Does Japanese Citrus Fruit Yuzu (Citrus junos Sieb. ex Tanaka) Fragrance Have Lavender-Like Therapeutic Effects That Alleviate Premenstrual Emotional Symptoms? A Single-Blind Randomized Crossover Study

The Effects of Essential Oils on the Nervous System: A Scoping Review

Essential oils are a mixture of natural aromatic volatile oils extracted from plants. The use of essential oils is ancient, and has prevailed in different cultures around the world, such as those of the Egyptians, Greeks, Persians, and Chinese. Today, essential oils are used in traditional and complimentary medicines, aromatherapy, massage therapies, cosmetics, perfumes and food industries. The screening effect of essential oils has been studied worldwide. They demonstrate a range of biological activities, such as antiparasitic, antifungal, antibacterial, antiviral, antioxidant, anti-inflammatory, anticancer, antiaging, and neuroprotective properties. In this scoping review, we provide a 10-year updated comprehensive assessment of volatile oils and their effects on the nervous system. MEDLINE, Scopus, and Google Scholar were systematically and strategically searched for original studies investigating these effects from 2012 to 2022. Approximately seventy studies were selected as included studies. Among these studies, several outcomes were reported, including antistress, antianxiety, analgesic, cognitive, and autonomic effects. Some essential oils showed developmental benefits, with the potential to induce neurite outgrowth. The neurotransmitter receptor level can also be modified by essential oil application. Physiological and pathophysiological outcome measures were reported. For physiological outcomes, arousal, cognitive performance, circadian eating behavior, emotional modulation, consumer acceptance, preferences, and willingness to buy were investigated. For pathophysiological conditions, pain, depression, anxiety, stress, sleep disorder, mental fatigue, agitated behavior, and quality of life were measured. In conclusion, essential oils showed promising effects on the nervous system, which can be further applied to their use in functional foods, drinks, and alternative therapy.

Citrus By-Products: Valuable Source of Bioactive Compounds for Food Applications

Citrus production produces about 15 million tons of by-products/waste worldwide every year. Due to their high content of bioactive compounds, several extraction techniques can be applied to obtain extracts rich in valuable compounds and further application into food applications. Distillation and solvent extraction continues to be the most used and applied extraction techniques, followed by newer techniques such as microwave-assisted extraction and pulsed electric field extraction. Although the composition of these extracts and essential oils directly depends on the edaphoclimatic conditions to which the fruit/plant was exposed, the main active compounds are D-limonene, carotenoids, and carbohydrates. Pectin, one of the most abundant carbohydrates present in Citrus peels, can be used as a biodegradable polymer to develop new food packaging, and the extracted bioactive compounds can be easily added directly or indirectly to foods to increase their shelf-life. One of the applications is their incorporation in active food packaging for microbiological and/or oxidation inhibition, prolonging foods' shelf-life and, consequently, contributing to reducing food spoilage. This review highlights some of the most used and effective extraction techniques and the application of the obtained essential oils and extracts directly or indirectly (through active packaging) to foods.

Essential Oils, Phytoncides, Aromachology, and Aromatherapy—A Review

Chemical compounds from plants have been used as a medicinal source for various diseases. Aromachology is a unique field that studies the olfactory effects after inhaling aromatic compounds. Aromatherapy is a complementary treatment methodology involving the use of essential oils containing phytoncides and other volatile organic compounds for various physical and mental illnesses. Phytoncides possess an inherent medicinal property. Their health benefits range from treating stress, immunosuppression, blood pressure, respiratory diseases, anxiety, and pain to anti-microbial, anti-larvicidal, anti-septic, anti-cancer effects, etc. Recent advancements in aromatherapy include forest bathing or forest therapy. The inhalation of phytoncide-rich forest air has been proven to reduce stress-induced immunosuppression, normalize immune function and neuroendocrine hormone levels, and, thus, restore physiological and psychological health. The intricate mechanisms related to how aroma converts into olfactory signals and how the olfactory signals relieve physical and mental illness still pose enormous questions and are the subject of ongoing research. Aromatherapy using the aroma of essential oils/phytoncides could be more innovative and attractive to patients. Moreover, with fewer side effects, this field might be recognized as a new field of complementary medicine in alleviating some forms of physical and mental distress. Essential oils are important assets in aromatherapy, cosmetics, and food preservatives. The use of essential oils as an aromatherapeutic agent is widespread. Detailed reports on the effects of EOs in aromatherapy and their pharmacological effects are required to uncover its complete biological mechanism. This review is about the evolution of research related to phytoncides containing EOs in treating various ailments and provides comprehensive details from complementary medicine.

