The Effect of Green Tea and Sour Tea (Hibiscus sabdariffaL.) Supplementation on Oxidative Stress and Muscle Damage in Athletes

The effects of green tea extract supplementation on body composition, obesity-related hormones and oxidative stress markers: a grade-assessed systematic review and dose-response meta-analysis of randomised controlled trials

Research indicates that green tea extract (GTE) supplementation is beneficial for a range of conditions, including several forms of cancer, CVD and liver diseases; nevertheless, the existing evidence addressing its effects on body composition, oxidative stress and obesity-related hormones is inconclusive. This systematic review and meta-analysis aimed to investigate the effects of GTE supplementation on body composition (body mass (BM), body fat percentage (BFP), fat mass (FM), BMI, waist circumference (WC)), obesity-related hormones (leptin, adiponectin and ghrelin) and oxidative stress (malondialdehyde (MDA) and total antioxidant capacity (TAC)) markers. We searched proper databases, including PubMed/Medline, Scopus and Web of Science, up to July 2022 to recognise published randomised controlled trials (RCT) that investigated the effects of GTE supplementation on the markers mentioned above. A random effects model was used to carry out a meta-analysis. The heterogeneity among the studies was assessed using the I2 index. Among the initial 11 286 studies identified from an electronic database search, fifty-nine studies involving 3802 participants were eligible to be included in this meta-analysis. Pooled effect sizes indicated that BM, BFP, BMI and MDA significantly reduced following GTE supplementation. In addition, GTE supplementation increased adiponectin and TAC, with no effects on FM, leptin and ghrelin. Certainty of evidence across outcomes ranged from low to high. Our results suggest that GTE supplementation can attenuate oxidative stress, BM, BMI and BFP, which are thought to negatively affect human health. Moreover, GTE as a nutraceutical dietary supplement can increase TAC and adiponectin.

Molecular and biochemical investigations of the anti-fatigue effects of tea polyphenols and fruit extracts of Lycium ruthenicum Murr. on mice with exercise-induced fatigue

Background: The molecular mechanisms regulating the therapeutic effects of plant-based ingredients on the exercise-induced fatigue (EIF) remain unclear. The therapeutic effects of both tea polyphenols (TP) and fruit extracts of Lycium ruthenicum (LR) on mouse model of EIF were investigated. Methods: The variations in the fatigue-related biochemical factors, i.e., lactate dehydrogenase (LDH), superoxide dismutase (SOD), tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), interleukin-2 (IL-2), and interleukin-6 (IL-6), in mouse models of EIF treated with TP and LR were determined. The microRNAs involved in the therapeutic effects of TP and LR on the treatment of mice with EIF were identified using the next-generation sequencing technology. Results: Our results revealed that both TP and LR showed evident anti-inflammatory effect and reduced oxidative stress. In comparison with the control groups, the contents of LDH, TNF-α, IL-6, IL-1β, and IL-2 were significantly decreased and the contents of SOD were significantly increased in the experimental groups treated with either TP or LR. A total of 23 microRNAs (21 upregulated and 2 downregulated) identified for the first time by the high-throughput RNA sequencing were involved in the molecular response to EIF in mice treated with TP and LR. The regulatory functions of these microRNAs in the pathogenesis of EIF in mice were further explored based on Gene Ontology (GO) annotation and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses with a total of over 20,000-30,000 target genes annotated and 44 metabolic pathways enriched in the experimental groups based on GO and KEGG databases, respectively. Conclusion: Our study revealed the therapeutic effects of TP and LR and identified the microRNAs involved in the molecular mechanisms regulating the EIF in mice, providing strong experimental evidence to support further agricultural development of LR as well as the investigations and applications of TP and LR in the treatment of EIF in humans, including the professional athletes.

Mechanisms Underlying the Effects of the Green Tea Polyphenol EGCG in Sarcopenia Prevention and Management

Sarcopenia is prevalent among the older population and severely affects human health. Tea catechins may benefit for skeletal muscle performance and protect against secondary sarcopenia. However, the mechanisms underlying their antisarcopenic effect are still not fully understood. Despite initial successes in animal and early clinical trials regarding the safety and efficacy of (-)-epigallocatechin-3-gallate (EGCG), a major catechin of green tea, many challenges, problems, and unanswered questions remain. In this comprehensive review, we discuss the potential role and underlying mechanisms of EGCG in sarcopenia prevention and management. We thoroughly review the general biological activities and general effects of EGCG on skeletal muscle performance, EGCG's antisarcopenic mechanisms, and recent clinical evidence of the aforesaid effects and mechanisms. We also address safety issues and provide directions for future studies. The possible concerted actions of EGCG indicate the need for further studies on sarcopenia prevention and management in humans.

Essential Amino Acid and Tea Catechin Supplementation after Resistance Exercise Improves Skeletal Muscle Mass in Older Adults with Sarcopenia: An Open-Label, Pilot, Randomized Controlled Trial

Tea catechins (TCCs) have gained significant attention owing to their health effects. However, evidence is limited regarding the benefit of TCC and essential amino acids (EAAs) ingestion plus that of TCC ingestion after resistance exercise (RE) among older individuals with sarcopenia. We aimed to evaluate whether a 24-week nutritional program involving EAA and TCC supplementation after RE improved skeletal muscle mass (SMM) among older adults with sarcopenia.

METHODS

We conducted an open-label, pilot, randomized controlled trial among older adults with sarcopenia at the Harima Care Center or community in Hyogo, Japan. Participants were allocated to RE (n = 18), RE with EAA supplementation (RE + EAA, n = 18), or RE with EAA and TCC supplementation (RE + EAA + TCC, n = 18) groups. Sarcopenia was defined using the Asian Working Group for Sarcopenia 2019 criteria. A 24-week resistance exercise program was carried out twice weekly, with an intake of 3,000 mg and 540 mg of EAA and TCC supplements, respectively. SMM was the primary outcome parameter.

The mean adherence rate to exercise and supplementation intake over the 24-week intervention period was 86.8% in the RE + EAA + TCC group, 86.4% in the RE + EAA group, and 85.4% in the RE group. A significant group-by-time interaction was identified for SMM (p = 0.010). The pre- to post-intervention increase in SMM was significantly higher in the RE + EAA + TCC group than in the RE group (p = 0.010).

These results suggest that supplementation with EAA and TCC after RE, compared to RE only, improves SMM in older people with sarcopenia. To the best of our knowledge, our study is the first pilot randomized controlled trial to evaluate the effect of TCC supplementation on SMM in older people with sarcopenia.

Supplemental data for this article is available online at http://dx.doi.org/10.1080/07315724.2022.2025546.

