Last fall, President Obama visited the National Institutes of Health to discuss the impact of the American Recovery and Reinvestment Act. During his speech, the President made a comment that strongly resonated with me:

"Breakthroughs in medical research take far more than the occasional flash of brilliance, as important as that can be. Progress takes time; it takes hard work; it can be unpredictable; it can require a willingness to take risks and going down some blind alleys occasionally—figuring out what doesn't work is sometimes as important as figuring out what does—all of this needs the support of government." [emphasis mine]

I think this concept is often lost in our eagerness to find answers that will bring help to people suffering from disease.

Chronic, long-term sleep disorders affect millions of Americans each year. These disorders and the sleep deprivation they cause can interfere with work, driving, social activities, and overall quality of life, and can have serious health implications.

In 2002 and 2007, the National Health Interview Survey (NHIS) asked Americans about use of complementary and alternative medicine (CAM). Among respondents with insomnia, 4.5 percent (which translates to a total of 1.6 million U.S. adults) used some form of CAM to treat their condition—primarily biological/herbal therapies or mind-body/relaxation therapies. Most found these therapies helpful.

NCCAM supports studies on sleep disorders. Some people with sleep problems may try CAM therapies, including dietary supplements. If you are considering using CAM therapies, talk to your health care providers to ensure safe and coordinated care.

No one looks forward to the cold and flu season. Americans catch an estimated 1 billion colds each year. In fact, the common cold is among the leading reasons for visiting a doctor and for missing school or work. The flu, with its potential complications, can be an even greater concern. Each year, an estimated 5 to 20 percent of Americans come down with the flu. Although most recover without incident, flu-related complications result in more than 200,000 hospitalizations and 36,000 deaths annually.

In an effort to prevent or treat these all-too-common illnesses, some people turn to complementary and alternative medicine (CAM) approaches. This fact sheet provides basic information on colds and flu, as well as "what the science says" about some of these CAM approaches. If you are considering using a CAM therapy for colds or flu, this information can help you talk to your health care provider about it.

The National Center for Complementary and Alternative Medicine (NCCAM) welcomes five new members to the National Advisory Council for Complementary and Alternative Medicine (NACCAM). The council serves as the principal advisory body to NCCAM, the lead Federal agency for complementary and alternative medicine (CAM) research, and a component of the National Institutes of Health.

The council is composed of physicians, scientists, licensed CAM practitioners, and members of the public who contribute their time and expertise over a four-year term. Members meet three times per year, offering advice and recommendations on prioritization, conduct, and support of CAM research, including research training and communication of evidence-based health information.

Update: Due to the impending major snowstorm predicted for the mid-Atlantic region on Friday, the agenda for the February 5, 2010, meeting of the National Advisory Council for Complementary and Alternative Medicine will be shortened.

Those who wish to provide public comments must be present at the meeting. For updates, please visit http://nccam.nih.gov/ or call 301.594.9632.

NCCAM distributes its resources among many programs and mechanisms. The Center is committed to funding the largest number of meritorious projects possible, while allowing the flexibility needed to support selected program priorities and to respond to emerging scientific opportunities.

The Center establishes general guidelines for funding based on the overall NCCAM appropriation, allowing for necessary adjustments throughout the year to reflect directives from Congress, the Department of Health and Human Services, and the National Institutes of Health (NIH), as well as emerging program priorities.

President Obama released his budget for Fiscal Year 2011 on February 1. NCCAMs Congressional Justification for Fiscal Year 2011 was also released that day. The document outlines our plans and priorities, provides details of our budget, and notes our legislative history.

February is National Wise Health Consumer Month. Please take time this month to view our resources on complementary and alternative medicine (CAM) and being an informed consumer. By being aware of issues to consider and questions to ask, you're well on your way to being a wise consumer!

Within the last month, NCCAM has published 4 new Funding Opportunity Announcements related to the American Recovery and Reinvestment Act (ARRA). Also, there are several new NIH Notices announcing availability of funds for competitive revision applications and administrative supplements.

Emmeline Edwards, Ph.D., a specialist in neural mechanisms of complex behaviors, has been appointed director of the Division of Extramural Research at the National Center for Complementary and Alternative Medicine (NCCAM), a component of the National Institutes of Health.

The Division of Extramural Research develops and oversees NCCAM-funded research and research training programs. Division staff provide guidance regarding NCCAM research interests and priorities, and funding mechanisms and opportunities. The Division also coordinates research efforts with other NIH Institutes and Centers.

"We are pleased to have Dr. Edwards join in our mission to research complementary and alternative medicine using the highest possible standards," said Josephine P. Briggs, M.D., NCCAM Director. "Her background and her proven expertise in the oversight of basic and applied research will prove invaluable to NCCAM."

Knee osteoarthritis (OA) is an increasing problem among older adults, causing pain, functional limitations, and reduced quality of life. The traditional Chinese practice of tai chi, with its combination of physical and mental components, seems promising for OA patients; however, scientific evidence to support its use for this purpose has been limited. To strengthen the evidence base on this topic, NCCAM-funded researchers at Tufts Medical Center recently conducted a long-term, randomized, controlled trial comparing tai chi and conventional exercise in a group of 40 adults (mean age 65) with symptomatic knee OA.

As we welcome the New Year and a new decade, I'm mindful that we have just ended NCCAM's 10th anniversary. For us, it has been a decade of growth, progress, and promise.

As we begin this new decade, we are developing our third strategic plan, which will provide guidance for our future scientific direction, priority setting, and advancement of the organization. We have gained invaluable knowledge from our first decade, which is providing the strong base from which we will continue to build. I look forward to the future as we continue our 2010 strategic planning process and beyond as we work to fulfill the scientific mission of NCCAM.

The National Advisory Council for Complementary and Alternative Medicine (NACCAM) is charged with the responsibility of advising, consulting with, and making recommendations to the Director, NCCAM, on matters relating to the research activities and functions of the Center. The role and responsibilities of the council members include secondary review of grant applications in light of NCCAM scientific program priorities and program balance.

The agenda for the upcoming February meeting is posted for your review.

For many older adults, cognitive health and performance remain stable over the course of their lifetime, with only a gradual and slight decline in short-term memory and reaction times. But for others, this normal, age-related decline in cognitive function progresses into a more serious state of cognitive impairment or into various forms of dementia, including Alzheimer's disease. Such loss of cognitive function—the ability to think, learn, remember, and reason—substantially interferes with everyday function. As researchers continue to explore changes in the brain that take place possibly decades before cognitive decline and dementia symptoms appear, they also hope to discover more about the relationship between normal age-related cognitive decline and the development of cognitive impairment or Alzheimer's disease.

The Texas Department of State Health Services is warning consumers, especially pregnant or breastfeeding women, to avoid consuming a traditional product called Nzu because of the potential health risks from high levels of lead and arsenic.

Although the herb Ginkgo biloba is widely marketed and used to improve cognitive health in aging, adequate scientific evidence of its effect on long-term cognitive functioning has been lacking. In a recent study, NCCAM-funded researchers analyzed data from the Ginkgo Evaluation of Memory (GEM) study to determine ginkgo's effect on cognitive health in older adults.

Atlas Operations, Inc. Recalls Many Sexual Enhancement Products (FDA; 12/15/2009)

Atlas Operations, Inc. and FDA notified consumers of a nationwide recall of the company's dietary supplements for sexual enhancement. These products are currently being sold as dietary supplements throughout the United States. FDA lab analyses found that the products tested from certain batches contain Sulfoaildenafil, an analogue of Sildenafil, an FDA-approved drug used as treatment for male Erectile Dysfunction (ED), making these products unapproved drugs. The active drug ingredient is not listed on the product labels.

Oh, my aching back! I am sure you have all heard this from a family member—or said it yourself.

In previous messages, I've mentioned the high use of complementary and alternative medicine (CAM) for treating back pain. Back pain is a very common and bothersome symptom; it is a symptom that really matters and a major health burden in the United States. It is the leading cause of work-related disability and missed days of work, the fifth-most-common reason for physician visits, and a leading factor in health care costs.

Although progress has been made in the global fight against HIV/AIDS, the epidemic continues to devastate the United States and the international community with 56,300 new HIV infections each year in the U.S. and an estimated 33 million people living with HIV worldwide.

NCCAM supports studies on HIV/AIDS and related complications. Those considering using CAM therapies should talk to their health care providers to ensure safe and coordinated care.

The National Center for Complementary and Alternative Medicine (NCCAM) will celebrate a decade of rigorous research with NCCAM's 10th Anniversary Research Symposium: Exploring the Science of Complementary and Alternative Medicine. Speakers will discuss topics including natural products, mind-body medicine, and the intersection of behavioral science and integrative medicine. People have used some CAM therapies since ancient times and often with little scientific evidence.

Urinary Tract Conditions: Examining the Evidence on Cranberry and Saw Palmetto
Patients with urinary tract infections often ask health care providers about using complementary and alternative medicine to relieve symptoms or prevent recurrences.

