Natural Standard Blog

Tobacco Plant Family May Reduce Parkinson's Risk

Consumption of plants that are in the same botanical family as tobacco, Solanaceae, may help reduce the risk of Parkinson's disease (PD), a study reports.

PD is a movement disorder that is chronic and progressive, meaning that symptoms continue and worsen over time. PD affects nerve cells in a part of the brain that controls muscle movement. The four primary symptoms of PD are tremor, or trembling in hands, arms, legs, jaw, and face; rigidity, or stiffness of the limbs and trunk; slowness of movement; and postural instability, or impaired balance and coordination. As these symptoms become more severe, people may have difficulty walking, talking, or completing other simple tasks.

In addition to tobacco, the Solanaceae family includes flowering plants and important crops such as peppers, tomatoes, and potatoes. In the current study, the researchers set out to determine whether consuming these plants may affect risk of PD. They looked at 490 cases of PD that had been diagnosed between 1992 and 2008, and compared them to 644 healthy controls. The team evaluated self-reported consumption of peppers, tomatoes, tomato juice, or potatoes during adulthood, as well as other vegetable consumption, age, gender, race, and use of tobacco and caffeine.

The results suggested that PD risk decreased with consumption of all edible Solanaceae plants combined, but not with the consumption of all other vegetables combined. The researchers found significant results for peppers in particular. These benefits appeared to be more common among men and women who had never used tobacco or who had smoked cigarettes for fewer than 10 years.

The researchers concluded that components of these plants may help reduce the risk of PD. However, they emphasized that further study is needed before firm conclusions can be made in this area.

Many integrative therapies have been studied for potential benefits in PD. There is good scientific evidence supporting the use of music therapy for this condition. Other treatments that have been studied include 5-HTP, acupressure, acupuncture, ayurveda, caffeine, chromium, and coenzyme Q10. However, there is unclear or conflicting evidence on the effectiveness of these therapies. More research is needed.

For more information about PD, please visit Natural Standard's Medical Conditions Database.

FDA: Three Sex Enhancement Products Contain Hidden Ingredients

The U.S. Food and Drug Administration (FDA) recently issued consumer warnings for several sexual enhancement products.

These products include Lightning ROD, Vicerex, and Bullet Proof.

Lightning ROD contains the undeclared ingredient hydroxythiohomosildenafil. This ingredient has a structure similar to that of sildenafil, the active ingredient in the FDA-approved drug Viagra. Vicerex and Bullet Proof both contain the undeclared ingredient tadalafil. Tadalafil is the active ingredient in the FDA-approved drug Cialis.

These undeclared ingredients may interact with nitrates, which are found in some prescription drugs, and may lower blood pressure to dangerous levels. Men who have conditions such as diabetes, heart disease, high blood pressure, or high cholesterol often take nitrate-containing prescription medications.

The FDA advises consumers in possession of Lightning ROD, Vicerex, or Bullet Proof to discard them immediately and report any side effects to a healthcare provider. Side effects associated with these products should also be reported to the FDA's Medwatch Safety Information and Adverse Event Reporting Program.

For more information about erectile dysfunction, please visit Natural Standard's Medical Conditions Database.

Glucosamine and Chondroitin Studied For Colon Cancer Risk

Glucosamine and chondroitin may be an effective treatment in reducing the risk of colorectal cancer (CRC), according to a study.

Colon cancer is cancer of the large intestine, which is the lower part of the digestive system. Rectal cancer occurs on the last eight to ten inches of the colon. They are often referred to together as colorectal cancers, and are the second-leading cause of cancer-related deaths in the United States.

Glucosamine is a natural compound that is found in healthy cartilage. It is supported by strong scientific evidence for its effectiveness in treating osteoarthritis of the knee. Chondroitin was first extracted and purified in the 1960s. It is currently made from natural sources such as shark or beef cartilage, or by synthetic means. There is much support for the use of chondroitin together with glucosamine for improving symptoms and possibly reversing the process of osteoarthritis.

In the current study, scientists evaluated the potential use of glucosamine and chondroitin in reducing the risk of CRC. They analyzed information from 75,137 Washington residents who had participated in the Vitamins and Lifestyle (VITAL) study between 2000 and 2002. All participants completed a questionnaire detailing their supplement use and were followed for CRC through 2008.

The results suggested that people who used a combination of glucosamine and chondroitin at least four days a week for over three years had a 45 percent lower risk of CRC, compared to non-users. This link appeared to vary depending on body mass index. There was a lack of significant effect of glucosamine alone on CRC risk.

The researchers concluded that glucosamine and chondroitin combined may merit further study as a possible preventative for CRC. More information is needed before firm conclusions can be made.

Light therapy, strontium, and vitamin A have all been studied for the treatment of colon cancer and related conditions. These integrative therapies are backed by strong scientific evidence for this purpose. There is good scientific evidence supporting the effectiveness of greater celandine, meditation, psychotherapy, and selenium in treating colon cancer.

For more information about CRC, please visit Natural Standard's Medical Conditions Database.

Ginkgo Studied For Chemotherapy Cognitive Side Effects

A recent study found a lack of evidence to support the use of Ginkgo biloba for preventing chemotherapy-related cognitive impairment.

Ginkgo biloba has been used as medicine for thousands of years. Today, it is one of the top-selling herbs in the United States. Ginkgo has been studied for the treatment of many conditions. Evidence suggests that ginkgo may be effective in managing claudication (pain or weakness in the legs due to blocked arteries), Alzheimer's disease, and dementia. There is promising early evidence favoring the use of ginkgo for memory enhancement in healthy subjects, altitude sickness, premenstrual syndrome (PMS), age-related eye disorders, and some chemotherapy side effects (such as blood vessel damage).