The Use of Some Polyphenols in the Modulation of Muscle Damage and Inflammation Induced by Physical Exercise: A Review

Food bioactive compounds (FBC) comprise a vast class of substances, including polyphenols, with different chemical structures, and they exert physiological effects on individuals who consume them, such as antioxidant and anti-inflammatory action. The primary food sources of the compounds are fruits, vegetables, wines, teas, seasonings, and spices, and there are still no daily recommendations for their intake. Depending on the intensity and volume, physical exercise can stimulate oxidative stress and muscle inflammation to generate muscle recovery. However, little is known about the role that polyphenols may have in the process of injury, inflammation, and muscle regeneration. This review aimed to relate the effects of supplementation with mentation with some polyphenols in oxidative stress and post-exercise inflammatory markers. The consulted papers suggest that supplementation with 74 to 900 mg of cocoa, 250 to 1000 mg of green tea extract for around 4 weeks, and 90 mg for up to 5 days of curcumin can attenuate cell damage and inflammation of stress markers of oxidative stress during and after exercise. However, regarding anthocyanins, quercetins, and resveratrol, the results are conflicting. Based on these findings, the new reflection that was made is the possible impact of supplementation associating several FBCs simultaneously. Finally, the benefits discussed here do not consider the existing divergences in the literature. Some contradictions are inherent in the few studies carried out so far. Methodological limitations, such as supplementation time, doses used, forms of supplementation, different exercise protocols, and collection times, create barriers to knowledge consolidation and must be overcome.

Polyphenol Supplementation and Antioxidant Status in Athletes: A Narrative Review

Antioxidants in sports exercise training remain a debated research topic. Plant-derived polyphenol supplements are frequently used by athletes to reduce the negative effects of exercise-induced oxidative stress, accelerate the recovery of muscular function, and enhance performance. These processes can be efficiently modulated by antioxidant supplementation. The existing literature has failed to provide unequivocal evidence that dietary polyphenols should be promoted specifically among athletes. This narrative review summarizes the current knowledge regarding polyphenols' bioavailability, their role in exercise-induced oxidative stress, antioxidant status, and supplementation strategies in athletes. Overall, we draw attention to the paucity of available evidence suggesting that most antioxidant substances are beneficial to athletes. Additional research is necessary to reveal more fully their impact on exercise-induced oxidative stress and athletes' antioxidant status, as well as optimal dosing methods.

Twelve weeks of treadmill exercise training with green tea extract reduces myocardial oxidative stress and alleviates cardiomyocyte apoptosis in aging rat: The emerging role of BNIP3 and HIF-1α/IGFBP3 pathway

In this study, we consider the effect of treadmill exercise training, green tea extract, and combination of exercise training with green tea extract, in aging rat cardiac myocytes apoptosis markers (i.e., HIF-1α, BNIP3, Bax, IGFBP3, Bcl-2, caspase-3, MDA, GPx, Bax/Bcl-2 ratio, and hematoxylin and eosin). Twenty-four rats (male, Wistar) were divided into four groups: (I) control (n = 6), (II) green tea extract (n = 6), (III) exercise (n = 6), and (IV) exercise + green tea extract (n = 6). Exercise groups performed 12 weeks of running on a rodent treadmill at 17-27 m.min^-1 (60-75% vo2peak) for 5 days per week. Green tea extract involved 300 mg.kg^-1 , 5 days per week for 12 weeks. After being euthanized, the blood and heart were collected for glutathione peroxidase (GPx) activity, malondialdehyde (MDA), HIF-1α, BNIP3, insulin-like growth factor-binding protein-3 (IGFBP3), Bax, Bcl-2, caspase-3, Bax/Bcl-2 ratio, and hematoxylin and eosin level measurements. Compared to control, the ANOVA demonstrated significant effects of green tea extract (F = 14.646 to 32.453, p = .009 to .001, η = 0.295 to 0.715) and exercise training (F = 9.213 to 133.828, p = .007 to .001, η = 0.315 to η = 0.870) on HIF-1a, BNIP3, Bax, IGFBP3, Bcl-2, caspase-3, MDA, GPx, and Bax/Bcl-2 ratio. However, the combination of green tea extract and exercise had no effect on the aforementioned apoptosis markers when compared to isolated green tea extract or isolated exercise (F = 0.002 to 4.068, p = .057 to .968, and η = 0.001 to 0.169). PRACTICAL APPLICATIONS: Isolated exercise training and green tea extract may provide a cardioprotective effect on aging-induced apoptosis through the downregulation of HIF-1α, BNIP3, and IGFBP3 in the heart muscle. However, further research is needed to clarify the effects of combining exercise and green tea.

Effects of Polyphenol Consumption on Recovery in Team Sport Athletes of Both Sexes: A Systematic Review

Previous studies have shown that polyphenol consumption enhances recovery of the muscle after exercise-induced muscle damage (EIMD). However, EIMD markers have not been studied by sport type. The main aim of this research was to perform a systematic review to determine the efficacy of polyphenolic consumption in increasing muscle recovery for performing team sport skills. Eligible studies included, following PICOS structure, presented at least one of the following outcomes: maximal isometric voluntary contraction (MVIC); countermovement jump (CMJ); delayed onset muscle soreness (DOMS); 20 m sprint test; creatine kinase (CK); and C-reactive protein (hsCRP). A structured search was carried out following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. The risk of bias was assessed using the PEDro scale tool. The review showed a possibly positive impact of polyphenol consumption on recovery after EIMD in team sports athletes. No differences were found between sexes. Considering the limitations, there is moderate to very low certainty of polyphenol supplementation effects on recovery of team sport females and males. A dose of 60 mL/day, divided into two times per day, ingested for >7 days may present positive effects on muscle function and muscle soreness in team sport athletes. However, further investigation is required, specifically in females.

