1
|
Zyryanov SK, Strok AB. [Problems of polypragmasia and drug interaction in the treatment of uncomplicated acute rhinosinusitis]. Vestn Otorinolaringol 2024; 89:71-81. [PMID: 38805467 DOI: 10.17116/otorino20248902171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2024]
Abstract
This publication discusses polypragmasia and drug interactions in the treatment of uncomplicated acute rhinosinusitis in children and adults. Treatment of rhinosinusitis on an outpatient basis in multimorbid patients may be accompanied by multiple prescriptions, which increases the risk of drug interactions. The article reflects the most significant inappropriate combinations of both medicines and biologically active additives, herbal preparations. The advantages of using drugs with proven effectiveness, in particular intranasal glucocorticosteroids, are considered.
Collapse
Affiliation(s)
- S K Zyryanov
- Patrice Lumumba Peoples' Friendship University of Russia, Moscow, Russia
- City Clinical Hospital No. 24, Moscow, Russia
| | - A B Strok
- Patrice Lumumba Peoples' Friendship University of Russia, Moscow, Russia
- Russian Children's Clinical Hospital of the Pirogov Russian National Research Medical University, Moscow, Russia
| |
Collapse
|
2
|
Swarna Nantha Y, Vijayasingham S, Adam NL, Vengadasalam P, Ismail M, Ali N, Chang LC, Ling LYL, Tee TT, Cheah YH. Labisia pumila standardized extract (SKF7®) reduces percentage of waist circumference and waist-to-height ratio in individuals with obesity. Diabetes Obes Metab 2023; 25:3298-3306. [PMID: 37551550 DOI: 10.1111/dom.15229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 07/13/2023] [Accepted: 07/14/2023] [Indexed: 08/09/2023]
Abstract
AIM Evidence from the literature points towards a viable choice of utilizing Labisia pumila to improve the metabolic profile in animal studies. To that end, this prospective study was designed to assess the health impact of the consumption of L. pumila standardized extract (SKF7®) on key parameters of obesity in humans such as body weight (BW), body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WHtR). MATERIALS AND METHODS A dose-ranging analysis using SKF7® was conducted through a randomized, double-blind, multicentre, placebo-controlled, phase 2 clinical trial involving individuals with obesity (N = 133) between January 2020 and April 2021. The potential percentage of change was assessed in relation to BW, BMI, WC and WHtR. RESULTS Average treatment effect estimates (treatment group vs. placebo) show a statistically significant reduction in the percentage of change for BW (mean = -2.915; CI: -4.546, -1.285), BMI (-2.921; CI: -4.551, -1.291), WC (mean = -2.187; CI: -3.784, -0.589) and WHtR (mean = -2.294, CI: -3.908, -0.681) in the group with a total of 750 mg of SKF7® (p < .01). An incremental reduction in WC and WHtR was consistent with the gradual increase in the total daily concentration of SKF7® from 375 to 750 mg. WC and WHtR had higher effect size (f 2 = 0.11 and f 2 = 0.13 respectively) in comparison with BW and BMI. CONCLUSIONS SKF7® is potentially a novel therapeutic treatment for obesity, reflected by reductions in BW, BMI, WC and WHtR. The use of SKF7® suggests a dose-dependent reduction in abdominal obesity, exemplified by a decline in WC and WHtR.
Collapse
Affiliation(s)
- Yogarabindranath Swarna Nantha
- Jeffrey Cheah School of Medicine and Health Sciences, Department of General Practice, Monash University, Sunway Campus, Bandar Sunway, Malaysia
| | - Shalini Vijayasingham
- Department of Medicine, Clinical Research Centre, Melaka General Hospital, Melaka, Malaysia
| | - Noor Lita Adam
- Department of Medicine, Tuanku Ja'afar Hospital, Clinical Research Centre, Seremban, Malaysia
| | | | - Mastura Ismail
- Seremban 2 Primary Healthcare Clinic, Seremban, Malaysia
| | - Norsiah Ali
- Masjid Tanah Primary Healthcare Clinic, Melaka, Malaysia
| | | | | | | | | |
Collapse
|
3
|
Esposito G, Sciuto S, Martello E, Pezzolato M, Bozzetta E. Disclosing Frauds in Herbal Food Supplements Labeling: A Simple LC-MS/MS Approach to Detect Alkaloids and Biogenic Amines. J Food Prot 2023; 86:100152. [PMID: 37640156 DOI: 10.1016/j.jfp.2023.100152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 08/18/2023] [Accepted: 08/23/2023] [Indexed: 08/31/2023]
Abstract
Food supplements are a category of products perceived safe and therefore commonly used by different categories of consumers without any particular attention or precaution. However, health risks associated with the consumption of supplements containing undeclared substances cannot be excluded. A variety of analytical methods are used to control supplement quality composition, but usually, these procedures are complex and time-consuming. Here, we report the results of a simple and fast liquid chromatography-tandem mass spectrometry (LC-MS/MS) method, to detect and quantify simultaneously different categories of active molecules, such as biogenic ammines and natural alkaloids that at high doses can produce negative health effect in consumers. Three categories of products intended for body weight loss, energy boosting, and erectile dysfunction treatment, purchased through e-commerce sites and from local supermarkets, were analyzed (n = 91). The caffeine, synephrine, agmatine sulfate, yohimbine, phenethylamine, and icariin were correctly separated and identified with good precision (RSD < 20%) and recovery (89-109%). The identification and quantification of the analytes in real samples highlighted that the 26% of the samples were not compliant with labeling, confirming that frauds are very common also in the natural supplements market. This LC-MS/MS method could be easily used to test natural supplements in order to check the correct labeling and to protect consumers from potential health risks and food frauds.
Collapse
Affiliation(s)
- Giovanna Esposito
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta, via Bologna 148 - 10154, Turin, Italy
| | - Simona Sciuto
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta, via Bologna 148 - 10154, Turin, Italy
| | - Elisa Martello
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, United Kingdom.
| | - Marzia Pezzolato
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta, via Bologna 148 - 10154, Turin, Italy.
| | - Elena Bozzetta
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta, via Bologna 148 - 10154, Turin, Italy
| |
Collapse
|
4
|
Patel D, Sorkin BC, Mitchell CA, Embry MR, Rina-Kong S, Adams RE, DeTemple ER, Reddam A, Gafner S, Kelber O, Rider CV, Oketch-Rabah H, Roe AL, Marles RJ, Dever J, Dentali S. Improving the rigor and utility of botanical toxicity studies: Recommended resources. Regul Toxicol Pharmacol 2023; 144:105471. [PMID: 37604297 PMCID: PMC10591999 DOI: 10.1016/j.yrtph.2023.105471] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 08/04/2023] [Accepted: 08/17/2023] [Indexed: 08/23/2023]
Abstract
Interest in botanicals, particularly as dietary supplement ingredients, is growing steadily. This growth, and the marketing of new ingredients and combination products as botanical dietary supplements, underscores the public health need for a better understanding of potential toxicities associated with use of these products. This article and accompanying template outline the resources to collect literature and relevant information to support the design of botanical toxicity studies. These resources provide critical information related to botanical identification, characterization, pre-clinical and clinical data, including adverse effects and interactions with pharmaceuticals. Toxicologists using these resources should collaborate with pharmacognosists and/or analytical chemists to enhance knowledge of the botanical material being tested. Overall, this guide and resource list is meant to help locate relevant information that can be leveraged to inform on decisions related to toxicity testing of botanicals, including the design of higher quality toxicological studies.
Collapse
Affiliation(s)
- Deval Patel
- Amway Corporation, Buena Park, California, USA
| | - Barbara C Sorkin
- Office of Dietary Supplements, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD, USA
| | | | - Michelle R Embry
- Health and Environmental Sciences Institute, Washington, DC, USA
| | | | | | | | - Aalekhya Reddam
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | | | - Olaf Kelber
- Bayer Consumer Health, Steigerwald Arzneimittelwerk GmbH, Darmstadt, Germany
| | - Cynthia V Rider
- Division of Translational Toxicology, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | | | - Amy L Roe
- Procter & Gamble Company, 8700 Mason-Montgomery Rd, Box 2006, Cincinnati, OH, 45040, USA
| | - Robin J Marles
- USP Botanical Dietary Supplements and Herbal Medicines Expert Committee, United States Pharmacopeial Convention (USP), Rockville, MD, USA
| | - Joseph Dever
- Amway Corporation, Buena Park, California, USA; NSF International, Ann Arbor, MI, USA
| | | |
Collapse
|
5
|
Caré W, Grenet G, Schmitt C, Michel S, Langrand J, Le Roux G, Vodovar D. [Adverse effects of licorice consumed as food: An update]. Rev Med Interne 2023; 44:487-494. [PMID: 37005098 DOI: 10.1016/j.revmed.2023.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 02/07/2023] [Accepted: 03/09/2023] [Indexed: 04/03/2023]
Abstract
The word "licorice" refers to the plant, its root, and its aromatic extract. From a commercial point of view, Glycyrrhiza glabra is the most important species with a wide range of uses (herbal medicine, tobacco industry, cosmetics, food and pharmaceutical). Glycyrrhizin is one of the main constituents of licorice. Glycyrrhizin is hydrolyzed in the intestinal lumen by bacterial β-glucuronidases to 3β-monoglucuronyl-18β-glycyrrhetinic acid (3MGA) and 18β-glycyrrhetinic acid (GA), which are metabolized in the liver. Plasma clearance is slow due to enterohepatic cycling. 3MGA and GA can bind to mineralocorticoid receptors with very low affinity, and 3MGA induces apparent mineralocorticoid excess syndrome through dose-dependent inhibition of 11β-hydroxysteroid dehydrogenase type 2 in renal tissue. The cases of apparent mineralocorticoid excess syndrome reported in the literature are numerous and sometimes severe, even fatal, most often in cases of chronic high dose consumption. Glycyrrhizin poisonings are characterized by hypertension, fluid retention, and hypokalemia with metabolic alkalosis and increased kaliuresis. Toxicity depends on the dose, the type of product consumed, the mode of consumption (acute or chronic) and a very large inter-individual variability. The diagnosis of glycyrrhizin-induced apparent mineralocorticoid excess syndrome is based on the history, clinical examination, and biochemical analysis. Management is primarily based on symptomatic care and stopping licorice consumption.
Collapse
Affiliation(s)
- W Caré
- Centre antipoison de Paris, Fédération de toxicologie (FeTox), hôpital Fernand-Widal (AP-HP), 200, rue du faubourg Saint-Denis, 75010 Paris, France; Service de médecine interne, hôpital d'instruction des armées Bégin, 69, avenue de Paris, 91460 Saint-Mandé, France; Université Paris Cité, Inserm UMR-S 1144, optimisation thérapeutique en neuropsychopharmacologie, 75006 Paris, France.
| | - G Grenet
- Service hospitalo-universitaire de pharmacotoxicologie, Hospices Civils de Lyon, Lyon, France; UMR - CNRS 5558, laboratoire de biométrie et biologie évolutive, université Lyon 1, 69000 Lyon, France; Université de Lyon, Université Lyon 1, 69000 Lyon, France
| | - C Schmitt
- Pharmacologie clinique, centre antipoison et de toxicovigilance de Marseille, APHM, Hôpitaux Sud, Marseille, France
| | - S Michel
- Produit naturel, analyse et synthèse, UMR CNRS 8038, UFR Pharmacie, université Paris Cité, 4, avenue de l'Observatoire, 75006 Paris, France
| | - J Langrand
- Centre antipoison de Paris, Fédération de toxicologie (FeTox), hôpital Fernand-Widal (AP-HP), 200, rue du faubourg Saint-Denis, 75010 Paris, France; Université Paris Cité, Inserm UMR-S 1144, optimisation thérapeutique en neuropsychopharmacologie, 75006 Paris, France
| | - G Le Roux
- Centre antipoison d'Angers, Centre hospitalier universitaire d'Angers, 4, rue Larrey, 49000 Angers, France; Institut de recherche en santé, environnement et travail (IRSET), Inserm UMR 1085, équipe 10 ESTER, université d'Angers, 49000 Angers, France
| | - D Vodovar
- Centre antipoison de Paris, Fédération de toxicologie (FeTox), hôpital Fernand-Widal (AP-HP), 200, rue du faubourg Saint-Denis, 75010 Paris, France; Université Paris Cité, Inserm UMR-S 1144, optimisation thérapeutique en neuropsychopharmacologie, 75006 Paris, France; UFR de médecine, université de Paris, 75006 Paris, France
| |
Collapse
|
6
|
Pan L, Wang Y, Yue L, Wang N, Xu W, Liao X, Wang H, Xiu Y. Review on Processing Methods of Toxic Chinese Materia Medica and the Related Mechanisms of Action. THE AMERICAN JOURNAL OF CHINESE MEDICINE 2023; 51:1385-1412. [PMID: 37545180 DOI: 10.1142/s0192415x23500635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
Toxic Chinese materia medica (CMM) has both pharmacological activities and toxic effects. Based on thousands of years of experience in the application of CMMs, people have explored many practical processing methods of CMMs, also known as "Pao Zhi", to reduce/control toxicity and preserve/enhance efficacy. Toxic CMMs have been used throughout China's hospitals. Yet, the production and use of toxic CMM should be carried out in accordance with the Chinese pharmacopoeia (ChP) and the processing regulations formulated by the health administrative departments of provinces, autonomous regions, and municipalities directly under the Central Government. This paper summarizes the current understanding and awareness of toxicity and 45 toxic CMMs, the commonly used processing methods of toxic CMMs recorded in the 2020 edition of ChP, and the changes in the chemical component, toxicity, or efficacy profiles after processing. This review may provide useful information for the processing methods of toxic CMMs worldwide. We believe that with an in-depth study and understanding of toxic CMMs combined with a standardized application, the toxicity of CMMs will be predictable and controllable in the future.
Collapse
Affiliation(s)
- Lingyun Pan
- Experiment Center for Science and Technology, Shanghai 201203, P. R. China
| | - Yingshu Wang
- School of Pharmacy, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, P. R. China
| | - Lixia Yue
- School of Pharmacy, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, P. R. China
| | - Nan Wang
- School of Pharmacy, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, P. R. China
| | - Wen Xu
- School of Pharmacy, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, P. R. China
| | - Xue Liao
- School of Pharmacy, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, P. R. China
| | - Haiying Wang
- School of Pharmacy, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, P. R. China
| | - Yanfeng Xiu
- School of Pharmacy, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, P. R. China
| |
Collapse
|
7
|
Shor SM, Schweig SK. The Use of Natural Bioactive Nutraceuticals in the Management of Tick-Borne Illnesses. Microorganisms 2023; 11:1759. [PMID: 37512931 PMCID: PMC10384908 DOI: 10.3390/microorganisms11071759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 06/29/2023] [Accepted: 06/29/2023] [Indexed: 07/30/2023] Open
Abstract
The primary objective of this paper is to provide an evidence-based update of the literature on the use of bioactive phytochemicals, nutraceuticals, and micronutrients (dietary supplements that provide health benefits beyond their nutritional value) in the management of persistent cases of Borrelia burgdorferi infection (Lyme disease) and two other tick-borne pathogens, Babesia and Bartonella species. Recent studies have advanced our understanding of the pathophysiology and mechanisms of persistent infections. These advances have increasingly enabled clinicians and patients to utilize a wider set of options to manage these frequently disabling conditions. This broader toolkit holds the promise of simultaneously improving treatment outcomes and helping to decrease our reliance on the long-term use of pharmaceutical antimicrobials and antibiotics in the treatment of tick-borne pathogens such as Borrelia burgdorferi, Babesia, and Bartonella.
Collapse
Affiliation(s)
- Samuel M Shor
- Internal Medicine of Northern Virginia, George Washington University Health Care Sciences, Reston, VA 20190, USA
| | - Sunjya K Schweig
- California Center for Functional Medicine, Oakland, CA 94619, USA
| |
Collapse
|
8
|
Tsele-Tebakang T, Morris-Eyton H, Pretorius E. Concurrent use of herbal and prescribed medicine by patients in primary health care clinics, South Africa. Afr J Prim Health Care Fam Med 2023; 15:e1-e7. [PMID: 37403682 PMCID: PMC10319942 DOI: 10.4102/phcfm.v15i1.3829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 03/04/2023] [Accepted: 03/09/2023] [Indexed: 07/06/2023] Open
Abstract
BACKGROUND The use of herbal medicine (HM) as a self-management practice for treating various diseases has gained popularity worldwide. Consumers co-administer herbal products with conventional medicine without the knowledge of possible herb-drug interaction (HDI). AIM This study aimed to assess patients' perception and use of HM and their knowledge of HDI. SETTING Participants attending primary health care (PHC) clinics in three provinces (Gauteng, Mpumalanga and Free State), South Africa, were recruited. METHODS Focus group discussions comprising a total of thirty (N = 30) participants were conducted using a semi-structured interview guide. Discussions were audio-recorded and then transcribed verbatim. Data were analysed using thematic content analysis. RESULTS Reasons for using HM, sources of information on HM, co-administration of HM and prescribed medicine, disclosure of the use of HM, PHC nurses' attitudes and not having time to engage were frequently discussed. Respondents' lack of knowledge and perceptions about HDI and their dissatisfaction with prescribed medicine because of experienced side effects were also discussed. CONCLUSION Because of the lack of discussions and non-disclosure about HM in PHC clinics, patients are at risk of experiencing HDIs. Primary health care providers should regularly enquire about HM use on every patient, to identify and prevent HDIs. The lack of knowledge about HDIs by patients further compromises the safety of HM.Contribution: The results highlighted the lack of knowledge of HDI by patients thus assisting the healthcare stakeholders in South Africa to implement measures to educate patients attending PHC clinics.
