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Association Between Cinnamon Consumption and Risk of Cardiovascular Health: A Systematic Review and Meta-Analysis.
Krittanawong, C, Isath, A, Scott, CZ, Wang, Z, Kaplin, S, Jneid, H, Lavie, CJ, Virani, SS
The American journal of medicine. 2022;(1):110-117
Abstract
BACKGROUND Cinnamon has been used as a traditional herbal medication for decades. Several studies have investigated cinnamon consumption and cardiovascular risk. So far, the evidence remains inconclusive. Thus, we aim to systematically review the currently available literature and quantify the evidence, if possible. METHODS We systematically searched Ovid MEDLINE, Ovid Embase, Ovid Cochrane Database of Systematic Reviews, Scopus, and Web of Science from database inception in 1966 through December 2020. The exposure of interest was cinnamon consumption, the outcome was cardiovascular risk defined as hemoglobin A1C, low-density lipoprotein cholesterol (LDL-c), and high-density lipoprotein cholesterol (HDL-c). Two investigators independently reviewed the data. Conflicts were resolved through consensus. Random-effects meta-analyses were used. RESULTS Of 23 studies (1070 subjects), the included studies were heterogeneous, generally of very poor quality. We found no difference in LDL-c levels in patients who consumed cinnamon vs those who did not, with a weighted mean difference (WMD) of 0.38 (confidence interval [CI], -6.07-6.83). We also found no difference in HDL-c between the 2 groups with WMD 0.40 (CI, -1.14-1.94). In addition, we found no statistical differences in hemoglobin A1C between the 2 groups with WMD of 0.0 (CI, -0.44-0.45). CONCLUSIONS Our meta-analysis suggests that there is no association between cinnamon consumption and differences in LDL-c, HDL-c, and hemoglobin A1C levels. Further randomized control trials studies using a robust design with long-term cinnamon consumption are needed to further investigate any potential effect.
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The effect of grapes/grape products on glycemic response: A systematic review and meta-analysis of randomized controlled trials.
Moodi, V, Abedi, S, Esmaeilpour, M, Asbaghi, O, Izadi, F, Shirinbakhshmasoleh, M, Behrouzian, M, Shahriari, A, Ghaedi, E, Miraghajani, M
Phytotherapy research : PTR. 2021;(9):5053-5067
Abstract
The aim of this study was to perform a systematic review and meta-analysis of randomized clinical trials (RCTs) to examine the effect of grapes/grape products supplementation on glycemic indices in adults. Our systematic search to find relevant RCTs was performed up to February 2020 using PubMed, Scopus, ISI Web of Science, Cochrane Library, and Google Scholar. Based on the heterogeneity between included studies, a random effects or a fixed model was applied in the meta-analysis, and results were expressed as weighted mean differences (WMD) with 95% confidence intervals (CI). Twenty-nine clinical trials (1,297 participants) fulfilled the eligibility criteria of the present meta-analysis. Overall, the grapes/grape products supplementation significantly reduced homeostatic model assessment of insulin resistance (HOMA-IR) (WMD: -0.54, 95% CI: -0.91, -0.17, p = . 004) but did not affect fasting insulin levels (WMD: -0.90 μIU/ml, 95% CI: -1.04, 2.84, p = .362) and hemoglobin A1C (Hb1Ac) percentage (WMD: 0.00%, 95% CI: -0.10, 0.11, p = . 916) in the main analyses. In addition, changes to fasting blood glucose (FBG) levels were in favor of the control group (WMD: 1.19 mg/dl, 95% CI: 0.05, 2.34, p = .041). We found that giving grapes/grape products to adults might have beneficial effects on the HOMA-IR. Further, large-scale RCTs with longer duration are required to confirm these results.
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Effect of Nigella sativa in the treatment of nonalcoholic fatty liver disease: A systematic review and meta-analysis of randomized controlled trials.