Influence of 5-Week Snack Supplementation with the Addition of Gelatin Hydrolysates from Carp Skins on Pro-Oxidative and Antioxidant Balance Disturbances (TOS, TAS) in a Group of Athletes

The research objective was to assess the effects of 5-week snack supplementation with added enzymatic hydrolysates from carp skins on shifts in pro-oxidative and antioxidant balance among athletes. The study comprised 49 adults (experimental group (E)—17, placebo (P)—16, control (C)—16) practicing endurance disciplines. Selected somatic indices and maximal oxygen uptake/m (VO2max) were measured. Based on VO2max, an individual exercise intensity was selected with predominating eccentric contractions (60% VO2max). The conducted tests consisted of 2 series (1st—graded and eccentric, 2nd—eccentric). The experimental group consumed a snack with added gelatin hydrolysates from carp skins for 5 weeks in between the series, the placebo—a snack without added hydrolysates, and in the control—no supplementation was implemented. Blood samples were taken before, and 1, 24 and 48 h after completion of the eccentric test. TAS and TOC concentrations in the blood plasma were assessed. No significant changes in TOS/TOC and TAS/TAC concentrations were noted between the 1st and the 2nd test series, before or following the eccentric test in the control and placebo groups. In the measurements performed 1, 24 and 48 h after completion, the observed differences were highly significant (p < 0.001). After 5 weeks of snack consumption, an increase from medium to high antioxidant potential was observed for E. Differences between the 1st and the 2nd test series were of high statistical significance (p < 0.001). The demonstrated differences in pro-oxidative-antioxidant balance indices between successive series allow to confirm antioxidant effects and indicate possibilities for its implementation, not only in sports.

Improvement on blood pressure and skin using roselle drink: A clinical trial

Roselle (Hibiscus sabdariffa L.) is an increasingly attractive plant for its health and pharmaceutical, beverage, and cosmetic applications. The purpose of this study was to investigate the clinical effects of roselle drink on antioxidant activity, blood pressure, and skin condition. Roselle drink used in this study contained rich phenolics (1.96 g of gallic acid equivalent/100 ml) and anthocyanins (1.65 g of cyanidin-3-glucoside equivalent/100 ml). In a randomized, cross-over, double-blind, placebo-controlled clinical study, 39 healthy adults received drank 200 ml of roselle drink or placebo-control drink for 6 months. A significant reduction in the blood pressure was observed in the roselle drink treated group when compared with preintervention values. After 6 months of treatment with roselle drink, serum phenolics contents, the levels of Trolox equivalent antioxidant capacity (TEAC), glutathione, superoxide dismutase (SOD), glucose-6-phosphate dehydrogenase (G-6-PDH), glutathione peroxidase (GSH-Px), and glutathione reductase (GSH-Rd) were significantly increased in healthy subjects. However, a significant increment in skin redness and skin moisture was observed in the facial skin of roselle drink-treated participants. Oral administration of roselle drink for 6 months significantly lowered the blood pressure, improved antioxidation level, and positively regulated skin redness as well as moisture. Phenolics and anthocyanins in roselle could be the major potential contributors to such health effects. PRACTICAL APPLICATIONS: Roselle is a typical plant. Continuous administration of roselle drink clearly improved antioxidation levels, reduced blood pressure and positively regulated skin redness and moisture. Phenloics and anthocyanins in roselle could be the major potentila contributors of such health benefits.

Comparative study of phenolic profile, antioxidant and antimicrobial activities of aqueous extract of white and green tea

The sole difference between white tea (WT) and green tea (GT) is the former that made only from the buds and young leaves of the Camelia sinensis plant, whilst the latter is made from matured tea leaves. The phytochemical profiles, phenolic compounds, antioxidant, and antimicrobial activity of two varieties of Camellia sinensis teas, white and green, were compared in this study. Total antioxidant capacity, reducing power, DPPH radical scavenging, and Fe+2 chelating activities were used to determine antioxidant activities in water extract of GT and WT. The largest level of phenolic content was discovered in WGTE compared with the lowest amount was found in WWTE (290.67 mg/100 g tea and 185.96 mg/100 g tea, respectively). Phenoilc acids (gallic, benzoic, chlorogenic, ellagic, and ρ-coumaric acids) and flavonoids (rutin and kampherol) were found in the two extracts. The findings of DPPH radical scavenging assays were 84.06 and 82.37% inhibition. In vitro antimicrobial activity was indicated that (WWTE and WGTE) had a high level of activity against Staphylococcus aureus, and gave negative activity against Salmonella typhimurium, and Aspergillus Niger. The WT and GT extracts are a great source of natural antioxidants with biological effects on human health.

Beneficial Effects of Flavonoids on Skeletal Muscle Health: A Systematic Review and Meta-Analysis

Skeletal muscle (SkM) is a highly dynamic tissue that responds to physiological adaptations or pathological conditions, and SkM mitochondria play a major role in bioenergetics, regulation of intracellular calcium homeostasis, pro-oxidant/antioxidant balance, and apoptosis. Flavonoids are polyphenolic compounds with the ability to modulate molecular pathways implicated in the development of mitochondrial myopathy. Therefore, it is pertinent to explore its potential application in conditions such as aging, disuse, denervation, diabetes, obesity, and cancer. To evaluate preclinical and clinical effects of flavonoids on SkM structure and function. We performed a systematic review of published studies, with no date restrictions applied, using PubMed and Scopus. The following search terms were used: "flavonoids" OR "flavanols" OR "flavones" OR "anthocyanidins" OR "flavanones" OR "flavan-3-ols" OR "catechins" OR "epicatechin" OR "(-)-epicatechin" AND "skeletal muscle." The studies included in this review were preclinical studies, clinical trials, controlled clinical trials, and randomized-controlled trials that investigated the influence of flavonoids on SkM health. Three authors, independently, assessed trials for the review. Any disagreement was resolved by consensus. The use of flavonoids could be a potential tool for the prevention of muscle loss. Their effects on metabolism and on mitochondria function suggest their use as muscle regulators.

Physiological Effects and Human Health Benefits of Hibiscus sabdariffa: A Review of Clinical Trials

Hibiscus sabdariffa Linn. Malvaceae (HS) is characterized by its edible calyxes. The HS calyxes are widely used for cosmetic, food, and medicinal applications. According to ethnobotanical evidence, decoction, infusion, or maceration extracts from HS calyxes have been used in folk medicine to treat many ailments. Moreover, several in vitro and in vivo studies have demonstrated the pharmacological properties and potential human health benefits of HS consumption. On the other hand, the evaluation of the physiological effects and health benefits of HS in clinical studies is most challenging. Therefore, this narrative review summarizes and discusses the physiological effects and health benefits of HS calyxes reported in clinical trials. Preparations obtained from HS calyxes (extracts, infusions, decoction, teas, beverages, capsules, and pills) are used as non-pharmacological therapies to prevent/control diverse chronic non-communicable diseases. The most-reported HS health benefits are its antihypertensive, antidyslipidemic, hypoglycemic, body fat mass reduction, nephroprotective, antianemic, antioxidant, anti-inflammatory, and anti-xerostomic activities; these effects are associated with the phytochemicals found in HS. Moreover, no adverse effects were reported during the clinical trials. However, clinical studies exhibited some limitations; thus, further studies are required to validate the clinical efficacy of HS in large-scale studies with higher doses and a good experimental design

