Effect of ginger powder supplementation on nitric oxide and C-reactive protein in elderly knee osteoarthritis patients: A 12-week double-blind randomized placebo-controlled clinical trial

The Clinical Research on Ginger (Zingiber officinale): Insights from ClinicalTrials.gov analysis

Ginger (Zingiber officinale) has a rich history of traditional medicinal use and has attracted a global interest in its health benefits. This study aims to provide insights into the clinical research landscape on ginger, focusing on its pharmacological effects and studied health-related outcomes. The study design involves systematic analysis of data from clinical trials available on ClinicalTrials.gov and discussion of findings in the context of the existing scientific knowledge. A comprehensive analysis of clinical trials registered on ClinicalTrials.gov related to ginger was first conducted, and the scientific background related to specific ginger clinical research avenues was further evaluated through PubMed searches. A variety of trial designs were identified, including treatment, prevention, and supportive care objectives. A total of 188 studies were identified on ClinicalTrials.gov, of which 89 met the inclusion criteria. Among the 89 trials, treatment objectives were predominant (47.2%), and dietary supplements (40.4%) and drugs (27%) were the most prevalent intervention types. These trials covered various health outcomes, such as antiemetic activity, analgesic function, effects on health-related quality of life, blood pressure variation, energy expenditure, and reduction in xerostomia. This study analysis provides a comprehensive overview of the clinical trials landscape on ginger, focusing on its broad spectrum of potential health benefits. While individual trials show promising results, a significant gap in the available data with a low reporting rate of final results is identified, underscoring the need for further research to establish conclusive evidence of ginger's therapeutic potentials.

Osteoarthritis: Insights into Diagnosis, Pathophysiology, Therapeutic Avenues, and the Potential of Natural Extracts

Osteoarthritis (OA) stands as a prevalent and progressively debilitating clinical condition globally, impacting joint structures and leading to their gradual deterioration through inflammatory mechanisms. While both non-modifiable and modifiable factors contribute to its onset, numerous aspects of OA pathophysiology remain elusive despite considerable research strides. Presently, diagnosis heavily relies on clinician expertise and meticulous differential diagnosis to exclude other joint-affecting conditions. Therapeutic approaches for OA predominantly focus on patient education for self-management alongside tailored exercise regimens, often complemented by various pharmacological interventions primarily targeting pain alleviation. However, pharmacological treatments typically exhibit short-term efficacy and local and/or systemic side effects, with prosthetic surgery being the ultimate resolution in severe cases. Thus, exploring the potential integration or substitution of conventional drug therapies with natural compounds and extracts emerges as a promising frontier in enhancing OA management. These alternatives offer improved safety profiles and possess the potential to target specific dysregulated pathways implicated in OA pathogenesis, thereby presenting a holistic approach to address the condition's complexities.

Zingiber Officinale Roscoe: The Antiarthritic Potential of a Popular Spice-Preclinical and Clinical Evidence

The health benefits of ginger rhizomes (Zingiber officinale Roscoe) have been known for centuries. Recently, ginger root has gained more attention due to its anti-inflammatory and analgesic activities. Many of the bioactive components of ginger may have therapeutic benefits in treating inflammatory arthritis. Their properties seem especially helpful in treating diseases linked to persistent inflammation and pain, symptoms present in the course of the most prevalent rheumatic diseases, such as osteoarthritis (OA) and rheumatoid arthritis (RA). This review analyzes the current knowledge regarding ginger's beneficial anti-inflammatory effect in both in vitro and in vivo studies as well as clinical trials. The drug delivery systems to improve ginger's bioavailability and medicinal properties are discussed. Understanding ginger's beneficial aspects may initiate further studies on improving its bioavailability and therapeutic efficacy and achieving more a comprehensive application in medicine.

A Review of the Occurrence of Rheumatoid Arthritis and Potential Treatments through Medicinal Plants from an Indian Perspective

Arthritis is a medical condition that affects the joints and causes inflammation, pain, and stiffness. There are different types of arthritis, and it can affect people of all ages, even infants and the elderly. Recent studies have found that individuals with diabetes, heart disease, and obesity are more likely to experience arthritis symptoms. According to the World Health Organization, over 21% of people worldwide suffer from musculoskeletal problems. Roughly 42.19 million individuals in India, constituting around 0.31% of the populace, have been documented as having Rheumatic Arthritis (RA). Compared to other common diseases like diabetes, cancer, and AIDS, arthritis is more prevalent in the general population. Unfortunately, there is no specific cure for arthritis, and treatment plans usually involve non-pharmacological methods, surgeries, and medications that target specific symptoms. Plant-based remedies have also been shown to be effective in managing inflammation and related complications. In addition to therapies, maintaining a healthy diet, exercise, and weight management are essential for managing arthritis. This review discusses the causes, prevalence, diagnostic methods, current and prospective future treatments, and potential medicinal plants that may act as anti-inflammatory or anti-rheumatic agents. However, more research is necessary to identify the underlying mechanisms and active molecules that could improve arthritis treatment.

A comprehensive review on clinically proven natural products in the management of nerve pain, with mechanistic insights

Introduction

People are treating their neuropathic pain with several approved and licensed pharmacological drugs. But due to having existing limitations like low efficacy with some side effects, there needs to be a more effective alternative and complementary therapeutic options.

Purpose

s: The study was designed to discuss the mechanistic role of several clinically proven natural products that have been shown to play a significant role against different nerve pain or neuropathic pain.

Method

ology: Information for this review article was salvaged using several accessible searching databases like SciVerse Scopus ® (Elsevier Properties S. A, USA), Web of Science® (Thomson Reuters, USA), and PubMed® (U.S. National Library of Medicine, USA) considering some search items like - nerve pain, natural products in pain/nerve pain management, clinically proven natural products in pain management, pain-reducing agents and so on.

Result

Our study reported the therapeutic efficacy of natural products and their possible mechanism against neuropathic pain in the human body. Natural products widely used to treat neuropathic pain include comfrey root extract ointment, lavender oil, Rose Oil, aromatic essential oil, ginger oil, vitex agnus-castus, peganum oil, and ajwain 10%. Some common pathways are involved in pain relief through sensory stimulation, enzymatic, anti-inflammatory, and pain-related receptor regulation.

Conclusion

The present study suggests that the mentioned natural products can be an appropriate choice for the treatment and management of neuropathic pain.