Tang, G, Zhang, L, Tao, J, Wei, Z
Phytotherapy research : PTR. 2021;(8):4183-4193
Abstract
The effectiveness of Nigella sativa (NS) treatment for nonalcoholic fatty liver disease (NAFLD) remains controversial. This systematic review, and meta-analysis, was conducted to evaluate potential benefits of NS for NAFLD. Up to June 11, 2020, randomized controlled trials (RCTs) evaluating NS for the treatment of NAFLD were searched and included from PubMed, Embase, Cochrane Library, and Web of science. Mean differences (MD) or risk ratio (RR) and 95% confidence intervals (CI) were calculated. Six articles from five trails with a total of 358 participants were included. Although NS has no beneficial effect on the levels of total cholesterol (TC) and low-density lipoprotein cholesterol (LDL), triglyceride (TG), insulin, and tumor necrosis factor α (TNF-α), its supplementation did improve the levels of alanine transaminase (ALT), aspartate transaminase (AST), fasting blood sugar (FBS), high-density lipoprotein cholesterol (HDL), high-sensitivity C reactive protein (hs-CRP), and grade of fatty liver compared with placebo. In summary, this study showed that NS supplementation was effective in the treatment of NAFLD and could improve the levels of ALT, AST, FBS, HDL, and hs-CRP in patients with NAFLD, as well as the severity of NAFLD. High-quality large sample RCTs are necessary to confirm the benefit of NS supplementation for NAFLD.
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The efficacy of novel metabolic targeted agents and natural plant drugs for nonalcoholic fatty liver disease treatment: A PRISMA-compliant network meta-analysis of randomized controlled trials.
Zhou, J, Chen, Y, Yu, J, Li, T, Lu, Z, Chen, Y, Zhang, X, Ye, F
Medicine. 2021;(12):e24884
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Abstract
BACKGROUND Nonalcoholic fatty liver disease (NAFLD) is a highly prevalent chronic liver disease characterized by excess accumulation of fat in hepatocytes. Because no drug has been approved for NAFLD treatment, this work analyzed the effects of agents resulting from 2 research hotspots, metabolic target agents, and natural plant drugs, on NAFLD with network meta-analysis. METHODS Public databases were searched through August 14, 2020. Randomized controlled trials that compared obeticholic acid, elafibranor, cenicriviroc, selonsertib, curcumin, silymarin, and resveratrol to placebo were included. Liver pathology improvement, hepatic biochemical indicators, and lipid metabolism indicators were analyzed. RESULTS Thirty-five studies were included in the meta-analysis. Obeticholic acid was found to significantly increase the frequency of liver biopsy improvement compared to placebo (OR: 2.10; 95% CI: 1.60, 2.77). The ranking results among the hepatic biochemical indicators showed that obeticholic acid (94.9%) and elafibranor (86.3%) have a relative advantage in reducing alanine aminotransferase (ALT) levels, and obeticholic acid also had an advantage (95.4%) in reducing aspartate aminotransferase (AST) levels. Considering lipid metabolic indicators, elafibranor (expSMD: 0.01; 95% CI: 0.00, 0.05; SUCRA 100%), and obeticholic acid (expSMD: 0.48; 95% CI: 0.28,0.84; SUCRA 75.6%) significantly reduced triglyceride (TG) levels compared with placebo; moreover, obeticholic acid, but not elafibranor, caused a serious increase in total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) levels and a decrease in high-density lipoprotein cholesterol (HDL-C) levels. CONCLUSIONS Novel metabolic targeted agents generally have better effects than natural plant drugs, especially obeticholic acid, and elafibranor. However, obeticholic acid showed serious adverse effects such as increasing LDL-C levels and decreasing HDL-C levels. Curcumin showed potential advantages for NAFLD but lacked statistical significance.
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The effects of Cuminum cyminum on glycemic parameters: A systematic review and meta-analysis of controlled clinical trials.