Aromatherapy in Nursing and Midwifery Practice: A Scoping Review of Published Studies Since 2005

Background: Since the 1990's aromatherapy has been a popular adjunct to nursing and midwifery care in a variety of health care settings. Objective: The scoping review seeks to identify and confirm the benefits of incorporating aromatherapy into holistic nursing and midwifery practice Design: A scoping review using PRISMA-ScR of experimental studies where care is provided to the patient by a registered nurse or midwife. Settings and participants: Any health care setting where nurses or midwives provide care. Review Methods: A multi- engine search using a range of MeSH and non-MeSH terms with the Boolean search [AND]. Inclusion criteria were; publication date from 2005-2021, study involved aromatherapy as an intervention, conducted in a clinical nursing or midwifery environment and the published article is available in full in English. Excluded were; single patient cases, animal studies, in vitro studies, use of essential oils internally or a whole plant extract was used or use was non-nursing/midwifery related. Results: 124 studies met the inclusion criteria (n = 19188), classified into seven themes. Conclusion: The evidence supports the use of aromatherapy within a range of nursing and midwifery practices enhancing a holistic model of care. Impact: This scoping review contributes evidence to support the inclusion of aromatherapy into holistic nursing and midwifery practice.

The Effects of Aromatherapy on Premenstrual Syndrome Symptoms: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

ObjectivesPremenstrual syndrome (PMS) is a common disturbance among women of childbearing age. Aromatherapy is a commonly used form of complementary and alternative medicine (CAM) to treat PMS. The purpose of this study is to quantify and summarize the effects of aromatherapy on premenstrual syndrome symptoms. Methods. PubMed, Scopus, and Cochrane Library databases were searched through relevant search terms until October 2020. The effect sizes were pooled as weighted mean difference (WMD) and 95% confidence interval (CI) using the random effect model. Egger tests and visual inspection of the funnel plot were performed to identify the existence of publication bias. The I-squared (I²) test was applied to measure heterogeneity. Results. Eight studies (n = 8) were included in this analysis. The quantitative synthesis of evidence found that aromatherapy decreases PMS scores (WMD –13.83; 95% CI (−22.04, −5.63), I² = 94.5%), total psychological symptoms of PMS (WMD –3.51; 95% CI (−4.84, −2.18), I² = 82.6%), anxiety of PMS (WMD–1.78; 95% CI (−3.17, −0.38), I² = 94.2%), depression of PMS (WMD–2.0; 95% CI (−3.65, −0.34), I² = 93.7%), and fatigue of PMS (WMD – 1.44; 95% CI (−2.44, −0.44), I² = 89.7%) compared to the control group. Conclusion. Aromatherapy is an effective tool for the relief of PMS symptoms. Additional randomized controlled clinical trials with different durations and essential oils should be conducted to confirm our findings.

Effects of lavender on anxiety: A systematic review and meta-analysis

BACKGROUND

Anxiety is one of the uprising psychiatric disorders of the last decades and lavender administration has been traditionally suggested as a possible treatment. The objective of this review is to assess the efficacy of lavender, in any form and way of administration, on anxiety and anxiety-related conditions.

