Mary Ojukwu presents her research.
OCCAM fellow researches weight status and CAM use
The use of complementary and alternative medicine (CAM) can be influenced by many factors including a person’s age, economic status, and health status. Mary Ojukwu, B.S., a Cancer Research Training Award (CRTA) fellow at OCCAM, has decided to look at another factor that could be related to CAM use: a person’s Body Mass Index (BMI). BMI is an approximation of body fat based on height and weight. A BMI of 25–29.9 indicates a person is overweight; a BMI of greater than 30 indicates obesity.
Ms. Ojukwu is delving into the wealth of knowledge available to researchers from the National Health Interview Survey (NHIS), a population-based survey of U.S. households completed in 2007. The 2007 NHIS is the latest survey to date that contains a special supplement specifically related to CAM. The outcome of interest for Ms. Ojukwu was the frequency of use of CAM modalities by those survey respondents who indicated they had a prior diagnosis of cancer. The frequencies were determined for groups of individuals based on weight status, comparing overweight, obese, and normal weight respondents. Ms. Ojukwu and coauthors, Drs. Farah Zia and Oluwadamilola Olaku from OCCAM and Dr. Justice Mbizo of the University of West Florida, state that the purpose of this research is “to examine the prevalence of CAM use in overweight and obese U.S. adult cancer populations based on a nationally representative sample."
Prior literature states that the prevalence of CAM use is low in the overweight and obese population and high in the cancer population. For example, one study found that adults with obesity were less likely to use most individual CAM modalities compared to normal weight adults and another study found that cancer survivors used more CAM compared to the general population after controlling for other factors. Furthermore, cancer survivors used CAM at levels similar to those with chronic symptomatic illness. There has been no study to date on a sample population that reveals the prevalence and pattern of the use of CAM in cancer patients who are overweight. The literature suggests that chronic disease is a major determinant for CAM use. By virtue of the fact that there is a higher likelihood of comorbid conditions, like diabetes, among the overweight and obese cancer population, Ms. Ojukwu hypothesized that CAM use will be higher in overweight and obese cancer patients compared to normal weight cancer patients in order to improve symptoms associated with their cancer as well as their comorbid disease.
Ms. Ojukwu has presented her work at the New England Science Symposium at Harvard Medical School in Boston, MA. Recently, she was accepted to present her work as a poster at the Academy Health Annual Research Meeting in Baltimore, MD on June 23-25, 2013.
Of the 1,785 patients that had a diagnosis of cancer, 59.4% were overweight or obese. Of the total cancer patient population, 89% stated they used CAM, and the CAM interventions used by most of these patients were predominantly biologically-based approaches (70.5%) and mind-body interventions (69%). Biologically-based approaches include dietary supplements such as herbal extracts and vitamins and mind-body interventions include meditation, hypnosis, cognitive behavioral therapy, support groups, and relaxation therapy. Those with a BMI that labeled them as overweight or obese used CAM at a slightly higher percentage than the total sample at 92.9% and 90%, respectively. Eighty-eight percent of underweight and normal weight respondents used CAM and only 58% of respondents whose BMI could not be determined used CAM. The association between overweight BMI status and CAM use was significant based on a multivariate logistic regression model. Interestingly, Ms. Ojukwu looked at other non-BMI variables of the data and noted, “In contrast to previous findings in the literature, income, education, and race were not significant predictors of CAM use within the cancer population.”
While not related to CAM use, it is telling that many cancer patients did report comorbidities, which may affect their use of CAM. The highest reported comorbidities were cardiovascular and musculoskeletal ailments (44% and 43% respectively). In addition, 17% of patients reported having respiratory disease and 14% reported diabetes.
“Based on our findings, CAM use was highly prevalent among cancer patients regardless of BMI status. The association was significant only for the overweight cancer patients, thus, due to our findings, our hypothesis was not supported . We concluded that CAM use is high among the cancer population, and prospective clinical studies are needed to evaluate the efficacy and safety of these non-conventional interventions, with a focus on the biologically based therapies, for the well-being of the cancer population within the United States,” Ms. Ojukwu noted. She added, “Future directions of this research study include looking at the data again more closely with different variables such as physical activity status and causal reasons for CAM use. This will provide a better characterization of the relationship between CAM use and weight status within the U.S. adult cancer population.