Collapse
Affiliation(s)
- Tebogo Tsele-Tebakang
- Department of Complementary Medicine, Faculty of Health Sciences, University of Johannesburg, Johannesburg.
| | | | | |
Collapse
|
9
|
Villaescusa L, Zaragoza C, Zaragoza F, Tamargo J. Herbal medicines for the treatment of cardiovascular diseases: Benefits and risks- A narrative review. Int J Cardiol 2023:S0167-5273(23)00599-5. [PMID: 37116758 DOI: 10.1016/j.ijcard.2023.04.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 04/14/2023] [Accepted: 04/24/2023] [Indexed: 04/30/2023]
Abstract
Herbal medicines (HMs) have been traditionally used for the prophylaxis/treatment of cardiovascular diseases (CVDs). Their use is steadily increasing and many patients with CVDs often combine HMs with prescribed cardiovascular medications. Interestingly, up to 70% of patients do not notify cardiologists/physicians the use of HMs and up to 90% of cardiologists/physicians may not routinely inquire them about the use of HMs. There is limited scientific evidence from well-designed clinical trials supporting the efficacy and safety of HMs and because they do not reduce morbidity and mortality are not recommended in clinical guidelines for the prophylaxis/treatment of CVDs. There is also a great deal of confusion about the identification, active constituents and mechanisms of action of HMs; the lack of standardization and quality control (contaminations, adulterations) represent other sources of concern. Furthermore, the widespread perception that unlike prescription drugs HMs are safe is misleading and some HMs can cause clinically relevant adverse events and interactions, particularly when used with narrow therapeutic index prescribed cardiovascular drugs (antiarrhythmics, antithrombotics, digoxin). Cardiologists/physicians can no longer ignore the problem. They must improve their knowledge about the HMs their patients consume to provide the best advice and prevent adverse reactions and drug interactions. This narrative review addresses the putative mechanisms of action, suggested clinical uses and safety of most commonly used HMs, the pivotal role of cardiologists/physicians to protect consumers and the main challenges and gaps in evidence related to the use of HMs in the prophylaxis and treatment of CVDs.
Collapse
Affiliation(s)
- Lucinda Villaescusa
- Pharmacology Unit, Biomedical Sciences Department, University of Alcalá, Madrid, 28805 Alcalá de Henares, Spain.
| | - Cristina Zaragoza
- Pharmacology Unit, Biomedical Sciences Department, University of Alcalá, Madrid, 28805 Alcalá de Henares, Spain
| | - Francisco Zaragoza
- Pharmacology Unit, Biomedical Sciences Department, University of Alcalá, Madrid, 28805 Alcalá de Henares, Spain
| | - Juan Tamargo
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense, 28040 Madrid, Spain.
| |
Collapse
|
10
|
Plaskova A, Mlcek J. New insights of the application of water or ethanol-water plant extract rich in active compounds in food. Front Nutr 2023; 10:1118761. [PMID: 37057062 PMCID: PMC10086256 DOI: 10.3389/fnut.2023.1118761] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 03/03/2023] [Indexed: 03/30/2023] Open
Abstract
Plants are recognized as natural sources of antioxidants (e.g., polyphenols, flavonoids, vitamins, and other active compounds) that can be extracted by green solvents like water, ethanol, or their binary mixtures. Plant extracts are becoming more used as food additives in various food systems due to their antioxidant abilities. Their application in food increases the shelf life of products by preventing undesirable changes in nutritional and sensory properties, such as the formation off-flavors in lipid-rich food. This review summarizes the most recent literature about water or ethanol-water plant extracts used as flavors, colorings, and preservatives to fortify food and beverages. This study is performed with particular attention to describing the benefits of plant extract-fortified products such as meat, vegetable oils, biscuits, pastries, some beverages, yogurt, cheese, and other dairy products. Antioxidant-rich plant extracts can positively affect food safety by partially or fully replacing synthetic antioxidants, which have lately been linked to safety and health issues such as toxicological and carcinogenic consequences. On the other hand, the limitations and challenges of using the extract in food should be considered, like stability, level of purity, compatibility with matrix, price, sensory aspects like distinct taste, and others. In the future, continuous development and a tendency to use these natural extracts as food ingredients are expected, as indicated by the number of published works in this area, particularly in the past decade.
Collapse
Affiliation(s)
| | - Jiri Mlcek
- Department of Food Analysis and Chemistry, Faculty of Technology, Tomas Bata University in Zlin, Zlin, Czechia
| |
Collapse
|
11
|
Mancak Karakuş M, Tapısız A, Mutlu Karakaş N, Deniz M, Koca Çalışkan U. Use of Herbal Tea/Herbal Preparations for Children with Symptoms of Viral Upper Respiratory Infections. Turk J Pharm Sci 2023; 20:8-15. [PMID: 36862009 PMCID: PMC9986947 DOI: 10.4274/tjps.galenos.2022.65475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Objectives Respiratory tract infections (RTIs) are common in children. To treat the symptoms of simple health problems, individuals look for natural healing methods that can be easily prepared at home. The aim of this study was to determine the plants and herbal products used by the parents of children suffering from viral upper respiratory tract symptoms by questionaire. In the study, applications and products, other than plants used by families for their children were also investigated. Materials and Methods This study is a cross-sectional survey conducted at Faculty of Medicine, Gazi University (Ankara, Türkiye). A questionnaire form was used by scanning the existing literature and reviewed with the patients face to face by the researchers. The data obtained from the study were analyzed with the Statistical Package for the Social Sciences (SPSS) statistical program. Results About half of the participants reported that they used non-chemical drug practices for their children with upper RTIs. The most common practice was to prepare herbal tea (30.5%), followed by mandarin/orange and/or their juice (26.9%) for oral application. The most used herbal tea for upper RTIs is with linden (Tilia sp.). Patients who used linden usually prepared it as tea, in other words by infusion, and served their children 1-2 cups/1-3 times a week. Except for herbal tea, the participants mostly used honey (19.0%) for their children's symptoms. Conclusion Where available, appropriate doses and dosage forms of herbal supplement products with scientifically proven efficacy and safety should be determined for the pediatric population. Parents should use these products based on the recommendations of their pediatrician.
Collapse
Affiliation(s)
| | - Anıl Tapısız
- Gazi University, Faculty of Medicine, Department of Pediatric Infectious Diseases, Ankara, Türkiye
| | - Nazmi Mutlu Karakaş
- Gazi University, Faculty of Medicine, Department of Pediatrics, Ankara, Türkiye
| | - Melis Deniz
- Gazi University, Faculty of Medicine, Department of Pediatric Infectious Diseases, Ankara, Türkiye
| | - Ufuk Koca Çalışkan
- Gazi University, Faculty of Pharmacy, Department of Pharmacognosy, Ankara, Türkiye.,Düzce University, Faculty of Pharmacy, Department of Pharmacognosy, Düzce, Türkiye
| |
Collapse
|
12
|
Arora A, Behl T, Sehgal A, Singh S, Sharma N, Abdellatif AAH, Dailah HG, Bhatia S, Al-Harrasi A, Aleya L, Bungau S. Elucidating the promising role of traditional Chinese medicine in neuroprotection against oxidative stress encompassing Alzheimer's disease. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:39546-39557. [PMID: 36790717 DOI: 10.1007/s11356-023-25800-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 02/04/2023] [Indexed: 02/16/2023]
Abstract
Medicinal plants are being used from time immemorial for their therapeutic benefits and have immense value in the therapy of neurodegenerative disorders. One of the most important neurological disorders is Alzheimer's disease (AD) which is a major contributor to dementia and is accompanied by abundant oxidative stress in the brain tissue. A critical pathway to target the increased oxidative stress is to administer agents with antioxidant potential. Despite currently available clinical treatments to treat AD such as cholinesterase inhibitors or NMDA antagonists which address only the symptoms and cannot hamper disease progression, no efficient available clinical treatment can break the vicious cycle of oxidative stress and neurodegeneration till date. The main objective of presenting this review is that traditional Chinese medicine (TCM) acts as a promising candidate in breaking this vicious cycle and improves the quality of life of the debilitating patients. The active constituents of various herbs in TCM including Angelica sinensis, Radix polygalae, Polygala tenuifolia, and members of the Lamiaceae family have acquired experience of managing oxidative stress as indicated in the review for more than a thousand years now, and the preclinical and clinical evidence of their therapeutic potential has been highlighted in the review. Most importantly, Chinese herbs provide a multiple-target approach rather than a single-target approach and thus can target multiple pathways involved in AD at once. The Chinese herbs can definitely untangle the issues in the current therapy regimen of AD.
Collapse
Affiliation(s)
- Arpita Arora
- Chitkara College of Pharmacy, Chitkara University, Punjab, India
| | - Tapan Behl
- School of Health Science and Technology, University of Petroleum and Energy Studies, Bidholi, Dehradun, Uttarakhand, India.
| | - Aayush Sehgal
- GHG Khalsa College of Pharmacy, Gurusar Sadhar, Ludhiana, Punjab, India
| | - Sukhbir Singh
- Department of Pharmaceutics, MM College of Pharmacy, Maharishi Markandeshwar (Deemed to Be University), Mullana, Ambala, Haryana, India
| | - Neelam Sharma
- Department of Pharmaceutics, MM College of Pharmacy, Maharishi Markandeshwar (Deemed to Be University), Mullana, Ambala, Haryana, India
| | - Ahmed A H Abdellatif
- Department of Pharmaceutics, College of Pharmacy, Qassim University, Buraydah, Kingdom of Saudi Arabia.,Department of Pharmaceutics and Pharmaceutical Technology, Faculty of Pharmacy, Al-Azhar University, Asyut, Egypt
| | - Hamad Ghaleb Dailah
- Research and Scientific Studies Unit, College of Nursing, Jazan University, Jazan, Saudi Arabia
| | - Saurabh Bhatia
- Natural & Medical Sciences Research Centre, University of Nizwa, Birkat Al Mauz, Nizwa, Oman.,Centre for Transdisciplinary Research, Department of Pharmacology, Saveetha Dental College, Saveetha Institute of Medical and Technical Science, Chennai, India
| | - Ahmed Al-Harrasi
- Natural & Medical Sciences Research Centre, University of Nizwa, Birkat Al Mauz, Nizwa, Oman
| | - Lotfi Aleya
- Chrono-Environment Laboratory, UMR CNRS 6249, Bourgogne Franche-Comté University, Besançon, France
| | - Simona Bungau
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, Oradea, Romania.,Doctoral School of Biomedical Sciences, University of Oradea, Oradea, Romania
| |
Collapse
|
13
|
Rao J, Peng T, Li N, Wang Y, Yan C, Wang K, Qiu F. Nephrotoxicity induced by natural compounds from herbal medicines - a challenge for clinical application. Crit Rev Toxicol 2022; 52:757-778. [PMID: 36815678 DOI: 10.1080/10408444.2023.2168178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
Herbal medicines (HMs) have long been considered safe and effective without serious toxic and side effects. With the continuous use of HMs, more and more attention has been paid to adverse reactions and toxic events, especially the nephrotoxicity caused by natural compounds in HMs. The composition of HMs is complex and various, especially the mechanism of toxic components has been a difficult and hot topic. This review comprehensively summarizes the kidney toxicity characterization and mechanism of nephrotoxic natural compounds (organic acids, alkaloids, glycosides, terpenoids, phenylpropanoids, flavonoids, anthraquinones, cytotoxic proteins, and minerals) from different sources. Recommendations for the prevention and treatment of HMs-induced kidney injury were provided. In vitro and in vivo models for evaluating nephrotoxicity and the latest biomarkers are also included in this investigation. More broadly, this review may provide theoretical basis for safety evaluation and further comprehensive development and utilization of HMs in the future.
Collapse
Affiliation(s)
- Jinqiu Rao
- School of Chinese Materia Medica, Tianjin University of Traditional Chinese Medicine, Tianjin, P. R. China.,State Key Laboratory of Component-Based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, P. R. China
| | - Ting Peng
- School of Chinese Materia Medica, Tianjin University of Traditional Chinese Medicine, Tianjin, P. R. China.,State Key Laboratory of Component-Based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, P. R. China
| | - Na Li
- School of Chinese Materia Medica, Tianjin University of Traditional Chinese Medicine, Tianjin, P. R. China.,State Key Laboratory of Component-Based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, P. R. China
| | - Yuan Wang
- School of Chinese Materia Medica, Tianjin University of Traditional Chinese Medicine, Tianjin, P. R. China.,State Key Laboratory of Component-Based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, P. R. China
| | - Caiqin Yan
- School of Chinese Materia Medica, Tianjin University of Traditional Chinese Medicine, Tianjin, P. R. China
| | - Kai Wang
- School of Chinese Materia Medica, Tianjin University of Traditional Chinese Medicine, Tianjin, P. R. China
| | - Feng Qiu
- School of Chinese Materia Medica, Tianjin University of Traditional Chinese Medicine, Tianjin, P. R. China.,State Key Laboratory of Component-Based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, P. R. China
| |
Collapse
|
14
|
Extracts Rich in Nutrients as Novel Food Ingredients to Be Used in Food Supplements: A Proposal Classification. Nutrients 2022; 14:nu14153194. [PMID: 35956370 PMCID: PMC9370228 DOI: 10.3390/nu14153194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 07/26/2022] [Accepted: 07/30/2022] [Indexed: 12/03/2022] Open
Abstract
Consumers’ commitment to healthy lifestyles and a varied diet has experienced rapid growth in recent decades, causing an increase in the demand of better food quality and variety. The food industry has opted for innovation and the search for new sources of food, and these trends led to the need to develop a European regulatory framework. Novel foods are under Regulation (EU) 2015/2283 (formerly Regulation (EC) No 258/97), and this concept includes all food not used in an important measure for human consumption in the EU before 15 May 1997, and which is included in any of the food categories established. Currently, there are 26 extracts authorized as novel foods or ingredients, being one of the most numerous groups. These extracts are concentrated sources of nutrients, and 23 of them can be used in food supplements. Given their heterogeneous composition and the perceptive risk assessments performed, sometimes, the authorizations are limited to certain population groups. The present work is a comprehensive review of the extracts rich in nutrients authorized as novel ingredients to be used in food supplements within the EU. A classification is proposed according to their source of origin, resulting in four main groups: extracts of plant, animal, algae, and fungal origins. A description of each extract as well as the evaluation of the potential use restriction and health benefits are also addressed.
Collapse
|
15
|
Dawan J, Ahn J. Application of DNA barcoding for ensuring food safety and quality. Food Sci Biotechnol 2022; 31:1355-1364. [PMID: 36060568 PMCID: PMC9433498 DOI: 10.1007/s10068-022-01143-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 06/29/2022] [Accepted: 07/18/2022] [Indexed: 11/29/2022] Open
Abstract
With increasing international food trade, food quality and safety are high priority worldwide. The consumption of contaminated and adulterated food can cause serious health problems such as infectious diseases and allergies. Therefore, the authentication and traceability systems are needed to improve food safety. The mitochondrial DNA can be used for species authentication of food and food products. Effective DNA barcode markers have been developed to correctly identify species. The US FDA approved to the use of DNA barcoding for various food products. The DNA barcoding technology can be used as a regulatory tool for identification and authenticity. The application of DNA barcoding can reduce the microbiological and toxicological risks associated with the consumption of food and food products. DNA barcoding can be a gold-standard method in food authenticity and fraud detection. This review describes the DNA barcoding method for preventing food fraud and adulteration in meat, fish, and medicinal plants.