METHODS

The PRISMA guidelines were followed. Retrieved data were qualitatively and quantitatively synthesized. Randomized Controlled Trials (RCTs) and Non-Randomized Studies (NRSs) which investigated the efficacy of lavender, in any form and way of administration, on patients with anxiety, involved in anxiety-inducing settings or undergoing anxiety-inducing activities, compared to any type of control, without language restrictions, were identified through electronic database searches. Medline via PubMed, Scopus, Web of Science, Cochrane Library, EMBASE, and Google Scholar were systematically searched. All databases were screened up to November 2018. Risk of bias was assessed with the Cochrane risk-of-bias tool and the following domains were considered: randomization, allocation sequence concealment, blinding, incomplete outcome data, selective outcome reporting, and other biases.

RESULTS

65 RCTs (7993 participants) and 25 NRSs (1200 participants) were included in the qualitative synthesis and 37 RCTs (3964 participants) were included in the quantitative synthesis. Overall, the qualitative synthesis indicated that 54 RCTs and 17 NRSs reported at least a significant result in favor of lavender use for anxiety. The quantitative synthesis showed that lavender inhalation can significantly reduce anxiety levels measured with any validated scale (Hedges' g = -0.73 [95% CI -1.00 to -0.46], p < 0.00001, 1682 participants), as well as state anxiety (Spielberger's state-trait anxiety inventory (STAI)-State mean difference = -5.99 [95% CI -9.39 to -2.59], p < 0.001, 901 participants) and trait anxiety (STAI-Trait mean difference = -8.14 [95% CI -14.44 to -1.84], p < 0.05, 196 participants). Lavender inhalation did not show a significant effect in reducing systolic blood pressure as a physiological parameter of anxiety. A significant effect in diminishing anxiety levels was also found in favor of the use of oral Silexan® 80 mg/die for at least 6 weeks (Hamilton Anxiety Scale mean difference = -2.90 [95% CI -4.86 to -0.95], p = 0.004, 1173 participants; Zung Self-rating Anxiety Scale mean difference = -2.62 [95% CI -4.84 to -0.39], p < 0.05, 451 participants) or of the administration of massage with lavender oil (Hedges' g = -0.66 [95% CI -0.97 to -0.35], p < 0.0001, 448 participants).

DISCUSSION

The most important limitation of this review is the low average quality of available studies on the topic. The majority of included RCTs were characterized by a high overall risk of bias. Another limitation regards the heterogeneity of study designs, especially with regard to non-oral ways of administration. Overall, oral administration of lavender essential oil proves to be effective in the treatment of anxiety, whereas for inhalation there is only an indication of an effect of reasonable size, due to the heterogeneity of available studies. Lavender essential oil administered through massage appears effective, but available studies are not sufficient to determine whether the benefit is due to a specific effect of lavender. Further high-quality RCTs with more homogeneous study designs are needed to confirm these findings. Available information outlines a safe profile for lavender-based interventions, although more attention should be paid to the collection and reporting of safety data in future studies. Considering these findings, since treatments with lavender essential oil generally seem safe, and, in the case of inhalation, also simple and inexpensive, they are a therapeutic option which may be considered in some clinical contexts.

OTHER

The present systematic review was not funded and was registered in PROSPERO under the following number: CRD42019130126.

A potential relation between premenstrual symptoms and subjective perception of health and stress among college students: a cross-sectional study

Background

A majority of women from all cultures and socioeconomic levels experience myriad symptoms known as premenstrual syndrome during the days prior to menstruation. The present study investigated commonly reported symptoms in the premenstrual phase among college students. The authors further scrutinized potential factors, including subjective perceptions of health, which may be related to the premenstrual-symptom constellation.

Methods

We conducted a cross-sectional survey, which included 200 participants (mean age: 19.8 ± 0.1 years old). The subjects completed a rating of their premenstrual experiences relative to 46 symptoms in eight categories of the self-reporting menstrual distress questionnaire (MDQ) to evaluate the prevalence and severity of premenstrual symptoms. The participants also answered a standardized health questionnaire regarding subjective perceptions of health, self-rating stress, lifestyle, and demographic variables.