Revisiting the therapeutic potential of gingerols against different pharmacological activities

The rhizomes of ginger have been in use in many forms of traditional and alternative medicines. Besides being employed as condiment and flavoring agent, it is used in the treatment of nausea, osteoarthritis, muscle pain, menstrual pain, chronic indigestion, Alzheimer's disease, and cancer. Ginger rhizome contains volatile oils, phenolic compounds and resins, and characterization studies showed that [6]-gingerol, [6]-shogaol, and [6]-paradol are reported to be the pharmacologically active components. Gingerol is a major chemical constituent found as volatile oil in the rhizomes of ginger. It has several medicinal benefits and used for the treatment of rheumatoid arthritis, nausea, cancer, and diabetes. Many studies have been carried out in various parts of the world to isolate and standardize gingerol for their use as a complementary medicine. The present review summarizes wide range of research studies on gingerol and its pharmacological roles in various metabolic diseases.

Ginger (Zingiber officinale) Root Capsules Enhance Analgesic and Antioxidant Efficacy of Diclofenac Sodium in Experimental Acute Inflammation

Our study aimed to evaluate the analgesic and antioxidant effects of ginger (Zingiber officinale) root capsule extract (GRCE) in addition to diclofenac (D) sodium treatment in carrageenan-induced acute inflammation (AI). Seven groups of eight Wistar-Bratislava white rats were included in the study. One group was the control (C), and AI was induced in the other six groups. The following treatments were applied: saline solution for C and AI groups, D for the AID group, GRCE for two groups and GRCE and D for another two groups. The GRCE was administered by gavage in two doses (100 mg/Kg b.w. or 200 mg/kg b.w.), while D was administered intraperitoneally in a dose of 5 mg/kg b.w. The association of GRCE with this low dose of diclofenac reduced pain threshold and improved mobility with the best results for the dose of 200 mg/kg b.w. Moreover, this combination reduced, better than D alone, the serum levels of the evaluated pro-oxidant parameters (malondialdehyde, the indirect assessment of NO synthesis, total oxidative status and oxidative stress index) up to 78%, especially oxidative stress index (p < 0.0001). GRCE alone slightly improved the antioxidant parameters (total antioxidant capacity and total thiols), but when associated with, D the results were better, especially for total thiols as their plasma levels increased up to 50% (p < 0.0010), with the best results obtained for the 200 mg/kg b.w. dose of GRCE. In conclusion, ginger root capsules associated with diclofenac might offer additional antioxidant and analgesic effects in a dose-dependent manner in acute inflammation.

Natural Compounds: Potential Therapeutics for the Inhibition of Cartilage Matrix Degradation in Osteoarthritis

Osteoarthritis (OA) is the most common degenerative joint disease characterized by enzymatic degradation of the cartilage extracellular matrix (ECM) causing joint pain and disability. There is no disease-modifying drug available for the treatment of OA. An ideal drug is expected to stop cartilage ECM degradation and restore the degenerated ECM. The ECM primarily contains type II collagen and aggrecan but also has minor quantities of other collagen fibers and proteoglycans. In OA joints, the components of the cartilage ECM are degraded by matrix-degrading proteases and hydrolases which are produced by chondrocytes and synoviocytes. Matrix metalloproteinase-13 (MMP-13) and a disintegrin and metalloproteinase with thrombospondin motifs 4 and 5 (ADAMTS5) are the major collagenase and aggrecanase, respectively, which are highly expressed in OA cartilage and promote cartilage ECM degradation. Current studies using various in vitro and in vivo approaches show that natural compounds inhibit the expression and activity of MMP-13, ADAMTS4, and ADAMTS5 and increase the expression of ECM components. In this review, we have summarized recent advancements in OA research with a focus on natural compounds as potential therapeutics for the treatment of OA with emphasis on the prevention of cartilage ECM degradation and improvement of joint health.

The efficacy and safety of ginger supplementation in patients with multiple sclerosis: A rationale and study protocol for a double-blind randomized controlled trial

Background and Aims

Multiple sclerosis (MS) is a chronic disease characterized by axonal damage, demyelination, inflammation, oxidative stress, and immune cell infiltration. This disease is the first cause of nontraumatic disability in young adults leading to a decline in patients' quality of life. Patients with MS may also suffer from gastrointestinal symptoms due to the disease or prescription drugs. Unfortunately, no treatment for MS has been discovered yet, and prescribed drugs can only help control its clinical course. Interestingly, recent animal studies have shown positive effects of ginger administration in the MS model. Therefore, we aim to determine the effect of ginger supplementation on neurofilament light chain, matrix metalloproteinase-9, interleukin-17, nitric oxide, complete and differential blood counts, disability status, quality of life, gastrointestinal symptoms, and body mass index (BMI) in MS patients.

Methods

This study is a double-blind randomized controlled trial. Fifty-two patients with relapsing-remitting MS will be assigned to intervention and control groups using stratified permuted block randomization. The intervention and control groups will take 1500 mg/day ginger and placebo (as corn) supplements for 12 weeks, respectively. All outcomes will be assessed before and after the trial. Serum concentrations of neurofilament light chain, matrix metalloproteinase-9, and interleukin-17 will be measured by enzyme-linked immunosorbent assay. Nitric oxide serum levels will be detected using colorimetry. Complete and differential blood counts will be assessed by an automated hematology analyzer. Disability status, quality of life, and gastrointestinal symptoms will be evaluated by the Expanded Disability Status Scale, MS Impact Scale, and Visual Analog Scale, respectively. BMI will be calculated by dividing weight in kilograms by height in meters squared. Potential side effects of ginger supplementation will also be closely monitored during the study.

Trial Registration

This protocol was registered at the Iranian Registry of Clinical Trials (www.irct.ir) under the registration number IRCT20180818040827N3.

The efficacy of Zingiber officinale on dyslipidaemia, blood pressure, and inflammation as cardiovascular risk factors: A systematic review

BACKGROUND & AIMS

Hypertension, dyslipidaemia, and chronic inflammation contribute to the development of cardiovascular disease (CVD). Zingiber officinale has been suggested to reduce these CVD risk factors; however, the clinical evidence remains unclear. This systematic review aims to analyse the effect of Z. officinale as a sole intervention on these risk factors.

METHODS

In this PRISMA-based systematic review, we included randomised clinical trials from PubMed, Scopus and Cochrane Database of Systematic Reviews (July 2020) analysing triglycerides, low- and high-density lipoprotein (LDL, HDL), total cholesterol, C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-α), interleukin 1, 6, 10, systolic and/or diastolic blood pressure as outcomes. Quality of studies was evaluated by JADAD and the Cochrane risk-of-bias tools.

