{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:21:13Z","timestamp":1760145673697,"version":"build-2065373602"},"reference-count":75,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2024,8,21]],"date-time":"2024-08-21T00:00:00Z","timestamp":1724198400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"FCT\/MCTES","award":["UIDP\/50006\/2020"],"award-info":[{"award-number":["UIDP\/50006\/2020"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Foods"],"abstract":"<jats:p>The European population is ageing. Food Supplements (FSs) are foods with particular characteristics, consumed by elderly people for various purposes, including combating nutritional deficits. Their consumption in this age group, associated with a high prevalence of polypharmacy, can enhance interactions. Potential drug-food (or food supplements), drug-drug interactions and polypharmacy are common health issues among older adults. The prevalence of polypharmacy is high, and preliminary data also indicate that there is significant FS use, increasing the risk of the duplication of therapies and various adverse reactions as well as drug\u2013FS and FS-FS interactions. Therefore, the intervention of health professionals in mitigating these risks is essential. This review highlights and discusses the association between FSs, polypharmacy, and adverse reactions due to the risk of potential interactions between these products. Moreover, it also provides current scientific evidence regarding the use of FSs by the elderly. A review of the challenges, advantages, and risks of using FSs in elderly people who are malnourished and\/or polymedicated, focusing on the good practises needed to support healthy ageing, is presented. In this regard, this paper aims to help health professionals better deal with the issue of the use of multiple FSs and polypharmacy, overcome the malnutrition problem, and improve the health and well-being of older adults.<\/jats:p>","DOI":"10.3390\/foods13162618","type":"journal-article","created":{"date-parts":[[2024,8,22]],"date-time":"2024-08-22T04:26:57Z","timestamp":1724300817000},"page":"2618","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Food Supplements and Their Use in Elderly Subjects\u2014Challenges and Risks in Selected Health Issues: A Narrative Review"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2403-7073","authenticated-orcid":false,"given":"Maria Jo\u00e3o","family":"Campos","sequence":"first","affiliation":[{"name":"LAQV-REQUIMTE, Laboratory of Bromatology, Pharmacognosy and Analytical Sciences, Faculty of Pharmacy, University of Coimbra, 3000-295 Coimbra, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6085-4855","authenticated-orcid":false,"given":"Magdalena","family":"Czlapka-Matyasik","sequence":"additional","affiliation":[{"name":"Department of Human Nutrition and Dietetics, Poznan University of Life Sciences, 60-624 Poznan, Poland"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0902-647X","authenticated-orcid":false,"given":"Angelina","family":"Pena","sequence":"additional","affiliation":[{"name":"LAQV-REQUIMTE, Laboratory of Bromatology, Pharmacognosy and Analytical Sciences, Faculty of Pharmacy, University of Coimbra, 3000-295 Coimbra, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2024,8,21]]},"reference":[{"key":"ref_1","unstructured":"UN (2023, August 30). Envelhecimento. Available online: https:\/\/unric.org\/pt\/envelhecimento\/."},{"key":"ref_2","unstructured":"WHO (2023, October 30). By 2024, the 65-and-Over Age Group Will Outnumber the Youth Group: New WHO Report on Healthy Ageing. Available online: https:\/\/www.who.int\/europe\/news\/item\/11-10-2023-by-2024--the-65-and-over-age-group-will-outnumber-the-youth-group--new-who-report-on-healthy-ageing."},{"key":"ref_3","unstructured":"WHO (2023, October 31). Healthy Life Expectancy at Birth (Years). Available online: https:\/\/data.who.int\/indicators\/i\/C64284D."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Pleshkova, N., Tokhiriyon, B., Vekovtsev, A., Poznyakovsky, V.M., Lapina, V., Takaeva, M.A., Sorokopudov, V.N., and Karanina, E.V. (2022). Efficacy of Biologically Active Food Supplements for People with Atherosclerotic Vascular Changes. Molecules, 27.","DOI":"10.3390\/molecules27154812"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1113","DOI":"10.1080\/10715762.2019.1636045","article-title":"Contaminants: A Dark Side of Food Supplements?","volume":"53","author":"Costa","year":"2019","journal-title":"Free Radic. Res."