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International Journal of Environmental... Mar 2023Depression is considered the most important disorder affecting mental health. The aim of this systematic integrative review was: (i) to describe the effects of... (Review)
Review
Depression is considered the most important disorder affecting mental health. The aim of this systematic integrative review was: (i) to describe the effects of supplementation with adaptogens on variables related to depression in adults; and (ii) to discuss the potential combination with physical exercise to aid planning and commissioning future clinical research. An integrative review was developed complementing the Preferred Reporting Items for Systematic reviews and Meta-Analyses statement (PROSPERO registration: CRD42021249682). A total of 41 articles met the inclusion criteria. With a Price index of 46.4%, we found that: (i) (St. John's Wort) is the most studied and supported adaptogen (17/41 [41.46%], three systematic reviews with meta-analysis) followed by L. or saffron (6/41 [14.63%], three systematic reviews with meta-analysis and two systematic reviews); (ii) it is possible that the significantly better performance of adaptogens over placebo is due to the reduction of allostatic load via the action of secondary metabolites on BDNF regulation; and, (iii) the number of studies reporting physical activity levels is limited or null for those that combine an exercise program with the consumption of adaptogens. Aware of the need for a multidisciplinary approach for depression treatment, this systematic integrative review provides an up-to-date view for supporting the use of St. John's Wort and saffron as non-pharmacological strategies while also help commissioning future research on the efficacy of other adaptogens. It also contributes to the design of future clinical research studies that evaluate the consumption of herbal extracts plus physical exercise, mainly resistance training, as a potentially safe and powerful strategy to treat depression.
Topics: Depression; Drug Interactions; Exercise; Phytotherapy; Plant Extracts
PubMed: 37047914
DOI: 10.3390/ijerph20075298 -
PloS One 2021The efficacy of cranberry (Vaccinium spp.) as adjuvant therapy in preventing urinary tract infections (UTIs) remains controversial. This study aims to update and... (Meta-Analysis)
Meta-Analysis
Consumption of cranberry as adjuvant therapy for urinary tract infections in susceptible populations: A systematic review and meta-analysis with trial sequential analysis.
The efficacy of cranberry (Vaccinium spp.) as adjuvant therapy in preventing urinary tract infections (UTIs) remains controversial. This study aims to update and determine cranberry effects as adjuvant therapy on the recurrence rate of UTIs in susceptible groups. According to PRISMA guidelines, we conducted a literature search in Web of Science, PubMed, Embase, Scopus, and the Cochrane Library from their inception dates to June 2021. We included articles with data on the incidence of UTIs in susceptible populations using cranberry-containing products. We then conducted a trial sequential analysis to control the risk of type I and type II errors. This meta-analysis included 23 trials with 3979 participants. We found that cranberry-based products intake can significantly reduce the incidence of UTIs in susceptible populations (risk ratio (RR) = 0.70; 95% confidence interval(CI): 0.59 ~ 0.83; P<0.01). We identified a relative risk reduction of 32%, 45% and 51% in women with recurrent UTIs (RR = 0.68; 95% CI: 0.56 ~ 0.81), children (RR = 0.55; 95% CI: 0.31 ~ 0.97) and patients using indwelling catheters (RR = 0.49; 95% CI: 0.33 ~ 0.73). Meanwhile, a relative risk reduction of 35% in people who use cranberry juice compared with those who use cranberry capsule or tablet was observed in the subgroup analysis (RR = 0.65; 95% CI: 0.54 ~ 0.77). The TSA result for the effects of cranberry intake and the decreased risk of UTIs in susceptible groups indicated that the effects were conclusive. In conclusion, our meta-analysis demonstrates that cranberry supplementation significantly reduced the risk of developing UTIs in susceptible populations. Cranberry can be considered as adjuvant therapy for preventing UTIs in susceptible populations. However, given the limitations of the included studies in this meta-analysis, the conclusion should be interpreted with caution.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Capsules; Child; Child, Preschool; Dietary Supplements; Disease Susceptibility; Female; Fruit; Fruit and Vegetable Juices; Humans; Incidence; Infant; Male; Middle Aged; Phytotherapy; Plant Extracts; Proanthocyanidins; Recurrence; Tablets; Urinary Tract Infections; Vaccinium macrocarpon; Young Adult