Collapse
|
16
|
Zhai X, Li L, Zhang P, Guo Y, Jiang H, He W, Li Y, Zhang B, Yao D. Evaluation of the Inhibitory Effects of Six Natural Product Extracts against Babesia gibsoni in Vitro and in Vivo. J Parasitol 2022; 108:301-305. [DOI: 10.1645/21-108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Xiaohu Zhai
- Jiangsu Agri-Animal Husbandry Vocational College, Taizhou, Jiangsu, 225300, China
| | - Lingxu Li
- College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, Jiangsu, 210095, China
| | - Peihao Zhang
- College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, Jiangsu, 210095, China
| | - Yiwen Guo
- College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, Jiangsu, 210095, China
| | - Huaide Jiang
- College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, Jiangsu, 210095, China
| | - Weihua He
- Jiangsu Agri-Animal Husbandry Vocational College, Taizhou, Jiangsu, 225300, China
| | - Yanyan Li
- Jiangsu Agri-Animal Husbandry Vocational College, Taizhou, Jiangsu, 225300, China
| | - Bin Zhang
- Jiangsu Agri-Animal Husbandry Vocational College, Taizhou, Jiangsu, 225300, China
| | - Dawei Yao
- College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, Jiangsu, 210095, China
| |
Collapse
|
17
|
Jairoun AA, Al Hemyari SS, Abdulla NM, Shahwan M, Jairoun M, Godman B, El-Dahiyat F, Kurdi A. Development and Validation of a Tool to Improve Community Pharmacists’ Surveillance Role in the Safe Dispensing of Herbal Supplements. Front Pharmacol 2022; 13:916223. [PMID: 35860014 PMCID: PMC9289787 DOI: 10.3389/fphar.2022.916223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 05/20/2022] [Indexed: 12/11/2022] Open
Abstract
Background: There has been an appreciable increase in the use of herbal supplements, including immune boosters, during the current COVID-19 pandemic. However, there are concerns with falsified herbal supplements. Objectives: Developed a new questionnaire that can potentially help community pharmacists identify the extent of falsified herbal supplements. Methods: A 9-month cross sectional study was conducted among 500 community pharmacies across United Arab Emirates. A new 5-factor, 24-itmes scale was developed based on current labelling requirements across countries and piloted. This included seven items on identified uses and contraindication, seven items on hazard identification, four items on product identity, three items on packaging and product insert and three items on product handling and storage. The face and content validity of the scale was assessed via the content validity index (CVI). Its construct validity was tested using an exploratory factor analysis (EFA) via principally component analysis (PCA). The model was subsequently confirmed through partial confirmatory factor analysis (PCFA). Its reliability was assessed via test-retest reliability, internal consistency, item internal consistency (IIC), and intraclass correlation coefficients (ICCs). Results: The CVI of the finalized questionnaire was 0.843. The Kaiser-Meyer-Olkin measure of sampling adequacy was 0.891, and Bartlett’s test of sphericity indicated significance (p-value < 0.001). Confirmation of the subsequent 5-domains was achieved through PCFA using maximum likelihood analysis with oblimin rotation. The PCFA obtained values was 0.962 for NFI, 0.977 for CFI, and 0.987 for the Tucker Lewis Index. All values were greater than 0.95, and the RMSEA value was 0.03 (i.e., less than 0.06). Consequently, the model had a good fit. All domains demonstrated Cronbach’s alpha coefficients above 0.70, with 0.940 for the full instrument. Meanwhile, all items met the IIC correlation standard of ≥0.40. The instrument presented good ICC statistics of 0.940 (0.928–0.950) as well as statistical significance (p < 0.001). Community pharmacists with more than 10 experience years were more likely to identify falsified herbal supplements compared to those with 1–10 years experience (p < 0.001). Conclusion: This study developed and validated a new instrument to identify safe herbal supplements, which should enhance the role of the community pharmacists in the safe and effective treatment of suitable patients with herbal supplements.
Collapse
Affiliation(s)
- Ammar Abdulrahman Jairoun
- Health and Safety Department, Dubai Municipality, Dubai, United Arab Emirates
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
- *Correspondence: Ammar Abdulrahman Jairoun, ; Moyad Shahwan,
| | - Sabaa Saleh Al Hemyari
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
- Pharmacy Department, Emirates Health Services, Dubai, United Arab Emirates
| | - Naseem Mohammed Abdulla
- Health and Safety Department, Dubai Municipality, Dubai, United Arab Emirates
- School of Health and Environmental Studies, Hamdan Bin Mohammed Smart University (HBMSU), Dubai, United Arab Emirates
- Department of Environmental Health Sciences, Canadian University Dubai, Dubai, United Arab Emirates
| | - Moyad Shahwan
- Department of Clinical Sciences, College of Pharmacy and Health Sciences, Ajman University, Ajman, United Arab Emirates
- Centre of Medical and Bio-allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates
- *Correspondence: Ammar Abdulrahman Jairoun, ; Moyad Shahwan,
| | - Maimona Jairoun
- Department of Clinical Sciences, College of Pharmacy and Health Sciences, Ajman University, Ajman, United Arab Emirates
| | - Brian Godman
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
- Centre of Medical and Bio-allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates
- Strathclyde Institute of Pharmacy and Biomedical Sciences (SIPBS), University of Strathclyde, Glasgow, United Kingdom
- Division of Public Health Pharmacy and Management, School of Pharmacy, Sefako -Makgatho Health Sciences University, Pretoria, South Africa
| | - Faris El-Dahiyat
- Clinical Pharmacy Program, College of Pharmacy, Al Ain University, Al Ain, United Arab Emirates
- AAU Health and Biomedical Research Center, Al Ain University, Abu Dhabi, United Arab Emirates
| | - Amanj Kurdi
- Strathclyde Institute of Pharmacy and Biomedical Sciences (SIPBS), University of Strathclyde, Glasgow, United Kingdom
- Center of Research and strategic studies, Lebanese French University, Erbil, Iraq
- Department of Pharmacology and Toxicology, College of Pharmacy, Hawler Medical University, Erbil, Iraq
| |
Collapse
|
18
|
Mousavi SN, Hosseinikia M, Yousefi Rad E, Saboori S. Beneficial effects of Ginkgo biloba leaf extract on inflammatory markers: A systematic review and meta-analysis of the clinical trials. Phytother Res 2022; 36:3459-3469. [PMID: 35781715 DOI: 10.1002/ptr.7544] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 05/24/2022] [Accepted: 06/12/2022] [Indexed: 12/24/2022]
Abstract
The beneficial effects of Ginkgo biloba on cardio-metabolic markers have been reported. However, its effect on inflammation is not assessed in any meta-analysis. We performed a systematic review of randomized controlled trials evaluating the effects of Ginkgo biloba leaf extract (GBLE) on serum C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) levels. A systematic search was performed on four databases, including PubMed, Scopus, Web of Science, and Google Scholar, up to October 2021. After screening, 17 trials met our inclusion criteria. Trials were of 1-24 weeks of duration and included 1,104 participants. In the meta-analysis, the weighted mean differences (WMD) in change for serum CRP were -1.5 mg/L (95% CI: -2.16, -0.85, p < 0.001). Moreover, WMD for serum IL-6 and TNF-α were in favor of the GBLE compared to the placebo [(-16.86 pg/mL, 95% CI: -19.38, -14.34, p < 0.001); and (-4.19 pg/mL, 95%CI: -5.14, -3.23, p < 0.001), respectively]. Subgroup analysis showed that GBLE has a beneficial effect on serum CRP at the baseline levels≥3 mg/L and doses<500 mg/day. This meta-analysis showed that the GBLE could reduce serum inflammatory markers. Therefore, this medicinal herb might be a possible strategy for inflammation control.
Collapse
Affiliation(s)
- Seyedeh Neda Mousavi
- Zanjan Metabolic Diseases Research Center, Zanjan University of Medical Sciences, Zanjan, Iran.,Department of Nutrition, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Mahboobe Hosseinikia
- Department of Nutrition and food Technology, Faculty of nutrition and Health, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Esmaeil Yousefi Rad
- Nutritional Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Somayeh Saboori
- Nutritional Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| |
Collapse
|
19
|
Papadi G, Bakhiya N, Ildico Hirsch‐Ernst K. Assessment of the possible health risks associated with the consumption of botanical preparations of Mitragyna speciosa (kratom). EFSA J 2022; 20:e200415. [PMID: 35634550 PMCID: PMC9131591 DOI: 10.2903/j.efsa.2022.e200415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The current report summarises the work performed in the context of the European Food Risk Assessment Fellowship Programme (EU‐FORA), which included the evaluation of health risks associated with the consumption of botanical preparations of Mitragyna speciosa (kratom). Mitragyna speciosa is a tree native to Southeast Asia, where its leaves and preparations of the leaves have been used for centuries, among others, as a stimulant or as a traditional herbal medicine. Preparations of the plant have recently gained increasing popularity in other parts of the world, and are presently also accessible via online platforms, e.g. as food supplements. Kratom has been considered a botanical of possible health concern by the FDA and EFSA, which together with its increasing popularity, makes kratom a subject of international concern. Major alkaloids of the plant, mitragynine and 7‐hydroxymitragynine, are agonists of the μ‐opioid human receptor and are assumed to be mainly responsible for its psychoactive effects. The aim of the present project was to conduct an assessment of potential health risks associated with oral use of kratom‐based preparations. The animal and human data that were evaluated in the course of the current assessment indicate that kratom consumption has the potential to not only lead to adverse neurological effects, including addiction and withdrawal syndrome, but also to elicit distinct organ toxicity with respect to e. g. liver and kidney as target organs. Nevertheless, actual risk characterisation is impeded by considerable uncertainties. Such uncertainties, based on the variability in composition of kratom preparations, insufficient information on dose–response relationships and on limited data on long‐term use effects, currently do not allow the derivation of distinct health based guidance values for kratom/kratom preparations. Further information from well‐designed studies, conducted with kratom preparations that have been clearly defined with respect to their composition, would be required to enable a more refined risk assessment of this botanical.
Collapse
|
20
|
Ginkgo biloba: A Treasure of Functional Phytochemicals with Multimedicinal Applications. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:8288818. [PMID: 35265150 PMCID: PMC8901348 DOI: 10.1155/2022/8288818] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 01/31/2022] [Indexed: 12/16/2022]
Abstract
Ginkgo biloba is an ancient plant species that is thought to provide a variety of health benefits to living organisms and contains plenty of bioactive components, making it a chemically diversified plant. G. biloba has been shown to have a variety of medicinal and pharmacological properties, including anticancer, antidementia, antidiabetic, antiobesity, antilipidemic, antimicrobial, antioxidant, antilipid peroxidation, antiplatelet, anti-inflammatory, hepatoprotective, antidepressant, antiaging, immunomodulatory, antihypertensive, and neuroprotective effects and is frequently used to treat neurological, cardiovascular, and respiratory diseases, such as tardive dyskinesia. Therefore, this review described the therapeutic applications of G. biloba. In addition to describing the therapeutic potential, this review also evaluates the chemical constituents, toxicity, adverse effect, synergistic effect, and the clinical studies of this plant which have been utilized for therapeutic benefits but have demonstrated other consequences. The capacity of G. biloba components to act as free radical scavengers is critical, and combining its extract with other plant extracts has been shown to synergistically boost antioxidant properties. G. biloba used long-term or at high doses that resulted in some adverse effects. Severe drug interactions have also been reported in both animals and humans when combined with other medications. The available data established from both preclinical and clinical studies confirm the potential of G. biloba plant extract in various diseases. Besides, the safety and efficacy of G. biloba continue to require verification through additional experimentation to guide medicinal use.
Collapse
|
21
|
Durazzo A, Sorkin BC, Lucarini M, Gusev PA, Kuszak AJ, Crawford C, Boyd C, Deuster PA, Saldanha LG, Gurley BJ, Pehrsson PR, Harnly JM, Turrini A, Andrews KW, Lindsey AT, Heinrich M, Dwyer JT. Analytical Challenges and Metrological Approaches to Ensuring Dietary Supplement Quality: International Perspectives. Front Pharmacol 2022; 12:714434. [PMID: 35087401 PMCID: PMC8787362 DOI: 10.3389/fphar.2021.714434] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 12/16/2021] [Indexed: 12/23/2022] Open
Abstract
The increased utilization of metrology resources and expanded application of its' approaches in the development of internationally agreed upon measurements can lay the basis for regulatory harmonization, support reproducible research, and advance scientific understanding, especially of dietary supplements and herbal medicines. Yet, metrology is often underappreciated and underutilized in dealing with the many challenges presented by these chemically complex preparations. This article discusses the utility of applying rigorous analytical techniques and adopting metrological principles more widely in studying dietary supplement products and ingredients, particularly medicinal plants and other botanicals. An assessment of current and emerging dietary supplement characterization methods is provided, including targeted and non-targeted techniques, as well as data analysis and evaluation approaches, with a focus on chemometrics, toxicity, dosage form performance, and data management. Quality assessment, statistical methods, and optimized methods for data management are also discussed. Case studies provide examples of applying metrological principles in thorough analytical characterization of supplement composition to clarify their health effects. A new frontier for metrology in dietary supplement science is described, including opportunities to improve methods for analysis and data management, development of relevant standards and good practices, and communication of these developments to researchers and analysts, as well as to regulatory and policy decision makers in the public and private sectors. The promotion of closer interactions between analytical, clinical, and pharmaceutical scientists who are involved in research and product development with metrologists who develop standards and methodological guidelines is critical to advance research on dietary supplement characterization and health effects.
Collapse
Affiliation(s)
| | - Barbara C Sorkin
- Office of Dietary Supplements, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD, United States
| | | | - Pavel A Gusev
- Beltsville Human Nutrition Research Center, Agricultural Research Service, US Department of Agriculture, Bethesda, MD, United States
| | - Adam J Kuszak
- Office of Dietary Supplements, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD, United States
| | - Cindy Crawford
- Consortium for Health and Military Performance, Department of Military & Emergency Medicine, F. Edward Hebert School of Medicine, Uniformed Services University, Bethesda, MD, United States
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, United States
| | - Courtney Boyd
- Consortium for Health and Military Performance, Department of Military & Emergency Medicine, F. Edward Hebert School of Medicine, Uniformed Services University, Bethesda, MD, United States
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, United States
| | - Patricia A Deuster
- Consortium for Health and Military Performance, Department of Military & Emergency Medicine, F. Edward Hebert School of Medicine, Uniformed Services University, Bethesda, MD, United States
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, United States
| | - Leila G Saldanha
- Office of Dietary Supplements, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD, United States
| | - Bill J Gurley
- National Center for Natural Products Research, University of Mississippi, Bethesda, MD, United States
| | - Pamela R Pehrsson
- Beltsville Human Nutrition Research Center, Agricultural Research Service, US Department of Agriculture, Bethesda, MD, United States
| | - James M Harnly
- Beltsville Human Nutrition Research Center, Agricultural Research Service, US Department of Agriculture, Bethesda, MD, United States
| | - Aida Turrini
- CREA - Research Centre for Food and Nutrition, Rome, Italy
| | - Karen W Andrews
- Beltsville Human Nutrition Research Center, Agricultural Research Service, US Department of Agriculture, Bethesda, MD, United States
| | - Andrea T Lindsey
- Consortium for Health and Military Performance, Department of Military & Emergency Medicine, F. Edward Hebert School of Medicine, Uniformed Services University, Bethesda, MD, United States
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, United States
| | - Michael Heinrich
- UCL School of Pharmacy, Pharmacognosy and Phytotherapy, London, United Kingdom
| | - Johanna T Dwyer
- Office of Dietary Supplements, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD, United States
| |
Collapse
|
22
|
Sikder L, Khan MR, Smrity SZ, Islam MT, Khan SA. Phytochemical and pharmacological investigation of the ethanol extract of Byttneria pilosa Roxb. CLINICAL PHYTOSCIENCE 2022. [PMCID: PMC8720464 DOI: 10.1186/s40816-021-00333-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Traditionally, the herb Byttneria pilosa Roxb. is used for bone fractures, boils, scabies, rheumatalgia, snake bites, syphilis, elephantiasis, poisoning, and eye infection. Scientific reports suggest that it has significant anti-inflammatory, analgesic, anti-diarrheal, anxiolytic, locomotion, sedative and anti-obesity effects. This study aims at the investigation of the phytochemical and pharmacological properties of the ethanol extract of this herb.
Methods
Fresh whole plant was extracted with absolute ethanol. A preliminary phytochemical investigation was followed by the evaluation of thrombolytic, anti-inflammatory, and anti-nociceptive activities by applying human clotted blood lysis, egg albumin, and acetic acid-induced writhing models, respectively.
Results
Phytochemical investigation suggests that B. pilosa possesses alkaloids, flavonoids, glycosides, terpenoids, tannins, saponins, and reducing sugars. The extract exhibited clot lysis and anti-inflammatory effects in a concentration-dependent manner. B. pilosa extract at 250 and 500 mg/kg also showed significant (p < 0.05) dose-dependent anti-nociceptive activity in Swiss albino mice.
Conclusion
The B. pilosa ethanol extract contains many important secondary metabolites and has thrombolytic, anti-inflammatory, and anti-nociceptive activities. More research is necessary on this hopeful medicinal herb.