Results

Regardless of severity, the 10 symptoms most often occurring among the participants included skin disorders, irritability, fatigue, mood swings, general aches and pains, lowered school or work performance, backache, painful breasts, weight gain, and swelling. Stepwise multiple regression analysis revealed subjective perception of health (β = 0.28; p <  0.001) and self-rating stress (β = 0.18; p = 0.008) as the factors most strongly related to the MDQ total scores. In addition, the 19 women who evaluated themselves as “unhealthy and stressed” had greater prevalence of severe or extremely severe physical (general aches and pains) and psychosocial symptoms (confusion, lowered school or work performance, decreased efficiency, loneliness, anxiety, restlessness, mood swings, and depression), compared to the healthy and non-stressed women.

Conclusions

The present study indicates the prevalence of premenstrual symptoms, regardless of severity and number, among college students and suggests that negative subjective perceptions of health and stress may be related to the intensity of premenstrual symptomatology.

Biological Activities and Safety of Citrus spp. Essential Oils

Citrus fruits have been a commercially important crop for thousands of years. In addition, Citrus essential oils are valuable in the perfume, food, and beverage industries, and have also enjoyed use as aromatherapy and medicinal agents. This review summarizes the important biological activities and safety considerations of the essential oils of sweet orange (Citrus sinensis), bitter orange (Citrus aurantium), neroli (Citrus aurantium), orange petitgrain (Citrus aurantium), mandarin (Citrus reticulata), lemon (Citrus limon), lime (Citrus aurantifolia), grapefruit (Citrus × paradisi), bergamot (Citrus bergamia), Yuzu (Citrus junos), and kumquat (Citrus japonica).

Evaluation of aromatherapy with essential oils of Rosa damascena for the management of premenstrual syndrome

OBJECTIVE

To investigate the efficacy of aromatherapy with essential oils of Rosa damascena for the management of premenstrual syndrome (PMS).

METHODS

The present triple-blind randomized clinical trial was conducted between March 5, 2016, and February 20, 2017, among female students attending Shiraz University of Medical Sciences, Shiraz, Iran, who experienced PMS, had a menstrual cycle of 24-35 days, were not using vitamin supplements or hormonal drugs, and did not have any underlying diseases. Block randomization was used to assign participants to an intervention group receiving aromatherapy with R. damascena at a 4% concentration or a control group who received aromatherapy with 100% sweet almond oil. Aromatherapy was performed for 5 minutes, twice daily, for a total of 5 days during the luteal phase. The premenstrual symptoms screening tool questionnaire was completed at baseline and after 1 and 2 months of treatment. Per-protocol analyses were performed with patients and investigators masked to group assignments.

RESULTS

There were 66 participants enrolled and 64 completed the study (33 in the intervention group and 31 in the control group). At 2 months, aromatherapy with R. damascena was associated with improved psychological (P<0.001), physical (P<0.001), social (P=0.002), and total (P<0.001) PMS symptoms compared with baseline. By contrast, no improvements were recorded in the control group.

CONCLUSION

Aromatherapy with R. damascena improved multiple symptoms of PMS.

IRANIAN REGISTRY OF CLINICAL TRIALS

IRCT2016031113940N3.

Investigation of the effect of aromatherapy with Citrus aurantium blossom essential oil on premenstrual syndrome in university students: A clinical trial study

BACKGROUND

The aim was to investigate the effect of aromatherapy using Citrus aurantium blossom essential oil on premenstrual syndrome in university students.

METHODS

In this double-blind clinical trial controlled on 62 students from March 2016 to February 2017. The intervention with 0.5% of C. Aurantium blossom essential oil and control was inhalation of odorless sweet almond oil in the luteal phase of the menstrual cycle. The screening questionnaire (PSST) for PMSwas filled out before and also one and two months after the intervention.

RESULTS

Mean score of overall symptoms of PMS between the Bitter orange and control groups In the first (p < 0.003) and second months (p < 0.001) of the intervention was significant. Besides, decreased the mean score of psychological symptoms in the intervention group (p < 0.001), but on physical symptoms and social function was not significant (p > 0.05).

CONCLUSION

The aromatherapy with Citrus aurantium blossom improved the symptoms of premenstrual syndrome.