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Australian Journal of Pharmacy : March 2005
Did you see this? NEWS BRIEFS continued Diet, vitamins and breast disease … shown serious deficits in their knowledge of common herbal medicine safety and interactions Risk of benign breast disease (BBD) is not influenced by fat intake or micronutrient intake, but risk of atypical hyperplasia (AH) is increased with high caffeine intake and decreased with multivitamin supple- mentation, a prospective study has found. The Queensland Institute of Medical Research at the Royal Brisbane Hospital collaborated with Harvard researchers in an analysis of the diets of a cohort of 58,628 women with a six- year follow-up. A total of 9645 women reported a medical diagnosis of BBD, and the highest intake of vegetable fat was associated with a 16% lower incidence of biopsy-confirmed BBD compared to the lowest fat intake. Use of vitamin supplements (multitvit- amins, vitamins A, C, E, betacarotene and/or folic acid) was also associated with an 11% lower rate of reported BBD, regardless of type of supplement used. Only 67 women were diagnosed with AH, and use of vitamin supplements was associated with an almost 50% lower rate of atypia. A similar effect was seen for multivitamins alone, while women consuming the most caffeine had more than a dietary and lifestyle risks,’ Dr Crowe told the JCM. Cancer Epidemiol Biomarkers Prevent 2004;13:1106–13 Poor herb QUM in pharmacy twofold increased incidence of AH compared to those consuming the least. The researchers concluded that their data added weight to the argument that high-fat diets do not play a major role in the development of breast cancer, ‘Although it is possible that they could influence breast-cancer risk among women with BBD.’ Dr Tim Crowe, Lecturer in Nutrition and Metabolism at the School of Exercise and Nutrition Sciences at Deakin University, agreed that the findings were in line with current thinking that dietary fat has only a minimal independent effect on breast-cancer risk. ‘Much of the risk of devel- oping breast cancer centres around factors that influence oestrogen levels during a woman's reproductive life, such as age of menarche, number of pregnancies and breastfeeding practices. Obesity, inactivity and alcohol intake are still regarded as the major A survey of Australian pharmacists and instore naturopaths has shown serious deficits in their knowledge of common herbal medicine safety and interactions, with pharmacy- assistant staff showing considerably less awareness. Dr Ramesh Manocha, Clinical Research Fellow at Sydney’s Royal Hospital for Women, told delegates at the hospital’s Centenary Scientific Meeting that the problems were so large that pharmacists were exposed to professional liability and that consumers’ health and safety were potentially in danger. The telephone and ‘mystery shopper’ walk-in survey involved a standardised set of questions being posed to 220 retail outlets of herbal medicines. The first enquired about the shelf availability of St John’s wort, however most staff approached (this was an assistant in 70% of pharmacies entered) did not ask about the intended recipient. When it was revealed that it was for a mildly depressed elderly relative who had received kidney transplant in the previous 12 months, it was mostly pharmacists who said it was not a suitable treatment, with naturopaths equally likely to endorse or demur herbal treatment and pharmacy assistants least likely to contraindicate it. Most respondents did not recognise that St John’s wort was only indicated for mild-to-moderate depression, and said it was good for all depressive states which, in the words of one respondent, consisted of ‘normal’ and ‘manic’. Most pharmacists asked about concurrent medication, whereas most naturopaths and pharmacy assistants did not; similarly pharmacists appeared better informed about dosage and estimated time of effect. • Pharmacists have a dilemma in defining the extent of their obligation to provide evidence-based information on CMs to consumers, Dr Michael Bollen, Chair of the Expert Committee on CMs in the Health System, told delegates at the Pharmacy Australia Congress in October. However, they should be at least able to access such information to answer consumers’ questions or address the potential for interaction between medicines, he said: ‘A professional has an obligation to place client interest before self-interest.’ JANUARY / FEBRUARY 2005 Complementary Medicine 11 … the problems were so large that pharmacists were exposed to professional liability The Journal of Complementary Medicine ? Evidence Based ? Peer Reviewed ? Referenced ? Independent ? Drug Interaction Guides ? CPE helps you gain the required knowledge and necessary understanding to provide informed advice to your customers ComplementaryMedicine The Journal of Bridging conventional and complementary medicine Watch for the next issue – a copy is delivered to every pharmacy every two months. If you want your own personal copy of this Journal, you can subscribe by visiting www.jnlcompmed.com.au or phone (02) 9439 4366 >