Effect of Hibiscus syriacus Linnaeus extract and its active constituent, saponarin, in animal models of stress-induced sleep disturbances and pentobarbital-induced sleep

Treatment of sleep disorders promotes the long-term use of commercially available sleep inducers that have several adverse effects, including addiction, systemic fatigue, weakness, loss of concentration, headache, and digestive problems. Therefore, we aimed to limit these adverse effects by investigating a natural product, the extract of the Hibiscus syriacus Linnaeus flower (HSF), as an alternative treatment. In the electric footshock model, we measured anxiety and assessed the degree of sleep improvement after administering HSF extract. In the restraint model, we studied the sleep rate using PiezoSleep, a noninvasive assessment system. In the pentobarbital model, we measured sleep improvement and changes in sleep-related factors. Our first model confirmed the desirable effects of HSF extract and its active constituent, saponarin, on anxiolysis and Wake times. HSF extract also increased REM sleep time. Furthermore, HSF extract and saponarin increased the expression of cortical GABAA receptor α1 (GABAAR α1) and c-Fos in the ventrolateral preoptic nucleus (VLPO). In the second model, HSF extract and saponarin restored the sleep rate and the sleep bout duration. In the third model, HSF extract and saponarin increased sleep maintenance time. Moreover, HSF extract and saponarin increased cortical cholecystokinin (CCK) mRNA levels and the expression of VLPO c-Fos. HSF extract also increased GABAAR α1 mRNA level. Our results suggest that HSF extract and saponarin are effective in maintaining sleep and may be used as a novel treatment for sleep disorder. Eventually, we hope to introduce HSF and saponarin as a clinical treatment for sleep disorders in humans.

Efficacy of Hibiscus sabdariffa on Reducing Blood Pressure in Patients With Mild-to-Moderate Hypertension: A Systematic Review and Meta-Analysis of Published Randomized Controlled Trials

We aimed to assess the efficacy of Hibiscus sabdariffa in patients with mild-to-moderate hypertension or metabolic syndrome (MetS) by comparing it against placebo, antihypertensive drugs, or other herbal products. Four databases were searched for randomized clinical trials (RCTs) examining the efficacy of H. sabdariffa in patients with mild-to-moderate hypertension or hypertension associated with MetS. Data on the change in systolic blood pressure (SBP) and diastolic blood pressure (DBP) were extracted and analyzed using Review Manager Version 5.3. A total of 13 RCTs (1205 participants) were analyzed. Hibiscus sabdariffa significantly reduced both SBP and DBP compared with placebo (mean difference -6.67, P = 0.004 and -4.35 mm Hg, P = 0.02). Subgroup analysis showed that change in SBP and DBP was statistically significant in patients with only hypertension, whereas not significant in patients with hypertension associated with MetS. When H. sabdariffa was compared with active controls (antihypertensive drugs or other herbals), the change in SBP and DBP was not statistically significant (all P > 0.05). Hibiscus sabdariffa is effective in reducing the SBP and DBP in patients with mild-to-moderate hypertension, but was neither effective in those with MetS nor superior to antihypertensive drugs. Further RCTs are required to determine the long-term efficacy of H. sabdariffa and to describe patients who would benefit most from this treatment.

Effectiveness of green tea extract (Camellia sinensis) capsule supplementation on post-exercise muscle recovery in healthy adults: a systematic review protocol

OBJECTIVE

The objective of the review is to evaluate the effectiveness of green tea extract (Camellia sinensis) capsule supplementation compared with placebo on post-exercise muscle pain and muscle recovery in healthy adults.

INTRODUCTION

Green tea extract is popularly consumed by athletes and practitioners of physical activity, as it is easily accessible in supermarkets and health food stores. It is a source of catechins, which assist the endogenous antioxidant system in combating free radicals produced during exercise that can lead to oxidative stress and, therefore, muscle damage and delayed-onset muscle pain. However, there is no consensus on the effect of green tea extract and the ideal and safe dosage to promote muscle recovery.

INCLUSION CRITERIA

Studies on the effectiveness of supplementation with green tea extract capsules compared with placebo in post-exercise muscle pain and muscle recovery in healthy adults will be included. Studies that are associated with any other source of polyphenols with green tea extract will be excluded.

METHODS

Studies will be identified using the following databases: Cochrane Library, PubMed, Embase, Web of Science, Virtual Health Library, SPORTDiscus, Science Direct, and Scopus. OpenGrey, DART-Europe, and Google Scholar will be used to identify unpublished studies. Two authors will independently screen titles and abstracts following previously defined eligibility criteria. After excluding irrelevant studies, the authors will read the full texts of any articles potentially eligible for further evaluation. Any disagreements will be resolved by discussion or by consulting a third author. The included studies will be assessed on their methodological quality using the appropriate JBI critical appraisal checklist, and the data will be extracted by the two authors. A meta-analysis will be performed using a random effects or fixed effects model. The heterogeneity of the data will be calculated. This review will follow the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) to classify the certainty of the evidence.

SYSTEMATIC REVIEW REGISTRATION NUMBER

PROSPERO CRD42020138772.

An Overview on How Exercise with Green Tea Consumption Can Prevent the Production of Reactive Oxygen Species and Improve Sports Performance

Free radicals are reactive products that have multiple effects on the human body. Endogenous and exogenous antioxidants manage the overproduction of free radicals. However, an imbalance between free radicals and antioxidant factors causes oxidative stress. Exercise and physical activity are factors that increase oxidative stress and disrupts the body’s homeostasis. Intensity and duration of training, training characteristics, and fitness level can have positive or negative effects on oxidative stress. Green tea consumption is recommended for the prevention of a variety of diseases, health maintenance, and weight loss. The effectiveness of green tea is primarily due to the presence of catechins and polyphenols, specifically (–)-epigallocatechin-3-gallate, which has antioxidant and anti-inflammatory properties based on clinical and animal studies. This review investigates the effect of green tea exercise and their interactive effects on free radicals and sports improvement.