Collapse
|
23
|
Herb-drug interactions: Perception and revelations of nurses in primary healthcare clinics, South Africa. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2022. [DOI: 10.1016/j.ijans.2022.100409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
|
24
|
Zhang QH, Huang HZ, Qiu M, Wu ZF, Xin ZC, Cai XF, Shang Q, Lin JZ, Zhang DK, Han L. Traditional Uses, Pharmacological Effects, and Molecular Mechanisms of Licorice in Potential Therapy of COVID-19. Front Pharmacol 2021; 12:719758. [PMID: 34899289 PMCID: PMC8661450 DOI: 10.3389/fphar.2021.719758] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 10/29/2021] [Indexed: 12/19/2022] Open
Abstract
The current Coronavirus disease 2019 (COVID-19) pandemic has become a global challenge, and although vaccines have been developed, it is expected that mild to moderate patients will control their symptoms, especially in developing countries. Licorice, not only a food additive, but also a common traditional Chinese herbal medicine, which has several pharmacological effects, such as anti-inflammation, detoxification, antibacterial, antitussive, and immunomodulatory effects, especially in respiratory diseases. Since the outbreak of COVID-19, glycyrrhizin, glycyrrhizin diamine and glycyrrhizin extract have been widely studied and used in COVID-19 clinical trials. Therefore, it is a very interesting topic to explore the material basis, pharmacological characteristics and molecular mechanism of licorice in adjuvant treatment of COVID-19. In this paper, the material basis of licorice for the prevention and treatment of COVID-19 is deeply analyzed, and there are significant differences among different components in different pharmacological mechanisms. Glycyrrhizin and glycyrrhetinic acid inhibit the synthesis of inflammatory factors and inflammatory mediators by blocking the binding of ACE 2 to virus spike protein, and exert antiviral and antibacterial effects. Immune cells are stimulated by multiple targets and pathways to interfere with the pathogenesis of COVID-19. Liquiritin can prevent and cure COVID-19 by simulating type I interferon. It is suggested that licorice can exert its therapeutic advantage through multi-components and multi-targets. To sum up, licorice has the potential to adjuvant prevent and treat COVID-19. It not only plays a significant role in anti-inflammation and anti-ACE-2, but also significantly improves the clinical symptoms of fever, dry cough and shortness of breath, suggesting that licorice is expected to be a candidate drug for adjuvant treatment of patients with early / mild COVID-19.
Collapse
Affiliation(s)
- Qian-Hui Zhang
- State Key Laboratory of Southwestern Chinese Medicine Resources, Pharmacy School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Hao-Zhou Huang
- State Key Laboratory of Southwestern Chinese Medicine Resources, Pharmacy School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Min Qiu
- State Key Laboratory of Southwestern Chinese Medicine Resources, Pharmacy School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Zhen-Feng Wu
- Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Zhan-Chang Xin
- Gansu Qilian Mountain Pharmaceutical Limited Liability Company, Jiuquan, China
| | - Xin-Fu Cai
- Sichuan Guangda Pharmaceutical Co. Ltd, Pengzhou, China.,National Engineering Research Center for Modernization of Traditional Chinese Medicine, Pengzhou, China
| | - Qiang Shang
- Sichuan Guangda Pharmaceutical Co. Ltd, Pengzhou, China.,National Engineering Research Center for Modernization of Traditional Chinese Medicine, Pengzhou, China
| | - Jun-Zhi Lin
- TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Ding-Kun Zhang
- State Key Laboratory of Southwestern Chinese Medicine Resources, Pharmacy School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Li Han
- State Key Laboratory of Southwestern Chinese Medicine Resources, Pharmacy School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| |
Collapse
|
25
|
Chen Q, Xu Z, Li X, Du D, Wu T, Zhou S, Yan W, Wu M, Jin Y, Zhang J, Wang S. Epigallocatechin gallate and theaflavins independently alleviate cyclophosphamide-induced ovarian damage by inhibiting the overactivation of primordial follicles and follicular atresia. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2021; 92:153752. [PMID: 34601223 DOI: 10.1016/j.phymed.2021.153752] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 09/08/2021] [Accepted: 09/12/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Cyclophosphamide (CTX), which has been used to treat common female cancers for several years, often causes ovarian damage, early menopause and infertility. However, strategies for the effective prevention and treatment of CTX-induced ovarian damage are still lacking. Epigallocatechin gallate (EGCG) and theaflavins (TFs), key molecules derived from green tea or black tea, have been shown to exert preventive effects on many ageing-related diseases. PURPOSE We aimed to explore the potential preventive and protective effects of EGCG and TFs on CTX-induced ovarian damage and compare the two compounds. STUDY DESIGN Six-week-old female mice were administered a low or high dose of EGCG or TFs. The low dose was equivalent to the average daily amount of tea consumed by a drinker. METHODS We determined the oestrous cycle and serum hormone levels to evaluate ovarian endocrine function, and we performed mating tests for reproductivity. We also assessed the follicle count and AMH level to evaluate ovarian reserve, and we performed Masson's trichrome and Sirius red staining to evaluate ovarian fibrosis. We conducted γ-H2AX and TUNEL analyses to evaluate DNA damage, and we also measured the relevant indicators of oxidative stress and follicular activation, including NRF2, HO-1, SOD2, AKT, mTOR and RPS6. RESULTS EGCG and TFs treatment independently improved the ovarian endocrine function and reproductivity of mice that were administered CTX. EGCG and TFs also increased the ovarian reserve of these animals. Furthermore, EGCG and TFs alleviated oxidation-induced damage to ovarian DNA in mice by activating the NRF2/HO-1 and SOD2 pathways and reducing the apoptosis of growing follicles. At the same time, EGCG and TFs reduced the overactivation of primordial follicles by inhibiting the AKT/mTOR/RPS6 pathway. CONCLUSION The present study showed that EGCG and TFs independently improved ovarian function in mice with CTX-induced ovarian damage, thereby providing useful information for designing a potential clinical strategy that will protect against chemotherapy-induced ovarian damage.
Collapse
Affiliation(s)
- Qian Chen
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, National Clinical Research Center for Obstetrical and Gynecological Diseases, Wuhan, Hubei, China
| | - Zheyuan Xu
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, National Clinical Research Center for Obstetrical and Gynecological Diseases, Wuhan, Hubei, China; Department of Pediatrics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Xiang Li
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, National Clinical Research Center for Obstetrical and Gynecological Diseases, Wuhan, Hubei, China; Department of pathology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Dingfu Du
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, National Clinical Research Center for Obstetrical and Gynecological Diseases, Wuhan, Hubei, China; Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Tong Wu
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, National Clinical Research Center for Obstetrical and Gynecological Diseases, Wuhan, Hubei, China
| | - Su Zhou
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, National Clinical Research Center for Obstetrical and Gynecological Diseases, Wuhan, Hubei, China
| | - Wei Yan
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, National Clinical Research Center for Obstetrical and Gynecological Diseases, Wuhan, Hubei, China
| | - Meng Wu
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, National Clinical Research Center for Obstetrical and Gynecological Diseases, Wuhan, Hubei, China
| | - Yan Jin
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, National Clinical Research Center for Obstetrical and Gynecological Diseases, Wuhan, Hubei, China
| | - Jinjin Zhang
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, National Clinical Research Center for Obstetrical and Gynecological Diseases, Wuhan, Hubei, China.
| | - Shixuan Wang
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, National Clinical Research Center for Obstetrical and Gynecological Diseases, Wuhan, Hubei, China.
| |
Collapse
|
26
|
Crawford C, Boyd C, Deuster PA. Dietary Supplement Ingredients for Optimizing Cognitive Performance Among Healthy Adults: A Systematic Review. J Altern Complement Med 2021; 27:940-958. [PMID: 34370563 DOI: 10.1089/acm.2021.0135] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Background: Dietary supplements promoted for brain health and enhanced cognitive performance are widely available. Claims made for these products are directed not only to the elderly wishing to prevent or mitigate cognitive decline, but also young healthy populations looking to boost their cognitive performance. It is unclear whether these claims made on product bottles and through advertising match the science. Objectives: To explore the evidence on the efficacy and safety of single dietary supplement ingredients frequently marketed with claims of enhanced cognitive performance among healthy adults. Design: A systematic review. Results: Nine of 54 dietary supplement ingredients identified through a scoping review met the eligibility criteria with at least 3 published studies identified per ingredient, yielding 69 unique publications. Ingredients evaluated included Bacopa monnieri, choline, creatine, omega-3 fatty acids, Ginkgo biloba, ginseng, Rhodiola rosea, tyrosine, and valerian root, all in supplement form and compared with a placebo, at various serving sizes and durations of use. Conclusions: The low level of certainty in the state of the science, coupled with not always knowing what is in a dietary supplement product, make weighing risks and benefits difficult; these data hinder the ability to develop recommendations about using such ingredients for consumers interested in boosting their cognitive performance. Whereas certain trends regarding promising serving sizes or duration for use, are pointed to in this synthesis, when combined, studies are inconsistent and imprecise, and many are methodologically flawed. Potential solutions to address research gaps are offered, for future research next steps, which is needed to strengthen the evidence and inform decisions.
Collapse
Affiliation(s)
- Cindy Crawford
- Consortium for Health and Military Performance, Department of Military and Emergency Medicine, F. Edward Hébert School of Medicine, Uniformed Services University, Bethesda, MD, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Courtney Boyd
- Consortium for Health and Military Performance, Department of Military and Emergency Medicine, F. Edward Hébert School of Medicine, Uniformed Services University, Bethesda, MD, USA.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Patricia A Deuster
- Consortium for Health and Military Performance, Department of Military and Emergency Medicine, F. Edward Hébert School of Medicine, Uniformed Services University, Bethesda, MD, USA
| |
Collapse
|
27
|
Ishitsuka K, Sasaki S, Mezawa H, Konishi M, Igarashi M, Yamamoto-Hanada K, Nakayama SF, Ohya Y. Dietary supplement use in elementary school children: a Japanese web-based survey. Environ Health Prev Med 2021; 26:63. [PMID: 34090343 PMCID: PMC8180069 DOI: 10.1186/s12199-021-00985-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 05/26/2021] [Indexed: 11/13/2022] Open
Abstract
Background A variety of dietary supplements are commercially available. However, the efficacy and safety of dietary supplement use in children are not well established. Understanding dietary supplement use is important for developing public health policy regarding dietary supplements. This study aimed to investigate the types of dietary supplements used and characteristics of dietary supplement users among Japanese elementary school children. Method We conducted a cross-sectional web-based questionnaire study. Dietary supplement use, socio-demographics, and health-related behaviors were assessed through mother-reported questionnaire. Types of dietary supplements were identified based on ingredient using product barcodes and brand names. Multivariate logistic regression analysis was conducted to investigate the socio-demographics and health-related behaviors associated with supplement use. Results Among 4933 children, 333 (6.8%) were identified as dietary supplement users. The most common supplement was amino acids or protein (1.4%), followed by n–3 fatty acids or fish oil (1.0%), probiotics (1.0%), multivitamins (0.9%), multivitamin-minerals (0.8%), and botanicals (0.8%). Overall, any dietary supplement use was significantly associated with the highest frequency of sports participation (odds ratio [OR], 2.58; 95% confidence interval [CI], 1.65–4.02), highest household income (OR, 1.87; 95% CI, 1.13–3.10), highest maternal educational level (OR, 1.82; 95% CI, 1.31–2.52), and male sex (OR, 1.38; 95% CI, 1.09–1.75). The highest frequency of sports participation was significantly associated with higher odds of use of amino acids or protein (OR, 6.06; 95% CI, 1.78–20.6) and multivitamins (OR, 3.56; 95% CI, 1.11–11.5), compared to the lowest frequency of sports participation. Conclusion This study showed that Japanese children primarily use non-vitamin, non-mineral supplements. Non-vitamin, non-mineral supplements should thus be included in future studies aimed at monitoring dietary supplement use. We also found that dietary supplement use in children was associated with sports participation. Guidelines for dietary supplement use for children, in particular sport participants, are needed. Supplementary Information The online version contains supplementary material available at 10.1186/s12199-021-00985-7.
Collapse
Affiliation(s)
- Kazue Ishitsuka
- Medical Support Center for the Japan Environment and Children's Study, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan. .,Department of Social and Preventive Epidemiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8654, Japan.
| | - Satoshi Sasaki
- Department of Social and Preventive Epidemiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8654, Japan.,Department of Social and Preventive Epidemiology, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8654, Japan
| | - Hidetoshi Mezawa
- Medical Support Center for the Japan Environment and Children's Study, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan
| | - Mizuho Konishi
- Medical Support Center for the Japan Environment and Children's Study, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan
| | - Maki Igarashi
- Department of Molecular Endocrinology, National Research Institute for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan
| | - Kiwako Yamamoto-Hanada
- Medical Support Center for the Japan Environment and Children's Study, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan
| | - Shoji F Nakayama
- Centre for Health and Environmental Risk Research, National Institute for Environmental Studies, 16-2 Onogawa, Tsukuba, 305-8506, Japan
| | - Yukihiro Ohya
- Medical Support Center for the Japan Environment and Children's Study, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan
| |
Collapse
|
28
|
Zhang Y, Alvarez-Manzo H, Leone J, Schweig S, Zhang Y. Botanical Medicines Cryptolepis sanguinolenta, Artemisia annua, Scutellaria baicalensis, Polygonum cuspidatum, and Alchornea cordifolia Demonstrate Inhibitory Activity Against Babesia duncani. Front Cell Infect Microbiol 2021; 11:624745. [PMID: 33763384 PMCID: PMC7982592 DOI: 10.3389/fcimb.2021.624745] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 01/08/2021] [Indexed: 12/15/2022] Open
Abstract
Human babesiosis is a CDC reportable disease in the United States and is recognized as an emerging health risk in multiple parts of the world. The current treatment for human babesiosis is suboptimal due to treatment failures and unwanted side effects. Although Babesia duncani was first described almost 30 years ago, further research is needed to elucidate its pathogenesis and clarify optimal treatment regimens. Here, we screened a panel of herbal medicines and identified Cryptolepis sanguinolenta, Artemisia annua, Scutellaria baicalensis, Alchornea cordifolia, and Polygonum cuspidatum to have good in vitro inhibitory activity against B. duncani in the hamster erythrocyte model. Furthermore, we found their potential bioactive compounds, cryptolepine, artemisinin, artesunate, artemether, and baicalein, to have good activity against B. duncani, with IC50 values of 3.4 μM, 14 μM, 7.4 μM, 7.8 μM, and 12 μM, respectively, which are comparable or lower than that of the currently used drugs quinine (10 μM) and clindamycin (37 μM). B. duncani treated with cryptolepine and quinine at their respective 1×, 2×, 4× and 8× IC50 values, and by artemether at 8× IC50 for three days could not regrow in subculture. Additionally, Cryptolepis sanguinolenta 90% ethanol extract also exhibited no regrowth after 6 days of subculture at doses of 2×, 4×, and 8× IC50 values. Our results indicate that some botanical medicines and their active constituents have potent activity against B. duncani in vitro and may be further explored for more effective treatment of babesiosis.
Collapse
Affiliation(s)
- Yumin Zhang
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Hector Alvarez-Manzo
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Jacob Leone
- FOCUS Health Group, Naturopathic, Novato, CA, United States
| | - Sunjya Schweig
- California Center for Functional Medicine, Kensington, CA, United States
| | - Ying Zhang
- State Key Laboratory for the Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| |
Collapse
|
29
|
Bax CE, Maddukuri S, Ravishankar A, Pappas-Taffer L, Werth VP. Environmental triggers of dermatomyositis: a narrative review. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:434. [PMID: 33842655 PMCID: PMC8033368 DOI: 10.21037/atm-20-3719] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Dermatomyositis (DM) is an autoimmune disease that affects the skin, lungs, and muscle. Although the pathogenesis of DM is not completely understood, several environmental triggers have been linked to DM onset or flare. This article specifically examines the effects of herbal supplements, drugs, infections, ultraviolet (UV) radiation, and environmental pollutants on the onset or exacerbation of DM. Herbal supplements such as Spirulina platensis, Aphanizomenon flos-aquae, Chlorella, Echinacea, and Alfalfa have been implicated and are frequently used in health foods. Medications such as hydroxyurea, TNF-α inhibitors, immune checkpoint inhibitors (ICI), and penicillamine, as well as certain viral infections, such as parvovirus B19, coxsackie virus, polyomavirus, Epstein-Barr virus (EBV), hepatitis, influenza, and human immunodeficiency viruses (HIV) have been associated with DM onset. Bacterial infections and vaccinations have also been linked to the development of DM. Additional environmental factors, including UV radiation and air pollutants, such as silica, biological/mineral dust, and particulate air matter from vehicle and industrial emissions, may also play a role in DM pathogenesis. Overall, there is general agreement that an autoimmune attack of the skin, muscle, and lungs in DM can be triggered by various environmental factors and warrants further investigation.