RESULTS

A total of 24 studies were included, mostly (79.2%) showing low risk of bias. These were based on obesity and cardio-metabolic derangements (33.3%), type 2 diabetes mellitus (37.5%), and miscellaneous conditions (29.2%). While total cholesterol and triglycerides levels mostly improved after Z. officinale, results were inconsistent for other blood lipids markers. Inflammatory markers (CRP, TNF-α) were more consistently reduced by Z. officinale, while only 3 studies reported a non-significant reduction of blood pressure.

CONCLUSIONS

Although there remains a paucity of studies, Z. officinale may be beneficial for improving dyslipidaemia and inflammation.

Zingiber officinale and Vernonia amygdalina Infusions Improve Redox Status in Rat Brain

The study investigated the effects of Zingiber officinale root and Vernonia amygdalina leaf on the brain redox status of Wistar rats. Twenty-four (24) rats weighing 160 ± 20 g were randomly assigned into four (4) groups, each with six (6) rats. Animals in Group 1 (control) were orally administered distilled water (1 mL), while the test groups were orally administered 5 mg/mL of either Z. officinale, V. amygdalina infusion, or a combination of both, respectively, for 7 days. The rats were sacrificed at the end of treatments and blood and tissue were harvested and prepared for biochemical assays. Results showed that administration of V. amygdalina and Z. officinale, as well as their coadministration, reduced the levels of malondialdehyde (MDA), nitric oxide (NO), acetylcholinesterase (AChE), and myeloperoxidase (MPO) in rat brain tissue compared with the control group. Conversely, coadministration of V. amygdalina and Z. officinale increased the levels of reduced glutathione (GSH) in rat brain tissue compared with the control group. However, the administration of the infusions singly, as well as the combination of both infusions, did not have any effect on the rat brain levels of glutathione peroxidase (GPx) and catalase (CAT) antioxidant enzymes compared to the control. Taken together, the findings indicate that the V. amygdalina and Z. officinale tea infusions have favorable antioxidant properties in the rat brain. The findings are confirmatory and contribute to deepening our understanding of the health-promoting effects of V. amygdalina and Z. officinale tea infusions.

Nutritional benefits of ginger for patients with non-communicable diseases

Ginger (Zingiber officinale) is a famous dietary spice rich in bioactive components like gingerols, and it has been used for a long time as food and medicine. Indeed, clinical studies have confirmed the anti-inflammatory and antioxidant properties of ginger. Thus, ginger seems to be an excellent complementary nutritional strategy for non-communicable diseases (NCD) such as obesity, diabetes, cardiovascular disease and chronic kidney disease. This narrative review aims to discuss the possible effects of ginger on the mitigation of common complications such as inflammation, oxidative stress, and gut dysbiosis in NCD.

A Meta-Analysis of the Impact of Nutritional Supplementation on Osteoarthritis Symptoms

Conflicting evidence exists concerning the effects of nutrient intake in osteoarthritis (OA). A systematic literature review and meta-analysis were performed using PubMed, EMBASE, and Cochrane Library up to November 2021 to assess the effects of nutrients on pain, stiffness, function, quality of life, and inflammation markers. We obtained 52 references including 50 on knee OA. Twelve studies compared 724 curcumin patients and 714 controls. Using the standardized mean difference, improvement was significant with regard to pain and function in the curcumin group compared to placebo, but not with active treatment (i.e., nonsteroidal anti-inflammatory drugs, chondroitin, or paracetamol). Three studies assessed the effects of ginger on OA symptoms in 166 patients compared to 164 placebo controls. Pain was the only clinical parameter that significantly decreased. Vitamin D supplementation caused a significant decrease in pain and function. Omega-3 and vitamin E caused no changes in OA parameters. Herbal formulations effects were significant only for stiffness compared to placebo, but not with active treatment. A significant decrease in inflammatory markers was found, especially with ginger. Thus, curcumin and ginger supplementation can have a favorable impact on knee OA symptoms. Other studies are needed to better assess the effects of omega-3 and vitamin D.

Potential Role of Ginger (Zingiber officinale Roscoe) in the Prevention of Neurodegenerative Diseases

Ginger is composed of multiple bioactive compounds, including 6-gingerol, 6-shogaol, 10-gingerol, gingerdiones, gingerdiols, paradols, 6-dehydrogingerols, 5-acetoxy-6-gingerol, 3,5-diacetoxy-6-gingerdiol, and 12-gingerol, that contribute to its recognized biological activities. Among them, the major active compounds are 6-shogaol and 6-gingerol. Scientific evidence supports the beneficial properties of ginger, including antioxidant and anti-inflammatory capacities and in contrast, a specific and less studied bioactivity is the possible neuroprotective effect. The increase in life expectancy has raised the incidence of neurodegenerative diseases (NDs), which present common neuropathological features as increased oxidative stress, neuroinflammation and protein misfolding. The structure-activity relationships of ginger phytochemicals show that ginger can be a candidate to treat NDs by targeting different ligand sites. Its bioactive compounds may improve neurological symptoms and pathological conditions by modulating cell death or cell survival signaling molecules. The cognitive enhancing effects of ginger might be partly explained via alteration of both the monoamine and the cholinergic systems in various brain areas. Moreover, ginger decreases the production of inflammatory related factors. The aim of the present review is to summarize the effects of ginger in the prevention of major neurodegenerative diseases such as Alzheimer's disease, Parkinson's disease and multiple sclerosis.

Ingredients of a Natural Oral Nutritional Supplement and Their Role in the Treatment of Osteoarthritis

Osteoarthritis is a prevalent degenerative disease affecting a large portion of the world’s aging population. Currently, nonsteroidal anti-inflammatory drugs and acetaminophen are first-line medications for treating osteoarthritis patients’ pain. However, several studies have noted that while these medications control pain they do not halt progressive degeneration and tend to have an unfavorable side-effect profile with prolonged use. Recently, due to their more favorable side-effect profiles, herbal alternatives for controlling osteoarthritis symptoms and for alleviating the progression of the disease are being increasingly studied. Synogesic is a newly developed herbal supplement blend by renowned orthopedic surgeons and physiatrists consisting of turmeric, rutin, ginger root, vitamin C, vitamin D, and boswellia extracts. A study by Sharkey et al. has commented on the efficacy of the blend on the patients with knee osteoarthritis. So far, a review on the ingredients of the blend has not yet carried outbeen. By exploring prominent literature databases including PubMed and ScienceDirect, our aim is to write a narrative review to explore the individual ingredients of this blend and delve into their characteristics, as well as the most recent literature on their mechanism and efficacy in patients with osteoarthritis. Through this, we hope to inform clinicians and patients alike on relevant up-to-date research on the supplement and provide insight on the potential for this supplement for alleviating the disease course of patients with osteoarthritis.