Ergogenic Effects of Green Tea Combined with Isolated Soy Protein on Increasing Muscle Mass and Exercise Performance in Resistance-Trained Mice

It is well known that supplementation with high protein after exercise can effectively promote muscle synthesis and repair, while green tea is rich in catechins that have antioxidant effects. We aimed to explore the effects of green tea combined with isolated soy protein on increase muscle mass in resistance-trained mice. A total of 32 male ICR mice (8-weeks old) were divided into four groups (n = 8/group), sedentary control group (SC), isolated soy protein with green tea group (ISPG), resistance training group (RT), isolated soy protein and green tea combine with resistance training group (ISPG + RT). All mice received control or ISPG by oral gavage for four consecutive weeks. Forelimb grip and exhaustive swimming time were used for exercise performance evaluation. In biochemical profile, we analyzed lactate, ammonia, blood urea nitrogen (BUN), and glucose and muscle damage index creatine kinase (CK) after exercise as biochemical parameters of exercise fatigue. The grip strength, muscular endurance, and exhaustive swimming time of the ISPG + RT group were significantly increased than other groups (p < 0.05), and also significantly decreased in serum lactate and ammonia levels (p < 0.05, respectively). The ISP + RT group was not only increased in quadriceps weight, (p < 0.05) but also decreased EFP (p < 0.05). We recommend using a 4-week supplementation with ISPG, combined with RT, to increase muscle mass, exercise performance, glycogen storage, and reduce fatigue biochemical parameters after exercise. The benefits of long-term supplementation or application to human supplementation can be further explored in the future.

Roselle for hypertension in adults

BACKGROUND

Hypertension is considered to be a serious health problem worldwide. Controlling and lowering blood pressure are of significant benefit to people with hypertension because hypertension is a risk factor for stroke, heart disease, and cardiovascular disease. Roselle, the tropical plant Hibiscus sabdariffa, also commonly called sour tea or red tea, has been used as both a thirst-quenching drink and for medicinal purposes.

OBJECTIVES

To assess the effect of Roselle on blood pressure in people with primary hypertension.

SEARCH METHODS

For this update, the Cochrane Hypertension Information Specialist searched the following databases and trials registers for randomised controlled trials (RCTs): the Cochrane Hypertension Specialised Register (to 6 August 2021), Cochrane Central Register of Controlled Trials (CENTRAL; 2021, Issue 7), MEDLINE Ovid (1946 to 5 August 2021), Embase Ovid (1974 to 5 August 2021), ProQuest Dissertations & Theses (to 6 August 2021), Web of Science Clarivate (to 7 August 2021), Food Science and Technology Abstracts Clarivate (to 7 August 2021), the WHO International Clinical Trials Registry Platform (to 6 August 2021), and the US National Institutes of Health Ongoing Trials Register ClinicalTrials.gov (to 6 August 2021). We searched Google Scholar and OpenSIGLE. We also handsearched local and regional Chinese databases: CBM, CMCC, TCMLARS, CNKI, CMAC, and the Index to Chinese Periodical Literature (to 14 September 2020), as well as Thai databases (ThaiJO, CUIR, TDC, CMU e-Theses, TCTR) (to 3 October 2020). There were no language or publication date restrictions.

SELECTION CRITERIA

We sought RCTs evaluating the use of any forms of Roselle with placebo or no treatment in adults with hypertension. Our primary outcome was change in trough and/or peak systolic and diastolic blood pressure (SBP, DBP). Secondary outcomes were withdrawals due to adverse effects, change in pulse pressure, and change in heart rate.

DATA COLLECTION AND ANALYSIS

All search results were managed using Covidence and re-checked for the number of records, inclusion and exclusion of studies with Mendeley reference management software. We used standard methodological procedures expected by Cochrane. Two review authors worked independently in parallel for screening (titles and abstracts, and full reports), data extraction, risk of bias assessment, and assessment of the certainty of the evidence using the GRADE approach. Any disagreements were resolved by discussion or by consultation with the third review author if necessary. We presented mean difference (MD) of change in SBP and DBP with their corresponding 95% confidence interval (CI).

MAIN RESULTS

For this update, only one RCT with a parallel-group design involving 60 participants with type 2 diabetes mellitus fulfilled the inclusion criteria. This study investigated the effect of Roselle extract capsules (total dose of 5600 mg) compared with placebo (lactose) at eight weeks. The study was at low risk of selection bias, performance bias, and detection bias. Conversely, it was at high risk of attrition bias, reporting bias, and other bias (baseline imbalance). We have very little confidence in the effect estimate of Roselle on change-from-baseline in both SBP and DBP between the two groups. The MD of change in SBP was 1.65, 95% CI -7.89 to 11.19 mmHg, 52 participants, very low-certainty evidence. The MD of change in DBP was 4.60, 95% CI -1.38 to 10.58 mmHg, 52 participants, very low-certainty evidence. Our secondary outcomes of withdrawals due to adverse effects, change in pulse pressure, and change in heart rate were not reported. Due to the limited available data, no secondary analyses were performed (subgroup and sensitivity analysis).

AUTHORS' CONCLUSIONS

The evidence is currently insufficient to determine the effectiveness of Roselle compared to placebo for controlling or lowering blood pressure in people with hypertension. The certainty of evidence was very low due to methodological limitations, imprecision, and indirectness. There is a need for rigorous RCTs that address the review question.

Physicochemical properties of and volatile compounds in riboflavin fortified cloudy apple juice; study of its effect on job fatigue among Egyptian construction workers

Fatigue and rapid exhaustion are common complaints among construction workers, as a result of high-effort levels, physical overexertion, weather and long physically demanding work hours. This study aimed to fortify cloudy apple juice with riboflavin (vitamin B2) to evaluate changes in chemical composition, antioxidant activity and volatile compounds in the fortified juice and to study its effect on the volunteer construction workers complaining of fatigue resulting from demanding physical duties. Analysis of volatile compounds in the fortified cloudy apple juice using Gas Chromatography and Gas Chromatography-Mass Spectrometry identified thirty-four volatile compounds including esters, alcohols, aldehydes and acids. The most predominant volatile compounds were alcohols followed by esters in both the control and fortified samples. We studied the effect of the supplementation of riboflavin-fortified cloudy apple juice versus conventional cloudy apple juice on the anthropometric parameters, the scores of two fatigue questionnaires (Checklist Individual Strength and Fatigue Severity Scale) and antioxidants biomarkers among young Egyptian male construction workers. This study revealed that consumption of 1.3 mg of riboflavin-fortified cloudy apple juice per day for twenty-eight days significantly improved their metabolism, with a decrease in mean body fat percentage and an increase in body muscle mass without statistically significant differences, the fortified juice significantly improved the fatigue questionnaires' scores. Moreover, the fortified supplement had a substantial change in antioxidant activity; there was significant increase in the plasma total antioxidant capacity (+74.19 %change) and catalase enzyme (+54.65 %change) with a significant decrease in the serum malondialdehyde level (−53.78 %change). When compared to the administration of conventional cloudy apple juice, although there was a significant decrease in serum malondialdehyde level (−4.63 %change) at the end of the study, only the subjective fatigue subscale of the CIS fatigue score significantly decreased among the construction workers (−24.61 %change). It could be concluded that vitamin B2 fortified-cloudy apple juice was effective in the reduction of fatigue and exhaustion in the study's subjects.