Also Featuring: NCCAM's 1st Decade of Discovery and Achievement; An Interview With Wendy Weber, N.D., Ph.D., M.P.H.; North American Research Conference on CAM/Integrative Medicine; New Survey Details Americans' Spending on CAM; and other stories

Take our Reader Survey at http://nccam.nih.gov/news/newsletter/survey.html?nav=rss

GMP Herbal Products and FDA notified consumers and healthcare professionals of a recall of Pai You Guo, a weight loss dietary supplement, due to the presence of undeclared drug ingredients. FDA lab analyses of dietary supplements were found to contain undeclared sibutramine, an FDA-approved drug used as an appetite suppressant for weight loss; and phenolphthalein, a solution used in chemical experiments and a suspected cancer-causing agent that is not approved for marketing in the United States. The FDA has not approved the Pai You Guo products as a drug; therefore the safety and effectiveness of this product is unknown. The product is sold either in a box of 30 capsules or a bag of 10 g powder. The affected products were sold and distributed nationwide via the internet.

IDS Sports announced today that it is conducting a voluntary nationwide recall of five of the companys dietary supplement products sold under the following names: Bromodrol, Dual Action Grow Tabs, Grow Tabs, Mass Tabs, and Ripped Tabs TR.

People with pre-diabetes have higher than normal levels of blood glucose, a form of sugar the body uses for energy. Pre-diabetes, also called impaired fasting glucose or impaired glucose tolerance, can lead to type 2 diabetes, heart disease, and stroke. Preventive measures include weight loss, behavior modification, and glucose-lowering drugs. In China and other Asian countries, Chinese herbal medicines have long been used to prevent or delay the onset of diabetes, and there is anecdotal evidence regarding efficacy for this purpose. A recent review, funded in part by NCCAM, examined related clinical trials to see whether scientific evidence supports recommending Chinese herbal medicine as a treatment option for people with pre-diabetes.

Bodybuilding.com and FDA notified healthcare professionals and patients of a nationwide and international recall of all lots and expiration dates of 65 dietary supplement products that were sold through the Company's website, www.bodybuilding.com.

FDA believes that the recalled products contain the following ingredients that are currently classified, or the FDA believes should be classified, as steroids: "Superdrol," "Madol," "Tren," "Androstenedione," and/or "Turinabol." Acute liver injury is known to be a possible harmful effect of using steroid-containing products. In addition, steroids may cause other serious long-term adverse health consequences in men, women, and children. These include shrinkage of the testes and male infertility, masculinization of women, breast enlargement in males, short stature in children, a higher predilection to misuse other drugs and alcohol, adverse effects on blood lipid levels, and increased risk of heart attack, stroke, and death.

Although acupuncture has long been used to treat pain, the underlying cellular and molecular mechanisms are not fully understood. The process appears to involve the brain's ability to produce opioids (pain-reducing chemicals) that bind to neurons in distinct regions of the brain, and the ability of neurons to produce receptors for these endogenous opioids—specifically, mu-opioid receptors (MORs). Recent clinical trials have indicated that both traditional (actual) and simulated (sham/placebo) acupuncture decrease pain, but other studies have suggested that the neural mechanisms involved may be different.

Alzheimer's disease (AD) is an irreversible, progressive brain disease that slowly destroys memory and thinking skills and, eventually, the ability to carry out the simplest tasks of daily living. Among older people, AD is the most common cause of dementia (a decline in cognitive function that interferes with daily life and activities). However, AD is not a normal part of aging. Although treatment can slow the progression of AD and help manage its symptoms in some people, currently there is no cure for this devastating disease. Scientists are learning more every day, but right now, they still do not know what causes Alzheimer's disease.

NCCAM supports studies on Alzheimer's and diseases and conditions related to aging. In one recent NCCAM-funded study, it was found that 240 milligrams per day of the dietary supplement Ginkgo biloba was ineffective in reducing the development of dementia and Alzheimer's disease in older people. Those considering using CAM therapies, should talk to their health care providers to ensure safe and coordinated care.

As we are all aware, flu season is upon us. In a typical year, approximately 5 to 20 percent of the population gets the seasonal flu and approximately 36,000 flu-related deaths are reported. This year, we are faced with not only the seasonal flu, but also the novel H1N1 flu virus. This additional virus may cause a more dangerous flu season with more people getting sick, being hospitalized and dying than during a regular flu season. Like seasonal flu, illness in people with H1N1 can vary from mild to severe.

NCCAM is now seeking stakeholder comments on three "big picture" topics:

• Mission
• Priority setting
• Information and communication

Comments will be accepted through November 19, 2009. More »

Looking for an exciting opportunity? Come join the nation's medical research agency, where we are making important medical discoveries that improve health and save lives!

If you are a knowledgeable and motivated individual, interested in joining a diverse team dedicated to exploring complementary and alternative healing practices, then consider joining the National Center for Complementary and Alternative Medicine (NCCAM), Office of the Director (OD), Office of Policy, Planning and Evaluation (OPPE). Our office is responsible for developing and coordinating science policy and program planning and evaluation for the Center. For more information about the NCCAM, visit our website at www.nccam.nih.gov.

CAM approaches have sometimes been discounted in popular press as only being helpful for "life's little miseries"—trouble falling asleep, menopausal hot flashes, memory lapses, the need to lose weight, and sexual problems. I'm sure I'm not alone in thinking that these and other "little miseries" have a tremendous impact on one's quality of life and are worth researching.

About 50 to 60 percent of women are diagnosed with a urinary tract infection (UTI) at least once during their lifetime. Many experience multiple recurrences. Cranberry juice, a popular home remedy for UTI, is often taken along with low-dose antibiotics as a preventive measure. Because little is known about the potential of cranberry juice to interact with drugs, NCCAM-funded researchers at the University of Washington studied cranberry's effects on two antibiotics frequently prescribed for UTI: amoxicillin and cefaclor.

Today, NCCAM and the National Center for Health Statistics at the Centers for Disease Control and Prevention released new information on Americans' spending on CAM. Even in these difficult economic times, Americans are spending almost $34 billion per year on various CAM products and visits to CAM practitioners. By any measure, this is a substantial amount of money. This number, while only 1.5 percent of total health care expenditures, represents about 11.2 percent of all out-of-pocket spending on health care in the United States.

Americans spent $33.9 billion out-of-pocket on complementary and alternative medicine (CAM) over the previous 12 months, according to a 2007 government survey. CAM is a group of diverse medical and health care systems, practices, and products such as herbal supplements, meditation, chiropractic, and acupuncture that are not generally considered to be part of conventional medicine. CAM accounts for approximately 1.5 percent of total health care expenditures ($2.2 trillion) and 11.2 percent of total out-of-pocket expenditures (conventional out-of-pocket: $286.6 billion and CAM out-of-pocket: $33.9 billion) on health care in the United States.

Colloidal silver consists of tiny silver particles suspended in liquid. Usually marketed as dietary supplements, colloidal silver products have been used for a variety of health purposes—although there is no scientific evidence to support their safety or effectiveness. This fact sheet provides a general overview of colloidal silver products and suggests sources for additional information.

Key Points

• The U.S. Food and Drug Administration (FDA) does not consider colloidal silver to be safe or effective for treating any disease or condition.
• The FDA and the Federal Trade Commission (FTC) have taken action against a number of colloidal silver companies (including some companies that sell products over the Internet) for making drug-like claims about their products.
• Colloidal silver can cause many side effects. One example is argyria, a bluish-gray discoloration of the body, which is not treatable or reversible.
• Tell all your health care providers about any complementary and alternative practices you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.

Doctors often prescribe statin drugs to lower cholesterol levels and reduce the risk of coronary artery disease. These drugs, which interfere with the liver's production of cholesterol, are relatively safe for most people but sometimes can cause muscle problems known as statin-associated myalgia (SAM). Some patients who cannot tolerate statins because of muscle problems use the dietary supplement red yeast rice as a cholesterol-lowering alternative. In light of previous findings that red yeast rice can reduce levels of low-density lipoprotein (LDL, or "bad" cholesterol), researchers from the University of Pennsylvania and Thomas Jefferson University investigated the effects of this supplement in patients with high cholesterol and a history of SAM. The study was funded by the Commonwealth of Pennsylvania, with additional support from NCCAM.

Older adults tend to take a number of different prescription medications, and according to previous studies, they also often use dietary supplements. Because of the potential for adverse interactions between prescription drugs and dietary supplements, it is important to learn as much as possible about the real-life practices of older people—the extent to which they take both prescription drugs and dietary supplements, and what kinds of drugs and supplements are being used. NCCAM-funded researchers recently analyzed the use of prescription drugs and dietary supplements in a sample of 3,070 people aged 75 and older. The data had been gathered during the Gingko for the Evaluation of Memory (GEM) study, a clinical trial that examined the effects of Gingko biloba on the development of dementia.

Young You Corporation and FDA notified healthcare professionals and consumers that four weight loss dietary supplements sold and marketed by the firm contain an undeclared drug ingredient, Sibutramine.