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1007\/s41999-021-00479-3","article-title":"Polypharmacy in Older Adults: A Narrative Review of Definitions, Epidemiology and Consequences","volume":"12","author":"Pazan","year":"2021","journal-title":"Eur. Geriatr. Med."},{"key":"ref_7","unstructured":"WHO (2004). A Glossary of Terms for Community Health Care and Services for Older Persons. Methods Enzymol., 105, 283\u2013293."},{"key":"ref_8","unstructured":"WHO (2021). WHO-Global Patient Safety Action Plan 2021\u20132030, WHO."},{"key":"ref_9","unstructured":"Lopes, C., Torres, D., Oliveira, A., Severo, M., Alarc\u00e3o, V., Guiomar, S., Mota, J., Teixeira, P., Rodrigues, S., and Lobato, L. (2017). IAN-AF, Inqu\u00e9rito Alimentar Nacional e de Atividade F\u00edsica-Relat\u00f3rio de Resultados de 2017, Universidade do Porto."},{"key":"ref_10","unstructured":"(2009). European Parliament and Council of the European Union COMISSION REGULATION (EC) No 1170\/2009 as Regards the Lists of Vitamin and Minerals and Their Forms That Can Be Added to Foods, Including Food Supplements. Off. J. Eur. Union, L314, 36\u201342."},{"key":"ref_11","unstructured":"(2002). European Union Directive 2002\/46\/EC of the European Parliament and of the Council of June 10 2002 on the Approximation of the Laws of the Member States Relating to Food Supplements. Off. J. L 183, 12\/07\/2002, 0051\u20130057. Available online: https:\/\/eur-lex.europa.eu\/eli\/dir\/2002\/46\/oj."},{"key":"ref_12","unstructured":"(2003). Assembleia da Rep\u00fablica Decreto Lei No 136\/2003 de 28 de Junho. Di\u00e1rio da Rep\u00fablica, 3724\u20133728."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"(2015). Minist\u00e9rio da Agricultura e do Mar Decreto-Lei No 118\/2015. Di\u00e1rio da Rep\u00fablica, 4389\u20134394.","DOI":"10.37856\/bja.v75i1.1264"},{"key":"ref_14","unstructured":"(2023, August 29). Dietary Supplement Health and Education Act of 1994 Public Law 103-417 103rd Congress, Available online: https:\/\/ods.od.nih.gov\/About\/DSHEA_Wording.aspx."},{"key":"ref_15","unstructured":"WHO (2023, December 27). Unlocking the Future of Healthy Ageing: The Lisbon Outcome Statement. Available online: https:\/\/www.who.int\/europe\/news\/item\/21-10-2023-unlocking-the-future-of-healthy-ageing-the-lisbon-outcome-statement."},{"key":"ref_16","first-page":"489","article-title":"Defining \u2018Elderly\u2019 in Clinical Practice Guidelines for Pharmacotherapy","volume":"12","author":"Singh","year":"2014","journal-title":"Pharm. Pract."},{"key":"ref_17","unstructured":"WHO (2023, August 29). Available online: https:\/\/www.who.int\/pt\/."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.clnu.2018.05.024","article-title":"ESPEN Guideline on Clinical Nutrition and Hydration in Geriatrics","volume":"38","author":"Volkert","year":"2019","journal-title":"Clin. Nutr."},{"key":"ref_19","unstructured":"WHO (2019). Medication Safety in Polypharmacy, WHO."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Masnoon, N., Shakib, S., Kalisch-Ellett, L., and Caughey, G.E. (2017). What Is Polypharmacy? A Systematic Review of Definitions. BMC Geriatr., 17.","DOI":"10.1186\/s12877-017-0621-2"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1097\/MCO.0000000000000425","article-title":"Updates in Nutrition and Polypharmacy","volume":"21","author":"Little","year":"2018","journal-title":"Curr. Opin. Clin. Nutr. Metab. Care"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"141","DOI":"10.20344\/amp.10683","article-title":"Inappropriate Prescribing to Elderly Patients in an Internal Medicine Ward","volume":"32","author":"Urzal","year":"2019","journal-title":"Acta Med. Port."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Delara, M., Murray, L., Jafari, B., Bahji, A., Goodarzi, Z., Kirkham, J., Chowdhury, Z., and Seitz, D.P. (2022). Prevalence and Factors Associated with Polypharmacy: A Systematic Review and Meta-Analysis. BMC Geriatr., 22.","DOI":"10.1186\/s12877-022-03279-x"},{"key":"ref_24","first-page":"939","article-title":"Like Mother, like Daughter? Dietary and Non-Dietary Bone Fracture Risk Factors in Mothers and Their Daughters","volume":"44","author":"Sobas","year":"2015","journal-title":"Iran. J. Public Health"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Krustev, T., Milushewa, P., and Tachkov, K. (2022). Impact of Polypharmacy, Drug-Related Problems, and Potentially Inappropriate Medications in Geriatric Patients and Its Implications for Bulgaria\u2014Narrative Review and Meta-Analysis. Front. Public Health, 10.","DOI":"10.3389\/fpubh.2022.743138"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1680","DOI":"10.1016\/S0140-6736(17)31047-4","article-title":"Medication without Harm: WHO\u2019s Third Global Patient Safety Challenge","volume":"389","author":"Donaldson","year":"2017","journal-title":"Lancet"},{"key":"ref_27","unstructured":"WHO (2023, October 29). World Patient Safety Day 2023. Available online: https:\/\/www.who.int\/campaigns\/world-patient-safety-day\/2023."