PubMed: 34473789
DOI: 10.1371/journal.pone.0256992 -
Nutrients Jan 2023The plant extract guarana is known for its caffeine content and other bioactive ingredients, which purportedly may improve cognitive performance. Recent reviews have... (Meta-Analysis)
Meta-Analysis Review
The plant extract guarana is known for its caffeine content and other bioactive ingredients, which purportedly may improve cognitive performance. Recent reviews have examined the effects of chronic supplementation of guarana in clinical populations; however, the acute effects of guarana on cognitive tasks, while of interest, have produced mixed results. Whether acute guarana ingestion improves human cognitive performance was assessed by performing a systematic review coupled with a meta-analysis. Eight placebo-controlled studies were identified and met the inclusion criteria providing data on 328 participants. The dose of guarana (37.5 to 500 mg) with reported caffeine content (4.3 to 100 mg) varied. Effect sizes (ESs) were calculated as the standardized mean difference and meta-analyses were completed using a random-effects model. The ESs for guarana averaged across a variety of cognitive measures and outcome variables were less than trivial (Hedge’s g = 0.076, p = 0.14). Using a subgroup meta-analysis (Q = 12.9, p < 0.001), ESs indicating a faster response time for guarana vs. a placebo (g = 0.202, p = 0.005) differed from the accuracy measures (g = −0.077, p = 0.4) which were non-significant. For response time, guarana ingested in a capsule (g = 0.111) tended to differ (Q = 2.96, p = 0.085) compared to guarana when dissolved in liquid (g = 0.281). Meta-regression of the study ESs of overall cognitive task performance was not related to the guarana dose (R2 < 0.001) or to the time allowed prior to cognitive testing (R2 < 0.001). Acute guarana ingestion had a small effect on the response time (faster performance) during a variety of cognitive tasks without affecting the accuracy. Whether the changes were linked to the caffeine content or other bioavailable substances in guarana is unknown. Additional studies that directly compare matched doses of caffeine versus guarana are needed to understand its effects on cognitive performance.
Topics: Humans; Caffeine; Paullinia; Plant Extracts; Reaction Time; Cognition
PubMed: 36678305
DOI: 10.3390/nu15020434 -
The American Journal of Clinical... Oct 2022Chronic constipation is a prevalent disorder that remains challenging to treat. Studies suggest increasing fiber intake may improve symptoms, although recommendations on... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Chronic constipation is a prevalent disorder that remains challenging to treat. Studies suggest increasing fiber intake may improve symptoms, although recommendations on the fiber type, dose, and treatment duration are unclear.
OBJECTIVES
We investigated the effects of fiber supplementation on stool output, gut transit time, symptoms, and quality of life in adults with chronic constipation via a systematic review and meta-analysis of randomized controlled trials (RCTs).
METHODS
Studies were identified using electronic databases, backward citation, and hand searches of abstracts. RCTs reporting administration of fiber supplementation in adults with chronic constipation were included. Risks of bias (RoB) was assessed with the Cochrane RoB 2.0 tool. Results were synthesized using risk ratios (RRs), mean differences, or standardized mean differences (SMDs) and 95% CIs using a random-effects model.
RESULTS
Sixteen RCTs with 1251 participants were included. Overall, 311 of 473 (66%) participants responded to fiber treatment and 134 of 329 (41%) responded to control treatment [RR: 1.48 (95% CI: 1.17, 1.88; P = 0.001); I2 = 57% (P = 0.007)], with psyllium and pectin having significant effects. A higher response to treatment was apparent in fiber groups compared to control groups irrespective of the treatment duration, but only with higher fiber doses (>10 g/d). Fiber increased stool frequency [SMD: 0.72 (95% CI: 0.36, 1.08; P = 0.0001); I2 = 86% (P < 0.00001)]; psyllium and pectin had significant effects, and improvement was apparent only with higher fiber doses and greater treatment durations (≥4 weeks). Fiber improved stool consistency (SMD: 0.32; 95% CI: 0.18, 0.46; P < 0.0001), particularly with higher fiber doses. Flatulence was higher in fiber groups compared to control groups(SMD: 0.80; 95% CI: 0.47, 1.13; P < 0.00001).