Vital Pharmaceuticals Inc. and FDA notified healthcare professionals and consumers of a nationwide recall of the powdered dietary supplement, Stealth Chocolate and Stealth Vanilla, because it has the potential to be contaminated with Salmonella.

Omega-3 fatty acids are a group of polyunsaturated fatty acids that are important for a number of functions in the body. They are found in foods such as fatty fish and vegetable oils and are also available as dietary supplements. People take omega-3 supplements to improve their health and prevent various diseases. This fact sheet provides a general overview of omega-3 fatty acids—with a focus on dietary supplements—and suggests sources for additional information.

People who have trouble sleeping may try dietary supplements, relaxation therapies, or other forms of complementary and alternative medicine (CAM) in an effort to fall asleep faster, stay asleep longer, and improve the overall quality of their sleep. This fact sheet provides basic information on sleep disorders and "what the science says" about the effectiveness of CAM practices people use as sleep aids. If you are considering a CAM therapy for sleep problems, this information can help you talk with your health care provider about it.

About 47 million Americans have some form of metabolic syndromea group of conditions that increase the risk of diabetes, heart disease, and related complications. Metabolic syndrome is often characterized by abdominal obesity, impaired fasting glucose (an increase in glucose levels), elevated blood pressure, and high cholesterol and triglycerides. It is also associated with insulin resistance, a condition in which the body cannot use insulin effectively. Previous studies have suggested that chromium picolinate dietary supplements can help people with type 2 diabetes by improving insulin resistance and increasing the bodys sensitivity to insulin. However, its effects on people with a high risk for developing type 2 diabetes, especially those with metabolic syndrome, are largely unknown.

Low-Back Pain and CAM
Four out of five American adults will experience low-back pain (LBP). Many will try CAM therapies to manage their pain. Given the many choices, how can one approach making decisions about CAM use for LBP?

Also Featuring: Moving the Economyand Biomedical DiscoveryAhead; Interview: Low-Back Pain and Evidence-Based Care; First Straus Lecture: Acupuncture and Medical Paradigms; and other stories

FDA notified consumers and healthcare professionals to discontinue use of three Zicam Nasal Gel/Nasal Swab products sold over-the-counter as cold remedies because they are associated with the loss of sense of smell that may be long-lasting or permanent. The FDA has received more than 130 reports of loss of sense of smell associated with the use of the three Zicam products. In these reports, many people who experienced a loss of smell said the condition occurred with the first dose; others reported a loss of the sense of smell after multiple uses of the products. People who have experienced a loss of sense of smell or other problems after use of the affected Zicam products should contact their health care professional. The loss of sense of smell can adversely affect a persons quality of life, and can limit the ability to detect the smell of gas or smoke or other signs of danger in the environment.

Please use our link about Zicam to read more on these warnings.

Considering All Perspectives

Recently, a series of articles appeared in the media that were critical of complementary and alternative medicine (CAM) and how NCCAM directs taxpayer resources to study these modalities. While the articles contained several misconceptions regarding NCCAM's research, they also raised some important concerns that I share. No one likes criticism, but it is important to listen to the critics and look for any threads of truth that can help us fulfill our mission better. While the value of research on CAM interventions will probably continue to be the subject of some controversy, there are many areas of promise in CAM that need to be pursued. NCCAM is committed to this path.

Budget Request for FY 2010
Before the Senate Subcommittee on Labor-HHS-Education Appropriations

The President's Fiscal Year 2010 Budget request for the National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health includes $127,241,000, which is $1,770,000 more than the comparable FY 2009 appropriation of $125,471,000.

Physical pain is a common occurrence for many Americans; in fact, a national survey found that more than one-quarter of U.S. adults had recently experienced some sort of pain lasting more than a day. In addition to conventional treatments, such as over-the-counter and prescription medications, people may try acupuncture in an effort to relieve pain. This fact sheet provides basic information about pain and acupuncture, summarizes scientific research on acupuncture for specific kinds of pain, and suggests sources for additional information.

Neck pain is a common health problem in the United States. People suffering from neck pain often turn to complementary and alternative medicine (CAM) therapies. Although therapeutic massage is one of the most popular CAM therapies for neck pain, little is known about its effectiveness for this condition.

This 1-day workshop will identify clinical research questions related to nonpharmacologic interventions to treat back pain. This information will help inform future research directions.

El número de sitios Web que ofrecen recursos relacionados con la salud, incluso información sobre medicina complementaria y alternativa, crece día a día. Si bien muchos sitios de Internet resultan útiles, es posible que algunos presenten información inexacta o engañosa. Al visitar un sitio por primera vez es importante evaluar si es confiable. Esta guía describe algunos aspectos que debe considerar al evaluar estas fuentes.

People suffering from chronic low back pain who received acupuncture or simulated acupuncture treatments fared better than those receiving only conventional care according to a recent study published in the Archives of Internal Medicine. The study highlights central questions about the mechanisms of benefit seen in acupuncture studies.

"Because of the lack of highly effective medical treatments for chronic low back pain, we were pleased to find that acupuncture-like treatments were helpful for persons suffering from chronic back pain," said Daniel Cherkin, Ph.D. "However, the finding that real acupuncture produced no greater benefit than simulated acupuncture raises important questions about acupuncture's mechanisms of action."

Caution: Using CAM to Prevent the H1N1 Flu

Recently, the U.S. Food and Drug Administration and the Federal Trade Commission alerted the public to be wary of Internet sites and other promotions for CAM products that claim to diagnose, prevent, mitigate, treat, or cure the 2009 H1N1 influenza virus (swine flu). Such products have not been tested for safety and efficacy. Currently, the only approved medications for this flu virus are Tamiflu (oseltamivir phosphate) and Relenza (zanamivir).

FDA, FTC Warn Public of Fraudulent 2009 H1N1 Influenza Products
Offending web sites and illegal activity targeted for action

The U.S. Food and Drug Administration and the Federal Trade Commission are alerting the public to be wary of Internet sites and other promotions for products that claim to diagnose, prevent, mitigate, treat or cure the 2009 H1N1 influenza virus. The agencies are also advising operators of offending web sites that they must take prompt action to correct and/or remove promotions of these fraudulent products or face enforcement action.

If you are a motivated individual with an excellent attention to detail AND you want to play a significant role in a dynamic organization, then consider joining the National Center for Complementary and Alternative Medicine (NCCAM), Office of Administrative Operations (OAO)! Our office provides leadership and direction for NCCAM's business and administrative operations to promote organizational growth, encourage and empower NCCAM's staff, and optimize effective management of the public's investment in CAM research.

FDA Warns Consumers to Stop Using Hydroxycut Products
Dietary Supplements Linked to One Death; Pose Risk of Liver Injury

The U.S. Food and Drug Administration is warning consumers to immediately stop using Hydroxycut products by Iovate Health Sciences Inc., of Oakville, Ontario and distributed by Iovate Health Sciences USA Inc. of Blasdell, N.Y. Some Hydroxycut products are associated with a number of serious liver injuries. Iovate has agreed to recall Hydroxycut products from the market.

Progressive resistance exercise training (known as PRT) can increase muscle mass and preserve physical functioning in people with HIV. In light of evidence that the dietary supplement creatine can enhance PRT-related benefits in athletes and improve muscle function in patients with muscle-wasting conditions, a recent NCCAM-funded study investigated creatine's effects on PRT results in a group of HIV-positive men. The researchers were affiliated with the University of California at San Francisco and Santa Cruz, San Francisco General Hospital, Northern California Institute for Research and Education, the University of Massachusetts, and the University of Thessaly (Greece).

The purpose of the Biomedical Research Core Centers program is to support the hiring of newly-recruited faculty to develop research projects within the context of Biomedical Core Centers. For this announcement, a Biomedical Core Center is defined as a community of multidisciplinary researchers focusing on areas of biomedical research relevant to NIH, such as centers. These awards are designed to enhance innovative programs of excellence by providing scientific and programmatic support for promising research faculty and their areas of research. Specifically for the purposes of this announcement, Core Center Grants are institutional awards that provide funding to hire, provide appropriate start-up packages, and develop pilot research projects for newly independent investigators, with the goal of augmenting and expanding the institution's community of multidisciplinary researchers focusing on areas of biomedical research relevant to NIH.

This initiative is one of several being offered by NCCAM to help fulfill the goals of the American Recovery and Reinvestment Act (ARRA) to help stimulate the economy through support of biomedical and behavioral research. Additional information the Recovery Act and related NIH opportunities is available through the Office of Extramural Research.

For 10 years, NCCAM has been supporting research studies on complementary and alternative medicine (CAM) practices, determining their safety and effectiveness, and reporting the findings to the medical community and to the public. In these 10 years, we have funded more than 2,200 research projects, resulting in more than 3,300 articles published in peer-reviewed medical journals.

A paper published in the April 13, 2009 Archives of Internal Medicine exposes a gap in the knowledge and application of CAM research in clinical practice. In sum, approximately one in four clinicians was aware of two major CAM clinical trials. The 1,561 clinicians surveyed included acupuncturists, naturopaths, internists, and rheumatologists.