Collapse
Affiliation(s)
- Christina E Bax
- Corporal Michael J. Crescenz VAMC, Philadelphia, PA, USA.,Department of Dermatology, University of Pennsylvania, Philadelphia, PA, USA
| | - Spandana Maddukuri
- Corporal Michael J. Crescenz VAMC, Philadelphia, PA, USA.,Department of Dermatology, University of Pennsylvania, Philadelphia, PA, USA
| | - Adarsh Ravishankar
- Corporal Michael J. Crescenz VAMC, Philadelphia, PA, USA.,Department of Dermatology, University of Pennsylvania, Philadelphia, PA, USA
| | - Lisa Pappas-Taffer
- Corporal Michael J. Crescenz VAMC, Philadelphia, PA, USA.,Department of Dermatology, University of Pennsylvania, Philadelphia, PA, USA
| | - Victoria P Werth
- Corporal Michael J. Crescenz VAMC, Philadelphia, PA, USA.,Department of Dermatology, University of Pennsylvania, Philadelphia, PA, USA
| |
Collapse
|
30
|
Liang Z, Chen X, Shi J, Hu H, Xue Y, Ung COL. Efficacy and safety of traditional Chinese medicines for non-alcoholic fatty liver disease: a systematic literature review of randomized controlled trials. Chin Med 2021; 16:9. [PMID: 33430929 PMCID: PMC7802307 DOI: 10.1186/s13020-020-00422-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 12/26/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Non-alcoholic fatty liver disease (NAFLD) is a common liver disease that may progress into, in the absence of proper treatment, severe liver damage. While the optimal pharmacotherapy for NAFLD remains uncertain and the adherence to lifestyle interventions is challenging, the use of herbal medicines such as traditional Chinese medicines (TCMs) to manage the condition is common. The evidence about TCMs in the management of NAFLD is continuously developing through randomized controlled trials (RCTs). This study aims to identify and evaluate the emerging evidence about the efficacy and safety of TCMs for NAFLD. METHODS A systematic literature search was conducted to identify RCTs which investigated TCMs in the management of NAFLD published in 6 electronic databases including PubMed, the Cochrane Library, EMBASE, Web of Science, Scopus and China National Knowledge Infrastructure since inception to September 2020. RCTs comparing TCMs with no treatment, placebo, non-pharmacological and/or pharmacological interventions were included irrespective of language or blinding. The quality of reporting was evaluated using the Consolidated Standards of Reporting Trials Statement extensions for Chinese herbal medicine Formulas (CONSORT-CHM). Risk-of-bias for each study was assessed using the Cochrane risk of bias tool. RESULTS A total of 53 RCTs involving 5997 participants with NAFLD were included in this review. Each included RCT tested a different TCMs giving a total of 53 TCMs identified in this study. Based on the evaluation of the RCT results, TCMs might have various beneficial effects such as improving TCM syndrome score, liver function, and body lipid profile. A range of non-serious, reversible adverse effects associated with the use of TCMs were also reported. However, no conclusion about the efficacy and safety of TCMs in NAFLD can be made. The quality of reporting was generally poor and the risks of bias was mostly uncertain in all trials. CONCLUSIONS There is some evidence from RCTs that supported the effectiveness and safety of TCMs for NAFLD. However, no conclusive recommendations can be made due to the questionable quality of the RCTs. Improvement in the RCT protocol, the use of a larger sample size, a setting of multicenter, and a more focused approach in selecting TCMs are recommended for developing high quality evidence about the use of TCMs in managing NAFLD.
Collapse
Affiliation(s)
- Zuanji Liang
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macao
| | - Xianwen Chen
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macao
| | - Junnan Shi
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macao
| | - Hao Hu
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macao
| | - Yan Xue
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macao
| | - Carolina Oi Lam Ung
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macao
| |
Collapse
|
31
|
Gutiérrez-Hellín J, Baltazar-Martins G, Rodríguez I, Lara B, Ruiz-Moreno C, Aguilar-Navarro M, Del Coso J. p-Synephrine, the main protoalkaloid of Citrus aurantium, raises fat oxidation during exercise in elite cyclists. Eur J Sport Sci 2020; 21:1273-1282. [PMID: 32859142 DOI: 10.1080/17461391.2020.1817154] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The aim of this study was to investigate the acute effects of p-synephrine ingestion on substrate oxidation during exercise in elite cyclists. Fifteen elite cyclists volunteered to participate in a double blind, crossover, randomized and placebo-controlled experimental trial. During two different trials, participants either ingested a placebo (cellulose) or 3 mg/kg of p-synephrine. After 60 min for substances absorption, participants performed an incremental maximal cycle ergometer test until volitional fatigue (25 W/min). Breath-by-breath gas exchange data was continuously recorded during the entire test to estimate energy expenditure, carbohydrate oxidation, and fat oxidation rates by stoichiometric equations. Heart rate was continuously measured by using a heart rate monitor. The ingestion of p-synephrine had no significant effects on energy expenditure (F = 0.71, P = 0.40) or heart rate (F = 0.66, P = 0.43) during exercise. However, there was a main effect of p-synephrine to increase the rate of fat oxidation over the placebo (F = 5.1, P = 0.04) and the rate of fat oxidation was higher with p-synephrine in the following loads: 45 ± 2%, 51 ± 3%, 62 ± 3%, 67 ± 4%, 79 ± 5% and 85 ± 5% of the maximum wattage obtained in the test (all P < 0.05). The ingestion of p-synephrine did not modify the maximal rate of fat oxidation during the ramp test (mean value; 95%CI = 0.91; 0.79-1.03 vs 1.01; 0.91-1.11 g/min, respectively, P = 0.06) nor the exercise intensity at which maximal fat oxidation was achieved (i.e. Fatmax = 49; 48-53 vs 50; 47-51% Wmax, P = 0.52). Acute p-synephrine ingestion moved the fat oxidation-exercise intensity curve upwards during an incremental cycling test without affecting Fatmax.
Collapse
Affiliation(s)
| | | | - Iván Rodríguez
- Sports performance Lab, Reebok Sport Club, Madrid, Spain
| | - Beatriz Lara
- Camilo José Cela University, Exercise Physiology Laboratory, Madrid, Spain
| | - Carlos Ruiz-Moreno
- Camilo José Cela University, Exercise Physiology Laboratory, Madrid, Spain
| | | | - Juan Del Coso
- Centre for Sport Studies, Rey Juan Carlos University
| |
Collapse
|
32
|
Colombo F, Di Lorenzo C, Biella S, Vecchio S, Frigerio G, Restani P. Adverse effects to food supplements containing botanical ingredients. J Funct Foods 2020. [DOI: 10.1016/j.jff.2020.103990] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
|
33
|
Siriyong T, Phungtammasan S, Jansorn S, Chonsongkram N, Chanwanitsakul S, Subhadhirasakul S, Voravuthikunchai SP. Traditional Thai herbal medicine as an alternative treatment for refractory chronic eczema. Explore (NY) 2020; 16:242-249. [DOI: 10.1016/j.explore.2019.10.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 09/03/2019] [Accepted: 10/07/2019] [Indexed: 11/28/2022]
|
34
|
Botanicals in Functional Foods and Food Supplements: Tradition, Efficacy and Regulatory Aspects. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10072387] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
In recent decades, the interest in products containing botanicals and claiming “functional” properties has increased exponentially. Functional foods, novel foods and food supplements have a special impact on the consumers, who show significant expectation for their well-being. Food supplements with botanical ingredients are the food area that has witnessed the greatest development, in terms of the number of available products, budget, and consumer acceptability. This review refers to and discusses some open points, such as: (1) the definitions and regulation of products containing botanicals; (2) the difficulty in obtaining nutritional and functional claims (botanical ingredients obtaining claims in the EU are listed and summarized); (3) the safety aspects of these products; and (4) the poor harmonization between international legislations. The availability of these “new” products can positively influence the well-being of the population, but it is essential to provide the consumers with the necessary recommendations to guide them in their purchase and use.
Collapse
|
35
|
|
36
|
Feng J, Leone J, Schweig S, Zhang Y. Evaluation of Natural and Botanical Medicines for Activity Against Growing and Non-growing Forms of B. burgdorferi. Front Med (Lausanne) 2020; 7:6. [PMID: 32154254 PMCID: PMC7050641 DOI: 10.3389/fmed.2020.00006] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 01/09/2020] [Indexed: 12/14/2022] Open
Abstract
Lyme disease is the most common vector-borne disease in the US and Europe. Although the current recommended Lyme antibiotic treatment is effective for the majority of Lyme disease patients, about 10-20% of patients continue to suffer from persisting symptoms. There have been various anecdotal reports on the use of herbal extracts for treating patients with persisting symptoms with varying degree of improvements. However, it is unclear whether the effect of the herb products is due to their direct antimicrobial activity or their effect on host immune system. In the present study, we investigated the antimicrobial effects of 12 commonly used botanical medicines and three other natural antimicrobial agents for potential anti-Borrelia burgdorferi activity in vitro. Among them, 7 natural product extracts at 1% were found to have good activity against the stationary phase B. burgdorferi culture compared to the control antibiotics doxycycline and cefuroxime. These active botanicals include Cryptolepis sanguinolenta, Juglans nigra (Black walnut), Polygonum cuspidatum (Japanese knotweed), Artemisia annua (Sweet wormwood), Uncaria tomentosa (Cat's claw), Cistus incanus, and Scutellaria baicalensis (Chinese skullcap). In contrast, Stevia rebaudiana, Andrographis paniculata, Grapefruit seed extract, colloidal silver, monolaurin, and antimicrobial peptide LL37 had little or no activity against stationary phase B. burgdorferi. The minimum inhibitory concentration (MIC) values of Artemisia annua, Juglans nigra, and Uncaria tomentosa were quite high for growing B. burgdorferi, despite their strong activity against the non-growing stationary phase B. burgdorferi. On the other hand, the top two active herbs, Cryptolepis sanguinolenta and Polygonum cuspidatum, showed strong activity against both growing B. burgdorferi (MIC = 0.03-0.06% and 0.25-0.5%, respectively) and non-growing stationary phase B. burgdorferi. In subculture studies, only 1% Cryptolepis sanguinolenta extract caused complete eradication, while doxycycline and cefuroxime and other active herbs could not eradicate B. burgdorferi stationary phase cells as many spirochetes were visible after 21-day subculture. Further studies are needed to identify the active constituents of the effective botanicals and evaluate their combinations for more effective eradication of B. burgdorferi in vitro and in vivo. The implications of these findings for improving treatment of persistent Lyme disease are discussed.
Collapse
Affiliation(s)
- Jie Feng
- Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Jacob Leone
- FOCUS Health Group, Naturopathic, Novato, CA, United States
| | - Sunjya Schweig
- California Center for Functional Medicine, Kensington, CA, United States
| | - Ying Zhang
- Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| |
Collapse
|
37
|
Jiang J, Xiao S, Yan S, Xiao J, Xu X. Glycyrrhizae Radix et Rhizoma Processed by Sulfur Fumigation Damaged the Chemical Profile Accompanied by Immunosuppression and Liver Injury. BIOMED RESEARCH INTERNATIONAL 2020; 2020:5439853. [PMID: 32090097 PMCID: PMC7026913 DOI: 10.1155/2020/5439853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 11/05/2019] [Indexed: 11/17/2022]
Abstract
Glycyrrhizae Radix et Rhizoma (GRER) has been used as a medicinal plant and dietary supplements for its beneficial effect in immunomodulatory effects. Sulfur fumigation (SF) processing was widely used in the storage and maintenance of Chinese medicine because of its convenience and cheapness. However, the disadvantage of SF has been reported, but the systematic study of SF on GRER was deficient. In this paper, the active ingredients, sulfur-fumigated products, immunomodulatory effect, and liver injury of SF-GRER were studied. After SF, the liquiritin decreased from 4.49 ± 0.03 mg/g to 3.94 ± 0.08 mg/g (P < 0.01). Compared with the NSF-GRER group, the SF-GRER group showed a decreased immunoregulation in the thymus index, spleen index, and serum IL-6 and SOD levels (P < 0.05). After 2 weeks of continuous intragastric administration of SF-GRER in healthy mice, the level of serum aspartate aminotransferase (AST) significantly increased (P < 0.05) and the area of liver lesion significantly increased compared with the NSF-GRER (P < 0.05) group. The sulfonated products (m/z, 631.13) corresponding to liquiritin apioside (m/z, 551.17) and isoliquiritin apioside (m/z, 551.17) were screened out in SF-GRER by using UPLC-Orbitrap-MS. The sulfonated products provided in this paper were discovered for the first time and could be powerfully applied for the identification of SF-GRER. SF destroyed the chemical composition of GRER, inhibited immunoregulation, and induced liver injury. The feasibility of this processing method needs to be reconsidered.
Collapse
Affiliation(s)
- Jun Jiang
- School of Pharmacy, Jiangsu University, 301 Xuefu Road, Zhenjiang 212013, Jiangsu Province, China
| | - Shichang Xiao
- School of Pharmacy, Jiangsu University, 301 Xuefu Road, Zhenjiang 212013, Jiangsu Province, China
| | - Shu Yan
- ADR Monitoring Center, Zhenjiang Food and Drug Supervision and Inspection Center, 62 Nanxu Road, Zhenjiang 212000, Jiangsu Province, China
| | - Jianpeng Xiao
- School of Pharmacy, Jiangsu University, 301 Xuefu Road, Zhenjiang 212013, Jiangsu Province, China
| | - Ximing Xu
- School of Pharmacy, Jiangsu University, 301 Xuefu Road, Zhenjiang 212013, Jiangsu Province, China
| |
Collapse
|
38
|
Bagheri R, Rashidlamir A, Ashtary-Larky D, Wong A, Alipour M, Motevalli MS, Chebbi A, Laher I, Zouhal H. Does green tea extract enhance the anti-inflammatory effects of exercise on fat loss? Br J Clin Pharmacol 2020; 86:753-762. [PMID: 31747468 DOI: 10.1111/bcp.14176] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Revised: 08/19/2019] [Accepted: 11/10/2019] [Indexed: 12/14/2022] Open
Abstract
AIMS Green tea extract (GTE) can exert antiobesity and anti-inflammatory effects. Our study determined whether the benefits of GTE are summative with exercise-induced changes in anthropometric indices, and the levels of inflammatory cytokines, adiponectin and irisin in inactive overweight women. METHODS Thirty overweight female participants were randomized to 3 groups: endurance training + placebo (ET + P); endurance training + GTE (ET + GTE); and Control (no exercise) + placebo (Control, n = 10). The exercise intervention consisted of an 8-week endurance-training programme of 3 sessions per week (aerobics, aerobic circuit training, and fast walking or jogging at a moderate intensity of 40-59% of the heart rate reserve). The dose of GTE used was 500 mg/day in the form of a green tea capsule. RESULTS Body weight, body mass index, waist to hip ratio and body fat percentage were decreased in both ET + P and ET + GTE interventions (P < .001 for both interventions). The reduction of anthropometric values in the ET + GTE group was significantly higher than ET + P interventions (P < .001). Both exercise interventions also significantly (P < .001) increased adiponectin (ET + GTE = 5.28 mg/mL [95% confidence interval {CI}, 4.48 to 6.08] and ET + P = 3.34 mg/mL [95% CI, 2.76 to 3.92]) and decreased high-sensitivity C-reactive protein (hs-CRP; ET + GTE = -0.95 mg/L [95% CI, -1.15 to -0.75] and ET + P = -0.35 mg/L [95% CI, -0.46 to -0.24]). Changes in adiponectin and hs-CRP were greater (P < .05) in ET + GTE compared to ET + P. There were no significant differences in irisin, interleukin-6 or tumour necrosis factor-α between the 3 groups (P > .05). CONCLUSIONS GTE improves exercise-induced body composition by further decreasing exercise-induced changes in weight, body mass index, waist to hip ratio and body fat percentage. The combination of GTE and exercise also produced greater changes in anti-inflammatory (increases in adiponectin) and metabolic (decreases in hs-CRP) markers than exercise alone.
