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COMPLEMENTARY AND ALTERNATIVE MEDICINE

Consumption of Dietary Supplements Containing Citrus aurantium (Bitter Orange)—2004 California Behavioral Risk Factor Surveillance Survey (BRFSS)

Medical Officer, Center for Food Safety and Applied Nutrition, Food and Drug Administration, College Park, MD

Babgaleh B Timbo, MD DrPH

Medical Epidemiologist, Center for Food Safety and Applied Nutrition, Food and Drug Administration

Debra Street, PhD MPH

Supervisor, Epidemiology Team, Center for Food Safety and Applied Nutrition, Food and Drug Administration

Reprints: Dr. Klontz, Center for Food Safety and Applied Nutrition, Food and Drug Administration, 5100 Paint Branch Pkwy., College Park, MD 20740-3835, fax 301/436-2626, karl.klontz{at}cfsan.fda.gov

BACKGROUND: Following the marketing ban of ephedra-containing supplements in April 2004, many manufacturers substituted the herb Citrus aurantium for ephedra and marketed the products as "ephedra-free" supplements. Extracts of C. aurantium contain synephrine, a sympathomimetic alkaloid.

OBJECTIVE: To determine the prevalence of consumption of dietary supplements containing C. aurantium in California during 2004.

METHODS: We used the 2004 California Behavioral Risk Factor Surveillance Survey to determine the prevalence of consumption of dietary supplements containing C. aurantium in California during 2004.

RESULTS: Two percent (n = 70) of the 4140 survey respondents reported taking a dietary supplement containing C. aurantium in the previous year. Reasons stated included energy enhancement, weight loss, and appetite suppression. Compared with nonusers, users were more likely to report being single, aged 18-34 years, and Hispanic; consuming 3 or more alcoholic drinks on days that they imbibed; and having a heavier body mass index. Among the 5 users who reported experiencing an adverse event that they attributed to the supplement, 3 indicated that the severity was mild.

CONCLUSIONS: Given that supplements containing ephedra were banned in April 2004, the results from this study may serve as a baseline estimate against which future studies of the use of C. aurantium products may be compared.

Key Words: bitter orange, Citrus aurantium, dietary supplements

Published Online, September 12, 2006. www.theannals.com, DOI 10.1345/aph.1H196