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"2042098620933741","DOI":"10.1177\/2042098620933741","article-title":"An Overview of Prevalence, Determinants and Health Outcomes of Polypharmacy","volume":"11","author":"Khezrian","year":"2020","journal-title":"Ther. Adv. Drug Saf. Rev."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1016\/j.therap.2019.10.001","article-title":"Polypharmacy: A General Review of Definitions, Descriptions and Determinants","volume":"75","author":"Guillot","year":"2020","journal-title":"Therapie"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/j.archger.2018.06.018","article-title":"Polypharmacy Prevalence among Older Adults Based on the Survey of Health, Ageing and Retirement in Europe","volume":"78","author":"Giardini","year":"2018","journal-title":"Arch. Gerontol. Geriatr."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Castioni, J., Marques-Vidal, P., Abolhassani, N., Vollenweider, P., and Waeber, G. (2017). Prevalence and Determinants of Polypharmacy in Switzerland: Data from the CoLaus Study. BMC Health Serv. Res., 17.","DOI":"10.1186\/s12913-017-2793-z"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1007\/s40520-019-01136-3","article-title":"Polypharmacy and Sarcopenia in Hospitalized Older Patients: Results of the GLISTEN Study","volume":"31","author":"Agosta","year":"2019","journal-title":"Aging Clin. Exp. Res."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"289","DOI":"10.2147\/CLEP.S153458","article-title":"The Epidemiology of Polypharmacy in Older Adults: Register-Based Prospective Cohort Study","volume":"10","author":"Morin","year":"2018","journal-title":"Clin. Epidemiol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1007\/s00228-013-1639-9","article-title":"Prevalence of Polypharmacy in a Scottish Primary Care Population","volume":"70","author":"Payne","year":"2014","journal-title":"Eur. J. Clin. Pharmacol."},{"key":"ref_35","unstructured":"Mair, A., Fernandez-Llimos, F., Alonso, A., Harrison, C., Hurding, S., Kempen, T., Kinnear, M., Michael, N., McIntosh, J., and Wilson, M. (2017). Polypharmacy Management by 2030: A Patient Safety Challenge, The SIMPATHY Consortium."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1007\/s11739-016-1451-5","article-title":"Is Polypharmacy an Independent Risk Factor for Adverse Outcomes after an Emergency Department Visit?","volume":"12","author":"Salvi","year":"2017","journal-title":"Intern. Emerg. Med."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Kardas, P., Urba\u0144ski, F., Lichwierowicz, A., Chudzy\u0144ska, E., Kardas, G., and Czech, M. (2021). Prevalence and Age Structure of Polypharmacy in Poland: Results of the Analysis of the National Real-World Database of 38\u2002Million Citizens. Front. Pharmacol., 12.","DOI":"10.3389\/fphar.2021.655364"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1016\/j.clnu.2015.03.001","article-title":"Diagnostic Criteria for Malnutrition\u2014An ESPEN Consensus Statement","volume":"34","author":"Cederholm","year":"2015","journal-title":"Clin. Nutr."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1016\/j.maturitas.2019.05.006","article-title":"Prevalence of Protein-Energy Malnutrition Risk in European Older Adults in Community, Residential and Hospital Settings, According to 22 Malnutrition Screening Tools Validated for Use in Adults \u226565 Years: A Systematic Review and Meta-Analysis","volume":"126","author":"Verwijs","year":"2019","journal-title":"Maturitas"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"951","DOI":"10.1016\/S0140-6736(22)02612-5","article-title":"Malnutrition in Older Adults","volume":"401","author":"Dent","year":"2023","journal-title":"Lancet"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/j.archger.2018.06.004","article-title":"Food Insecurity, Weight and Nutritional Status among Older Adults Attending Senior Centres in Lisbon","volume":"78","author":"Ramalho","year":"2018","journal-title":"Arch. Gerontol. Geriatr."