Collapse
Affiliation(s)
- Reza Bagheri
- Department of Exercise Physiology, University of Isfahan, Isfahan, Iran
| | - Amir Rashidlamir
- Department of Exercise Physiology, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Damoon Ashtary-Larky
- Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Alexei Wong
- Department of Health and Human Performance, Marymount University, Arlington, VA, USA
| | - Meysam Alipour
- Alimentary Tract Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohamad S Motevalli
- Department of Exercise Physiology, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Amel Chebbi
- Faculty of Medicine of Tunis, University of Tunis, Tunis, Tunisia
| | - Ismail Laher
- Department of Pharmacology and Therapeutics, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Hassane Zouhal
- Univ Rennes, M2S (Laboratoire Mouvement, Sport, Santé), Rennes, France
| |
Collapse
|
39
|
Ferro Y, Montalcini T, Mazza E, Foti D, Angotti E, Gliozzi M, Nucera S, Paone S, Bombardelli E, Aversa I, Musolino V, Mollace V, Pujia A. Randomized Clinical Trial: Bergamot Citrus and Wild Cardoon Reduce Liver Steatosis and Body Weight in Non-diabetic Individuals Aged Over 50 Years. Front Endocrinol (Lausanne) 2020; 11:494. [PMID: 32849284 PMCID: PMC7431622 DOI: 10.3389/fendo.2020.00494] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 06/22/2020] [Indexed: 12/16/2022] Open
Abstract
Background: Non-alcoholic fatty liver disease is the most common cause of liver-related morbidity and mortality in the world. However, no effective pharmacological treatment for this condition has been found. Purpose: This study evaluated the effect of a nutraceutical containing bioactive components from Bergamot citrus and wild cardoon as a treatment for individuals with fatty liver disease. The primary outcome measure was the change in liver fat content. Methods: A total of 102 patients with liver steatosis were enrolled in a double-blind placebo controlled clinical trial. The intervention group received a nutraceutical containing a Bergamot polyphenol fraction and Cynara Cardunculus extract, 300 mg/day for 12 weeks. The control group received a placebo daily. Liver fat content, by transient elastography, serum transaminases, lipids and glucose were measured at the baseline and the end of the study. Results: We found a greater liver fat content reduction in the participants taking the nutraceutical rather than placebo (-48.2 ± 39 vs. -26.9 ± 43 dB/m, p = 0.02); The percentage CAP score reduction was statistically significant in those with android obesity, overweight/obesity as well as in women. However, after adjustment for weight change, the percentage CAP score reduction was statistically significant only in those over 50 years (44 vs. 78% in placebo and nutraceutical, respectively, p = 0.007). Conclusions: This specific nutraceutical containing bioactive components from Bergamot and wild cardoon reduced the liver fat content during 12 weeks in individuals with liver steatosis over 50 years. If confirmed, this nutraceutical could become the cornerstone treatment of patients affected by liver steatosis. Clinical Trial Registration: www.isrctn.com, identifier ISRCTN12833814.
Collapse
Affiliation(s)
- Yvelise Ferro
- Department of Health Science, University Magna Grecia, Catanzaro, Italy
| | - Tiziana Montalcini
- Department of Clinical and Experimental Medicine, University Magna Grecia, Catanzaro, Italy
- *Correspondence: Tiziana Montalcini
| | - Elisa Mazza
- Department of Medical and Surgical Science, University Magna Grecia, Catanzaro, Italy
| | - Daniela Foti
- Department of Health Science, University Magna Grecia, Catanzaro, Italy
| | - Elvira Angotti
- Department of Clinical and Experimental Medicine, University Magna Grecia, Catanzaro, Italy
| | - Micaela Gliozzi
- Department of Health Science, University Magna Grecia, Catanzaro, Italy
| | - Saverio Nucera
- Department of Health Science, University Magna Grecia, Catanzaro, Italy
| | - Sara Paone
- Department of Health Science, University Magna Grecia, Catanzaro, Italy
| | | | - Ilaria Aversa
- Department of Clinical and Experimental Medicine, University Magna Grecia, Catanzaro, Italy
| | - Vincenzo Musolino
- Department of Health Science, University Magna Grecia, Catanzaro, Italy
| | - Vincenzo Mollace
- Department of Health Science, University Magna Grecia, Catanzaro, Italy
| | - Arturo Pujia
- Department of Medical and Surgical Science, University Magna Grecia, Catanzaro, Italy
| |
Collapse
|
40
|
Gürol A, Şener Taplak A, Polat S. Herbal supplement products used by mothers to cope with the common health problems in childhood. Complement Ther Med 2019; 47:102214. [DOI: 10.1016/j.ctim.2019.102214] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Revised: 08/27/2019] [Accepted: 10/09/2019] [Indexed: 01/06/2023] Open
|
41
|
Shi J, Hu H, Harnett J, Zheng X, Liang Z, Wang YT, Ung COL. An evaluation of randomized controlled trials on nutraceuticals containing traditional Chinese medicines for diabetes management: a systematic review. Chin Med 2019; 14:54. [PMID: 31798675 PMCID: PMC6884840 DOI: 10.1186/s13020-019-0276-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 11/07/2019] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Nutraceuticals containing traditional Chinese medicine (TCM) are promoted for use in the management of diabetes. The evidence to support such use is largely unknown. This study aimed to summarise and evaluate the literature reporting the results of randomized controlled trials (RCTs) investigating the effects of nutraceuticals in people living with diabetes. METHODS Literature from four electronic databases (PubMed, Scopus, CINAHL and Web of Science) was searched following PRISMA guidelines to yield RCT publications on nutraceutical for diabetes management published since 2009. The quality of reporting was assessed using the CONSORT 2010 checklist statement. Risk-of-bias for each study was assessed using the Cochrane risk of bias tool. RESULTS Out of 1978 records identified in the initial search, 24 randomized, double/triple-blinded, controlled trials that investigated the effect of nutraceuticals covering 17 different TCM herbs for diabetes management were selected. Participants included people who were diabetic (n = 16), pre-diabetic (n = 3) or predisposed to diabetes (n = 5). Sample sizes ranged between 23 and 117 for 2 arms, or 99-165 for 3 arms. Comparisons were made against placebo (n = 22), conventional medicine (n = 1), or regular diet (n = 1) for a duration between 4 and 24 weeks. All but one study tested the effect on fasting blood glucose levels (n = 23) or glycated haemoglobin levels (n = 18), and/or postprandial 2-h blood glucose levels (n = 4) as the primary outcomes. Nineteen studies reported some statistically significant reductions in the respective measures while 5 studies showed no effect on primary or secondary outcomes. None of the included studies met all the criteria for the CONSORT guidelines. Incomplete reporting about randomization and blinding, and a lack of ancillary analyses to explore other influential factors and potential harms associated with the use were repeatedly noted. Based on the Cochrane risk-of-bias tool, 19 studies were deemed to have a high risk of bias mainly attributed to sponsor bias. CONCLUSIONS There is some evidence to suggest positive clinical outcomes in response to the administration of a range of nutraceuticals containing TCM in the management of diabetes. However, these results must be interpreted with caution due to the overall low quality of the trials.
Collapse
Affiliation(s)
- Junnan Shi
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macao
| | - Hao Hu
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macao
| | - Joanna Harnett
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| | - Xiaoting Zheng
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macao
| | - Zuanji Liang
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macao
| | - Yi-Tao Wang
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macao
| | - Carolina Oi Lam Ung
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macao
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| |
Collapse
|
42
|
Dickinson R, Kennedy MC, Raynor DK, Knapp P, Thomas M, Adami E. What has been the impact of the Traditional Herbal Registration (THR) scheme in the UK on information provided with herbal products bought over the counter? Altern Ther Health Med 2019; 19:85. [PMID: 30975140 PMCID: PMC6460666 DOI: 10.1186/s12906-019-2494-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 03/28/2019] [Indexed: 01/22/2023]
Abstract
BACKGROUND In 2011 there was a strengthening of European Union (EU) legislation on the licencing of herbal products which, in the UK, resulted in the introduction of the Traditional Herbal Registration (THR) scheme. This scheme sets out standards for the safety and quality of herbal medicines and includes the provision of information to the customer on the safe use of the product. The aim of this study is to replicate a survey undertaken in 2011, prior to the implementation of the THR scheme, and evaluate the impact of this scheme on the information provided with herbal products bought over-the-counter. METHODS We undertook a survey on 5 herbal products commonly available over-the-counter (St John's wort, echinacea, Ginkgo biloba, Asian ginseng, garlic). The information was searched for key safety messages identified by the National Center for Complementary and Integrative Health (NCCIH). We also explored the presence of risk of harm information. RESULTS We recorded a rise in the number of products registered with the THR scheme (37% in 2016 compared to 7% in 2011). We also identified a reduction in the number of products that did not contain key safety information (75% in 2011 compared to 20% of products obtained in 2016). Risk of harm information was only communicated in products containing a PIL. We identified more products containing frequency of risk of harm information but this was not statistically significant. CONCLUSION The introduction of the THR scheme appears to be associated with an increase in the provision of information about key safety messages on the safe use of herbal products. However, it is important to note that at least half of the products on the market that are not included in the THR scheme do not contain any information about their safe use; this includes information about precautions, interactions and side effects. The use of NCCIH herbal monographs replicated the methods used in the previous study; we recognise that the use of a different resource might effect the appraisal of the information provided. We also acknowledge that surveying presence of information does not assure that the latter is effectively communicated to patients, for which a close textual analysis would be required. While it is promising that more information is available after the introduction of the THR scheme, the public needs to be informed about ways to optimise safe use of all herbal products.
Collapse
|
43
|
Puga AM, Lopez-Oliva S, Trives C, Partearroyo T, Varela-Moreiras G. Effects of Drugs and Excipients on Hydration Status. Nutrients 2019; 11:nu11030669. [PMID: 30897748 PMCID: PMC6470661 DOI: 10.3390/nu11030669] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 03/14/2019] [Accepted: 03/15/2019] [Indexed: 12/17/2022] Open
Abstract
Despite being the most essential nutrient, water is commonly forgotten in the fields of pharmacy and nutrition. Hydration status is determined by water balance (the difference between water input and output). Hypohydration or negative water balance is affected by numerous factors, either internal (i.e., a lack of thirst sensation) or external (e.g., polypharmacy or chronic consumption of certain drugs). However, to date, research on the interaction between hydration status and drugs/excipients has been scarce. Drugs may trigger the appearance of hypohydration by means of the increase of water elimination through either diarrhea, urine or sweat; a decrease in thirst sensation or appetite; or the alteration of central thermoregulation. On the other hand, pharmaceutical excipients induce alterations in hydration status by decreasing the gastrointestinal transit time or increasing the gastrointestinal tract rate or intestinal permeability. In the present review, we evaluate studies that focus on the effects of drugs/excipients on hydration status. These studies support the aim of monitoring the hydration status in patients, mainly in those population segments with a higher risk, to avoid complications and associated pathologies, which are key axes in both pharmaceutical care and the field of nutrition.
Collapse
Affiliation(s)
- Ana M Puga
- Department of Pharmaceutical and Health Sciences, Faculty of Pharmacy, CEU San Pablo University, 28668 Madrid, Spain.
| | - Sara Lopez-Oliva
- Department of Pharmaceutical and Health Sciences, Faculty of Pharmacy, CEU San Pablo University, 28668 Madrid, Spain.
| | - Carmen Trives
- Department of Pharmaceutical and Health Sciences, Faculty of Pharmacy, CEU San Pablo University, 28668 Madrid, Spain.
| | - Teresa Partearroyo
- Department of Pharmaceutical and Health Sciences, Faculty of Pharmacy, CEU San Pablo University, 28668 Madrid, Spain.
| | - Gregorio Varela-Moreiras
- Department of Pharmaceutical and Health Sciences, Faculty of Pharmacy, CEU San Pablo University, 28668 Madrid, Spain.
- Spanish Nutrition Foundation (FEN), 28010 Madrid, Spain.
| |
Collapse
|
44
|
Omelchenko DO, Speranskaya AS, Ayginin AA, Khafizov K, Krinitsina AA, Fedotova AV, Pozdyshev DV, Shtratnikova VY, Kupriyanova EV, Shipulin GA, Logacheva MD. Improved Protocols of ITS1-Based Metabarcoding and Their Application in the Analysis of Plant-Containing Products. Genes (Basel) 2019; 10:genes10020122. [PMID: 30736447 PMCID: PMC6409534 DOI: 10.3390/genes10020122] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Revised: 01/28/2019] [Accepted: 02/04/2019] [Indexed: 12/16/2022] Open
Abstract
Plants are widely used for food and beverage preparation, most often in the form of complex mixtures of dried and ground parts, such as teas, spices or herbal medicines. Quality control of such products is important due to the potential health risks from the presence of unlabelled components or absence of claimed ones. A promising approach to analyse such products is DNA metabarcoding due to its high resolution and sensitivity. However, this method’s application in food analysis requires several methodology optimizations in DNA extraction, amplification and library preparation. In this study, we present such optimizations. The most important methodological outcomes are the following: (1) the DNA extraction method greatly influences amplification success; (2) the main problem for the application of metabarcoding is DNA purity, not integrity or quantity; and (3) the “non-amplifiable” samples can be amplified with polymerases resistant to inhibitors. Using this optimized workflow, we analysed a broad set of plant products (teas, spices and herbal remedies) using two NGS platforms. The analysis revealed the problem of both the presence of extraneous components and the absence of labelled ones. Notably, for teas, no correlation was found between the price and either the absence of labelled components or presence of unlabelled ones; for spices, a negative correlation was found between the price and presence of unlabelled components.
Collapse
Affiliation(s)
- Denis O Omelchenko
- Skolkovo Institute of Science and Technology, Nobel St. 3, Moscow 143026, Russia.
- Institute for Information Transmission Problems, Bolshoy Karetny per. 19, build.1, Moscow 127051, Russia.
| | - Anna S Speranskaya
- Skolkovo Institute of Science and Technology, Nobel St. 3, Moscow 143026, Russia.
- Central Research Institute of Epidemiology, Novogireevskaya St. 3а, Moscow 111123, Russia.
- Lomonosov Moscow State University, Leninskie Gory, GSP-1, Moscow 119991, Russia.
| | - Andrey A Ayginin
- Skolkovo Institute of Science and Technology, Nobel St. 3, Moscow 143026, Russia.
- Moscow Institute of Physics and Technology, Institutskiy Ln. 9, Dolgoprudny 141701, Moscow Region, Russia.
| | - Kamil Khafizov
- Skolkovo Institute of Science and Technology, Nobel St. 3, Moscow 143026, Russia.
- Central Research Institute of Epidemiology, Novogireevskaya St. 3а, Moscow 111123, Russia.
- Moscow Institute of Physics and Technology, Institutskiy Ln. 9, Dolgoprudny 141701, Moscow Region, Russia.
- Center for Strategic Planning, Ministry of Health of the Russian Federation, Pogodinskaya St. 10, build.1, Moscow 119121, Russia.
| | - Anastasia A Krinitsina
- Skolkovo Institute of Science and Technology, Nobel St. 3, Moscow 143026, Russia.
- Lomonosov Moscow State University, Leninskie Gory, GSP-1, Moscow 119991, Russia.
| | - Anna V Fedotova
- Skolkovo Institute of Science and Technology, Nobel St. 3, Moscow 143026, Russia.
- Lomonosov Moscow State University, Leninskie Gory, GSP-1, Moscow 119991, Russia.
| | - Denis V Pozdyshev
- Lomonosov Moscow State University, Leninskie Gory, GSP-1, Moscow 119991, Russia.
| | - Viktoria Y Shtratnikova
- Skolkovo Institute of Science and Technology, Nobel St. 3, Moscow 143026, Russia.
- Lomonosov Moscow State University, Leninskie Gory, GSP-1, Moscow 119991, Russia.
| | - Evgenia V Kupriyanova
- Skolkovo Institute of Science and Technology, Nobel St. 3, Moscow 143026, Russia.
- Lomonosov Moscow State University, Leninskie Gory, GSP-1, Moscow 119991, Russia.
| | - German A Shipulin
- Center for Strategic Planning, Ministry of Health of the Russian Federation, Pogodinskaya St. 10, build.1, Moscow 119121, Russia.
| | - Maria D Logacheva
- Skolkovo Institute of Science and Technology, Nobel St. 3, Moscow 143026, Russia.
- Institute for Information Transmission Problems, Bolshoy Karetny per. 19, build.1, Moscow 127051, Russia.
