Use of ethnic spices by adults in the United States: An exploratory study

Introduction

Globally, spices are a group of botanicals known best for their role in cooking and are frequently employed as dietary supplements to enhance health and wellness.¹ Many of these spices are used in disease management within the field of complementary and alternative medicine (CAM).^1-3 Preclinical and clinical research results have suggested a strong correlation between usage of certain ethnic spices and positive health benefits against several common illnesses and diseases while reducing health risks, improving metabolism, and providing relief from numerous disease related symptoms.^2-5 Spices and herbs have been found to possess anti-diabetic, anti-lithogenic, anti-mutagenic, anti-inflammatory, antiviral, antibacterial, as well as other positive health benefits such as reduction of body fat, reduced sodium intake, and enhancing metabolism.^3-9

Spices have been used for various purposes and explored for their utility for hundreds of years in various parts of the world, but the interest in spices has grown in the Western world only during recent times.^9-12 The United States Department of Agriculture reports that the consumption of spices in the United States has climbed exponentially over the course of the last half-century, with spices such as ginger and chili pepper being used more frequently than ever before.^10-12 In the United States, health promotion through CAM is also of growing interest.^12-14 It has been suggested that more than one-third of all adults currently use some form of CAM. According to the US National Health and Nutrition Examination Survey (NHANES), 5%-10% of adults in the United States utilize botanical supplements such as spices, for health benefits.^13-15 In addition to the adult population use, spices have also been explored in pediatric populations. For example, more than a tenth of the infants and children have used spices, primarily to remedy minor ailments such as fussiness or stomach complications, and cough and cold. Such increased usage could in part be due to lack of side effects from spices, greater availability than traditional medicines, and consideration of known health benefits of spices.^12-16

As more Americans are considering the use of spices and herbs for medicinal and therapeutic use, especially to remedy various chronic conditions, reduce disease symptoms, and aid in treatment and management of common health problems, it is prudent to examine consumers’ perceptions about spices and their utility and predictors of spice usage.^12-16 Although a handful of studies in the United States have observed the use of herbs and spices, they have several limitations.^17-21 First, the studies are from small convenience samples of individuals. Second, most studies use few itemized questions to examine spice usage without estimating perceptions and predictors of spice usage. Third, studies frequently inquire about CAM usage and do not examine usage of various CAM products such as spices. In addition, the few studies that we found in a comprehensive literature review focused on special groups in the United States such as registered dietitians and dietetics students. Finally, none of the studies looked at general adult population in the Midwestern US. Therefore, the purpose of this study was to assess knowledge, perceptions, and predictors of spice use for health promotion among adults in the Midwestern US.

Methods

Results

Discussion

Ethnic spices have long been studied in various regions around the world as medicinal agents, for culinary use, and as health promotion supplements.^1-3 Yet there exists a lack of understanding about usage and perceptions of common ethnic spices in the United States.^17-21 With increasing prevalence of spice usage in the United States as a form of CAM, this study explored consumers’ perceptions and predictors of spice usage in a unique population (adults in the Midwestern US). Several unique findings of this study warrant attention. Majority of the participants reported using a spice on a daily basis, were interested in learning more about the health benefits of spices, and were willing to use spices as CAM. This is interesting given that our sample mostly consisted of people from Midwestern US and may not have the exposure to or cultural diversity in available food items. Along the Western and Eastern regions of the United States, there is greater ethnic and cultural diversity when compared to the Midwestern regions. Furthermore, those with higher income and more education levels had a greater propensity to use spices, which speaks of awareness and affordability that might be low in the Midwestern US. Most of the participants were familiar with and believed in the efficacy of few spices in health promotion and disease prevention. The common spices in this category were garlic, cinnamon, ginger, and chili pepper. This finding is in agreement with studies of US based registered dietitians and dietetic students who reported greater benefits of and familiarity with these few spices, especially as it relates to prevention and reduction of diabetes, cardiovascular disease, and gastrointestinal diseases.^18-20In addition, these are widely known spices as there is ample evidence from studies to show the utility and health benefits of these commonly used spices.^24-26 Participants were least likely to use or be familiar with fenugreek and curry leaves, which are highly utilized in many Asian and Middle-Eastern cuisines, these cuisines may not be as common in the Midwestern US. This lack of awareness about many spices could also be in part because less than a fifth of study participants saw a registered dietitian or received advice to consume spices from a health professional, highlighting the role of such professionals in advancing the use of CAM approaches.^18-20Results of this study also revealed that consumers received most of their information about spices from friends, family, and the internet, sources that may not be credible.

