIII/number 9/p. 90, 94

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