NCCAM has posted the Center's guidelines for Grand Opportunities (GO) Grants. This new program will support projects that address large, specific biomedical and biobehavioral research endeavors that will benefit from significant 2-year funds without the expectation of continued NIH funding beyond two years. The center is also participating in an initiative that supports new faculty recruitments to biomedical core centers (P30 grant). These grants will be institutional awards that provide funding to hire, provide appropriate start-up packages, and develop pilot research projects for newly independent investigators, with the goal of augmenting and expanding the institutions community of multidisciplinary researchers focusing on areas of biomedical research relevant to NIH.

In an initial investigation of the potential for information from CAM research to influence clinical practice, a 2007 national survey asked acupuncturists, naturopaths, internists, and rheumatologists about their awareness of CAM clinical trials, their ability to interpret research results, and their use of research evidence in decisionmaking. The survey was conducted by researchers affiliated with the National Institutes of Health, the Mayo Clinic, the University of Chicago, Harvard Medical School, and the University of Massachusetts. The survey focused on awareness of two major NCCAM-funded clinical trials that studied acupuncture or glucosamine/chondroitin for osteoarthritis of the knee.

What Is Tai Chi?

Tai chi (pronounced "tie chee" and also known by some other names and spellings) is a mind-body practice that originated in China as a martial art. A person doing tai chi moves his body slowly and gently, while breathing deeply and meditating (tai chi is sometimes called "moving meditation").

What Is Qi Gong?

A component of traditional Chinese medicine that combines movement, meditation, and controlled breathing. The intent is to improve blood flow and the flow of qi.

Teleconference

April 7, 2009

1:00 P.M.1:15 P.M. EST

877-719-9799 (toll-free); Passcode: 6064250

The first 15 minutes of the teleconference will be monitored by the Premiere Conferencing Operator. People who are calling on this line just listen only when Dr. Briggs speaks. This line will be closed at 1:15 P.M. EST.

NCCAM has posted the Center's guidelines for ARRA Administrative Supplements, ARRA Competitive Revisions, and Recovery Act Funds for Summer Research Opportunities. Information about NCCAM's Challenge Grant Topics is also available.

Headaches affect millions of Americans. According to the National Institute of Neurological Disorders and Stroke, about 45 million Americans suffer from chronic headaches. Tension-type headaches (or tension headaches)—characterized by pain or discomfort from tense or constricted muscles in the head, neck, or scalp—are one of the most common forms of headaches. In most patients, tension headaches occur infrequently and can be treated with over-the-counter pain medicine. However, some people experience these headaches several days per month, or even daily, and may benefit from other treatments.

Tauopathies—a group of neurodegenerative conditions such as Alzheimer's disease—have been linked to the build-up of "misfolded" tau proteins in the brain. (Tau proteins are associated with microtubules, which help to regulate important cellular processes.) In light of previous studies indicating that grape-derived polyphenols may inhibit protein misfolding, an NCCAM-funded research center at the Mount Sinai School of Medicine recently examined the potential role of a particular grape seed polyphenol extract (GSPE) in preventing and treating tau-associated neurodegenerative disorders.

On February 17, President Obama signed the American Recovery and Reinvestment Act of 2009 (Recovery Act). Funds from the Recovery Act will be invested in the construction and renovation of research and educational facilities, as well as groundbreaking scientific research that will improve the health of our Nation.

We appreciate that the President and Congress have recognized both the economic and health impacts of biomedical and behavioral research.

The goals of the Recovery Act include:

1. Preserving and creating jobs


2. Promoting economic recovery


3. Increasing economic efficiency by spurring technological advances in science and health.

Welcome to Our New Newsletter

A fresh new design and content that is more focused on research and patient care.

Survey Sheds New Light on Adults'—and Children's—Use of CAM

A new national survey on Americans' use of CAM and, for the first time, data on children's use of CAM.

Also Featuring: Sorting Claims from Facts About CAM; Interview: Cognitive Disorders in Later Life; Children and CAM; Using Dietary Supplements Wisely; and other stories

Heart disease is the leading cause of death for both men and women in the United States and is a major cause of disability. About 1.2 million people will have a first or recurrent coronary attack. Each year, about 700,000 people die of heart disease. (CDC) NCCAM supports studies on heart disease. Some people at risk for heart disease may try complementary and alternative medicine (CAM) therapies, including dietary supplements. An individual considering using CAM therapy, should talk to their health care providers to ensure safe and coordinated care.

Yesterday, NCCAM and the National Center for Health Statistics released the results of a survey on the use of complementary and alternative medicine (CAM) in the United States. The report confirms that CAM practices are a frequently used component of Americans health care regimens. Whether people use CAM for chronic health conditions or to prevent disease and maintain wellness, these approaches are a part of health care in America today.

Although acupuncture has long been used to relieve pain, scientific understanding of how acupuncture might achieve an analgesic effect is incomplete. Previous research has linked acupuncture's effects to the neuronal networks and opioid (pain response) systems of the brain. In light of these findings, NCCAM-funded researchers at Massachusetts General Hospital recently used two imaging technologies—functional magnetic resonance imaging (fMRI) and positron emission tomography (PET)—to investigate how specific areas of the brain might be involved in acupuncture analgesia.

Rheumatoid arthritis (RA) is an autoimmune disease that affects more than 2.1 million Americans. It is characterized by joint pain, stiffness, inflammation, swelling, and sometimes joint destruction. Nonsteroidal anti-inflammatory drugs are the standard treatment for RA, but their prolonged use is associated with adverse effects and discomfort. Natural plant alternatives like green tea are being investigated for the management of RA. Green tea is the most widely consumed beverage in the world, and its polyphenols (substances rich in antioxidants) possess anti-inflammatory properties.

Major depression is a disorder characterized by a depressed mood and/or a loss of interest in nearly all activities consistently for at least 2 weeks. People with major depression may also experience a variety of other symptoms such as loss of appetite, fatigue, sleep disturbance, irritability, difficulty concentrating, and thoughts of death or suicide. Extracts from the herb St. John's wort (Hypericum perforatum) are used in many countries, especially Germany, to treat depression. However, results from clinical trials worldwide have been contradictory, and the effectiveness of St. John's wort for depression is still questionable. Additionally, major depression is often treated with antidepressant drugs, which have only shown modest effects over placebo in clinical trials.

Approximately 38 percent of adults in the United States aged 18 years and over and nearly 12 percent of U.S. children aged 17 years and under use some form of complementary and alternative medicine (CAM), according to a new nationwide government survey. This survey marks the first time questions were included on children's use of CAM, which is a group of diverse medical and health care systems, practices, and products such as herbal supplements, meditation, chiropractic, and acupuncture that are not generally considered to be part of conventional medicine.

The survey, conducted as part of the 2007 National Health Interview Survey (NHIS), an annual study in which tens of thousands of Americans are interviewed about their health- and illness-related experiences, was developed by the National Center for Complementary and Alternative Medicine (NCCAM), a part of the National Institutes of Health (NIH) and the National Center for Health Statistics (NCHS), a part of the Centers for Disease Control and Prevention (CDC). The survey included questions on 36 types of CAM therapies commonly used in the United States—10 types of provider-based therapies, such as acupuncture and chiropractic, and 26 other therapies that do not require a provider, such as herbal supplements and meditation.

"The 2007 NHIS provides the most current, comprehensive, and reliable source of information on Americans' use of CAM," said Josephine P. Briggs, M.D., director of NCCAM. "These statistics confirm that CAM practices are a frequently used component of Americans' health care regimens, and reinforce the need for rigorous research to study the safety and effectiveness of these therapies. The data also point out the need for patients and health care providers to openly discuss CAM use to ensure safe and coordinated care.

This fact sheet provides basic information about the black cohosh—common names, uses, potential side effects, and resources for more information. Black cohosh, a member of the buttercup family, is a plant native to North America. It was used in Native American medicine and was a home remedy in 19th-century America.

What It Is Used For

• Black cohosh has a history of use for rheumatism (arthritis and muscle pain) but has been used more recently to treat hot flashes, night sweats, vaginal dryness, and other symptoms that can occur during menopause.
• Black cohosh has also been used for menstrual irregularities and premenstrual syndrome, and to induce labor.

AIDS (acquired immunodeficiency syndrome) is caused by the human immunodeficiency virus, or HIV. By killing or damaging cells of the body's immune system, HIV progressively destroys the body's ability to fight infections and certain cancers. These infections are caused by viruses or bacteria that usually do not make healthy people sick.

Many people infected with HIV or living with AIDS may be considering the use of complementary and alternative medicine (CAM) to boost their immune system; treat complications of disease; or cope with side effects of conventional medications.

In a study published in the Journal of the American Medical Association, 240 milligrams per day of the dietary supplement Ginkgo biloba was found to be ineffective in reducing the development of dementia and Alzheimer's disease in older people. Researchers led by Steven T. DeKosky, M.D., conducted the trial known as the Ginkgo Evaluation of Memory (GEM) study at four clinical sites over the course of 8 years. GEM is the largest clinical trial ever to evaluate ginkgo's effect on the occurrence of dementia.