The Effect of Ginger (Zingiber officinale) on Improving Blood Lipids and Body Weight; A Systematic Review and Multivariate Meta-analysis of Clinical Trials

BACKGROUND

Beneficial effects of ginger consumption on metabolic biomarkers has been reported previously. The current research aimed to investigate the effects of ginger supplementation on lipid profile and body weight using a meta-analysis of randomized, controlled trials.

METHODS

Online databases PubMed, Embase, Web of Science, and Science Direct were searched until December 2021 to identify eligible articles. Twenty-six trials were included.

RESULTS

The results showed that ginger consumption could significantly improve lipid profile including total triglyceride (-12.54 (-20.01 to -5.08)), cholesterol (-6.53 (-10.76 to -2.31)), LDL (-5.14 (-8.79 to -1.50)), and HDL (1.13 (0.35 to 1.91)). Moreover, ginger supplementation could significantly decrease body mass index (BMI) (-0.49 (-0.79 to -0.18)). However, the small number of sample studies that investigated reductions in body weight (-0.52 (-1.48 to 0.43)) were not statistically significant. Sub-group analysis of treatment dose and duration showed that in most of the analyzed lipid profiles, both ≤1500 and >1500 mg/d for both of ≤8 and >8 weeks could be effective; however, in the case of weight control dose of >1500 mg/d for more than 8 weeks was more effective. Besides, the results of multivariate meta-analysis revealed the effect of the intervention on all lipid profiles simultaneously.

CONCLUSION

The present meta-analysis and review revealed that ginger supplementation can improve lipid profile and body weight if used at the appropriate dose and duration. More studies are needed to fully evaluate the effect of ginger supplements' different doses and duration on lipid profile and BMI.

Effect of Zingiber officinale Roscoe rhizome (ginger) capsule on postpartum pain: Double-blind randomized clinical trial

BACKGROUND

Postpartum pain contributes to increased irritability and excessive stress in the mother and consequently may inhibit successful breastfeeding, reduce a mother's ability to take care of her baby, and cause an imperfect mother-baby interaction. Evidence suggests the positive effect of ginger on reduction in uterus-associated pain. The objective of this study is to investigate the effect of ginger capsules on postpartum pain.

MATERIALS AND METHODS

The present double-blinded, randomized, placebo-controlled trial was conducted in Mahdiyeh Educational Hospital, Tehran. One hundred and twenty-eight mothers having moderate-to-severe pain following vaginal delivery were included. The participants were divided into two groups (A and B). Interventions were performed every 8 h in 24 h. In the first intervention (2 h after the delivery), Group A received 500 mg of placebo capsules (containing chickpea flour) and Group B received 500 mg of Zintoma (ginger rhizome) capsules. In the second and third interventions, Group A received 250 mg placebo capsules and Group B received 250 mg Zintoma capsules. All participants received 250 mg capsules of mefenamic acid in each intervention in addition to ginger or placebo capsules. The pain severity was measured before and half an hour, an hour, and 2 h after each intervention. Statistical analysis was performed using the SPSS software version. 22. The Chi-square, Fisher's, and t tests and the GEE model were applied to assess the pain severity.

RESULTS

The average pain severity was not statistically significant between the groups in the beginning of the intervention (P = 0.623). The mean score of pain significantly decreased within the duration of intervention in both groups (P < 0.001); however, the pain severity was significantly lower in the intervention group as compared to the control group at any point after the intervention (P = 0.006).

CONCLUSION

Ginger can be used as an effective remedy for postpartum pain relief.

Extract, fractions, and ethyl-p-methoxycinnamate isolate from Kaempferia galanga Elicit anti-inflammatory activity by limiting leukotriene B4 (LTB4) production

Background and aim

Kaempferia galanga, also known as aromatic Ginger (kencur) in Indonesia, has been widely explored and shows potential as an anti-inflammatory agent. However, there has been limited research to show a possible mechanism by which aromatic ginger inhibits lipoxygenase (LOX). Therefore, this study aims to determine the anti-inflammatory activity of aromatic ginger by comparing extract, fractions, and ethyl-p-methoxycinnamate (EPMC) isolate, as well as possible LOX inhibition activity, by reducing the production of leukotriene B4 (LTB4).

Experimental procedure

Two animal models were used, namely, the carrageenan-induced granuloma air pouch model and the pleurisy model. The test substance was administered 1 h before carrageenan induction, which was performed orally for each animal model. The number of leukocytes and the malondialdehyde (MDA) levels, leukotriene B4 (LTB4) levels, and histology were observed. GC-MS and LC-MS were used for analysis of the chemical compounds in the test samples.

Results and conclusion

The results of GC-MS analysis showed that aromatic ginger rhizome extract and fractions were dominated by ethyl-trans-p-methoxycinnamate, with the highest level found in the extract. K. galanga showed significant anti-inflammatory activity compared to the control (p < 0.01) in both the granuloma air pouch and pleurisy models. The results of examining the LTB4 concentration showed comparable activity between K. galanga extract, fractions and EMPC isolate, these results were not better than those of zileuton. Overall, this study shows that aromatic ginger extract, fractions and EPMC isolate have anti-inflammatory properties and have the potential to inhibit LOX, thereby reducing LTB4 levels.

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Comparison of extract, fraction and isolate of Kamperia galanga anti-inflammation activity.

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Anti-inflammatory activity of Kaempferia galanga in pleurisy model.

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Extract, fraction and isolate of Kamperia galanga as LOX inhibitor.

Emerging Natural-Product-Based Treatments for the Management of Osteoarthritis

Osteoarthritis (OA) is a complex degenerative disease in which joint homeostasis is disrupted, leading to synovial inflammation, cartilage degradation, subchondral bone remodeling, and resulting in pain and joint disability. Yet, the development of new treatment strategies to restore the equilibrium of the osteoarthritic joint remains a challenge. Numerous studies have revealed that dietary components and/or natural products have anti-inflammatory, antioxidant, anti-bone-resorption, and anabolic potential and have received much attention toward the development of new therapeutic strategies for OA treatment. In the present review, we provide an overview of current and emerging natural-product-based research treatments for OA management by drawing attention to experimental, pre-clinical, and clinical models. Herein, we review current and emerging natural-product-based research treatments for OA management.

