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Traditional healthcare approaches in developing countries such as Africa, Asia, and Latin America differ from conventional medicine in developed countries, where they are referred to as alternative and complementary medicine. These traditional health practices, knowledge, and beliefs incorporate plant-, animal-, and mineral-based medicines, spiritual therapies, manual techniques, and exercises and are applied alone or in combination to treat, diagnose, and prevent illnesses or maintain well-being.
An example is Traditional Chinese Medicine (TCM), a whole medical system that has its roots in 3rd century B.C. China. It is based on a concept of vital energy, or qi, that is believed to flow throughout the body. TCM practitioners believe that ordinary foods contain powerful healing properties. Disease is proposed to result from disruption of the flow of qi and unbalancing of yin (negative energy) and yang (positive energy).
Nearly 17 years ago, the United States’ National Institutes of Health established an office and advisory panel to investigate promising unconventional medical practices. The National Center for Complementary and Alternative Medicine (NCCAM) was formally established in 1998, with about $6.5 million of funding available annually. Such areas as chiropractic, yoga, intercessory prayer, herbs, and massage were included in the funding cycle.
The NCCAM 5-point strategic plan (http://nccam.nih.gov/about/plans/2005/strategicplan.pdf) seeks to explore ways of enhancing physical and mental health and wellness; managing pain and other symptoms, disabilities, and functional impairments, which have a significant impact on a specific disease or disorder; preventing disease; and empowering individuals to take responsibility for their health. Reduction of selected health problems of specific populations in which complementary and alternative practices occur was also mandated as a study priority.
The emerging evidence and the associated traditional medicine practices fueled the World Health Organization’s launch of its first-ever comprehensive traditional medicine strategy in 2002.
It is noteworthy that approximately 62% of Americans use some form of alternative and complementary medicine, and prefer to self-diagnose and self-treat for a variety of acute and chronic maladies (Barnes et al., 2002). As consumers seek to reduce healthcare costs and use alternative forms of healthcare, healthcare providers must continue to assess the clinical merit of complementary and alternative medicine. This assessment includes adverse events that should expand the health care horizon through caution.
It is important to note that in 1976, California became the first state to license acupuncture as an independent healthcare profession. Since then, 40 states and the District of Columbia have adopted similar statutes. Most states allow herbal medicine within the scope of acupuncture practice; only a few states require the supervision of a physician for the almost 11,000 practicing non-physician acupuncturists. The number of acupuncturists is rapidly growing and is projected to quadruple by 2015.
The mere fact that much of the armamentarium of alternative medicine exists outside the conventional regulatory process means that a special public health responsibility (and burden) falls on manufacturers and distributors. Medicinal agents and bioactives in nutraceutical products or foods themselves must be well-defined and at least standardized in some reliable fashion so that patients/consumers and their physicians can access just what it is that may be ingested.
In this era of alternative and complementary medicine and a self-medicating consumer, the food industry can deliver potentially valuable agents through functional foods, which may protect us from potentially dangerous health consequences of unproven or contraindicated therapies. Some of the dynamics of functional foods and complementary and alternative medicine will be discussed during the Institute of Food Technologists’ Annual Meeting & Food ExpoSM in Chicago, Ill, July 28–August 1, 2007.
by Roger Clemens, Dr.P.H.,
Special Projects Advisor, ETHorn, La Mirada, Calif.
by Peter Pressman, M.D.,
Attending Staff, Internal
Medicine, Cedars-Sinai Medical Center, Los Angeles, Calif.
Barnes, P., Powell-Griner, E., McFann, K., and Nahin, R.L. 2002. Complementary and alternative medicine use among adults: United States, 2002. CDC Advance Data Report 343, May 27, 2004. Centers for Disease Control and Prevention, Atlanta, Ga.
Lee, A., Chui, P.T., Aun, C.S.T., Lau, A.S.C., and Gin, T. 2006. Incidence and risk of adverse perioperative events among surgical patients taking traditional Chinese herbal medicines. Anesthesiology 105: 454-461.