P04.47 LBPhysical Health, Mental Health, and Utilizationof Complementary and Integrative ServicesAmong Gulf War Veterans

Stephanie Brooks Holliday (1), Amanda Hull (1), ChristineEickhoff (1), Patrick Sullivan (1), Matthew Reinhard (1)

(1) War Related Illness and Injury Study Center, WashingtonDC VA Medical Center, Washington, DC, USA

Purpose: Gulf War Veterans have received attention as a pop-ulation for which there is great need to identify services thatpositively impact physical and mental health. This study ex-plored differences in physical/mental health and service utili-zation among Gulf War and non-Gulf War Veterans enrolled inthe Integrative Health and Wellness Program, a comprehensiveCIM clinic within the Washington DC VA War Related Illnessand Injury Study Center.Methods: This study focused on individual acupuncture, groupacupuncture, and iRest� yoga nidra utilization in the six monthsfollowing program enrollment. Forty-two of the 226 individualsin this study were Gulf War Veterans.Results: A series of t-tests compared Gulf War and non-GulfWar Veterans on self-reported physical and mental healthsymptoms. Gulf War Veterans reported more depressive symp-toms (BDI-II, p = .04), and greater pain and pain-related dis-ability (PDQ, p = .04; DVPRS, p = .02). A trend toward greaterseverity of sleep impairment was observed (ISI, p = 0.06). Chisquare analyses revealed no differences in use of each type ofservice (defined dichotomously). Analyses focused on individ-uals who enrolled in at least one service type (n = 163) revealedno differences in the symptom severity of Gulf War and non-Gulf War Veterans, and indicated that Gulf War Veterans at-tended less group acupuncture (p = .01). Subsequent analysescompared Gulf War Veterans who attended services (n = 30)with those who did not (n = 12). No significant differences wereobserved for self-reported physical/mental health symptoms.Point biserial correlations examined the relationship betweenphysical/mental health symptoms and service participation(defined dichotomously). Results demonstrated that those whoendorsed higher levels of pain had lower utilization of iRestyoga nidra (r = - .40, p = .01).Conclusion: These results are an important initial examinationof CIM utilization by Gulf War Veterans. Implications fortreatment provision are discussed.Contact: Stephanie Brooks Holliday, stephanie.holliday@va.gov

P04.48 LBDietary Supplement (DS) Use and Source of AdviceDuring Cancer Treatment

Gary Asher (1), Qianlai Luo (1)

(1) University of North Carolina, Chapel Hill, NC, USA

Purpose: We sought to investigate factors associated with DSuse during cancer treatment.Methods: We conducted a cross-sectional survey of Com-plementary and Alternative Medicine (CAM) use by adults di-agnosed with breast, prostate, lung, or colorectal cancer between2010–2012 at the UNC Comprehensive Cancer Center. An in-troductory letter, questionnaire, and return-postage envelopewere sent to 1794 patients. Follow-up phone call and second

mailing were made to non-respondents. Multivariate logisticregression was used to investigate the association between DSuse and sources of advice for DS use.Results: We received 603 completed questionnaires (33%). 503respondents (83%) reported ever using a DS: 427 before (85%),354 during (70%), and 414 after (82%) cancer treatment. Amongrespondents who had ever used a DS, category-specific DS usewas: vitamin (95%), mineral (46%), herbal (26%) and other(43%). 76% of patients (325/427) that had used a DS prior tocancer treatment continued to take a DS during treatment; per-cent decrease in DS use by category was vitamin (19%), mineral(14%), herbal (39%), other (21%). Among all sources of adviceon DS use, including medical providers, media, and lay sources,only discussion with a CAM provider was associated with dis-continuing DS use during cancer treatment (p = 0.037).Conclusion: Consistent with previous studies, DS use wascommon among our study population. Not surprisingly, DS usedecreased during active cancer treatment. However, amongsources of advice on DS use, cessation of DS during treatmentwas associated only with discussion with a CAM provider.Contact: Gary Asher, gasher@med.unc.edu

P04.49 LBVitamin D Recommended Daily Allowance (RDA)Insufficiency in Female Healthcare Employeesof Childbearing Age

Gregory Plotnikoff (1), Michael Finch (2), Steven Calvin (3),Jeffery Dusek (1)

(1) Allina Health, Minneapolis, MN, USA(2) University of Minnesota, Minneapolis, MN, USA(3) Minnesota Birth Center, Minneapolis, MN, USA

Purpose: The Recommended Dietary Allowance (RDA) to en-sure a serum 25-OH-vitamin D level ‡ 20 ng/ml in 97.5% of allhealthy individuals was recently re-calculated and increased by50% to 600 IUs. We sought to assess the accuracy of this cal-culation in medically literate, fully insured women of child-bearing age.Methods: Observational study of early spring serum levels of25-OH-vitamin D and self-reported vitamin D intake in femalehealthcare employees aged 15–49.Results: Of the 6874 participants, 2809 (40.9%) reported takingno vitamin D, 639 (9.35%) reported 200–400 IUs (prenatal/multivitamin), and 3426 (49.8%) exceeded the previous RDA of400 IUs. There was a strong linear relationship between self-reported dose and serum level (R2 = 0.9759, p = 0.001). For allreported doses, the mean serum level for 25-OH-vitamin ex-ceeded the 20 ng/ml goal. The mean level for doses 3001–4000IUs (n = 132) was 42.1 ng/ml ( + / - 16.6) and for > 4000 IUs perday (n = 279) was 41.8 ng/ml ( + / - 18.4). At all doses, womenwith a BMI ‡ 30 exhibited significantly lower 25-OH-vitamin Dstatus compared to those women with BMI < 30 (p < .0001). Thepercent achieving sufficiency by dose also shows a strong lineartrend (R2 = 0.9424, p = 0.001). This data documents that for97.5% of this population to achieve ‡ 20 ng/ml would requiredoses several fold higher than 600 IUs per day.Conclusion: Daily prenatal or multivitamin supplementationdoes not ensure adequate 25-OH-vitamin D levels in Minnesotanfemale healthcare workers of child-bearing age. For women witha BMI < 30, the RDA appears to be at least 2000 IUs too low.For women with a BMI ‡ 30, at least an additional 3000 IUs/day would be needed to achieve the same goal. For any BMI,

A124