- Lomonosov Moscow State University, Leninskie Gory, GSP-1, Moscow 119991, Russia.
| |
Collapse
|
45
|
Garg AX, Devereaux PJ, Hill A, Sood M, Aggarwal B, Dubois L, Hiremath S, Guzman R, Iyer V, James M, McArthur E, Moist L, Ouellet G, Parikh CR, Schumann V, Sharan S, Thiessen-Philbrook H, Tobe S, Wald R, Walsh M, Weir M, Pannu N. Oral curcumin in elective abdominal aortic aneurysm repair: a multicentre randomized controlled trial. CMAJ 2018; 190:E1273-E1280. [PMID: 30373740 PMCID: PMC6205831 DOI: 10.1503/cmaj.180510] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2018] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Curcumin, a popular herbal supplement from the plant turmeric, has prevented ischemic reperfusion and toxin-induced injury in many animal studies and a single-centre randomized human trial. We sought to test whether perioperative oral curcumin (compared with placebo) affects the inflammatory response and risk of postrepair complications after elective abdominal aortic aneurysm repair in humans. METHODS We conducted a parallel-group, randomized, placebo-controlled trial of patients from 10 hospitals in Canada who were scheduled to undergo elective repair of an unruptured abdominal aortic aneurysm (November 2011 to November 2014). Patients in the treatment group received perioperative oral curcumin (2000-mg doses 8 times over 4 d). Patients, health care providers and local research staff were unaware of the treatment assignment. The primary outcomes were median concentrations of 4 bio markers indicating injury and inflammation (postoperative urine interleukin-18 and perioperative rise in serum creatinine, plasma N-terminal pro-B-type natriuretic peptide and plasma high-sensitivity C-reactive protein). RESULTS Baseline characteristics were similar in the 2 groups (606 patients overall; median age 76 yr). More than 85% of patients in each group took more than 80% of their scheduled capsules. Neither curcumin nor placebo significantly affected any of the 4 biomarkers (p > 0.05 for all comparisons). Regarding the secondary outcomes, there was a higher risk of acute kidney injury with curcumin than with placebo (17% v. 10%, p = 0.01), but no between-group difference in the median length of hospital stay (5 v. 5 days, p > 0.9) or the risk of clinical events (9% v. 9%, p = 0.9). INTERPRETATION Curcumin had no beneficial effects when used in elective abdominal aortic aneurysm repair. These findings emphasize the importance of testing turmeric and curcumin before espousing their health benefits, as is currently done in the popular media. TRIAL REGISTRATION ClinicalTrials.gov, no. NCT01225094.
Collapse
Affiliation(s)
- Amit X Garg
- Departments of Medicine (Garg, McArthur, Moist, Schumann, Thiessen-Philbrook, Weir), of Epidemiology and Bio-statistics (Garg, Dubois, Moist, Weir) and of Surgery (Dubois), Western University, London, Ont.; Departments of Health Research Methods, Evidence, and Impact (Devereaux, Walsh), of Medicine (Devereaux, Walsh) and of Surgery (Iyer), McMaster University, Hamilton, Ont.; Departments of Surgery (Hill) and of Medicine (Sood, Hiremath), University of Ottawa, Ottawa, Ont.; Department of Experimental Therapeutics, Cancer Medicine and Immunology (Aggarwal), The University of Texas MD Anderson Cancer Center, Houston, Tex.; Department of Surgery (Guzman), University of Manitoba, Winnipeg, Man.; Department of Medicine (James), University of Calgary, Calgary, Alta.; Faculté de médecine (Ouellet), Université de Montréal, Montréal, Que.; Program of Applied Translational Research, Department of Medicine (Parikh), and Section of Nephrology (Parikh), Yale University School of Medicine, New Haven, Conn.; Department of Anesthesia (Sharan), Laurentian University, Sudbury, Ont.; Department of Medicine (Tobe, Wald), University of Toronto, Toronto, Ont.; Department of Medicine (Pannu), University of Alberta, Edmonton, Alta.
| | - P J Devereaux
- Departments of Medicine (Garg, McArthur, Moist, Schumann, Thiessen-Philbrook, Weir), of Epidemiology and Bio-statistics (Garg, Dubois, Moist, Weir) and of Surgery (Dubois), Western University, London, Ont.; Departments of Health Research Methods, Evidence, and Impact (Devereaux, Walsh), of Medicine (Devereaux, Walsh) and of Surgery (Iyer), McMaster University, Hamilton, Ont.; Departments of Surgery (Hill) and of Medicine (Sood, Hiremath), University of Ottawa, Ottawa, Ont.; Department of Experimental Therapeutics, Cancer Medicine and Immunology (Aggarwal), The University of Texas MD Anderson Cancer Center, Houston, Tex.; Department of Surgery (Guzman), University of Manitoba, Winnipeg, Man.; Department of Medicine (James), University of Calgary, Calgary, Alta.; Faculté de médecine (Ouellet), Université de Montréal, Montréal, Que.; Program of Applied Translational Research, Department of Medicine (Parikh), and Section of Nephrology (Parikh), Yale University School of Medicine, New Haven, Conn.; Department of Anesthesia (Sharan), Laurentian University, Sudbury, Ont.; Department of Medicine (Tobe, Wald), University of Toronto, Toronto, Ont.; Department of Medicine (Pannu), University of Alberta, Edmonton, Alta
| | - Andrew Hill
- Departments of Medicine (Garg, McArthur, Moist, Schumann, Thiessen-Philbrook, Weir), of Epidemiology and Bio-statistics (Garg, Dubois, Moist, Weir) and of Surgery (Dubois), Western University, London, Ont.; Departments of Health Research Methods, Evidence, and Impact (Devereaux, Walsh), of Medicine (Devereaux, Walsh) and of Surgery (Iyer), McMaster University, Hamilton, Ont.; Departments of Surgery (Hill) and of Medicine (Sood, Hiremath), University of Ottawa, Ottawa, Ont.; Department of Experimental Therapeutics, Cancer Medicine and Immunology (Aggarwal), The University of Texas MD Anderson Cancer Center, Houston, Tex.; Department of Surgery (Guzman), University of Manitoba, Winnipeg, Man.; Department of Medicine (James), University of Calgary, Calgary, Alta.; Faculté de médecine (Ouellet), Université de Montréal, Montréal, Que.; Program of Applied Translational Research, Department of Medicine (Parikh), and Section of Nephrology (Parikh), Yale University School of Medicine, New Haven, Conn.; Department of Anesthesia (Sharan), Laurentian University, Sudbury, Ont.; Department of Medicine (Tobe, Wald), University of Toronto, Toronto, Ont.; Department of Medicine (Pannu), University of Alberta, Edmonton, Alta
| | - Manish Sood
- Departments of Medicine (Garg, McArthur, Moist, Schumann, Thiessen-Philbrook, Weir), of Epidemiology and Bio-statistics (Garg, Dubois, Moist, Weir) and of Surgery (Dubois), Western University, London, Ont.; Departments of Health Research Methods, Evidence, and Impact (Devereaux, Walsh), of Medicine (Devereaux, Walsh) and of Surgery (Iyer), McMaster University, Hamilton, Ont.; Departments of Surgery (Hill) and of Medicine (Sood, Hiremath), University of Ottawa, Ottawa, Ont.; Department of Experimental Therapeutics, Cancer Medicine and Immunology (Aggarwal), The University of Texas MD Anderson Cancer Center, Houston, Tex.; Department of Surgery (Guzman), University of Manitoba, Winnipeg, Man.; Department of Medicine (James), University of Calgary, Calgary, Alta.; Faculté de médecine (Ouellet), Université de Montréal, Montréal, Que.; Program of Applied Translational Research, Department of Medicine (Parikh), and Section of Nephrology (Parikh), Yale University School of Medicine, New Haven, Conn.; Department of Anesthesia (Sharan), Laurentian University, Sudbury, Ont.; Department of Medicine (Tobe, Wald), University of Toronto, Toronto, Ont.; Department of Medicine (Pannu), University of Alberta, Edmonton, Alta
| | - Bharat Aggarwal
- Departments of Medicine (Garg, McArthur, Moist, Schumann, Thiessen-Philbrook, Weir), of Epidemiology and Bio-statistics (Garg, Dubois, Moist, Weir) and of Surgery (Dubois), Western University, London, Ont.; Departments of Health Research Methods, Evidence, and Impact (Devereaux, Walsh), of Medicine (Devereaux, Walsh) and of Surgery (Iyer), McMaster University, Hamilton, Ont.; Departments of Surgery (Hill) and of Medicine (Sood, Hiremath), University of Ottawa, Ottawa, Ont.; Department of Experimental Therapeutics, Cancer Medicine and Immunology (Aggarwal), The University of Texas MD Anderson Cancer Center, Houston, Tex.; Department of Surgery (Guzman), University of Manitoba, Winnipeg, Man.; Department of Medicine (James), University of Calgary, Calgary, Alta.; Faculté de médecine (Ouellet), Université de Montréal, Montréal, Que.; Program of Applied Translational Research, Department of Medicine (Parikh), and Section of Nephrology (Parikh), Yale University School of Medicine, New Haven, Conn.; Department of Anesthesia (Sharan), Laurentian University, Sudbury, Ont.; Department of Medicine (Tobe, Wald), University of Toronto, Toronto, Ont.; Department of Medicine (Pannu), University of Alberta, Edmonton, Alta
| | - Luc Dubois
- Departments of Medicine (Garg, McArthur, Moist, Schumann, Thiessen-Philbrook, Weir), of Epidemiology and Bio-statistics (Garg, Dubois, Moist, Weir) and of Surgery (Dubois), Western University, London, Ont.; Departments of Health Research Methods, Evidence, and Impact (Devereaux, Walsh), of Medicine (Devereaux, Walsh) and of Surgery (Iyer), McMaster University, Hamilton, Ont.; Departments of Surgery (Hill) and of Medicine (Sood, Hiremath), University of Ottawa, Ottawa, Ont.; Department of Experimental Therapeutics, Cancer Medicine and Immunology (Aggarwal), The University of Texas MD Anderson Cancer Center, Houston, Tex.; Department of Surgery (Guzman), University of Manitoba, Winnipeg, Man.; Department of Medicine (James), University of Calgary, Calgary, Alta.; Faculté de médecine (Ouellet), Université de Montréal, Montréal, Que.; Program of Applied Translational Research, Department of Medicine (Parikh), and Section of Nephrology (Parikh), Yale University School of Medicine, New Haven, Conn.; Department of Anesthesia (Sharan), Laurentian University, Sudbury, Ont.; Department of Medicine (Tobe, Wald), University of Toronto, Toronto, Ont.; Department of Medicine (Pannu), University of Alberta, Edmonton, Alta
| | - Swapnil Hiremath
- Departments of Medicine (Garg, McArthur, Moist, Schumann, Thiessen-Philbrook, Weir), of Epidemiology and Bio-statistics (Garg, Dubois, Moist, Weir) and of Surgery (Dubois), Western University, London, Ont.; Departments of Health Research Methods, Evidence, and Impact (Devereaux, Walsh), of Medicine (Devereaux, Walsh) and of Surgery (Iyer), McMaster University, Hamilton, Ont.; Departments of Surgery (Hill) and of Medicine (Sood, Hiremath), University of Ottawa, Ottawa, Ont.; Department of Experimental Therapeutics, Cancer Medicine and Immunology (Aggarwal), The University of Texas MD Anderson Cancer Center, Houston, Tex.; Department of Surgery (Guzman), University of Manitoba, Winnipeg, Man.; Department of Medicine (James), University of Calgary, Calgary, Alta.; Faculté de médecine (Ouellet), Université de Montréal, Montréal, Que.; Program of Applied Translational Research, Department of Medicine (Parikh), and Section of Nephrology (Parikh), Yale University School of Medicine, New Haven, Conn.; Department of Anesthesia (Sharan), Laurentian University, Sudbury, Ont.; Department of Medicine (Tobe, Wald), University of Toronto, Toronto, Ont.; Department of Medicine (Pannu), University of Alberta, Edmonton, Alta
| | - Randolph Guzman
- Departments of Medicine (Garg, McArthur, Moist, Schumann, Thiessen-Philbrook, Weir), of Epidemiology and Bio-statistics (Garg, Dubois, Moist, Weir) and of Surgery (Dubois), Western University, London, Ont.; Departments of Health Research Methods, Evidence, and Impact (Devereaux, Walsh), of Medicine (Devereaux, Walsh) and of Surgery (Iyer), McMaster University, Hamilton, Ont.; Departments of Surgery (Hill) and of Medicine (Sood, Hiremath), University of Ottawa, Ottawa, Ont.; Department of Experimental Therapeutics, Cancer Medicine and Immunology (Aggarwal), The University of Texas MD Anderson Cancer Center, Houston, Tex.; Department of Surgery (Guzman), University of Manitoba, Winnipeg, Man.; Department of Medicine (James), University of Calgary, Calgary, Alta.; Faculté de médecine (Ouellet), Université de Montréal, Montréal, Que.; Program of Applied Translational Research, Department of Medicine (Parikh), and Section of Nephrology (Parikh), Yale University School of Medicine, New Haven, Conn.; Department of Anesthesia (Sharan), Laurentian University, Sudbury, Ont.; Department of Medicine (Tobe, Wald), University of Toronto, Toronto, Ont.; Department of Medicine (Pannu), University of Alberta, Edmonton, Alta
| | - Vikram Iyer
- Departments of Medicine (Garg, McArthur, Moist, Schumann, Thiessen-Philbrook, Weir), of Epidemiology and Bio-statistics (Garg, Dubois, Moist, Weir) and of Surgery (Dubois), Western University, London, Ont.; Departments of Health Research Methods, Evidence, and Impact (Devereaux, Walsh), of Medicine (Devereaux, Walsh) and of Surgery (Iyer), McMaster University, Hamilton, Ont.; Departments of Surgery (Hill) and of Medicine (Sood, Hiremath), University of Ottawa, Ottawa, Ont.; Department of Experimental Therapeutics, Cancer Medicine and Immunology (Aggarwal), The University of Texas MD Anderson Cancer Center, Houston, Tex.; Department of Surgery (Guzman), University of Manitoba, Winnipeg, Man.; Department of Medicine (James), University of Calgary, Calgary, Alta.; Faculté de médecine (Ouellet), Université de Montréal, Montréal, Que.; Program of Applied Translational Research, Department of Medicine (Parikh), and Section of Nephrology (Parikh), Yale University School of Medicine, New Haven, Conn.; Department of Anesthesia (Sharan), Laurentian University, Sudbury, Ont.; Department of Medicine (Tobe, Wald), University of Toronto, Toronto, Ont.; Department of Medicine (Pannu), University of Alberta, Edmonton, Alta
| | - Matthew James
- Departments of Medicine (Garg, McArthur, Moist, Schumann, Thiessen-Philbrook, Weir), of Epidemiology and Bio-statistics (Garg, Dubois, Moist, Weir) and of Surgery (Dubois), Western University, London, Ont.; Departments of Health Research Methods, Evidence, and Impact (Devereaux, Walsh), of Medicine (Devereaux, Walsh) and of Surgery (Iyer), McMaster University, Hamilton, Ont.; Departments of Surgery (Hill) and of Medicine (Sood, Hiremath), University of Ottawa, Ottawa, Ont.; Department of Experimental Therapeutics, Cancer Medicine and Immunology (Aggarwal), The University of Texas MD Anderson Cancer Center, Houston, Tex.; Department of Surgery (Guzman), University of Manitoba, Winnipeg, Man.; Department of Medicine (James), University of Calgary, Calgary, Alta.; Faculté de médecine (Ouellet), Université de Montréal, Montréal, Que.; Program of Applied Translational Research, Department of Medicine (Parikh), and Section of Nephrology (Parikh), Yale University School of Medicine, New Haven, Conn.; Department of Anesthesia (Sharan), Laurentian University, Sudbury, Ont.; Department of Medicine (Tobe, Wald), University of Toronto, Toronto, Ont.; Department of Medicine (Pannu), University of Alberta, Edmonton, Alta
| | - Eric McArthur
- Departments of Medicine (Garg, McArthur, Moist, Schumann, Thiessen-Philbrook, Weir), of Epidemiology and Bio-statistics (Garg, Dubois, Moist, Weir) and of Surgery (Dubois), Western University, London, Ont.; Departments of Health Research Methods, Evidence, and Impact (Devereaux, Walsh), of Medicine (Devereaux, Walsh) and of Surgery (Iyer), McMaster University, Hamilton, Ont.; Departments of Surgery (Hill) and of Medicine (Sood, Hiremath), University of Ottawa, Ottawa, Ont.; Department of Experimental Therapeutics, Cancer Medicine and Immunology (Aggarwal), The University of Texas MD Anderson Cancer Center, Houston, Tex.; Department of Surgery (Guzman), University of Manitoba, Winnipeg, Man.; Department of Medicine (James), University of Calgary, Calgary, Alta.; Faculté de médecine (Ouellet), Université de Montréal, Montréal, Que.; Program of Applied Translational Research, Department of Medicine (Parikh), and Section of Nephrology (Parikh), Yale University School of Medicine, New Haven, Conn.; Department of Anesthesia (Sharan), Laurentian University, Sudbury, Ont.; Department of Medicine (Tobe, Wald), University of Toronto, Toronto, Ont.; Department of Medicine (Pannu), University of Alberta, Edmonton, Alta
| | - Louise Moist