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1017\/S0029665118002744","article-title":"Nutritional Challenges for Older Adults in Europe: Current Status and Future Directions","volume":"78","author":"Kehoe","year":"2019","journal-title":"Proc. Nutr. Soc."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Ca\u00e7ador, C., Teixeira-Lemos, E., Martins, S.O., and Ramos, F. (2021). The Role of Nutritional Status on Polypharmacy, Cognition, and Functional Capacity of Institutionalized Elderly: A Systematic Review. Nutrients, 13.","DOI":"10.3390\/nu13103477"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1016\/j.jamda.2019.10.022","article-title":"Adverse Outcomes of Polypharmacy in Older People: Systematic Review of Reviews","volume":"21","author":"Davies","year":"2020","journal-title":"J. Am. Med. Dir. Assoc."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1016\/j.clnesp.2022.03.007","article-title":"The Association between Polypharmacy and Malnutrition(Risk) in Older People: A Systematic Review","volume":"49","author":"Kok","year":"2022","journal-title":"Clin. Nutr. ESPEN"},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Kose, E., Wakabayashi, H., and Yasuno, N. (2021). Polypharmacy and Malnutrition Management of Elderly Perioperative Patients with Cancer: A Systematic Review. Nutrients, 13.","DOI":"10.3390\/nu13061961"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Kim, H., and Park, S.G. (2023). Effect of a Single Multivitamin and Mineral Supplement on Nutritional Intake in Korean Elderly: Korean National Health and Nutrition Examination Survey 2018\u20132020. Nutrients, 15.","DOI":"10.3390\/nu15071561"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1002\/jcsm.13190","article-title":"Sarcopenia Is Associated with a Greater Risk of Polypharmacy and Number of Medications: A Systematic Review and Meta-Analysis","volume":"14","author":"Prokopidis","year":"2023","journal-title":"J. Cachexia Sarcopenia Muscle"},{"key":"ref_49","unstructured":"The European Parliament and the Council of the European Union (2013). Regulation (EU) No 1022\/2013 on Food Intended for Infants and Young Children, Food for Special Medical Purposes, and Total Diet Replacement for Weight Control and Repealing Council. Off. J. Eur. Union, L181, 35\u201356."},{"key":"ref_50","unstructured":"Dire\u00e7\u00e3o Geral de Alimenta\u00e7\u00e3o e Veterin\u00e1ria (2024, August 13). Produtos Fronteira Entre \u201cSuplementos Alimentares\u201d e \u201cAlimentos Para Desportistas\u201d. Available online: https:\/\/www.dgav.pt\/wp-content\/uploads\/2021\/04\/Prod-fronteira_Alim-Desport_26-10-2016.pdf."},{"key":"ref_51","unstructured":"Institut Scientifique de Sant\u00e9 Publique (2016). Enqu\u00eate de Consommation Alimentaire 2014\u20132015 Rapport 4: La Consommation Alimentaire, Institut Scientifique de Sant\u00e9 Publique."},{"key":"ref_52","unstructured":"European Public Affairs (2022). Consumer Survey on Food Supplements in the EU, European Public Affairs."},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Restani, P., Di Lorenzo, C., Garcia-Alvarez, A., Frigerio, G., Colombo, F., Maggi, F.M., Mil\u00e0-Villarroel, R., and Serra-Majem, L. (2018). The PlantLIBRA Consumer Survey: Findings on the Use of Plant Food Supplements in Italy. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0190915"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1186\/1475-2891-13-14","article-title":"Health Habits and Other Characteristics of Dietary Supplement Users: A Review","volume":"13","author":"Dickinson","year":"2014","journal-title":"Nutr. J."},{"key":"ref_55","first-page":"1","article-title":"Dietary Supplement Use among Adults: United States, 2017\u20132018","volume":"February","author":"Mishra","year":"2021","journal-title":"NCHS Data Brief"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"2219","DOI":"10.1111\/jgs.18305","article-title":"Dietary Supplement and Complementary and Alternative Medicine Use among Older Adults in Australia and the United States","volume":"71","author":"Fravel","year":"2023","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"762","DOI":"10.1016\/j.jval.2017.02.006","article-title":"Economic Consequences and Potentially Preventable Costs Related to Osteoporosis in the Netherlands","volume":"20","author":"Dunnewind","year":"2017","journal-title":"Value Health"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1093\/eurpub\/cku119","article-title":"Cost-Effectiveness of Vitamin D and Calcium Supplementation in the Treatment of Elderly Women and Men with Osteoporosis","volume":"25","author":"Hiligsmann","year":"2015","journal-title":"Eur. J. Public Health"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"e007910","DOI":"10.1136\/bmjopen-2015-007910","article-title":"Cost-Effectiveness and Budget Impact of Empirical Vitamin D Therapy on Unintentional Falls in Older Adults in the UK","volume":"5","author":"Poole","year":"2015","journal-title":"BMJ Open"},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Lenoir-Wijnkoop, I., Gerlier, L., Bresson, J.L., Le Pen, C., and Berdeaux, G. (2015). Public Health and Budget Impact of Probiotics on Common Respiratory Tract Infections: A Modelling Study. