title: Use of multivitamins, folic acid and herbal supplements among breast cancer survivors: the black women's health study.
abstract: BACKGROUND
  Complementary and alternative medicine (CAM) use, including herbals and multivitamin supplements, is quite common in the U.S., and has been shown to be highest in breast cancer survivors. However, limited data are currently available for CAM usage among African Americans. Thus, we sought to determine the prevalence of multivitamins, folic acid and herbal supplement usage in African American breast cancer survivors, and to compare the characteristics of users and nonusers.
  
  
  METHODS
  A cohort study of breast cancer survivors, who completed the 1999 Black Women's Health Study questionnaire and self-reported having been diagnosed with breast cancer between 1995 and 1999, comprised the study population. In this study, the intake of natural herbs, multivitamins and folic acid at least three days per week within the past two years was used as a proxy for typical usage of this complimentary alternative medicine (CAM) modality.
  
  
  RESULTS
  A total of 998 breast cancer survivors were identified. Overall, 68.2% had used either herbals or multivitamin supplements or both. The three most frequently used herbals were garlic (21.2%), gingko (12.0%), and echinacea (9.4%). The multivariate analysis determined that single marital status (OR=1.58; 95%CI: 1.04-2.41), and alcohol consumption of 1-3 drinks per week (OR=1.86, 95%CI: 1.28-2.68) were significantly associated with increased herbal use. Multivitamin use was significantly lower among obese women (OR=0.66, 95%CI: 0.46-0.94) and current smokers (OR=0.53, 95%CI: 0.34-0.82).
  
  
  CONCLUSIONS
  A significant number of African American breast cancer survivors are using herbals and multivitamins as CAM modality. Additional research is needed to understand the impact of herbals and multivitamins in African American breast cancer survivors.
authors.affiliation: Lombardi Comprehensive Cancer Center, Georgetown University, 3970 Reservoir Road, NW, Research Building, E501, Washington, DC 20057, USA.
authors.forename: Mireille
authors.initials: M
authors.lastname: Bright-Gbebry
authors.forename: Kepher H
authors.initials: KH
authors.lastname: Makambi
authors.forename: JoyAnn Phillips
authors.initials: JP
authors.lastname: Rohan
authors.forename: Adana A
authors.initials: AA
authors.lastname: Llanos
authors.forename: Lynn
authors.initials: L
authors.lastname: Rosenberg
authors.forename: Julie R
authors.initials: JR
authors.lastname: Palmer
authors.forename: Lucile L
authors.initials: LL
authors.lastname: Adams-Campbell
mesh_terms: D000328:Adult; D001741:Black or African American; D000368:Aged; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000208:ethnology*; D015331:Cohort Studies; D000529:Complementary Therapies / Q000379:methods* / Q000706:statistics & numerical data; D019587:Dietary Supplements / Q000706:statistics & numerical data; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage*; D006801:Humans; D008875:Middle Aged; D028321:Plant Preparations / Q000008:administration & dosage*; D017741:Survivors; D014815:Vitamins / Q000008:administration & dosage*; D016387:Women's Health; D055815:Young Adult
chemical_list: D028321:Plant Preparations; D014815:Vitamins; D005492:Folic Acid