The most interesting and unique finding of this study is the predictors of current usage and future use willingness. Females, more educated, older, those who make higher incomes, and individuals who cook at home more often were significantly more likely to use or willing to use spices. This is logical as women are commonly responsible as primary providers of meals for family and may have better knowledge, those with higher incomes may be more able to afford spices, and those with higher education could possibly know more about health benefits of spices. However, some predictors of spice usage need additional research. For example, those with poor health status were less likely to report current usage of spices, but two times more likely to be willing to use spices compared to those with good health. It could be possible that those currently using spices are in good health and those who have poor health may be willing to use spices for health benefits. There is evidence in published literature to show that individuals with severe chronic illness might be willing to participate in research, experiment with therapies, and look for any possible solutions in the hope of finding treatment of existing disease conditions.^13,21,27This can also be related to another finding of our study where those who are dissatisfied with their health are significantly more likely to be willing to consume spices in the future. Given the rising prevalence of chronic diseases in US population and the fact that most individuals who have a chronic disease often have multiple health issues, spices can certainly play a major role in preventing diseases and promoting good health as a CAM approach.^24-26,According to a study conducted with Oregonian dietitians, 80% of them believed that food supplements can play an effective role in preventing and treating chronic diseases; dietitians can therefore, serve as advocates for use of spices as a CAM approach along with other supplements.²⁸ Our study has profound implications for future research and health promotion practice. Overall, as majority of participants shared interest in learning about the health benefits of spices, there are avenues for providing knowledge. Evidence-based strategies and resources could be integrated in both culinary, nutrition and allied health courses throughout all phases of educational advancement (e.g. high school, university, etc). Additionally, community garden initiatives, local farmers, and health care professionals could also provide educational opportunities to increase consumers’ awareness of the health benefits of spices and utility as CAM.^17-21 While reasonable evidence exists for the efficacy of spices, further research is needed on the various benefits of spices- such studies should be conducted in larger community and clinic based samples. Some spices could more likely be used or known to consumers because of widespread and consistent evidence about their efficacy in disease prevention and health promotion. Registered dietitians and nutritionists have a key role in research and education related to spices and their uses.^28-30 In addition, they can serve as credible resource persons for information and prescription. In fact, a study of Californian dietitians, most of the dietitians (greater than two-thirds) believed that a dietitian should be proficient in discussing about dietary supplements with clients and be able to inform the public.²⁹ Studies have shown that more Americans suffer from chronic conditions now. As many ethnic spices have potential to aid in not just one, but also multiple chronic disease treatments, the use of ethnic spices could help prevent many co-morbidities simultaneously without precipitation of any side effects.

The results of our study should be viewed in light of several potential limitations.^22,23First, the results may be impacted by all the traditional limitations of survey research (i.e., self-reported data, selection bias, recall bias, and inability to establish cause and effect relationships). In addition, participants could have given socially desirable responses to study questions. The questionnaire was monothematic in nature and mostly closed format in nature, this could be a threat to internal validity. Our sample was limited to adults in the Midwestern US and cannot be generalized to adults across the United States. However, in spite of these factors, we observed high reliability and validity of the instrument in our unique sample, have the largest sample report to date for general population in the United States, and we also explored various predictors of spice usage, making our study unique.

Conclusion

This study was an attempt to assess perceptions about and the predictors of spice usage in a sample of adults in the Midwestern US. Individuals in our study did not use many ethnic spices and were unaware of potential health benefits of spices. Greater awareness and marketing of such ethnic spices as complementary and alternative options for disease prevention and health promotion are needed in this population. Given the spice use predictors we found, the information can be used to reach out to individuals who are less likely to use spices and may find it beneficial to use spices for health promotion.

Ethical approval

The study protocol and procedures were approved by the Institutional Review Board for Human Subjects Research at Ball State University, USA.

Competing interests

We declare no conflicts of interest.

Authors’ contributions

JI and JayK contributed to the conception and design of the study and the writing and editing of the manuscript. JK analyzed and interpreted the data and wrote the results. JayK and JK provided critical revision of the article. JI, JayK, and JK have approved this submission. All authors contributed equally to the work of the manuscript.

Funding

The authors did not receive any funding for this study.

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