Effect of ginger (Zingiber officinale) supplementation on oxidative stress parameters: A systematic review and meta-analysis

A wide variety of antioxidant properties are attributed to ginger (Zingiber officinale) and several randomized controlled trials (RCTs) have investigated the effect of ginger intake on major oxidative stress (OS) parameters. We conducted a systematic review and meta-analysis to evaluate the effects of using ginger to improve OS levels. Medline, Scopus, ISI Web of Science, EMBASE, and the Cochrane Central Register of Controlled Trials were systematically searched up until March 2020 to gather RCTs that evaluated the impact of ginger intake on the levels and activity of OS parameters in adult subjects. Means and standard deviations for relevant OS variables were extracted and evaluated to assess the quality of the trials based on the Cochrane risk-of-bias tool for randomized trials. The gathered data were pooled and expressed as standardized mean difference (SMD) with 95% Confidence Intervals (95% CI). Twelve trials were included in this review. Ginger intake was shown to significantly increase glutathione peroxidase (GPx) activity (SMD: 1.64; 95% CI: 0.43, 2.85; I2  = 86.8%) and total antioxidant capacity (TAC) (SMD: 0.40; 95% CI: 0.06, 0.73; I2  = 42.8%) and significantly decrease malondialdehyde (MDA) levels (SMD: -0.69; 95% CI: -1.26, -0.12; I2  = 85.8%) compared to control groups. Ginger supplementation also non-significantly associated with an increase in CAT activity (SMD: 1.09; 95% CI: -0.07, 2.25; I2  = 87.6%). This systematic review and meta-analysis presents convincing evidence supporting the efficacy of ginger supplementation on improving OS levels. PRACTICAL IMPLICATIONS: In health sciences, OS, due to its pivotal role in the pathophysiology of several chronic diseases, is a subject with a long history. Recent research strives for a safe, ideal, and effective antioxidant. Ginger is herbal medicine, which has been widely used in traditional and complementary medicine. Proving the antioxidant effect and potential benefit of ginger has positive clinical implications for the application of this practical herb.

Polyphenols for improvement of inflammation and symptoms in rheumatic diseases: systematic review

BACKGROUND

Rheumatic diseases (RDs) are a group of pathological conditions characterized by inflammation and functional disability. There is evidence suggesting that regular consumption of polyphenols has therapeutic effects capable of relieving RD symptoms.

OBJECTIVE

To synthesize data from randomized controlled trials on administration of polyphenols and their effects on RD activity.

DESIGN AND SETTING

Systematic review conducted at Universidade Federal de Ouro Preto, Minas Gerais, Brazil.

METHODS

A systematic search was conducted in the databases PubMed (Medline), LILACS (BVS), IBECS (BVS), CUMED (BVS), BINACIS (BVS), EMBASE, Web of Science and Cochrane Library and in the grey literature. The present study followed a PRISMA-P checklist.

RESULTS

In total, 646 articles were considered potentially eligible, of which 33 were then subjected to complete reading. Out of these, 17 randomized controlled trials articles were selected to form the final sample. Among these 17 articles, 64.71% assessed osteoarthritis (n = 11), 23.53% rheumatoid arthritis (n = 4), 5.88% rheumatoid arthritis and fibromyalgia (n = 1) and 5.88% osteoarthritis and rheumatoid (n = 1). Intake of polyphenol showed positive effects in most of the studies assessed (94.12%): it improved pain (64.70%) and inflammation (58.82%).

CONCLUSION

Polyphenols are potential allies for treating RD activity. However, the range of polyphenol sources administered was a limitation of this review, as also was the lack of information about the methodological characteristics of the studies evaluated. Thus, further primary studies are needed in order to evaluate the effects of polyphenol consumption for reducing RD activity.

SYSTEMATIC REVIEW REGISTER

PROSPERO - CRD42020145349.

Effect of ginger (Zingiber officinale) on inflammatory markers: A systematic review and meta-analysis of randomized controlled trials

The aim of this systematic review and meta-analysis was to investigate the efficacy of ginger supplementation on circulating levels of C-reactive protein (CRP), high sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-alpha (TNF-α), soluble intercellular adhesion molecule (sICAM), and interleukin-6 (IL-6) concentrations in randomized controlled trials (RCTs). The search included PubMed-Medline, EMBASE, Scopus, Web of Science and Cochrane Library databases to identify randomized clinical trials on the effect of ginger supplementation on circulation levels of CRP, hs-CRP, IL-6, sICAM, and TNF-α published up until February 1st, 2020. We did not restrict articles based on language of publication. Standard mean differences and 95% confidence intervals were calculated for net changes in inflammatory mediators using a random-effects model. Sixteen RCTs comprising 1010 participants were found to be eligible for this meta-analysis. There was a significant reduction of circulating CRP (SMD: -5.11, 95% CI: -7.91, -2.30, I2 = 98.1%), hs-CRP (SMD: -0.88, 95% CI: -1.63, -0.12, I2 = 90.8%) and TNF-α levels (SMD: -0.85, 95% CI: -1.48, -0.21, I2 = 89.4%) following ginger supplementation. However, meta-analysis results did not show any significant impact of ginger supplementation on IL-6 (SMD: -0.45, 95% CI: -1.29, 0.38, I2 = 89.2%), and sICAM levels (SMD: -0.05, 95% CI: -0.36, 0.26, I2 = 00.0%). This systematic review and meta-analysis of RCTs demonstrates a significant impact of ginger in lowering circulating CRP, hs-CRP and TNF-α levels. Large-scale RCTs are still needed to draw concrete conclusions about the effect of ginger on other inflammatory mediators.

Clinical trials on pain lowering effect of ginger: A narrative review

Ginger has a pain-reducing effect and it can modulate pain through various mechanisms: inhibition of prostaglandins via the COX and LOX-pathways, antioxidant activity, inibition of the transcription factor nf-kB, or acting as agonist of vanilloid nociceptor. This narrative review summarizes the last 10-year of randomized controlled trials (RCTs), in which ginger was traditionally used as a pain reliever for dysmenorrhea, delayed onset muscle soreness (DOMS), osteoarthritis (AO), chronic low back pain (CLBP), and migraine. Regarding dysmenorrhea, six eligible studies suggest a promising effect of oral ginger. As concerned with DOMS, the four eligible RCTs suggested a reduction of inflammation after oral and topical ginger administration. Regarding knee AO, nine RCTs agree in stating that oral and topical use of ginger seems to be effective against pain, while other did not find significant differences. One RCT considered the use of ginger in migraine and suggested its beneficial activity. Finally, one RCT evaluated the effects of Swedish massage with aromatic ginger oil on CLBP demonstrated a reduction in pain. The use of ginger for its pain lowering effect is safe and promising, even though more studies are needed to create a consensus about the dosage of ginger useful for long-term therapy.