• Press Release—summary of results of the study
• Questions and Answers—detailed background information on the study

People with advanced cancer often experience pain that causes physical and emotional distress, which leads to a decrease in functional ability and quality of life. Symptom relief is an important part of end-of-life care, and small studies have suggested that massage therapy may benefit people with advanced cancer.

In a study funded in part by NCCAM, researchers investigated the benefits of massage versus simple touch therapy (placing both hands on specific body sites) in patients with advanced cancer. This multisite study—conducted at 15 U.S. hospices in the Population-based Palliative Care Research Network—included 380 participants with advanced cancer who were experiencing moderate-to-severe pain. Participants were randomly assigned to receive six 30-minute treatment sessions of either massage or simple touch therapy over a 2-week period.

Hepatitis C, a liver disease caused by a virus, is usually chronic (long-lasting), with symptoms ranging from mild (or even none) to severe. Conventional medical treatments are available for hepatitis C; however, some people also try complementary and alternative medicine (CAM) therapies, especially herbal supplements. This fact sheet provides basic information on hepatitis C, summarizes scientific research on the effectiveness and safety of selected supplements, and suggests sources for additional information.

Key Points

• No CAM treatment has yet been proven effective for treating hepatitis C or its complications.


• It is important not to replace conventional medical therapy for hepatitis C with an unproven CAM therapy.


• Tell your health care providers about any complementary and alternative practices you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.

There are 23.6 million adults and children in the United States living with diabetes. Conventional medical treatments are available to control diabetes and its complications. However, some people also try complementary and alternative medicine (CAM) therapies, including dietary supplements. An individual considering using CAM therapy, should talk to their health care providers to ensure safe and coordinated care.

What is Diabetes?

Diabetes is a disease in which the body does not produce or properly use insulin. Insulin is a hormone that is needed to convert sugar, starches and other food into energy needed for daily life. The cause of diabetes continues to be a mystery, although both genetics and environmental factors such as obesity and lack of exercise appear to play roles.

Previous animal studies have indicated that an extract from leaves of the Ginkgo biloba tree may protect against stroke-related brain injury. However, the mechanism involved has not been fully understood. In a recent NCCAM-funded study, researchers at Johns Hopkins University investigated whether and how the ginkgo extract Egb761 alters outcomes in mice with brain injury from stroke.

Treating patients with placebos has a long, complicated, and often controversial history. Nonetheless, little is actually known about U.S. physicians' current attitudes toward and use of placebo treatments. A recent national survey of 679 physicians, funded in part by NCCAM, found that about half the physician respondents prescribed placebo treatments on a regular basis. Most (62%) said they think the practice is ethical. The surveyed physicians were internists and rheumatologists—specialties that commonly treat patients with debilitating chronic conditions.

Initial, independent review of study data from the Selenium and Vitamin E Cancer Prevention Trial (SELECT), funded by the National Cancer Institute (NCI) and other institutes that comprise the National Institutes of Health shows that selenium and vitamin E supplements, taken either alone or together, did not prevent prostate cancer. The data also showed two concerning trends: a small but not statistically significant increase in the number of prostate cancer cases among the over 35,000 men age 50 and older in the trial taking only vitamin E and a small, but not statistically significant increase in the number of cases of adult onset diabetes in men taking only selenium. Because this is an early analysis of the data from the study, neither of these findings proves an increased risk from the supplements and both may be due to chance.

Hot flashes are a problem for many menopausal women and a common side effect of breast cancer treatment. For many breast cancer survivors, vasomotor symptoms result in discomfort, disrupted sleep, anxiety, and decreased quality of life. Hormonal (estrogen) drugs have been used to treat hot flashes, but because estrogens are associated with an increased risk of breast cancer, they usually are avoided by breast cancer survivors. Since nonhormonal treatments do not work for some women and may have adverse effects, new interventions for hot flashes are needed. Previous research has indicated that hypnosis may be a promising alternative.

Chiropractic is a health care approach that focuses on the relationship between the body's structure—mainly the spine—and its functioning. Although practitioners may use a variety of treatment approaches, they primarily perform adjustments to the spine or other parts of the body with the goal of correcting alignment problems and supporting the body's natural ability to heal itself.

The National Institutes of Health's National Center for Complementary and Alternative Medicine (NCCAM) has added four new Centers of Excellence for Research on Complementary and Alternative Medicine (CERCs) to its research centers program. The new centers will add to knowledge about complementary and alternative medicine (CAM) approaches and their potential in treating and preventing diseases and conditions that are common among Americans.

In NCCAM's CERC program, highly accomplished researchers across a variety of disciplines apply cutting-edge technology to projects in CAM.

Disease risk, progression, and premature mortality—in many types of cancer and in cardiovascular and infectious diseases—have been linked to telomeres, which are protective DNA-protein complexes that keep cells genetically stable. The cellular enzyme telomerase is an important part of the body's maintenance system for these essential complexes. For example, a previous investigation found that increased stress among caregivers of Alzheimer's patients was associated with lower telomerase activity and telomere shortening.

In a recent pilot study funded by NCCAM and several other sponsors, researchers at the University of California-San Francisco investigated the effects of lifestyle changes on telomerase levels in 24 men with low-risk prostate cancer.

Feature Stories

• Tips for Talking with Your Health Care Provider
  Are you using—or thinking about using—complementary and alternative medicine (CAM)? If so, NCCAM provides some ideas on how to get a conversation started about CAM use when you talk to your health care providers.



• NCCAM Hosts Meditation Workshop
  Experts from a wide range of fields and disciplines who share a common interest in meditation for health purposes met to assess current scientific knowledge and identify areas of opportunity for future research.



• Meet NACCAM Member Margery Gass, M.D.
  What are some things that women can do to stay healthy at midlife and beyond? NCCAM National Advisory Council member Margery Gass, M.D., a specialist in women's health, discusses this topic.



• Happiness and Systematic Mind-Body Training
  What do monks, meditation, and music have in common? Dr. Richard Davidson discusses his work on the science of happiness and on systematic training of the mind and body.

Like many Americans, you may be using or considering some form of complementary and alternative medicine (CAM). If so, it is a good idea to talk with your health care providers about your CAM use. This fact sheet explains why and offers some tips to help you get the conversation started.

Key Points

• Tell your health care providers about all the complementary and alternative practices you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.
• Be proactive. Don't wait for your health care providers to ask about your CAM use.
• When you talk with your health care providers about CAM, make the most of the conversation. Bring a list of everything you use, keep a record of the information you receive, and ask questions if something is unclear.

The dietary supplements glucosamine and chondroitin sulfate, together or alone, appeared to fare no better than placebo in slowing loss of cartilage in osteoarthritis of the knee, researchers from the Glucosamine/chondroitin Arthritis Intervention Trial (GAIT) team report in the October issue of Arthritis & Rheumatism. Interpreting the study results is complicated, however, because participants taking placebo had a smaller loss of cartilage, or joint space width, than predicted. Loss of cartilage, the slippery material that cushions the joints, is a hallmark of osteoarthritis and its loss is typically measured as a reduction in joint space width—the distance between the ends of bones in a joint as seen on an X-ray.

"While these results are of interest, we cannot draw definitive conclusions about the utility of glucosamine or chondroitin in reducing joint space width loss, in part because the placebo group fared better than anticipated based on prior research results," said Josephine P. Briggs, M.D., director of the National Center for Complementary and Alternative Medicine, at the National Institutes of Health (NIH), one of the study's funders. "The results of the study provide interesting insights for future research."

The FTC today announced a new Web site about bogus cancer cures. The site — www.ftc.gov/curious — tells consumers how to spot and report bogus claims they see online, and urges people with cancer to talk to their treatment team about any products they'd like to try. The site features a video and includes a list of resources on cancer treatments from a variety of agencies within the federal government. Information is provided in English and Spanish.

The Federal Trade Commission also announced 11 law enforcement actions challenging deceptive advertising of bogus cancer cures. The FTC charged the companies with making unsupported claims that their products cured or treated one or more types of cancer. In each case, the company is charged with violating the FTC Act, which bars deceptive claims. Some complaints allege that the companies also falsely touted clinical or scientific proof for their products.

Clinical Trials to Target Hot Flashes, Night Sweats

Women troubled by hot flashes and night sweats during the years around menopause want safe, effective treatment options. A new research initiative from the National Institutes of Health (NIH) will establish a multisite research network to conduct clinical trials of promising treatments for the most common symptoms of the menopausal transition.

The initiative Menopause Strategies: Finding Lasting Answers for Symptoms and Health (MsFLASH) is led by the National Institute on Aging in collaboration with the National Center for Complementary and Alternative Medicine, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, and the Office of Research on Womens Health, all parts of the NIH. The MsFLASH network will be coordinated by principal investigators Andrea Z. LaCroix, Ph.D., and Garnet Anderson, Ph.D., both of the Fred Hutchinson Cancer Research Center in Seattle. The network centers will collectively receive approximately $4.4 million each year of the initiative, which is projected to run for five years.