Effect of Green Tea Supplementation on Antioxidant Status in Adults: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

It is well-established that green tea supplementation has antioxidant properties. However, whether green tea supplementation leads to oxidative stress reduction remains unclear, as clinical investigations on this subject have yielded inconsistent outcomes. Consequently, we aimed to determine the effects of green tea supplementation on oxidative stress in adults. A systematic search of English language publications up to 21 August 2021 was carried out in PubMed, Scopus, Embase, and ISI Web of Science, utilizing pertinent keywords. These searches included randomized controlled trials (RCTs) evaluating the relationship between green tea supplementation, malondialdehyde (MDA), and total antioxidant capacity (TAC) in adults. A random-effects model was used to estimate the weighted mean difference (WMD) and 95% confidence intervals (95% CI). Meta-regression and non-linear dose-response analyses were performed to investigate the association between the dosage of green tea (mg/day) and the duration of the intervention (weeks) with pooled effect size. Sixteen RCTs with seventeen arms including 760 participants met the inclusion criteria. Our results indicated that green tea supplementation had significant effects on TAC (weighted mean difference [WMD]: 0.20 mmol/L; 95% CI: 0.09, 0.30, p < 0.001) and significant heterogeneity between studies (I² = 98.6%, p < 0.001), which was largely related to gender and body mass index (BMI). Subgroup analysis in TAC identified a significant relationship except with low dose supplementation and obese individuals. No relationship between MDA and green tea supplementation was observed in any subgroups; however, meta-regression analysis revealed a linear inverse association between the dosage and significant change in MDA (r = −2117.18, p = 0.017). Our outcomes suggest that green tea supplementation improves TAC and affects MDA based on the dose of the intervention in adults. Future RCTs with longer durations are needed to expand our findings.

The effect of leaf extract supplementation on exercise-induced muscle damage and muscular performance: A systematic review and meta-analysis

This systematic review and meta-analysis investigated the effects of leaf-plant extracts typically used for tea beverages on the level of exercise-induced muscle damage. The meta-analysis was conducted by comparing measures between the leaf-extract supplements (SUPP) and placebo (PLA) conditions at 24 h and 48 h following the muscle-damaging protocols from 19 studies with 416 participants. The results showed that the SUPP condition exhibited significantly lower indirect muscle damage markers than the PLA condition at 24- and 48-h post-exercise (p < 0.05). Furthermore, oxidative stress markers were significantly lower for the SUPP condition than the PLA condition at 24-h post-exercise (p < 0.05), although not at 48-h post-exercise (p > 0.05). In addition, no differences were found for anti-oxidant status at 24- and 48-h post-exercise (p > 0.05) between conditions. Muscle performance measures significantly increased for the SUPP condition than the PLA condition at 24-h post-exercise (p < 0.05), but not at 48-h post-exercise (p > 0.05). These results demonstrate that leaf plant extracts reduces the level of various biomarkers indicative of exercise-induced stress, although its effect on anti-oxidant status remains equivocal. Nonetheless, leaf-plant extracts typically ingested as a tea beverage may be an effective recovery strategy following strenuous exercises.

Does Flavonoid Consumption Improve Exercise Performance? Is It Related to Changes in the Immune System and Inflammatory Biomarkers? A Systematic Review of Clinical Studies since 2005

Flavonoids are attracting increasing attention due to their antioxidant, cardioprotective, and immunomodulatory properties. Nevertheless, little is known about their role in exercise performance in association with immune function. This systematic review firstly aimed to shed light on the ergogenic potential of flavonoids. A search strategy was run using SCOPUS database. The returned studies were screened by prespecified eligibility criteria, including intervention lasting at least one week and performance objectively quantified, among others. Fifty-one studies (54 articles) met the inclusion criteria, involving 1288 human subjects, either physically untrained or trained. Secondly, we aimed to associate these studies with the immune system status. Seventeen of the selected studies (18 articles) assessed changes in the immune system. The overall percentage of studies reporting an improved exercise performance following flavonoid supplementation was 37%, the proportion being 25% when considering quercetin, 28% for flavanol-enriched extracts, and 54% for anthocyanins-enriched extracts. From the studies reporting an enhanced performance, only two, using anthocyanin supplements, focused on the immune system and found certain anti-inflammatory effects of these flavonoids. These results suggest that flavonoids, especially anthocyanins, may exert beneficial effects for athletes’ performances, although further studies are encouraged to establish the optimal dosage and to clarify their impact on immune status.

Redox biomarkers in dietary interventions and nutritional observation studies - From new insights to old problems

Purpose

The purpose of this review is to give an overview on recently published articles investigating the associations of diet and dietary interventions with biomarkers of oxidative stress with special emphasis on different categories of redox biomarkers.

Findings

Intervention and observational studies both in healthy participants and patients that investigated associations of dietary habits, foodstuffs or isolated nutrients with biomarkers of oxidative stress were included in this review. Recently published observation studies confirm the inverse association between fruit and vegetable intake and oxidative stress markers. Studies investigating the effect of vitamin D and vitamin E, magnesium, zinc, chromium, selenium, probiotic supplementation and several phytochemicals reported consistent changes in redox biomarkers. Of 88 articles included in this review, only seven studies measured biomarkers from the three categories: oxidative damage, endogenous antioxidants, and exogenous antioxidants. Many studies rely on controversial assays for total antioxidant capacity, thus there is potential in many studies to improve biomarker repertoire to cover all three categories of biomarkers and to turn away from such assays.

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Oxidative stress can be assessed by specific biomarker categories.

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Three biomarker categories: oxidative damage, endogenous, exogenous antioxidants.

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Only seven studies performed measurements of all three biomarker categories.

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TAC, TRAP, FRAP, ORAC should not be used as stand-alone redox marker.

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Several interventions reported improvements in markers of oxidative stress.

Effects of grape juice consumption on oxidative stress and inflammation in male volleyball players: A randomized, double-blind, placebo-controlled clinical trial

INTRODUCTION

Some foods are also demonstrated benefits, such as anti-inflammatory, antioxidant, and ergogenic activity, similar to that of sports supplements. Grape juice has been considered an important source of polyphenols and these compounds could promote positive effects to the sports players. In this sense, the objective was to evaluate the effects of purple grape juice consumption on indicators of oxidative stress, inflammation, muscle damage, global histone H4 acetylation levels, and muscle strength and muscle power in volleyball athletes.