Zingiber officinale Roscoe Prevents DNA Damage and Improves Muscle Performance and Bone Integrity in Old Sprague Dawley Rats

Age-related loss of skeletal muscle mass and strength or sarcopenia is attributed to the high level of oxidative stress and inadequate nutritional intake. The imbalance in oxidative status with increased production of free radicals results in damage to the DNA which leads to cell dysfunction. This study aimed to determine the effect of Zingiber officinale Roscoe (ginger) on muscle performance and bone integrity in Sprague Dawley (SD) rats. SD rats aged three (young), nine (adult), and twenty-one (old) months old were treated with either distilled water or ginger extract at a concentration of 200 mg/kg body weight (BW) daily for 3 months via oral gavage. Muscle performance was assessed at 0, 1, 2, and 3 months of treatment by measuring muscle strength, muscle function, and bone integrity while DNA damage was determined by comet assay. Muscle cell histology was analyzed by hematoxylin and eosin (H&E) staining. Young and adult ginger-treated rats showed a significant improvement in muscle strength after 3 months of supplementation. Bone mineral density (BMD) and bone mineral content (BMC) were increased while fat free mass (FMM) was decreased after 3 months of ginger supplementation in young rats but not changed in adult and old ginger supplemented groups. Interestingly, supplementation of ginger for 3 months to the old rats decreased the level of damaged DNA. Histological findings showed reduction in the size of muscle fibre and fascicles with heterogenous morphology of the muscle fibres indicating sarcopenia was evident in old rats. Treatment with ginger extract improved the histological changes even though there was evidence of cellular infiltration (mild inflammation) and dilated blood vessels. In conclusion, Z. officinale Roscoe prevents DNA damage and improves muscle performance and bone integrity in SD rats indicating its potential in alleviating oxidative stress in ageing and thus delaying sarcopenia progression.

The effects of ginger supplementation on markers of inflammatory and oxidative stress: A systematic review and meta-analysis of clinical trials

The present systematic review and meta-analysis was conducted to investigate the effects of ginger supplementation on markers of inflammatory and oxidative stress. PubMed, Embase, Scopus, and Web of Science were systematically searched to identify relevant clinical trials evaluating the effects of ginger on serum CRP (C-reactive protein), TNF-α (tumor necrosis factor-alpha), IL-6 (interleukin-6), PGE2 (prostaglandin E2), TAC (total antioxidant capacity), and MDA (malondialdehyde) from inception up to September 2019. Mean difference and 95% confidence intervals were pooled using a random-effects model. Potential publication bias was assessed using visual inspection of funnel plot and Egger's weighted regression tests. After excluding irrelevant records, 20 full-text articles that included 25 separate studies were included to the meta-analysis. Pooled results of this study indicated a statistically significant effect of ginger on serum CRP, TNF-α, IL-6, TAC, and MDA levels following ginger supplementation in compared to the controls. Also, the effects of ginger on serum PGE2 was marginally significant. Moreover, the high heterogeneity was disappeared in subgroup analysis performed by age, duration, dosage, and quality. This current analysis indicates that ginger supplementation has a significant effects on serum inflammatory and oxidative stress markers.

Ginger extract versus Loratadine in the treatment of allergic rhinitis: a randomized controlled trial

BACKGROUND

Allergic rhinitis (AR) is a non-infectious immune disease and incidents of the disease has continuously increased in Thailand. Ginger, a Thai herb, is used in food and Thai traditional medicine. This study was designed to assess efficacy and safety of ginger extract in comparison with loratadine for AR treatment.

METHODS

AR patients were treated with ginger extract 500 mg (n = 40) against those treated with loratadine 10 mg (n = 40) in a randomized, double-blind, controlled trial for 3 and 6 weeks. The efficacy was evaluated from clinical examinations i.e. total nasal symptom scores (TNSS), cross-sectional area of the nasal cavity with acoustic rhinometry (ARM) and rhinoconjunctivitis quality of life questionnaire (RQLQ). The safety of treatment was measured by blood pressure, blood analysis and history-taking for side effects.

RESULTS

The results showed both ginger extract and loratadine treated groups significantly decreased TNSS scores but there was no significant difference between the two groups. In acoustic rhinometry measurement, the ginger treated group significantly gradually increased the estimated volume of the nasal cavity and decreased distances from the nostril, but the loratadine treated group did not cause a change. Both groups gave significantly improvement in every aspect of the RQLQ at third weeks. The treatment with ginger extract was as safe as loratadine as shown by renal and liver function results obtained from blood analysis. Both treatments had no effect on blood pressure of the patients.

CONCLUSIONS

The ginger extract is as good as loratadine in improving nasal symptoms and quality of life in AR patients. However, ginger extract caused less side effects especially, drowsiness, fatigue, dizziness and constipation. Therefore, the ginger extract could be used as alternative treatment for patients with AR.

TRIAL REGISTRATION

Registered with ClinicalTrials.gov (Registration number: NCT02576808) on 15 October 2015.

Ginger in patients with active ulcerative colitis: a study protocol for a randomized controlled trial

BACKGROUND

As a lifetime disorder, ulcerative colitis (UC) is an inflammatory bowel disease (IBD) that affects quality of life and also demands long-term interventions. In spite of considerable side effects and sometimes restricted uses, efficient medications are available for UC treatment. Some in vitro and in vivo examinations have correspondingly introduced ginger and its active components with antioxidant, anti-inflammatory, and anti-ulcerative properties. Therefore, this trial aims to evaluate the effect of ginger supplementation on patients with active UC.

METHODS

This study will be a 12-week, double-blind, parallel-group, randomized, controlled trial (RCT) in which 44 patients will be allocated to ginger and placebo groups receiving basic routine treatments plus ginger or placebo capsules, respectively. The primary outcomes are inflammatory markers (TNF-α and hs-CRP) and total antioxidant capacity.