A Press Release from the National Institute on Aging

As I've had the opportunity to meet with many of our stakeholders over the past 6 months, I have learned a lot. I've gained a greater appreciation of the complexities of studying CAM, the challenges to conducting rigorous research, and the need for setting clear priorities for the years ahead.

The older population is growing rapidly, and the aging of the "baby boomers," born between 1946 and 1964 (and who begin turning age 65 in 2011), will accelerate this growth. Healthy Aging Month was designed to focus national attention on the positive aspects of growing older. Many older Americans use complementary and alternative medicine (CAM) to improve their health and maintain wellness. The National Center for Complementary and Alternative Medicine (NCCAM) conducts and supports research on many conditions associated with aging and provides information on how to be an informed consumer.

If you are using (or thinking about using), you may have financial questions about paying for treatment. This fact sheet answers some frequently asked questions on this topic. To find out more about any topic or resource that is mentioned.

What are some questions to ask about paying for CAM treatment?

Some questions to ask a CAM practitioner or his office staff are:

• What does the first appointment cost?
• What do followup appointments cost?
• How many appointments does someone with my condition typically need?
• Are there any additional costs (such as for tests, equipment, or supplements)?

If you have a health insurance plan, some other questions are:

• Do you accept this insurance?
• What has your experience been with coverage by this insurance company for my condition?
• Do I file the claim forms, or do you take care of that?

If it would be difficult for you to pay the full fee at each visit, you can ask:

• Could you arrange a payment plan over time?
• Do you offer a sliding-scale fee? (Sliding-scale fees are determined by people's income and ability to pay.)

The purpose of the meeting was to articulate potential goals and directions for research on the mechanisms and efficacy of meditation practices for a variety of health concerns. Experts from a range of disciplines and with a wide range of involvement in the field of meditation research were asked to critically examine the current state of science on meditation for health, and to identify existing or potential intersections and contributions from their fields to further this area of science. This group developed a set of critical questions and approaches that could better inform future research in this area.

Reiki is a healing practice that originated in Japan. Reiki practitioners place their hands lightly on or just above the person receiving treatment, with the goal of facilitating the person's own healing response. In the United States, Reiki is part of complementary and alternative medicine (CAM). This fact sheet provides a general overview of Reiki and suggests sources for additional information.

• People use Reiki to promote overall health and well-being. Reiki is also used by people who are seeking relief from disease-related symptoms and the side effects of conventional medical treatments.
• Reiki has historically been practiced as a form of self-care. Increasingly, it is also provided by health care professionals in a variety of clinical settings.
• People do not need a special background to learn how to perform Reiki. Currently, training and certification for Reiki practitioners are not formally regulated.
• Scientific research is under way to learn more about how Reiki may work, its possible effects on health, and diseases and conditions for which it may be helpful.
• Tell your health care providers about any complementary and alternative practices you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.

Ayurvedic medicine (also called Ayurveda) is one of the world's oldest medical systems. It originated in India and has evolved there over thousands of years. In the United States, Ayurvedic medicine is considered complementary and alternative medicine (CAM)—more specifically, a CAM whole medical system. Many therapies used in Ayurvedic medicine are also used on their own as CAM—for example, herbs, massage, and specialized diets. This fact sheet provides a general overview of Ayurvedic medicine and suggests sources for additional information.

Key Points

• The aim of Ayurvedic medicine is to integrate and balance the body, mind, and spirit. This is believed to help prevent illness and promote wellness.
• Ayurvedic medicine uses a variety of products and techniques to cleanse the body and restore balance. Some of these products may be harmful if used improperly or without the direction of a trained practitioner. For example, some herbs can cause side effects or interact with conventional medicines.
• Before using Ayurvedic treatment, ask about the practitioner's training and experience.
• Tell your health care providers about any complementary and alternative practices you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.

Feature Stories

• New Campaign Encourages Open Communication About CAM
  A new campaign from NCCAM, which offers free educational materials, is encouraging dialogue between patients and their health care providers about CAM use.



• A Walk in the Botanical Research Centers "Garden"
  Visit the NIH Botanical Research Centers "garden" to find out how Russian tarragon, prunella (self-heal), borage oil, and other botanical and dietary supplement ingredients are being examined to prevent and treat diseases and conditions.



• CAM and Fibromyalgia: At a Glance
  Fibromyalgia is a condition involving pain, "tender points" on the body, and fatigue. About nine out of 10 people with this condition use CAM. What is known from science about CAM's effectiveness for fibromyalgia?

People with chronic health conditions such as fibromyalgia often turn to some form of complementary and alternative medicine (CAM)—a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine. This fact sheet provides basic information on fibromyalgia and "what the science says" about the effectiveness of CAM practices that many people with fibromyalgia use. If you are considering a CAM therapy for fibromyalgia, this information can help you talk to your health care provider about it.

Diabetes is a chronic condition affecting millions of Americans. Conventional medical treatments are available to control diabetes and its complications. However, some people also try complementary and alternative medicine (CAM) therapies, including dietary supplements. This fact sheet provides basic information on diabetes (with a focus on type 2), summarizes scientific research on the effectiveness and safety of selected supplements that people with diabetes sometimes use, and suggests sources for additional information.

Key Points

• In general, there is not enough scientific evidence to prove that dietary supplements have substantial benefits for type 2 diabetes or its complications.
• It is very important not to replace conventional medical therapy for diabetes with an unproven CAM therapy.
• Tell your health care providers about any complementary and alternative practices you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.

According to the National Institute on Aging (NIA), Alzheimer's disease affects nearly 4.5 million Americans and is the most common form of dementia in the elderly. Alzheimer's disease is an incurable disease with a slow progression beginning with mild memory loss and ending with severe brain damage and death. While no treatment is proven to stop Alzheimer's disease, some conventional drugs may limit symptoms for a short period of time in the early stages of the disease. Emerging research shows a correlation between red wine consumption and reduced risk of Alzheimer's disease-type cognitive decline. Authors of a new NCCAM-funded study in mice found that grape seed-derived polyphenolics—similar to that in red wine—significantly reduced Alzheimer's disease-type cognitive deterioration.

According to the National Institute of Mental Health at NIH, Attention Deficit Hyperactivity Disorder (ADHD) affects 3 to 5 percent of children in the United States and it is one of the most common mental disorders that develop in children. NIMH states that children with ADHD have impaired functioning in multiple settings, including home, school, and in relationships with peers. Children with chronic conditions like ADHD are reported to have higher rates of complementary and alternative medicine use and may turn to dietary and herbal supplements such as St. John's wort. However, according to authors of a new NCCAM-funded study, St. John's wort does not appear to have an impact on the symptoms of ADHD in children and adolescents.

The National Center for Complementary and Alternative Medicine (NCCAM), part of the National Institutes of Health (NIH), has launched Time to Talk, an educational campaign to encourage patients—particularly those age 50 or older—and their health care providers to openly discuss the use of complementary and alternative medicine (CAM). CAM is a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine, such as herbal supplements, meditation, naturopathy, and acupuncture.

According to a national consumer survey conducted by NCCAM and AARP, almost two-thirds of people age 50 or older are using some form of CAM, yet less than one-third of these CAM users talk about it with their providers. The NCCAM/AARP survey revealed some reasons why this doctor-patient dialogue about CAM does not occur.

I am now 4 months into this exciting and challenging new job as Director of NCCAM. In this short period, I have been given an excellent orientation to all areas of responsibility of the Center, guided by our terrific staff. I have also had the opportunity to speak with many CAM investigators, practitioners, and thought leaders, and some of our critics as well. I am learning a great deal from these various communities and perspectives. Clinicians have given me a sense of the promise that they see in the CAM approaches to health and wellness. Scientists have discussed the many challenges and knowledge gaps in conducting CAM research as well as the opportunities that are emerging from new research methods. NCCAM staff members have shared with me their expertise and experience in the complexities of oversight of our highly varied research portfolio. And CAM advocates who closely follow our progress have shared their perspective and hopes for NCCAM as well.

International Pharmaceuticals, Ltd. is conducting this recall after being informed by representatives of the Food and Drug Administration (FDA) that lab analysis by FDA of a sample from one lot of the product revealed that it contained a potentially harmful undeclared ingredient, hydroxyhomosildenafil. FDA asserts that this ingredient is an analog of sildenafil. Sildenafil is the active chemical ingredient of an FDA-approved drug used for Erectile Dysfunction in men to enhance sexual performance. The use of undeclared chemicals pose a threat to consumers because they may harmfully interact with nitrates found in some prescription drugs (such as nitroglycerin) and may lower blood pressure to dangerous levels. Consumers with diabetes, high blood pressure, high cholesterol, or heart disease often take such nitrates.

VIP Tabs are sold in retail outlets nationwide and are packaged into 2-capsule blister packs and 8-capsule bottles.

Many people take herbal supplements to boost their immune systems, treat allergy symptoms, prevent a cold—all in an effort to be well and stay healthy. There are hundreds of herbal supplements available in the grocery store or pharmacy or for sale on the Internet. And, there are many claims about their health benefits. How can a consumer decide what's safe or effective?