METHODS

This is a randomized double-blind clinical trial in which 12 male volleyball players (16 ± 0.6 years old) participated in three different moments with match simulation: control (without beverage) (WB), grape juice (GJ) and placebo (PLA) (400 mL/day of grape juice or placebo (maltodextrin) for 14 days in a cross-over model). Before and immediately after each match, blood collection for analysis of indicators of systemic redox status, systemic concentrations of Interferon-γ (IFN- γ) and Interleukin-4 (IL-4), muscle damage, by Creatine Kinase (CK-NAC) and levels of global histone H4 acetylation were performed, as well as handgrip strength (HG) and lower limb power tests.

RESULTS

Consumption of grape juice significantly reduced lipid peroxidation (p = 0.04) and Deoxyribonucleic Acid (DNA) damage (p = 0.01) after the match. IFN-γ levels, IL-4, CK-NAC, and histone H4 acetylation post-match did not alter with the grape juice consumption. Lower limb power improved after acute exercise in WB and GJ conditions (p < 0.001).

CONCLUSION

In this pilot trial, the intake of grape juice for two weeks seems to reduce the protein oxidation and DNA damage by intermittent physical exercise, without epigenetics influence.

Impacts of Green Tea on Joint and Skeletal Muscle Health: Prospects of Translational Nutrition

Osteoarthritis and sarcopenia are two major joint and skeletal muscle diseases prevalent during aging. Osteoarthritis is a multifactorial progressive degenerative and inflammatory disorder of articular cartilage. Cartilage protection and pain management are the two most important strategies in the management of osteoarthritis. Sarcopenia, a condition of loss of muscle mass and strength, is associated with impaired neuromuscular innervation, the transition of skeletal muscle fiber type, and reduced muscle regenerative capacity. Management of sarcopenia requires addressing both skeletal muscle quantity and quality. Emerging evidence suggests that green tea catechins play an important role in maintaining healthy joints and skeletal muscle. This review covers (i) the prevalence and etiology of osteoarthritis and sarcopenia, such as excessive inflammation and oxidative stress, mitochondrial dysfunction, and reduced autophagy; (ii) the effects of green tea catechins on joint health by downregulating inflammatory signaling mediators, upregulating anabolic mediators, and modulating miRNAs expression, resulting in reduced chondrocyte death, collagen degradation, and cartilage protection; (iii) the effects of green tea catechins on skeletal muscle health via maintaining a dynamic balance between protein synthesis and degradation and boosting the synthesis of mitochondrial energy metabolism, resulting in favorable muscle homeostasis and mitigation of muscle atrophy with aging; and (iv) the current study limitations and future research directions.

The regulatory role of dietary factors in skeletal muscle development, regeneration and function

Skeletal muscle plays a crucial role in motor function, respiration, and whole-body energy homeostasis. How to regulate the development and function of skeletal muscle has become a hot research topic for improving lifestyle and extending life span. Numerous transcription factors and nutritional factors have been clarified are closely associated with the regulation of skeletal muscle development, regeneration and function. In this article, the roles of different dietary factors including green tea, quercetin, curcumin (CUR), eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and resveratrol (RES) in regulating skeletal muscle development, muscle mass, muscle function, and muscle recovery have been summarized and discussed. We also reviewed the potential regulatory molecular mechanism of these factors. Based on the current findings, dietary factors may be used as a potential therapeutic agent to treat skeletal muscle dysfunction as well as its related diseases.

Effect of sour tea supplementation on liver enzymes, lipid profile, blood pressure, and antioxidant status in patients with non-alcoholic fatty liver disease: A double-blind randomized controlled clinical trial

The aim of this study was to evaluate the efficacy of sour tea supplementation in patients with nonalcoholic fatty liver disease (NAFLD). Seventy NAFLD patients were enrolled in this randomized, double-blind, placebo-controlled clinical trial. Participants received sour tea in the form of a 450 mg capsule or a placebo capsule daily for 8 weeks. Anthropometric indices, liver enzymes, lipid profile, blood pressure, and antioxidant status were evaluated at the baseline and at the end of the study. Sixty-one participants completed the study. After 8 weeks, sour tea administration significantly decreased serum triglyceride (TG) (p = .03), alanine aminotransferase (ALT) (p = .01), and aspartate aminotransferase (AST) (p = .004) levels compared with the placebo. In addition, sour tea supplementation resulted in a significant reduction in systolic blood pressure (SBP) (p = .03) and diastolic blood pressure (DBP) (p = .04), and a significant increase in serum total antioxidant capacity (TAC) levels (p ˂ .001) compared with the placebo. However, no significant changes in anthropometric measures, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c), and high-density lipoprotein cholesterol (HDL-c) levels were observed after sour tea supplementation compared with the placebo (p > .05). Sour tea supplementation may be effective in improving serum TG, liver enzymes, and blood pressure in patients diagnosed with NAFLD. Further studies are needed to address the exact mechanism of action of these effects.

The efficacy of sour tea (Hibiscus sabdariffa L.) on selected cardiovascular disease risk factors: A systematic review and meta-analysis of randomized clinical trials

This study sought to summarize clinical evidence of sour tea (Hibiscus sabdariffa L.) administration on cardiovascular disease risk factors. PubMed, Scopus, Institute for Scientific Information Web of Science, and Google Scholar were systematically searched from inception to June 2019 to identify randomized clinical trials, which assessed the effect of sour tea consumption on lipid profiles, fasting plasma glucose, and blood pressure in adult populations. Mean and standard deviation for each parameter were extracted to calculate effect size. Cochrane Collaboration tools were used to evaluate risk of bias assessment. A total of seven randomized clinical trials consisting 362 participants were included in the meta-analysis. Pooled effect size demonstrated that sour tea consumption significantly reduces fasting plasma glucose (-3.67 mg/dl, 95% confidence interval, CI [-7.07, -0.27]; I² = 37%), systolic blood pressure (-4.71 mmHg, 95% CI [-7.87, -1.55]; I² = 53%), and diastolic blood pressure (-4.08 mmHg, 95% CI [-6.48, -1.67]; I² = 14%). Although no significant effect was observed on triacylglycerol, total cholesterol, and high-density lipoprotein cholesterol following sour tea consumption, a trend toward a significant reduction was found in low-density lipoprotein cholesterol serum concentrations (p = 0.08). This systematic review and meta-analysis suggests that sour tea consumption could have beneficial effect in controlling glycemic status and blood pressure among adult population.

