NIH five-year CAM plan seeks to advance "promising" science – and its use
The plan highlights the growing interest in CAMs and seeks to nurture scientific development and understanding by both health care professionals and the public so they can make better informed decisions when using CAMs.
“The plan calls for a sharper focus on research that shows the greatest scientific promise and public health potential for improving symptom management and overall well-being,” it states.
As an example of the importance of science it notes the reverse fortunes of omega-3 and St John’s wort supplements (Hypericum perforatum) between 2002 and 2007. According to National Health Interview Surveys, omega-3 supplements rose from the eighth most used, to the most used as cardiovascular and other science mounted for the nutrient.
Over the same period, St John’s wort slid from the sixth most popular in 2002 to 21st in 2007 as studies highlighted drug contraindication and efficacy issues for the herb whose popularity had been generated by studies indicating it could treat milder forms of depression.
Echinacea (pictured) was another that had seen sales drop after research questioned its ability to prevent or reduce the severity of the common cold.
Advance of science
The National Institutes of Health (NIH) body outlines three basic goals for sector it valued at $33.9bn in 2007 and which 40 percent of Americans utilized:
- Advance the science and practice of symptom management.
- Develop effective, practical, personalized strategies for promoting health and well-being.
- Enable better evidence-based decision making regarding CAM use and its integration into health care and health promotion.
“At its core is a vision in which rigorous scientific evidence about complementary and alternative medicine (CAM) informs both the decisions Americans make regarding CAM use and the potential for integration of CAM interventions into health care,” said NCCAM director, Josephine P Briggs, MD.
“As in the past, our plan emphasizes the importance of basic and clinical research as the core of building the evidence base for CAM. But in this plan, we give increased emphasis to translational research and bringing the methods of effectiveness and outcomes research to the real world where public use is extensive.”
The five-year plan evolved out of a prolonged assessment of the previous five-year plan achievements and an assay of scientific, medicinal and health care developments. Biomedical and behavioral research specialists, scientific and practitioner stakeholders, and the general public were consulted along the way.
“Symptoms matter, and few would dispute the fact that modern medicine does not always succeed in alleviating them,” added Briggs. “Few would also dispute the need for better approaches for encouraging healthy lifestyle choices. These are places in which I believe CAM-inclusive approaches offer promise, and I look forward to exploring the possibilities in the years ahead.”
Healthy food philosophy
CAMs include a range of treatments such as acupuncture and yoga and include botanical and non-botanical supplements and other extracts.
The five-year plan observes: “Newly emerging evidence suggests that CAM use may be associated with greater degrees of health-seeking behavior.”
This included encouraging, “dietary practices (sometimes grounded in traditional medical systems) that incorporate a healthy food philosophy.”
NCCAM classifies natural products as:
- Dietary supplements
- Herbal or botanical products
- Traditional medicine formulations
- Folk medicines
- Homeopathic remedies
- Probiotics
- Food-based phytochemicals
Probiotics are singled out as an area of focus, with the NCCAM noting: “There is scientific evidence that probiotics are useful in treating some forms of diarrhea, and emerging evidence that they may be helpful in treating a number of other conditions. NCCAM supports a large portfolio of research on probiotics.”
NCCAM said it was linking its probiotic research with the work of the NIH Human Microbiome Project, the FDA and USDA, "to share resources and expertise, harmonize technology standards and translational tools, develop biomarkers, and facilitate progress in research and regulatory policy."
NCCAM’s five-year plan can be found here.