DISCUSSION

The findings of this trial will provide evidence on the effect of ginger on patients with active UC.

TRIAL REGISTRATION

Iranian Registry of Clinical Trials, IRCT20190129042552N1. Registered on 21 June 2019.

Use of Complementary and Integrative Therapies by Fibromyalgia Patients: A 14-Year Follow-up Study

Objective

To reevaluate the frequency and pattern of complementary and integrative medicine (CIM) use in patients with fibromyalgia (FM).

Patients and Methods

Consecutive patients with FM who were referred to the Mayo Clinic fibromyalgia treatment program from January 5 through July 27, 2017, were invited to complete a survey about their use of CIM therapies in the preceding 6 months. The survey asked about 3 primary CIM domains: treatments and techniques, vitamins and minerals, and herbs and other dietary supplements. For direct comparative purposes, we reused the survey instrument from our prior analogous study of CIM use, performed in 2003.

Results

Of the 310 patients who completed the survey, 304 (98.1%) reported using some form of CIM, similar to the percentage reported in our 2003 study (98%). The most frequently used CIM therapies in the current cohort were spiritual healing (54.0% [163 of 302]), massage therapy (50.0% [152 of 304]), chiropractic treatments (39.3% [118 of 300]), aromatherapy (39.0% [117 of 300]), exercise for a specific medical problem (38.6% [117 of 303]), melatonin (37.9% [77 of 203]), magnesium (36.3% [107 of 295]), green tea (36.1% [73 of 202]), and fish oil (34.5% [68 of 197]). We noted numerous substantial differences from the 2003 data in terms of the pattern of CIM use.

Conclusion

The use of CIM therapies among patients with FM continues to be extremely common for adult patients of all ages. Given the continued high prevalence of CIM use, health care professionals must have awareness and knowledge of these various modalities and their potential incorporation into a multifaceted FM treatment regimen.

Ginger (Zingiber officinale Roscoe) in the Prevention of Ageing and Degenerative Diseases: Review of Current Evidence

Currently, the age of the population is increasing as a result of increased life expectancy. Ageing is defined as the progressive loss of physiological integrity, which can be characterized by functional impairment and high vulnerability to various types of diseases, such as diabetes, hypertension, Alzheimer's disease (AD), Parkinson's disease (PD), and atherosclerosis. Numerous studies have reported that the presence of oxidative stress and inflammation contributes to the development of these diseases. In general, oxidative stress could induce proinflammatory cytokines and reduce cellular antioxidant capacity. Increased oxidative stress levels beyond the production of antioxidant agents cause oxidative damage to biological molecules, including DNA, protein, and carbohydrates, which affects normal cell signalling, cell growth, differentiation, and apoptosis and leads to disease pathogenesis. Since oxidative stress and inflammation contribute to these diseases, ginger (Zingiber officinale Roscoe) is one of the potential herbs that can be used to reduce the level of oxidative stress and inflammation. Ginger consists of two major active components, 6-gingerol and 6-shogaol, which are essential for preventing oxidative stress and inflammation. Thus, this paper will review the effects of ginger on ageing and degenerative diseases, including AD, PD, type 2 diabetes mellitus (DM), hypertension, and osteoarthritis.

In Vitro Antioxidant and In Vivo Lipid-Lowering Properties of Zingiber officinale Crude Aqueous Extract and Methanolic Fraction: A Follow-Up Study

Over the past decades, cardiovascular diseases have become the leading cause of death all over the world, and among these diseases there is atherosclerosis caused mainly by an increase in plasmatic cholesterol levels and by strong oxidation caused by free radicals. For these reasons and others, we explored in this report the hypolipidemic and the antioxidant effects of Zingiber officinale crude aqueous and methanolic extract. The hypolipidemic study was carried out in high-fat-fed mice model. Animals were subdivided into four groups and were orally treated with the aqueous extract once daily for twelve weeks at two doses: 250 and 500 mg/Kg. During the treatment, the body weight, total cholesterol, triglycerides, and high-density lipoproteins have been defined every four weeks. The antioxidant activity has been studied using radical scavenging activity, β-carotene bleaching, reducing power assay, and the TBARs tests. The daily oral administration of the extracts for twelve weeks significantly improved the lipid profile in a dose-dependent manner, from the first until the twelfth week, and also showed a significant antioxidant effect. These findings may be potentially contributive to the validation of the medicinal use of Z. officinale to treat hyperlipidemia and cardiovascular complications.

Resveratrol Supplementation Reduces Pain and Inflammation in Knee Osteoarthritis Patients Treated with Meloxicam: A Randomized Placebo-Controlled Study

Resveratrol, a polyphenolic compound, is a powerful antioxidant with remarkable anti-inflammatory properties. Inflammation and pain plays an important role in the pathogenesis of knee osteoarthritis (OA) and could cause tissue damage and morbidity. The aim of this study was to evaluate the anti-inflammatory and pain reduction activities of orally administered resveratrol in patients with knee OA. We carried out a 90-day pilot study to evaluate the ability of orally administered resveratrol, as an adjuvant with meloxicam, to decrease knee joint pain and biomarkers of inflammation in comparison with a placebo. One hundred ten men and women (45-75 years old) diagnosed with mild to moderate knee OA were treated with 15 mg per day meloxicam and either 500 mg per day resveratrol or placebo for 90 days in a double-blind, randomized control trial. Pain severity was evaluated at the beginning and at the end of treatment using Visual Analogue Scale-100 scores. Fasting blood was collected to determine serum interleukins 1β and 6, tumor necrosis factor-α, C-reactive protein, and complement proteins C3 and C4. The resveratrol-treated group experienced a time-dependent significant decrease in pain severity (P < .001). Serum levels of the biochemical markers were significantly reduced compared with the placebo-treated group (P < .01). These findings suggest that resveratrol may be an effective "add-on" option with meloxicam in the treatment of patients with mild to moderate knee OA.

Nutraceuticals and osteoarthritis pain

Arthritis is a chronic disease of joints. It is highly prevalent, particularly in the elderly, and is commonly associated with pain that interferes with quality of life. Because of its chronic nature, pharmacological approaches to pain relief and joint repair must be safe for long term use, a quality many current therapies lack. Nutraceuticals refer to compounds or materials that can function as nutrition and exert a potential therapeutic effect, including the relief of pain, such as pain related to arthritis, of which osteoarthritis (OA) is the most common form. Of interest, nutraceuticals have recently been shown to have potential in relieving OA pain in human clinical trials. Emerging evidence indicates nutraceuticals may represent promising alternatives for the relief of OA pain. In this paper, we will overview OA pain and the use of nutraceuticals in OA pain management, focusing on those that have been evaluated by clinical trials. Furthermore, we discuss the biologic and pharmacologic actions underlying the nutraceutical effects on pain relief based on the potential active ingredients identified from traditional nutraceuticals in OA pain management and their potential for drug development. The review concludes by sharing our viewpoints that future studies should prioritize elucidating the mechanisms of action of nutraceuticals in OA and developing nutraceuticals that not only relieve OA pain, but also mitigate OA pathology.