Tavakoli-Rouzbehani, OM, Faghfouri, AH, Anbari, M, Papi, S, Shojaei, FS, Ghaffari, M, Alizadeh, M
Journal of ethnopharmacology. 2021;:114510
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Cuminum Cyminum (CC) is a traditional herbal medicine using as an antiseptic, anti-carcinogenic, anti-mutagenic, anti-cancer, anti-hypertensive, anti-inflammatory, and antioxidant. Recently hypoglycemic characteristics of CC have been indicated. AIM OF THE STUDY We intended to conduct a meta-analysis on the effect of CC supplementation on glycemic parameters in patients with different chronic diseases. MATERIALS AND METHODS PubMed, Embase, Web of Science, and Scopus were searched until May 2021. Random effect model was conducted to perform the meta-analysis. Source of heterogeneity was explored using the meta-regression and subgroup analyses. The Cochrane Collaboration's tool was used to assess the quality of studies. The GRADE approach was used to assess the quality of evidence. RESULTS Findings of eight studies showed that CC supplementation reduced FBS (SMD = -1.4 mg/dl; 95 % CI: -2.29, -0.51; P = 0.002), HbA1c (SMD = -1.71 %; 95 % CI: -3.24, -0.18; P = 0.028), and HOMA-β (SMD = 0.46; 95 % CI: -0.62, 1.55; P = 0.404) significantly. Also, CC increased QUICKI level (SMD = 0.89; 95 % CI: 0.37, 1.4; P = 0.001. However, no significant effect of CC was observed on insulin (SMD = -0.70 μIU/dl; 95 % CI: -1.84, 0.45; P = 0.234) and HOMA-IR (SMD = 0.46; 95 % CI: -0.62, 1.55; P = 0.404). CONCLUSION CC had an improving effect on FBS, HbA1C, HOMA-B, and QUICKI. The effect of CC on amending HOMA-IR was significant after sensitivity analysis. However, the insulin level was not changed significantly.
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Western herbal medicines in the treatment of irritable bowel syndrome: A systematic review and meta-analysis.
Hawrelak, JA, Wohlmuth, H, Pattinson, M, Myers, SP, Goldenberg, JZ, Harnett, J, Cooley, K, Van De Venter, C, Reid, R, Whitten, DL
Complementary therapies in medicine. 2020;:102233
Abstract
OBJECTIVE To evaluate the efficacy of Western herbal medicines in the treatment of irritable bowel syndrome (IBS). DESIGN A computer-based search of MEDLINE, EMBASE, CINAHL, AMED, GreenFILE, Health Source: Nursing/Academic Edition, and the Cochrane Library was conducted. A hand-search of the bibliographies of relevant papers and previous meta-analyses and reviews was also undertaken. Trials were included in the review if they were double-blind and placebo-controlled investigating the effects of Western herbal medicines on IBS-related symptoms or quality of life. There were no language restrictions. Eligibility assessment and data extraction were performed by two independent researchers. For herbal medicines where there was more than 1 trial of similar design, data were synthesised using relative risk of symptoms improving using the random effects model. RESULTS Thirty-three trials were identified that met all eligibility criteria. Seventeen of these evaluated peppermint essential oil, fifteen other Western herbal medicines, and one trial evaluated peppermint oil in one arm and aniseed essential oil in the other arm. Eighteen different herbal preparations were evaluated in these trials. Data suggests that a number of Western herbal medicines may provide relief of IBS symptoms. Meta-analyses suggest that peppermint essential oil is both efficacious and well-tolerated in the short-term management of IBS. Aloe vera and asafoetida also demonstrated efficacy in reducing global IBS symptoms in meta-analyses. The herbal formulas STW 5, STW 5-II and Carmint, along with Ferula assa-foetida, Pimpenella anisum oil, the combination of Curcumin and Foeniculum vulgare oil, and the blend of Schinopsis lorentzii, Aesculus hippocastanum, and peppermint essential oil also demonstrated efficacy in rigorously-designed clinical trials. CONCLUSION A number of Western herbal medicines show promise in the treatment of IBS. With the exception of peppermint essential oil, Aloe vera, and asafoetida, however, none of the positive trials have been replicated. This lack of replication limits the capacity to make definitive statements of efficacy for these herbal medicines.