CONCLUSIONS
Fiber supplementation is effective at improving constipation. Particularly, psyllium, doses >10 g/d and treatment durations of at least 4 weeks appear optimal, though caution is needed when interpreting the results due to considerable heterogeneity. These findings provide promising evidence on the optimal type and regime of fiber supplementation, which could be used to standardize recommendations to patients. The protocol for this review is registered at PROSPERO as CRD42020191404.
Topics: Adult; Constipation; Dietary Fiber; Dietary Supplements; Humans; Pectins; Psyllium; Randomized Controlled Trials as Topic
PubMed: 35816465
DOI: 10.1093/ajcn/nqac184 -
Regulatory Toxicology and Pharmacology... Jun 2018A systematic review of published toxicology and human intervention studies was performed to characterize potential hazards associated with consumption of green tea and... (Review)
Review
A systematic review of published toxicology and human intervention studies was performed to characterize potential hazards associated with consumption of green tea and its preparations. A review of toxicological evidence from laboratory studies revealed the liver as the target organ and hepatotoxicity as the critical effect, which was strongly associated with certain dosing conditions (e.g. bolus dose via gavage, fasting), and positively correlated with total catechin and epigallocatechingallate (EGCG) content. A review of adverse event (AE) data from 159 human intervention studies yielded findings consistent with toxicological evidence in that a limited range of concentrated, catechin-rich green tea preparations resulted in hepatic AEs in a dose-dependent manner when ingested in large bolus doses, but not when consumed as brewed tea or extracts in beverages or as part of food. Toxico- and pharmacokinetic evidence further suggests internal dose of catechins is a key determinant in the occurrence and severity of hepatotoxicity. A safe intake level of 338 mg EGCG/day for adults was derived from toxicological and human safety data for tea preparations ingested as a solid bolus dose. An Observed Safe Level (OSL) of 704 mg EGCG/day might be considered for tea preparations in beverage form based on human AE data.
Topics: Adult; Animals; Camellia sinensis; Eating; Humans; Plant Extracts; Tea
PubMed: 29580974
DOI: 10.1016/j.yrtph.2018.03.019 -
BMC Complementary Medicine and Therapies Apr 2021Elderberry has traditionally been used to prevent and treat respiratory problems. During the COVID-19 pandemic, there has been interest in elderberry supplements to...
BACKGROUND
Elderberry has traditionally been used to prevent and treat respiratory problems. During the COVID-19 pandemic, there has been interest in elderberry supplements to treat or prevent illness, but also concern that elderberry might overstimulate the immune system and increase the risk of 'cytokine storm'. We aimed to determine benefits and harms of elderberry for the prevention and treatment of viral respiratory infections, and to assess the relationship between elderberry supplements and negative health impacts associated with overproduction of pro-inflammatory cytokines.
METHODS
We conducted a systematic review and searched six databases, four research registers, and two preprint sites for studies. Two reviewers independently assessed studies for inclusion, extracted data from studies, assessed risk of bias using Cochrane tools, and evaluated certainty of estimates using GRADE. Outcomes included new illnesses and the severity and duration of illness.
RESULTS
We screened 1187 records and included five randomized trials on elderberry for the treatment or prevention of viral respiratory illness. We did not find any studies linking elderberry to clinical inflammatory outcomes. However, we found three studies measuring production of cytokines ex vivo after ingestion of elderberry. Elderberry may not reduce the risk of developing the common cold; it may reduce the duration and severity of colds, but the evidence is uncertain. Elderberry may reduce the duration of influenza but the evidence is uncertain. Compared to oseltamivir, an elderberry-containing product may be associated with a lower risk of influenza complications and adverse events. We did not find evidence on elderberry and clinical outcomes related to inflammation. However, we found evidence that elderberry has some effect on inflammatory markers, although this effect may decline with ongoing supplementation. One small study compared elderberry to diclofenac (a nonsteroidal anti-inflammatory drug) and provided some evidence that elderberry is as effective or less effective than diclofenac in cytokine reduction over time.