Current status of top 10 nutraceuticals used for Knee Osteoarthritis in India

Knee Osteoarthritis (OA) is a progressive degenerative joint disease affecting the quality of life of the elderly population. There is considerable evidence that nutraceuticals from natural herbs may play a significant role in inflammation and joint destruction in OA. We review the current status of some of the commonly used nutraceuticals in Indian market - Boswellia, Aflapin, Chondroitin sulphate, Glucosamine sulphate, Collagen peptide, Curcumin, Fish Oil, Ginger, Green tea, and Rosehip extract. We have summarized their mechanism of action, biological effects, toxicities and efficacy in the management of Knee OA. These supplements have been found to be effective in knee OA in various studies. No serious side effects have been reported for any of these supplements. Overall, our study identifies and support the use of these nutraceuticals to provide symptomatic relief to patients with knee OA and justify their use as an adjunct therapy for the management. More good quality trials are needed to provide definitive answers to questions related to their efficacy and safety for OA prevention and treatment.

Strawberries Improve Pain and Inflammation in Obese Adults with Radiographic Evidence of Knee Osteoarthritis

Osteoarthritis (OA), the most common form of arthritis, is a significant public health burden in U.S. adults. Among its many risk factors, obesity is a key player, causing inflammation, pain, impaired joint function, and reduced quality of life. Dietary polyphenols and other bioactive compounds in berries, curcumin, and tea have shown effects in ameliorating pain and inflammation in OA, but few clinical studies have been reported. The purpose of the present study was to examine the effects of dietary strawberries on pain, markers of inflammation, and quality of life indicators in obese adults with OA of the knee. In a randomized, double-blind cross-over trial, adults with radiographic evidence of knee OA (n = 17; body mass index (BMI): (mean ± SD) 39.1 ± 1.5; age (years): 57 ± 7) were randomized to a reconstituted freeze-dried strawberry beverage (50 g/day) or control beverage daily, each for 12 weeks, separated by a 2-week washout phase (total duration, 26 weeks). Blood draws and assessments of pain and quality of life indicators were conducted using the Visual Analog Scale for Pain (VAS Pain), Measures of Intermittent and Constant Osteoarthritis Pain (ICOAP), and Health Assessment Questionnaire-Disability Index (HAQ-DI) questionnaires, which were completed at baseline and at weeks 12, 14, and 26 of the study. Among the serum biomarkers of inflammation and cartilage degradation, interleukin (IL)-6, IL-1β, and matrix metalloproteinase (MMP)-3 were significantly decreased after strawberry vs. control treatment (all p < 0.05). Strawberry supplementation also significantly reduced constant, intermittent, and total pain as evaluated by the ICOAP questionnaire as well as the HAQ-DI scores (all p < 0.05). No effects of treatment were noted on serum C-reactive protein (CRP), nitrite, glucose, and lipid profiles. Dietary strawberries may have significant analgesic and anti-inflammatory effects in obese adults with established knee OA.

Phytomedicine in Joint Disorders

Chronic joint inflammatory disorders such as osteoarthritis and rheumatoid arthritis have in common an upsurge of inflammation, and oxidative stress, resulting in progressive histological alterations and disabling symptoms. Currently used conventional medication (ranging from pain-killers to biological agents) is potent, but frequently associated with serious, even life-threatening side effects. Used for millennia in traditional herbalism, medicinal plants are a promising alternative, with lower rate of adverse events and efficiency frequently comparable with that of conventional drugs. Nevertheless, their mechanism of action is in many cases elusive and/or uncertain. Even though many of them have been proven effective in studies done in vitro or on animal models, there is a scarcity of human clinical evidence. The purpose of this review is to summarize the available scientific information on the following joint-friendly medicinal plants, which have been tested in human studies: Arnica montana, Boswellia spp., Curcuma spp., Equisetum arvense, Harpagophytum procumbens, Salix spp., Sesamum indicum, Symphytum officinalis, Zingiber officinalis, Panax notoginseng, and Whitania somnifera.

The effect of ginger supplementation on serum C-reactive protein, lipid profile and glycaemia: a systematic review and meta-analysis

Aim

To undertake a systematic review and meta-analysis of prospective studies to determine the effect of ginger supplementation on serum C-reactive protein (CRP), lipid profile, and glycaemia.

Method

PubMed-MEDLINE, Web of Science, Cochrane Database, and Google Scholar databases were searched (up until July 2016) to identify prospective studies evaluating the impact of ginger supplementation on serum CRP. Random-effects model meta-analysis was used for quantitative data synthesis. Sensitivity analysis was conducted using the leave-one-out method. Heterogeneity was quantitatively assessed using the I² index. Systematic review registration: CRD42016035973.

Results

From a total of 265 entries identified via searches, 9 studies were included in the final selection. The meta-analysis indicated a significant reduction in serum CRP concentrations following ginger supplementation [weighted mean difference (WMD)−0.84 mg/L (95% CI −1.38 to −0.31, I² 56.3%)]. The WMD for fasting blood glucose and HbA1c was −1.35 mg/dl (95% CI −2.04 to −0.58, I² 12.1%) and −1.01 (95% CI −1.28 to −0.72, I² 9.4%), respectively. Moreover, high-density lipoprotein and triglyceride significantly improved after ginger administration [1.16 mg/dl (95% CI 0.52 to 1.08, I² 12.3%) and −1.63 mg/dl (95% CI −3.10 to −0.17, I² 8.1%), respectively]. These findings were robust in sensitivity analyses. Random-effects meta-regression revealed that changes in serum CRP levels were independent of the dosage of ginger supplementation (slope −0.20; 95% CI −0.95 to 0.55; p=0.60).

Conclusions

This meta-analysis suggests that ginger supplementation significantly reduces serum CRP and improves glycaemia indexes and lipid profile. Randomized control trials with larger sample size and with a longer-term follow-up period should be considered for future investigations.