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Effectiveness of Passion Fruit Peel Flour (Passiflora edulis L.) versus Turmeric Flour (Curcuma longa L.) on Glycemic Control: Systematic Review and Meta-Analysis.
Sousa, DF, Veras, VS, Freire, VECS, Paula, ML, Serra, MAAO, Costa, ACPJ, da Conceição S O Cunha, M, Queiroz, MVO, Damasceno, MMC, Paes, FER, et al
Current diabetes reviews. 2020;(5):450-456
Abstract
BACKGROUND It is undeniable that diabetes may cause several health complications for the population. Many of these complications are associated with poor glycemic control. Due to this, strategies to handle this problem are of great clinical importance and may contribute to reducing the various complications from diabetes. OBJECTIVE The aim of this study was to compare the effectiveness of the passion fruit peel flour versus turmeric flour on glycemic control. METHODS This is a systematic review and meta-analysis following the PRISMA protocol. The following inclusion criteria were applied: (1) Case-control studies, cohort studies, and clinical trials, due to the improved statistical analysis and, in restrict cases, cross-sectional studies; (2) Articles published in any language. The databases used for the search were PubMed, Scopus, Web of Science, Cochrane, and LILACS. A bias analysis and a meta-analyses were undertaken using R Studio (version 3.3.1) using effect- size models. RESULTS A total of 565 studies were identified from which 11 met the inclusion and exclusion criteria. Through isolated analysis, the effectiveness of turmeric flour on glycemic control was in the order of 0.73 CI (Confidence Interval) (from 0.68 to 0.79) and the effectiveness of passion fruit peel flour was 0.32 CI (0.23 to 0.45). The joint analysis resulted in 0.59 CI (0.52 to 0.68). The assessment of blood glucose was by glycated hemoglobin levels. All values were significant at a p < 0.05 level. CONCLUSION Both interventions showed significant effects on glycemic control.
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The effects of saffron (Crocus sativus L.) on mental health parameters and C-reactive protein: A meta-analysis of randomized clinical trials.
Ghaderi, A, Asbaghi, O, Reiner, Ž, Kolahdooz, F, Amirani, E, Mirzaei, H, Banafshe, HR, Maleki Dana, P, Asemi, Z
Complementary therapies in medicine. 2020;:102250
Abstract
BACKGROUND The findings of trials investigating the effects of saffron (Crocus sativus L.) supplementation on depression, anxiety, and C-reactive protein (CRP) are inconsistent. The current meta-analysis of randomized controlled trials (RCTs) was carried out to assess the effects of saffron (Crocus sativus L.) administration on mental health parameters and CRP levels. METHODS Two independent authors systematically searched online databases including EMBASE, Scopus, PubMed, Cochrane Library, and Web of Science from inception until 30th July 2019. Cochrane Collaboration risk of bias tool was applied to assess the methodological quality of included trials. The heterogeneity among the included studies was assessed using Cochrane's Q test and I-square (I2) statistic. Data were pooled using a random-effects model and weighted mean difference (WMD) was considered as the overall effect size. RESULTS Twenty one trials were included in this meta-analysis. Consumption of saffron resulted in a significant reduction in Beck Depression Inventory (BDI) (11 studies with 12 effect size) (WMD: -4.86; 95 % CI: -6.58, -3.14), Beck Anxiety Inventory (BAI) (5 studies) (WMD: -5.29; 95 % CI: -8.27, -2.31) and Pittsburgh Sleep Quality Index (PSQI) scores (3 studies with 4 effect size) (WMD: -2.22; 95 % CI: -2.73, -1.72). Saffron intake did not affect Hamilton Depression Rating Scale (HDRS-D), Hamilton Anxiety Rating Scale (HARS-A) scores and C-reactive protein (CRP) levels. CONCLUSIONS This meta-analysis demonstrated that saffron intake significantly reduced BDI, BAI and PSQI scores, but did not affect HDRS-D, HARS-A scores and CRP levels.