- Departments of Medicine (Garg, McArthur, Moist, Schumann, Thiessen-Philbrook, Weir), of Epidemiology and Bio-statistics (Garg, Dubois, Moist, Weir) and of Surgery (Dubois), Western University, London, Ont.; Departments of Health Research Methods, Evidence, and Impact (Devereaux, Walsh), of Medicine (Devereaux, Walsh) and of Surgery (Iyer), McMaster University, Hamilton, Ont.; Departments of Surgery (Hill) and of Medicine (Sood, Hiremath), University of Ottawa, Ottawa, Ont.; Department of Experimental Therapeutics, Cancer Medicine and Immunology (Aggarwal), The University of Texas MD Anderson Cancer Center, Houston, Tex.; Department of Surgery (Guzman), University of Manitoba, Winnipeg, Man.; Department of Medicine (James), University of Calgary, Calgary, Alta.; Faculté de médecine (Ouellet), Université de Montréal, Montréal, Que.; Program of Applied Translational Research, Department of Medicine (Parikh), and Section of Nephrology (Parikh), Yale University School of Medicine, New Haven, Conn.; Department of Anesthesia (Sharan), Laurentian University, Sudbury, Ont.; Department of Medicine (Tobe, Wald), University of Toronto, Toronto, Ont.; Department of Medicine (Pannu), University of Alberta, Edmonton, Alta
| | - George Ouellet
- Departments of Medicine (Garg, McArthur, Moist, Schumann, Thiessen-Philbrook, Weir), of Epidemiology and Bio-statistics (Garg, Dubois, Moist, Weir) and of Surgery (Dubois), Western University, London, Ont.; Departments of Health Research Methods, Evidence, and Impact (Devereaux, Walsh), of Medicine (Devereaux, Walsh) and of Surgery (Iyer), McMaster University, Hamilton, Ont.; Departments of Surgery (Hill) and of Medicine (Sood, Hiremath), University of Ottawa, Ottawa, Ont.; Department of Experimental Therapeutics, Cancer Medicine and Immunology (Aggarwal), The University of Texas MD Anderson Cancer Center, Houston, Tex.; Department of Surgery (Guzman), University of Manitoba, Winnipeg, Man.; Department of Medicine (James), University of Calgary, Calgary, Alta.; Faculté de médecine (Ouellet), Université de Montréal, Montréal, Que.; Program of Applied Translational Research, Department of Medicine (Parikh), and Section of Nephrology (Parikh), Yale University School of Medicine, New Haven, Conn.; Department of Anesthesia (Sharan), Laurentian University, Sudbury, Ont.; Department of Medicine (Tobe, Wald), University of Toronto, Toronto, Ont.; Department of Medicine (Pannu), University of Alberta, Edmonton, Alta
| | - Chirag R Parikh
- Departments of Medicine (Garg, McArthur, Moist, Schumann, Thiessen-Philbrook, Weir), of Epidemiology and Bio-statistics (Garg, Dubois, Moist, Weir) and of Surgery (Dubois), Western University, London, Ont.; Departments of Health Research Methods, Evidence, and Impact (Devereaux, Walsh), of Medicine (Devereaux, Walsh) and of Surgery (Iyer), McMaster University, Hamilton, Ont.; Departments of Surgery (Hill) and of Medicine (Sood, Hiremath), University of Ottawa, Ottawa, Ont.; Department of Experimental Therapeutics, Cancer Medicine and Immunology (Aggarwal), The University of Texas MD Anderson Cancer Center, Houston, Tex.; Department of Surgery (Guzman), University of Manitoba, Winnipeg, Man.; Department of Medicine (James), University of Calgary, Calgary, Alta.; Faculté de médecine (Ouellet), Université de Montréal, Montréal, Que.; Program of Applied Translational Research, Department of Medicine (Parikh), and Section of Nephrology (Parikh), Yale University School of Medicine, New Haven, Conn.; Department of Anesthesia (Sharan), Laurentian University, Sudbury, Ont.; Department of Medicine (Tobe, Wald), University of Toronto, Toronto, Ont.; Department of Medicine (Pannu), University of Alberta, Edmonton, Alta
| | - Virginia Schumann
- Departments of Medicine (Garg, McArthur, Moist, Schumann, Thiessen-Philbrook, Weir), of Epidemiology and Bio-statistics (Garg, Dubois, Moist, Weir) and of Surgery (Dubois), Western University, London, Ont.; Departments of Health Research Methods, Evidence, and Impact (Devereaux, Walsh), of Medicine (Devereaux, Walsh) and of Surgery (Iyer), McMaster University, Hamilton, Ont.; Departments of Surgery (Hill) and of Medicine (Sood, Hiremath), University of Ottawa, Ottawa, Ont.; Department of Experimental Therapeutics, Cancer Medicine and Immunology (Aggarwal), The University of Texas MD Anderson Cancer Center, Houston, Tex.; Department of Surgery (Guzman), University of Manitoba, Winnipeg, Man.; Department of Medicine (James), University of Calgary, Calgary, Alta.; Faculté de médecine (Ouellet), Université de Montréal, Montréal, Que.; Program of Applied Translational Research, Department of Medicine (Parikh), and Section of Nephrology (Parikh), Yale University School of Medicine, New Haven, Conn.; Department of Anesthesia (Sharan), Laurentian University, Sudbury, Ont.; Department of Medicine (Tobe, Wald), University of Toronto, Toronto, Ont.; Department of Medicine (Pannu), University of Alberta, Edmonton, Alta
| | - Sumit Sharan
- Departments of Medicine (Garg, McArthur, Moist, Schumann, Thiessen-Philbrook, Weir), of Epidemiology and Bio-statistics (Garg, Dubois, Moist, Weir) and of Surgery (Dubois), Western University, London, Ont.; Departments of Health Research Methods, Evidence, and Impact (Devereaux, Walsh), of Medicine (Devereaux, Walsh) and of Surgery (Iyer), McMaster University, Hamilton, Ont.; Departments of Surgery (Hill) and of Medicine (Sood, Hiremath), University of Ottawa, Ottawa, Ont.; Department of Experimental Therapeutics, Cancer Medicine and Immunology (Aggarwal), The University of Texas MD Anderson Cancer Center, Houston, Tex.; Department of Surgery (Guzman), University of Manitoba, Winnipeg, Man.; Department of Medicine (James), University of Calgary, Calgary, Alta.; Faculté de médecine (Ouellet), Université de Montréal, Montréal, Que.; Program of Applied Translational Research, Department of Medicine (Parikh), and Section of Nephrology (Parikh), Yale University School of Medicine, New Haven, Conn.; Department of Anesthesia (Sharan), Laurentian University, Sudbury, Ont.; Department of Medicine (Tobe, Wald), University of Toronto, Toronto, Ont.; Department of Medicine (Pannu), University of Alberta, Edmonton, Alta
| | - Heather Thiessen-Philbrook
- Departments of Medicine (Garg, McArthur, Moist, Schumann, Thiessen-Philbrook, Weir), of Epidemiology and Bio-statistics (Garg, Dubois, Moist, Weir) and of Surgery (Dubois), Western University, London, Ont.; Departments of Health Research Methods, Evidence, and Impact (Devereaux, Walsh), of Medicine (Devereaux, Walsh) and of Surgery (Iyer), McMaster University, Hamilton, Ont.; Departments of Surgery (Hill) and of Medicine (Sood, Hiremath), University of Ottawa, Ottawa, Ont.; Department of Experimental Therapeutics, Cancer Medicine and Immunology (Aggarwal), The University of Texas MD Anderson Cancer Center, Houston, Tex.; Department of Surgery (Guzman), University of Manitoba, Winnipeg, Man.; Department of Medicine (James), University of Calgary, Calgary, Alta.; Faculté de médecine (Ouellet), Université de Montréal, Montréal, Que.; Program of Applied Translational Research, Department of Medicine (Parikh), and Section of Nephrology (Parikh), Yale University School of Medicine, New Haven, Conn.; Department of Anesthesia (Sharan), Laurentian University, Sudbury, Ont.; Department of Medicine (Tobe, Wald), University of Toronto, Toronto, Ont.; Department of Medicine (Pannu), University of Alberta, Edmonton, Alta
| | - Sheldon Tobe
- Departments of Medicine (Garg, McArthur, Moist, Schumann, Thiessen-Philbrook, Weir), of Epidemiology and Bio-statistics (Garg, Dubois, Moist, Weir) and of Surgery (Dubois), Western University, London, Ont.; Departments of Health Research Methods, Evidence, and Impact (Devereaux, Walsh), of Medicine (Devereaux, Walsh) and of Surgery (Iyer), McMaster University, Hamilton, Ont.; Departments of Surgery (Hill) and of Medicine (Sood, Hiremath), University of Ottawa, Ottawa, Ont.; Department of Experimental Therapeutics, Cancer Medicine and Immunology (Aggarwal), The University of Texas MD Anderson Cancer Center, Houston, Tex.; Department of Surgery (Guzman), University of Manitoba, Winnipeg, Man.; Department of Medicine (James), University of Calgary, Calgary, Alta.; Faculté de médecine (Ouellet), Université de Montréal, Montréal, Que.; Program of Applied Translational Research, Department of Medicine (Parikh), and Section of Nephrology (Parikh), Yale University School of Medicine, New Haven, Conn.; Department of Anesthesia (Sharan), Laurentian University, Sudbury, Ont.; Department of Medicine (Tobe, Wald), University of Toronto, Toronto, Ont.; Department of Medicine (Pannu), University of Alberta, Edmonton, Alta
| | - Ron Wald
- Departments of Medicine (Garg, McArthur, Moist, Schumann, Thiessen-Philbrook, Weir), of Epidemiology and Bio-statistics (Garg, Dubois, Moist, Weir) and of Surgery (Dubois), Western University, London, Ont.; Departments of Health Research Methods, Evidence, and Impact (Devereaux, Walsh), of Medicine (Devereaux, Walsh) and of Surgery (Iyer), McMaster University, Hamilton, Ont.; Departments of Surgery (Hill) and of Medicine (Sood, Hiremath), University of Ottawa, Ottawa, Ont.; Department of Experimental Therapeutics, Cancer Medicine and Immunology (Aggarwal), The University of Texas MD Anderson Cancer Center, Houston, Tex.; Department of Surgery (Guzman), University of Manitoba, Winnipeg, Man.; Department of Medicine (James), University of Calgary, Calgary, Alta.; Faculté de médecine (Ouellet), Université de Montréal, Montréal, Que.; Program of Applied Translational Research, Department of Medicine (Parikh), and Section of Nephrology (Parikh), Yale University School of Medicine, New Haven, Conn.; Department of Anesthesia (Sharan), Laurentian University, Sudbury, Ont.; Department of Medicine (Tobe, Wald), University of Toronto, Toronto, Ont.; Department of Medicine (Pannu), University of Alberta, Edmonton, Alta
| | - Michael Walsh
- Departments of Medicine (Garg, McArthur, Moist, Schumann, Thiessen-Philbrook, Weir), of Epidemiology and Bio-statistics (Garg, Dubois, Moist, Weir) and of Surgery (Dubois), Western University, London, Ont.; Departments of Health Research Methods, Evidence, and Impact (Devereaux, Walsh), of Medicine (Devereaux, Walsh) and of Surgery (Iyer), McMaster University, Hamilton, Ont.; Departments of Surgery (Hill) and of Medicine (Sood, Hiremath), University of Ottawa, Ottawa, Ont.; Department of Experimental Therapeutics, Cancer Medicine and Immunology (Aggarwal), The University of Texas MD Anderson Cancer Center, Houston, Tex.; Department of Surgery (Guzman), University of Manitoba, Winnipeg, Man.; Department of Medicine (James), University of Calgary, Calgary, Alta.; Faculté de médecine (Ouellet), Université de Montréal, Montréal, Que.; Program of Applied Translational Research, Department of Medicine (Parikh), and Section of Nephrology (Parikh), Yale University School of Medicine, New Haven, Conn.; Department of Anesthesia (Sharan), Laurentian University, Sudbury, Ont.; Department of Medicine (Tobe, Wald), University of Toronto, Toronto, Ont.; Department of Medicine (Pannu), University of Alberta, Edmonton, Alta
| | - Matthew Weir
- Departments of Medicine (Garg, McArthur, Moist, Schumann, Thiessen-Philbrook, Weir), of Epidemiology and Bio-statistics (Garg, Dubois, Moist, Weir) and of Surgery (Dubois), Western University, London, Ont.; Departments of Health Research Methods, Evidence, and Impact (Devereaux, Walsh), of Medicine (Devereaux, Walsh) and of Surgery (Iyer), McMaster University, Hamilton, Ont.; Departments of Surgery (Hill) and of Medicine (Sood, Hiremath), University of Ottawa, Ottawa, Ont.; Department of Experimental Therapeutics, Cancer Medicine and Immunology (Aggarwal), The University of Texas MD Anderson Cancer Center, Houston, Tex.; Department of Surgery (Guzman), University of Manitoba, Winnipeg, Man.; Department of Medicine (James), University of Calgary, Calgary, Alta.; Faculté de médecine (Ouellet), Université de Montréal, Montréal, Que.; Program of Applied Translational Research, Department of Medicine (Parikh), and Section of Nephrology (Parikh), Yale University School of Medicine, New Haven, Conn.; Department of Anesthesia (Sharan), Laurentian University, Sudbury, Ont.; Department of Medicine (Tobe, Wald), University of Toronto, Toronto, Ont.; Department of Medicine (Pannu), University of Alberta, Edmonton, Alta
| | - Neesh Pannu
- Departments of Medicine (Garg, McArthur, Moist, Schumann, Thiessen-Philbrook, Weir), of Epidemiology and Bio-statistics (Garg, Dubois, Moist, Weir) and of Surgery (Dubois), Western University, London, Ont.; Departments of Health Research Methods, Evidence, and Impact (Devereaux, Walsh), of Medicine (Devereaux, Walsh) and of Surgery (Iyer), McMaster University, Hamilton, Ont.; Departments of Surgery (Hill) and of Medicine (Sood, Hiremath), University of Ottawa, Ottawa, Ont.; Department of Experimental Therapeutics, Cancer Medicine and Immunology (Aggarwal), The University of Texas MD Anderson Cancer Center, Houston, Tex.; Department of Surgery (Guzman), University of Manitoba, Winnipeg, Man.; Department of Medicine (James), University of Calgary, Calgary, Alta.; Faculté de médecine (Ouellet), Université de Montréal, Montréal, Que.; Program of Applied Translational Research, Department of Medicine (Parikh), and Section of Nephrology (Parikh), Yale University School of Medicine, New Haven, Conn.; Department of Anesthesia (Sharan), Laurentian University, Sudbury, Ont.; Department of Medicine (Tobe, Wald), University of Toronto, Toronto, Ont.; Department of Medicine (Pannu), University of Alberta, Edmonton, Alta
| |
Collapse
|
46
|
Quantitative assessment of dietary supplement intake in 77,000 French adults: impact on nutritional intake inadequacy and excessive intake. Eur J Nutr 2018; 58:2679-2692. [DOI: 10.1007/s00394-018-1815-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 09/06/2018] [Indexed: 10/28/2022]
|
47
|
Differences among health care students' attitudes, knowledge and use of dietary supplements: a cross-sectional study. Complement Ther Med 2018; 41:35-40. [PMID: 30477862 DOI: 10.1016/j.ctim.2018.09.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 09/05/2018] [Accepted: 09/06/2018] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES The objectives of this study were to evaluate the difference among pharmacy, dental and medical students' attitudes, knowledge and use of dietary supplements. Furthermore, factors likely to influence their personal use and willingness to recommend supplement to patient were investigated. DESIGN A cross-sectional survey study. SETTING The study was carried out at a single university. MAIN OUTCOME MEASURES Survey gathered socio-demographic data and questioned students' attitudes, knowledge and use of dietary supplements. RESULTS A total of 506 students were included in the study. Pharmacy students showed more positive attitudes about dietary supplements, and achieved higher knowledge scores when compared to dental or medical students (p < 0.001). Medical students were more likely to use evidence based sources of information about dietary supplements. There was no difference in supplements use across study programs (p = 0.177). As many as 59.7% of students that participated in the study reported using dietary supplements. Data analysis showed that the previous personal use supplements was a significant independent predictor whether students would recommend supplements to their patients (OR 27.03, 95% CI 14.08-50, p < 0.001). CONCLUSIONS Students' education did not influence their personal use of dietary supplements. However, their personal experience seems to influence their willingness to recommend supplements to patients. Pharmacy students showed greater knowledge about supplements than their dental or medical colleagues. In future practice, health care students could benefit from collaboration with pharmacists when they provide care to patients seeking advice about the use of dietary supplements.
Collapse
|
48
|
Martins C, Rueff J, Rodrigues AS. Genotoxic alkenylbenzene flavourings, a contribution to risk assessment. Food Chem Toxicol 2018; 118:861-879. [DOI: 10.1016/j.fct.2018.06.020] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 06/09/2018] [Accepted: 06/12/2018] [Indexed: 12/16/2022]
|
49
|
|
50
|
Bessada SM, Alves RC, Oliveira MBP. Caffeine-based food supplements and beverages: Trends of consumption for performance purposes and safety concerns. Food Res Int 2018; 109:310-319. [DOI: 10.1016/j.foodres.2018.04.050] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 04/20/2018] [Accepted: 04/22/2018] [Indexed: 01/12/2023]
|