CONCLUSIONS
Elderberry may be a safe option for treating viral respiratory illness, and there is no evidence that it overstimulates the immune system. However, the evidence on both benefits and harms is uncertain and information from recent and ongoing studies is necessary to make firm conclusions.
Topics: COVID-19; Common Cold; Cytokines; Humans; Inflammation; Influenza, Human; Pandemics; Phytotherapy; Plant Extracts; SARS-CoV-2; Sambucus; COVID-19 Drug Treatment
PubMed: 33827515
DOI: 10.1186/s12906-021-03283-5 -
International Journal of Environmental... Aug 2022L. () is a plant used in traditional Chinese medicine, Ayurvedic medicine, and sports nutrition to improve health and performance. However, no conclusive evidence... (Review)
Review
L. () is a plant used in traditional Chinese medicine, Ayurvedic medicine, and sports nutrition to improve health and performance. However, no conclusive evidence exists about the potential beneficial effects of on sport and health biomarkers in physically active adults. Based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and the modified McMaster Critical Review Form for methodological quality assessment, we systematically reviewed studies indexed in Web of Science, Scopus, and PubMed, to assess the effects of on immunological, hematological, biochemical, renal, lipidic, hormonal behavior, and anti-inflammatory response in physically active adult males. Among 340 records identified in the search, a total of 7 studies met the inclusion and exclusion criteria. Overall, participants supplemented with displayed significant improvements in lipid profile. Inflammatory and hematological biomarkers showed moderate beneficial effects with no significant changes on renal biomarkers. No positive effects were observed on the immune system response. Additionally, no -induced toxicity was reported. In conclusion, there was no clear evidence of the beneficial effects of supplementation on muscle damage markers and hormonal behavior. More studies are needed to confirm the benefits of due to the limited number of studies available in the current literature.
Topics: Adult; Biomarkers; Dietary Supplements; Humans; Male; Plant Extracts; Sports; Tribulus
PubMed: 35954909
DOI: 10.3390/ijerph19159533 -
Molecules (Basel, Switzerland) Jun 2021Plant-derived phytochemicals have been interested in as nutraceuticals for preventing the onset and progress of diabetes mellitus and its serious complications in recent... (Meta-Analysis)
Meta-Analysis
Plant-derived phytochemicals have been interested in as nutraceuticals for preventing the onset and progress of diabetes mellitus and its serious complications in recent years. Lam. is used in vegetables and in herbal medicine for its health-promoting properties against various diseases including diabetes mellitus. This study aimed to examine an effect of on diabetic hyperglycemia and dyslipidemia by meta-analyzing the current evidence of diabetic rodent models. Peer-reviewed studies written in English from two databases, PubMed and Embase, were searched to 30 April 2021. Studies reporting blood glucose or lipid levels in diabetic rodents with and without receiving extracts of were included. Forty-four studies enrolling 349 diabetic rodents treated with extracts of and 350 diabetic controls reported blood glucose levels. The pooled effect size was -3.92 (95% CI: -4.65 to -3.19) with a substantial heterogeneity. This effect was likely to be, at least in part, modified by the type of diabetic models. Moreover, diabetic hypertriglyceridemia and hypercholesterolemia were also significantly improved in diabetic rodent models treated with .
Topics: Animals; Blood Glucose; Diabetes Mellitus, Experimental; Dietary Supplements; Moringa oleifera; Phytotherapy; Plant Extracts; Plants, Medicinal
PubMed: 34207664
DOI: 10.3390/molecules26123513 -
Nutrients Jan 2020Clinical applications of ginger with an expectation of clinical benefits are receiving significant attention. This systematic review aims to provide a comprehensive...