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The best route of administration of lavender for anxiety: a systematic review and network meta-analysis.
Sayed, AM, Morsy, S, Tawfik, GM, Naveed, S, Minh-Duc, NT, Hieu, TH, Ali, ZA, Shinkar, A, Doheim, MF, Hashan, MR, et al
General hospital psychiatry. 2020;:33-40
Abstract
BACKGROUND There is preliminary evidence for lavender as an anxiolytic agent through various routes of administration. Our goal is to elucidate the best route of administration for lavender as a treatment for anxiety. METHODS Thirteen electronic search engines were systematically scanned for relevant publications. The relevant articles were included after the title and abstract screening followed by the full-text screening. This study included randomized control trials reporting lavender for the treatment of anxiety. The protocol was registered in PROSPERO (CRD42017076711). Frequentist network meta-analysis and Bayesian meta-regression were conducted to report the best treatment modality and the effect of covariates on the effectiveness as an anxiolytic. Treatment arms were ordered according P-scores, where higher P-score indicates better treatment choice. RESULTS Forty studies were eligible for qualitative analysis, and 32 were included in quantitative analysis. Lavender aromatherapy was the best approach for the treatment of anxiety among other lavender modalities at the first week recording [Standardized Mean Difference (SMD) = -0.57, 95% CI (-1.14-0.01), P-score = 0.72], in addition to achieve at the first time points [SMD = -0, 95% CI (-0.97 ̶ -0.16), P-score = 0.69], compared to placebo; however, lavender massage along with foot bath were found to be the most efficacious for anxiety treatment at the study endpoint [SMD = -1.10, 95% CI = (-7.41 ̶ 5.21), P-score = 0.65]. Furthermore, network meta-regression revealed that the duration of therapy influenced treatment, suggesting Silexan (oral lavender) 80 mg (first rank probability = .116) as the favorable option for anxiety in long-term treatment. CONCLUSIONS Lavender aromatherapy is, clinically, superior in short-duration, while Silexan (oral lavender) 80 mg is preferable for long-term treatment of anxiety.
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Herbal Medicine for Idiopathic Central Precocious Puberty: A Systematic Review and Meta-Analysis.
Lee, YB, Lee, JA, Lee, HL
Journal of alternative and complementary medicine (New York, N.Y.). 2020;(11):976-999
Abstract
Introduction: Herbal medicine (HM) is widely used in East Asia to treat idiopathic central precocious puberty (ICPP). However, no systematic reviews of the efficacy and safety of HM for treatment of ICPP have been reported. Thus, this systematic review assessed the efficacy and safety of HM for ICPP. Most available clinical trials that investigated HM for ICPP were included in this review. Methods and analysis: Eleven databases, including Asian databases, were searched from the date of inception until June 2018. We included randomized controlled trials (RCTs) that assessed HM for ICPP. Results: Nine RCTs including 650 participants with ICPP, were included in this review. As a result of meta-analysis, response rate of HM group was 1.14 times higher compared with control group, with moderate level of evidence. Also, serum estradiol (E2) level was significantly lower in HM group compared to control group with moderate level of evidence. Notably, serum luteinizing hormone (LH) level (IU/L) and E2 level were significantly lower in HM group than triptorelin injection group with moderate level of evidence. Bone age index and uterine volume were also significantly lower in HM group than control group with very low level of evidence. The incidence of adverse events was lower in the HM group than control group, but it was not statistically significant. Conclusions: According to the results of the meta-analysis, it seems that HM treatment has a significant effect on the treatment of ICPP and can effectively reduce serum LH, E2 level, and bone age. In particular, as gonadotropin-releasing hormone analog therapy has a negative effect on the growth rate and final height if bone age ≥13 years, this study suggests that HM treatment may be helpful. Additional higher quality RCTs are needed to demonstrate the efficacy and safety of HM for treatment of ICPP.