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0122765"},{"key":"ref_61","unstructured":"(2021). Food supplements Europe How Food Supplements Can Help Contribute to Public Health in Europe. Food Suppl. Eur., 1\u201314."},{"key":"#cr-split#-ref_62.1","unstructured":"(2006). European Parliament and Council of the European Union The Regulation"},{"key":"#cr-split#-ref_62.2","unstructured":"(EC) N. 1924\/2006 on Nutrition and Health Claims Made on Foods. Off. J. Eur. Union, 9-23."},{"key":"#cr-split#-ref_63.1","unstructured":"EFSA (2014). Scientific Opinion on the Substantiation of a Health Claim Related to Vitamin D and Risk of Falling Pursuant to Article 14 of Regulation"},{"key":"#cr-split#-ref_63.2","unstructured":"(EC) No 1924\/2006. EFSA J., 12, 3514."},{"key":"ref_64","unstructured":"Richard, O., Kellie, C., Colette, R., Eve, E.S., Patricia, B., Jill, R., Elizabeth, R., Janet, d.J., Katrina, P., and Amber, M. (2015). Dietary Guidelines for Americans 2015\u20132020, U.S. Department of Health and Human Services: U.S. Department of Agriculture."},{"key":"ref_65","unstructured":"USDA, and HHS (2020). Dietary Guidelines for Americans, 2020\u20132025, U.S. Department of Agriculture: U.S. Department of Health and Human."},{"key":"ref_66","unstructured":"(2023, November 07). Dire\u00e7\u00e3o Geral de Alimenta\u00e7\u00e3o e Veterin\u00e1ria Procedimento de Notifica\u00e7\u00e3o de Suplementos Alimentares. Available online: https:\/\/www.dgav.pt\/alimentos\/conteudo\/generos-alimenticios\/regras-especificas-por-tipo-de-alimentos\/suplementos-alimentares\/procedimento-de-notificacao-de-suplementos-alimentares\/."},{"key":"#cr-split#-ref_67.1","unstructured":"(2006). O PARLAMENTO EUROPEU E O CONSELHO DA UNI\u00c3O EUROPEIA Regulamento"},{"key":"#cr-split#-ref_67.2","unstructured":"(CE) n.o 1924\/2006 Relativo \u00c0s Alega\u00e7\u00f5es Nutricionais e de Sa\u00fade Sobre Os Alimentos. J. Of. da Uni\u00e3o Eur., 9-25."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1111\/cxo.12165","article-title":"Nutritional Supplements: Simply a Waste of Money or Poorly Targeted?","volume":"97","author":"Cockburn","year":"2014","journal-title":"Clin. Exp. Optom."},{"key":"ref_69","unstructured":"European Commission (2023, November 08). EU Register Health Claims. Available online: https:\/\/ec.europa.eu\/food\/food-feed-portal\/screen\/health-claims\/eu-register\/details\/POL-HC-8525."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1080\/02813130500475522","article-title":"Age and Gender Effect on the Use of Herbal Medicine Products and Food Supplements among the Elderly","volume":"24","author":"Stjernberg","year":"2006","journal-title":"Scand. J. Prim. Health Care"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"e613","DOI":"10.1200\/JOP.2017.020859","article-title":"Potential Drug-Drug and Herb-Drug Interactions in Patients with Cancer: A Prospective Study of Medication Surveillance","volume":"13","year":"2017","journal-title":"J. Oncol. Pract."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"4106","DOI":"10.1080\/10408398.2021.1997909","article-title":"Food Supplement Vitamins, Minerals, Amino-Acids, Fatty Acids, Phenolic and Alkaloid-Based Substances: An Overview of Their Interaction with Drugs","volume":"63","author":"Lopes","year":"2021","journal-title":"Crit. Rev. Food Sci. Nutr."}],"container-title":["Foods"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2304-8158\/13\/16\/2618\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:40:10Z","timestamp":1760110810000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2304-8158\/13\/16\/2618"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,21]]},"references-count":75,"journal-issue":{"issue":"16","published-online":{"date-parts":[[2024,8]]}},"alternative-id":["foods13162618"],"URL":"https:\/\/doi.org\/10.3390\/foods13162618","relation":{},"ISSN":["2304-8158"],"issn-type":[{"type":"electronic","value":"2304-8158"}],"subject":[],"published":{"date-parts":[[2024,8,21]]}}}