This booklet will give you a basic understanding of some of the most common herbs in popular dietary supplements—their historical uses, what they're used for now, the scientific evidence on their effectiveness, and side effects or cautions for you to consider.

To manage your health, you need to be an informed consumer. Learn about herbal supplements and talk with your health care provider about everything you are doing to stay well.

Low-back pain is a common condition that can be difficult to treat. Spinal manipulationThe application of controlled force to a joint, moving it beyond the normal range of motion in an effort to aid in restoring health. Manipulation may be performed as a part of other therapies or whole medical systems, including chiropractic medicine, massage, and naturopathy. is among the treatment options used by people with low-back pain in attempts to relieve pain and improve functioning. It is performed by chiropractors and other health care professionals such as physical therapists, osteopaths, and some conventional medical doctors. This fact sheet summarizes the current scientific knowledge about the effects of spinal manipulation on low-back pain.

Martin H. Goldrosen, Ph.D., was recently appointed director of the Division of Extramural Activities at the National Center for Complementary and Alternative Medicine, part of the National Institutes of Health.

In announcing Dr. Goldrosen's appointment, Josephine P. Briggs, M.D., NCCAM Director, said "The Division of Extramural Activities is crucial to NCCAM's ability to review and fund high-quality research, as well as coordinate grant management and advisory committee activities. Dr. Goldrosen's experience and his extensive research background make him well-suited for this important work for NCCAM."

Yoga is a mind–body practice in complementary and alternative medicine (CAM) with origins in ancient Indian philosophy. The various styles of yoga that people use for health purposes typically combine physical postures, breathing techniques, and meditation or relaxation. This Backgrounder provides a general overview of yoga and suggests sources for more information.

Yoga in its full form combines physical postures, breathing exercises, meditation, and a distinct philosophy. Yoga is intended to increase relaxation and balance the mind, body, and the spirit.

Early written descriptions of yoga are in Sanskrit, the classical language of India. The word "yoga" comes from the Sanskrit word yuj, which means "yoke or union." It is believed that this describes the union between the mind and the body. The first known text, The Yoga Sutras, was written more than 2,000 years ago, although yoga may have been practiced as early as 5,000 years ago. Yoga was originally developed as a method of discipline and attitudes to help people reach spiritual enlightenment. The Sutras outline eight limbs or foundations of yoga practice that serve as spiritual guidelines.

This 5-day series of events will highlight the science and practice of yoga. Participants will not only learn about yoga but also experience it first-hand through stretching and practice. NIH grantees as well as other local and international speakers will explore yoga practice for health. For a schedule of events and additional information visit: does.ors.od.nih.gov/fitness/yogaWeek.htm.

NCCAM provides resources and information on some health issues that affect women, such as menopause, osteoarthritis, and urinary tract infections. We also highlight some of the clinical trials related to women's health issues.

Decisions about medical care and treatment should be made in consultation with a health care provider and based on the condition and needs of each person. Discuss information on complementary and alternative medicine (CAM) with your health care provider before making any decisions about treatment or care. Tell your health care providers about any complementary and alternative practices you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.

I am pleased to present the President's Fiscal Year (FY) budget request for the National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health. The FY 2009 budget includes $121,695,000, which is $118,000 more than the comparable FY 2008 appropriation of $121,577,000.

The public's concept of health is broader than preventing and treating disease. Increasingly, Americans are using strategies that they can employ themselves to improve their health, maintain wellness, and improve quality of life. As part of this participatory approach to health, millions of people are using complementary and alternative medicine (CAM). Many of the leading U.S. medical institutions now offer integrative medicine services. These programs include personalized CAM interventions such as yoga, meditation, massage, and acupuncture. However, we know relatively little about the true potential of CAM to improve health and well being or to preempt disease, or about how best to use most CAM modalities. We also need to understand how CAM practices interact with other therapies and whether they are safe.

Given this consumer-driven call for better approaches to improved health and wellness, the medical research community has begun to explore promising CAM approaches and develop the scientific evidence base for CAM modalities that can be integrated as part of comprehensive health care. Using proven scientific methods and rigorous standards, NCCAM is building the research enterprise and the evidence base to better understand CAM. Through scientific investigation, research training programs, and outreach activities, NCCAM's efforts will support the rational integration of proven CAM approaches with conventional medicine.

Magnets have been used for health purposes for centuries. Static, or permanent, magnets are widely marketed for pain control and are considered part of complementary and alternative medicine. This fact sheet provides an overview of static magnets and summarizes current scientific knowledge about their effects on pain.

FDA has long regarded dietary supplements containing ephedra as potential health hazards because this botanical contains ephedrine alkaloids. Ephedrine alkaloids are adrenaline-like stimulants that can have potentially dangerous effects on the heart. Recent studies have confirmed that ephedrine alkaloids raise blood pressure and otherwise stress the circulatory system, effects that are linked to adverse health effects like heart attacks and strokes. Based on this and other evidence in the scientific literature, FDA issued a rule in February 2004 prohibiting the sale of dietary supplements containing ephedrine alkaloids because they present an unreasonable risk of illness or injury. The company is recalling nine products that contain ephedra, a source of ephedrine alkaloids.

NCCAM has a new director, Josephine L. Briggs, M.D. Meet this accomplished researcher and physician, and hear her foremost goal for the upcoming months.

It's been 10 years since a groundbreaking NIH conference on acupuncture. What has happened in acupuncture research since then? Where should the field go from here? A recent conference explored these questions.

The last thing people need when they are under stress is to get a cold—yet that's what often happens. Is there a scientific connection? A member of NCCAM's Advisory Council talks about some of his work in this area.

Researchers have found that a medical encounter may produce its own placebo effects that can bring about significant symptom improvement. The part of the encounter that plays the greatest role in the placebo effect appears to be the physician-patient relationship. In theory, the placebo effect of a medical encounter can be divided into the response to three main components: 1) the assessment and observation, 2) placebo treatment, and 3) patient-physician relationship. This study verified this theory and examined these components of the placebo effect.

Brain Awareness Week is an international effort to advance public awareness about the progress and benefits of brain research.

The National Center for Complementary and Alternative Medicine is actively involved in brain research, including research on mind-body medicine. Innovative use of imaging technology allows researchers to study the effects of specific CAM therapies on the brain. You can find out more about NCCAM's brain research efforts here.

Overall, in a pilot study of a ginkgo biloba extract for delaying the onset of dementia in the elderly, researchers did not find a reduction in progression to dementia in those using ginkgo versus those using placebo. However, when the researchers took into account participants' adherence to taking the compound, the group that took ginkgo did appear to have a reduced risk of progression and a smaller decline in memory.

A review of seven clinical trials of acupuncture given with embryo transfer in women undergoing in vitro fertilization (IVF) suggests that acupuncture may improve rates of pregnancy. An estimated 10 to 15 percent of couples experience reproductive difficulty and seek specialist fertility treatments, such as IVF.

Heart disease is the leading cause of death in the United States and is a major cause of disability. NCCAM has funded many basic and clinical studies related to heart disease. To ensure safe and coordinated care, people should talk to their health care providers about any CAM therapy that they are currently using or considering.

This fact sheet answers some frequently asked questions about St. John's wort and depression, and summarizes what the science says about its effectiveness and the research being done.

This Backgrounder will provide an introduction to acupuncture as well as resources for more information. Acupuncture is among the oldest healing practices in the world. As part of traditional Chinese medicine (TCM), acupuncture aims to restore and maintain health through the stimulation of specific points on the body.

The National Center for Complementary and Alternative Medicine (NCCAM) welcomes six new members to the National Advisory Council for Complementary and Alternative Medicine. The Council serves as the principal advisory body to NCCAM, the lead Federal agency for complementary and alternative medicine research and a component of the National Institutes of Health.

This fact sheet will provide information on menopausal symptoms and complementary and alternative medicine (CAM) based on findings from a 2005 National Institutes of Health State-of-the-Science conference on the management of menopause-related symptoms, as well as resources for more information.

This fact sheet provides basic information about the Chiropractic health care approach that focuses on the relationship between the body's structure-mainly the spine-and its functioning.

The posted table lists research and training grants funded for both new and ongoing research by the National Center for Complementary and Alternative Medicine during Fiscal Year 2007. The list includes the grant number, project title (linked to abstracts on CRISP), principal investigator, institution, and state.

National Institutes of Health (NIH) Director, Elias A. Zerhouni, M.D., today named Josephine P. Briggs, M.D., to be the director of the National Center for Complementary and Alternative Medicine (NCCAM). An accomplished researcher and physician, Dr. Briggs brings a focus on translational research to the study of complementary and alternative medicine (CAM) to help build a fuller understanding of the usefulness and safety of CAM practices.

The National Center for Complementary and Alternative Medicine (NCCAM), a component of the National Institutes of Health (NIH), will conduct a 3-day grantsmanship workshop. This workshop will provide researchers, fellows, and graduate students with an in-depth understanding of the NIH grants and review processes, clarify Federal regulations and policies, and highlight areas of special interest and concern.