Clinical applications of ginger with an expectation of clinical benefits are receiving significant attention. This systematic review aims to provide a comprehensive discussion in terms of the clinical effects of ginger in all reported areas. Following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guideline, randomized controlled trials on the effects of ginger were investigated. Accordingly, 109 eligible papers were fully extracted in terms of study design, population characteristics, evaluation systems, adverse effects, and main outcomes. The reporting quality of the included studies was assessed based on the Cochrane Collaboration's tool for assessing the risk of bias in randomized trials and integrated together with studies that investigated the same subjects. The included studies that examined the improvement of nausea and vomiting in pregnancy, inflammation, metabolic syndromes, digestive function, and colorectal cancer's markers were consistently supported, whereas other expected functions were relatively controversial. Nevertheless, only 43 clinical trials (39.4%) met the criterion of having a 'high quality of evidence.' In addition to the quality assessment result, small populations and unstandardized evaluation systems were the observed shortcomings in ginger clinical trials. Further studies with adequate designs are warranted to validate the reported clinical functions of ginger.
Topics: Colorectal Neoplasms; Digestive System; Female; Zingiber officinale; Humans; Inflammation; Metabolic Syndrome; Nausea; Phytotherapy; Plant Extracts; Pregnancy; Pregnancy Complications; Randomized Controlled Trials as Topic; Vomiting
PubMed: 31935866
DOI: 10.3390/nu12010157 -
Frontiers in Immunology 2022Dietary polyphenol treatment of non-alcoholic fatty liver disease (NAFLD) is a novel direction, and the existing clinical studies have little effective evidence for its... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Dietary polyphenol treatment of non-alcoholic fatty liver disease (NAFLD) is a novel direction, and the existing clinical studies have little effective evidence for its therapeutic effect, and some studies have inconsistent results. The effectiveness of dietary polyphenols in the treatment of NAFLD is still controversial. The aim of this study was to evaluate the therapeutic efficacy of oral dietary polyphenols in patients with NAFLD.
METHODS
The literature (both Chinese and English) published before 30 April 2022 in PubMed, Cochrane, Medline, CNKI, and other databases on the treatment of NAFLD with dietary polyphenols was searched. Manual screening, quality assessment, and data extraction of search results were conducted strictly according to the inclusion and exclusion criteria. RevMan 5.3 software was used to perform the meta-analysis.
RESULTS
The RCTs included in this study involved dietary supplementation with eight polyphenols (curcumin, resveratrol, naringenin, anthocyanin, hesperidin, catechin, silymarin, and genistein) and 2,173 participants. This systematic review and meta-analysis found that 1) curcumin may decrease body mass index (BMI), Aspartate aminotransferase (AST), Alanine aminotransferase (ALT), Triglycerides (TG) total cholesterol (TC), and Homeostasis Model Assessment-Insulin Resistance (HOMA-IR) compared to placebo; and curcumin does not increase the occurrence of adverse events. 2) Although the meta-analysis results of all randomized controlled trials (RCTs) did not reveal significant positive changes, individual RCTs showed meaningful results. 3) Naringenin significantly decreased the percentage of NAFLD grade, TG, TC, and low-density lipoprotein cholesterol (LDL-C) and increased high-density lipoprotein cholesterol (HDL-C) but had no significant effect on AST and ALT, and it is a safe supplementation. 4) Only one team presents a protocol about anthocyanin (from L. fruit extract) in the treatment of NAFLD. 5) Hesperidin may decrease BMI, AST, ALT, TG, TC, HOMA-IR, and so on. 6) Catechin may decrease BMI, HOMA-IR, and TG level, and it was well tolerated by the patients. 7) Silymarin was effective in improving ALT and AST and reducing hepatic fat accumulation and liver stiffness in NAFLD patients.
CONCLUSION
Based on current evidence, curcumin can reduce BMI, TG, TC, liver enzymes, and insulin resistance; catechin can reduce BMI, insulin resistance, and TG effectively; silymarin can reduce liver enzymes. For resveratrol, naringenin, anthocyanin, hesperidin, and catechin, more RCTs are needed to further evaluate their efficacy and safety.
Topics: Alanine Transaminase; Anthocyanins; Aspartate Aminotransferases; Catechin; Cholesterol, HDL; Cholesterol, LDL; Curcumin; Dietary Supplements; Genistein; Hesperidin; Humans; Insulin Resistance; Non-alcoholic Fatty Liver Disease; Plant Extracts; Polyphenols; Resveratrol; Silymarin; Triglycerides
PubMed: 36159792
DOI: 10.3389/fimmu.2022.949746