The Effect of Thiamine Concentration on the Antioxidative Activity Indices in Tea Extracts

The aim of the study was to determine correlations between the concentration of thiamine in systems and indicators of the antioxidative activity of ethanol tea extracts in the presence of soybean oil. Variability of the thiamine form was assumed by comparison of the influence of thiamine hydrochloride or thiamine pyrophosphate and fermentation of ethanol tea extracts. The study provides practical knowledge about the antioxidative activity of ethanol tea extracts in products containing fat and thiamine. The study showed that all tea extracts exhibited higher antioxidative activity in the presence of thiamine amounts of 0.1 and 0.8 mg/100 g. The antioxidative activity of ethanol tea extracts was significantly reduced when the concentrations were higher than the natural level for foods (over 1.0 mg/100 g). The systems containing white tea extract were the most vulnerable, whereas those with black tea were the least vulnerable. The presence of thiamine pyrophosphate in the system was more strongly correlated with reduced activity of the extracts than the presence of thiamine hydrochloride.

The role of nutraceuticals in prevention and treatment of hypertension: An updated review of the literature

Hypertension (HTN) is a worldwide epidemic in both developed and developing countries. It is one of the leading causes of major health problems such as cardiovascular disease, stroke, and heart attack. In recent years, several studies have reported associations between specific dietary ingredients and improving HTN. Nutraceuticals are natural food components with pharmacological properties. Reports suggest that functional foods and nutraceutical ingredients might support patients to obtain the desired therapeutic blood pressure (BP) goals and reduce cardiovascular risks by modulating various risk factors such as oxidative stress, renin-angiotensin system hyperactivity, inflammation, hyperlipidemia, and vascular resistance. We review the recent clinical experiments that have evaluated the biological and pharmacological activities of several types of nutraceuticals, including sour tea, cocoa, common spices, vitamin C, vitamin E, lycopene, flavonoids, coenzyme Q10, milk's tripeptides, calcium, magnesium, polyunsaturated fatty acids, and prebiotics in preventing and treating HTN. This review summarizes recent knowledge about the impact of common nutraceuticals for the regulation of BP.

Impairment between Oxidant and Antioxidant Systems: Short- and Long-term Implications for Athletes' Health

The role of oxidative stress, an imbalance between reactive oxygen species production (ROS) and antioxidants, has been described in several patho-physiological conditions, including cardiovascular, neurological diseases and cancer, thus impacting on individuals' lifelong health. Diet, environmental pollution, and physical activity can play a significant role in the oxidative balance of an organism. Even if physical training has proved to be able to counteract the negative effects caused by free radicals and to provide many health benefits, it is also known that intensive physical activity induces oxidative stress, inflammation, and free radical-mediated muscle damage. Indeed, variations in type, intensity, and duration of exercise training can activate different patterns of oxidant-antioxidant balance leading to different responses in terms of molecular and cellular damage. The aim of the present review is to discuss (1) the role of oxidative status in athletes in relation to exercise training practice, (2) the implications for muscle damage, (3) the long-term effect for neurodegenerative disease manifestations, (4) the role of antioxidant supplementations in preventing oxidative damages.

Green tea as a safe alternative approach for nonalcoholic fatty liver treatment: A systematic review and meta-analysis of clinical trials

This study aimed to evaluate the efficacy of green tea supplementation on nonalcoholic fatty liver disease treatment. Electronic databases, including PubMed, Scopus, Web of Science, and Google Scholar, were systematically searched up to October 30, 2017, to identify eligible trials based on the inclusion criteria. The effect size was presented as mean difference with 95% confidence intervals (CI). The meta-analysis of data from four studies indicated significant effects of green tea supplementation in altering alanine aminotransferases (-12.81 U/L; 95% CI: -18.17 to -7.45) and aspartate aminotransferases (-10.91 U/L; 95% CI: -19.66 to -2.17) blood concentrations. Likewise, a favorable effect of green tea administration was observed on body mass index (-2.08 kg/cm² ; 95% CI: -2.81 to -1.36), triacylglycerol (-31.87 mg/dl; 95% CI: -40.62 to -23.12), total cholesterol (-27.57 mg/dl; 95% CI: -36.17 to -18.98), and low-density lipoprotein cholesterol (-14.15 mg/dl; 95% CI: -23.69 to -4.60), whereas no significant effect was detected on high-density lipoprotein cholesterol concentrations (7.41 mg/dl; 95% CI: -1.49 to 16.30) and homeostasis model assessment of insulin resistance (-4.06; 95% CI: -10.22 to 2.09). This systematic review and meta-analysis of available trials suggests that there  are potential benefits of green tea supplementation on nonalcoholic fatty liver disease.

Roselle for hypertension in adults

BACKGROUND

Hypertension is considered a serious health problem worldwide. Controlling and lowering blood pressure have a significant benefit to the hypertensive patients because hypertension is a risk factor for stroke, heart disease and cardiovascular disease. A tropical plant called Roselle, or Red Sorrel in English-speaking countries, has been used both as a thirst-quenching drink and for medical purposes.

OBJECTIVES

To explore the effect of Roselle on blood pressure in hypertensive adult patients.

SEARCH STRATEGY

The following databases were searched (Date of most recent search was September 2009): - Cochrane Database of Systematic Reviews (2nd Quarter 2009) - DARE (2nd Quarter 2009) - Ovid MEDLINE (1950 to Present with Daily Update) - EMBASE (1980 to 2009 Week 22) - AMED (1985 to May 2009) - EBSCO CINAHL - BIOSIS (1969 to 2008) - AGRICOLA (1970 to May 2009) - Food Science and Technology Abstract (1969 to 2009 June Week 1) - International Pharmaceutical Abstracts - International Bibliographic Information on Dietary Supplements - Clinical Trials.gov and Current Controlled Trials - OpenSIGLE - Hand searching of journals - ISI Web of Knowledge

SELECTION CRITERIA

We sought randomised control trials (RCTs) evaluating use of any forms of Roselle with placebo or no treatment in hypertensive patients. Change in trough and/or peak systolic and diastolic blood pressure were primary outcomes. Secondary outcomes were withdrawals due to adverse effects, change of pulse pressure and change of heart rate.

DATA COLLECTION AND ANALYSIS

Two review authors (C Ngamjarus, CN and P Pattanittum, PP) independently scanned titles and abstracts, as well as independently screened the full reports of the potentially relevant studies. At each stage, the results were compared and disagreements were solved by discussion.

MAIN RESULTS

No studies were identified that met the inclusion criteria. However, one abstract of an ongoing study is likely to meet the inclusion criteria, when completed.

AUTHORS' CONCLUSIONS

There is insufficient evidence to support the benefit of Roselle for either controlling or lowering blood pressure in patients with hypertension. Based on the information of this review, there is a clear need to develop well-designed studies to assess the efficacy of Roselle on hypertensive patients.