Emphasis will be placed on complementary and alternative medicine (CAM) research. The workshop will include time to interact and discuss research ideas with NCCAM staff. Due to limited space, attendees will be selected through an application process.

International Team Studies South African Plant for HIV/AIDS
Could a plant that is unique to South Africa, and used as a traditional medicine there, be helpful to people with HIV/AIDS? A research team on two continents is working to find out.

Also Featuring: Meet NACCAM Member Carlo Calabrese, M.D., M.P.H.; Low Back Pain: NACCAM Symposium; First Transagency Fellow in Cancer CAM

If you are an exceptionally talented, knowledgeable and motivated individual with excellent knowledge of NIH training and career development programs; have scientific expertise in basic or clinical research that you wish to apply toward advancing the mission of the National Center for Complementary and Alternative Medicine (NCCAM), and ability to work as a member of and provide leadership for a team, within and across groups and organizations, AND you want to play a significant role in a dynamic organization, then consider joining NCCAM's Division of Extramural Research! The Division develops and oversees NCCAM-funded research and research training programs conducted across the country and around the world.

The deadline for applications is Friday, January 11, 2008.

After January 8, the "error correction window" for NIH eSubmission will be the two business days (Mon.–Fri., excluding Federal holidays) that follow the receipt deadline of the Funding Opportunity Announcement.

Many people infected with HIV or living with AIDS may be considering the use of complementary and alternative medicine (CAM) to boost their immune system; treat complications of disease; or cope with side effects of conventional medications. This information may be of interest.

The U.S. Food and Drug Administration requested a recall of True Man Sexual Energy Nutrient Capsules and Energy Max Energy Supplement Men's Formula Capsules, illegal drug products that contain potentially harmful, undeclared ingredients.

This fact sheet provides basic information about noni—common names, uses, potential side effects, and resources for more information. Noni is an evergreen shrub or small tree that grows throughout the tropical regions of the Pacific Ocean, from Southeast Asia to Australia and especially in Polynesia.

This fact sheet provides basic information about soy—uses, potential side effects, and resources for more information. Soy, a plant in the pea family, has been common in Asian diets for thousands of years. It is found in modern American diets as a food or food additive. Soybeans, the high-protein seeds of the soy plant, contain isoflavones-compounds similar to the female hormone estrogen. This fact sheet highlights what is known about soy when used by adults for health purposes.

This fact sheet provides basic information about the herb thunder god vine—common names, uses, potential side effects, and resources for more information. Thunder god vine has been used in China for health purposes for more than 400 years.

Nearly 21 million adults and children in the United States are living with diabetes. Some people with diabetes may be considering the use of complementary and alternative medicine (CAM) to either treat their diabetes or its complications. This information may be of interest.

With millions of Americans including complementary and alternative medicine (CAM) in their health care, and as CAM therapies become increasingly available as a result of consumer demand, it is critical that conventional health care professionals be familiar with the most commonly used forms of CAM. The October 2007 issue of the journal Academic Medicine, published by the American Association of Medical Colleges, highlights the results of 15 Education Project Grants funded by NCCAM.

The Image Gallery contains high quality digital photographs available from the National Center for Complementary and Alternative Medicine (NCCAM).

While there are no proven CAM treatments for cancer, CAM may be useful to relieve the side effects of treatment and to improve quality of life. NCCAM has a number of resources available for breast cancer patients considering complementary and alternative medicine (CAM).
Please visit our site to learn more.

Hoodia is a flowering, cactus-like plant native to the Kalahari Desert in southern Africa. Today, hoodia is marketed as an appetite suppressant for weight loss. This fact sheet provides basic information about the herb hoodia—common names, uses, potential side effects, and resources for more information.

Today, elderberry and elder flower are used for flu, colds, fevers, constipation, and sinus infections. This fact sheet provides basic information about European elder—common names, uses, potential side effects, and resources for more information.

Two types of chamomile are used for health conditions: German chamomile and Roman chamomile. This fact sheet provides basic information about the herb chamomile—common names, uses, potential side effects, and resources for more information.

The bitter orange tree is native to eastern Africa and tropical Asia. Today, it is grown throughout the Mediterranean region and elsewhere, including California and Florida. Bitter orange oil is used in foods, cosmetics, and aromatherapyA therapy in which the scent of essential oils from flowers, herbs, and trees is inhaled to promote health and well-being. products. This fact sheet provides basic information about bitter orange—common names, uses, potential side effects, and resources for more information.

The FDA is warning consumers not to buy or eat three red yeast rice products promoted and sold on Web sites.

On June 22, Ruth L. Kirschstein, M.D., Acting Director NCCAM, presented the President's Fiscal Year (FY) 2008 budget request of $121,699,000 for the National Center for Complementary and Alternative Medicine NCCAM) to the Senate Subcommittee on Labor-HHS-Education Appropriations.

The U.S. Food and Drug Administration today announced a final rule establishing regulations to require current good manufacturing practices (cGMP) for dietary supplements. The rule ensures that dietary supplements are produced in a quality manner, do not contain contaminants or impurities, and are accurately labeled.

"This rule helps to ensure the quality of dietary supplements so that consumers can be confident that the products they purchase contain what is on the label," said Commissioner of Food and Drugs Andrew C. von Eschenbach, M.D. "In addition, as a result of recent amendments to the Federal Food, Drug, and Cosmetic Act, by the end of the year, industry will be required to report all serious dietary supplement related adverse events to FDA."

Complementary and alternative medicine (CAM) is a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine. As with adults, a wide range of CAM therapies are used in children, including herbs and dietary supplements, massage, acupuncture, chiropractic care, naturopathy, and homeopathy. This fact sheet includes issues to consider and resources for more information when making decisions about CAM use and children.

Native to China, astragalus has been used for centuries in traditional Chinese medicine. In the United States, the herb gained popularity in the 1980s. This fact sheet provides basic information about the herb's common names, uses, potential side effects, and resources for more information.

NCCAM's Centers of Excellence: Focusing on the Big—and (Very) Small—Picture

What do Chinese herbal formulas, mindfulness meditation, electromagnetic beams, and the supplements alpha-lipoic acid and gamma tocopherol have in common? They are among CAM treatments being studied in depth at eight NCCAM-supported research centers.

In Memoriam: Stephen E. Straus, M.D.

Stephen E. Straus, M.D., founding Director of the National Center for Complementary and Alternative Medicine (NCCAM), died of brain cancer on May 14, 2007. He was 60.

Stephen E. Straus, M.D., 60, the first director of the National Center for Complementary and Alternative Medicine (NCCAM) at the National Institutes of Health (NIH), died of brain cancer May 14, 2007, at his home in Potomac, Maryland.

"As NCCAM's first Director, Dr. Straus articulated an uncompromising and compelling agenda for scientific research and research training that engendered broad interest and collaboration," noted Elias A. Zerhouni, M.D., Director of the National Institutes of Health. "His success stemmed from the fact that he understood that the commitment to help patients had to be constantly evolving in order to meet their needs. The NIH has lost a great leader and an outstanding scientist. Most of all, we have lost a dear friend."

The National Center for Complementary and Alternative Medicine (NCCAM) has established an Integrative Medicine Consult Service at the National Institutes of Health (NIH) Clinical Center, the world's largest hospital devoted to research. This service will provide physicians, nurses, and other members of the Clinical Center health care team the ability to discuss complementary and alternative medicine (CAM) therapies with knowledgeable medical staff from the consult service and learn how various CAM practices might complement or interact with a patient's care as a research participant at the Clinical Center.

Nearly 1 in 3 American adults has high blood pressure, or hypertension. If it is not found and treated, the condition can cause major health problems such as stroke, heart disease, eye problems, or kidney failure. Your doctor can tell you how to prevent and control high blood pressure. NCCAM is studying complementary and alternative medicine (CAM) for this condition—such as mindfulness-based stress reduction. Be sure to tell your doctor about any CAM therapies you are considering, including herbal or dietary supplements. Ask your health care providers about its safety, effectiveness, and possible interactions with medications (both prescription and nonprescription).

Naturopathy, also called naturopathic medicine, is a whole medical system—one of the systems of healing and beliefs that have evolved over time in different cultures and parts of the world. Naturopathy is rooted in health care approaches that were popular in Europe, especially in Germany, in the 19th century, but it also includes therapies (both ancient and modern) from other traditions. In naturopathy, the emphasis is on supporting health rather than combating disease.

As many as 20 percent of the adult population, or one in five Americans, has symptoms of irritable bowel syndrome (IBS), making it one of the most common disorders diagnosed by doctors. In an effort to bring attention to the symptoms and difficulties associated with the disorder, April has been designated as IBS Awareness Month.

The National Center for Complementary and Alternative Medicine conducts and supports research on many types of diseases and disorders, including IBS. Researchers are studying the effects of acupuncture and the placebo effect on pain caused by IBS. The results have not been published yet.

This fact sheet provides basic in