Chemotherapy is the use of drugs to treat cancer. These drugs are designed to kill cancer cells by affecting their ability to grow and reproduce. Many cancer drugs used today do not specifically attack cancer cells. This means that they not only affect cancer cells but also normal cells in people who take them, which is why chemotherapy drugs often produce severe side effects, including nausea, vomiting, diarrhea, hair loss, skin problems, and damage to blood and immune cells. Other types of side effects may also occur, depending upon the specific drug used.

Cognitive function problems have been reported by people undergoing cancer treatment. In the current study, researchers evaluated the possible benefits of ginkgo on protecting against cognitive impairment in those receiving chemotherapy. They studied 166 women with breast cancer who were randomly assigned to 60 milligrams of ginkgo or placebo, taken by mouth twice daily throughout chemotherapy and one month after completing treatment.

The results suggested that there was a lack of significant differences between the ginkgo group and the placebo group in terms of cognitive function. The placebo group reported worse nausea after chemotherapy.

The researchers concluded that these findings lack support for the use of ginkgo in preventing cognitive impairment caused by chemotherapy. Further study is needed to determine whether ginkgo may be effective for this purpose.

Many integrative therapies have been studied for a range of chemotherapy side effects. These include bee pollen, fermented milk extract, fermented wheat germ extract, grape, and hypnotherapy. However, there is unclear or conflicting evidence on the effectiveness of these treatments. More research is needed before firm conclusions can be made.

For more information about ginkgo, please visit Natural Standard's Foods, Herbs & Supplements Database.

Mindfulness Therapy May Improve Combat PTSD Symptoms

Mindfulness-based cognitive therapy (MBCT) may help symptoms of post-traumatic stress disorder (PTSD) in combat veterans, a study reports.

PTSD can follow an exposure to a traumatic event, such as sexual or physical assault, a death, or a natural disaster. There are three main symptoms associated with PTSD: "reliving" of the event through flashbacks and nightmares, avoiding places related to the trauma, detachment from other people. PTSD may also cause difficulty sleeping, irritability, or poor concentration. Both adults and children may develop PTSD if they have experienced, witnessed, or participated in a traumatic event, especially one that was life threatening.

Mindfulness is a type of meditative approach in which attention is focused on a physical sensation, such as the breath. Attention is placed on the present moment, rather than on the future or past. This technique may involve a "body scan," in which one focuses on the body from head to feet, concentrating on areas of pain or illness. This is usually performed while lying down. Regular practice is suggested to enhance self-awareness.

In the current study, scientists looked at the use of MBCT for relieving symptoms of combat-related PTSD. They enrolled 20 people seeking treatment for chronic PTSD at an outpatient clinic and randomly assigned them to MBCT or to regular treatment for this condition. Doctors performed psychological assessments both before and after the therapy.

The results suggested that MBCT resulted in significant improvement in PTSD symptoms, compared to regular treatment. Subjects assigned to MBCT showed good compliance and meaningful improvement in their condition during the post-treatment assessment. Symptoms such as avoidance, numbing, and self-blame were among those that improved in this group.

The researchers concluded that group MBCT may be an acceptable short-term treatment for combat-related PTSD. Further study is needed before firm conclusions on therapy effectiveness may be made.

There is good scientific evidence supporting the use of psychotherapy for treating PTSD. Psychotherapy is an interactive process between a person and a qualified mental health professional. Its purpose is the exploration of thoughts, feelings, and behavior for the purpose problem solving or achieving higher levels of functioning.

Other integrative therapies that have been studied for PTSD include acupuncture, healing touch, and relaxation therapy. However, there is unclear or conflicting evidence on the effectiveness of these techniques for PTSD. More research is needed.

For more information about mindfulness meditation, please visit Natural Standard's Health & Wellness Database.

Natural Standard Presenting at MLA Annual Meeting and Exhibition

Dr. Catherine Ulbricht, Founder of the Natural Standard Research Collaboration and Senior Attending Pharmacist at Massachusetts General Hospital, will be presenting at the 2013 Medical Library Association (MLA) Annual Meeting and Exhibition at the John B. Hynes Veterans Memorial Convention Center in Boston, Massachusetts on May 6, 2013.

Dr. Ulbricht's presentation, scheduled for 3-4:30pm in Room 301, will focus on an integrative approach to health and wellness. Lifestyle choices, including environment, diet, exercise, natural products, complementary and alternative medical (CAM) practices and conventional therapies, may all contribute to total body health and wellness. It is crucial that multidisciplinary health care providers and educators collaborate with patients (and pet owners) to consider all preventative and therapeutic options available towards achieving an integrative health care plan. Ideal evidence-based medical practice incorporates consumer preferences, clinical experience and scientific data to provide patients with the best health and wellness outcomes. Consolidating all of these important factors into high quality decision support tools aids practitioners and their clients to meet these goals with efficiency at the point-of-care.

Due to high utilization rates of CAM therapies, it is imperative that librarians are armed with trustworthy resources and proactively distribute efficacy and safety information to best serve their patrons.

In addition to Dr. Ulbricht's presentation on May 6, Natural Standard will be exhibiting throughout the meeting, May 4-7, at booth 716.

For more information about the 2013 MLA Annual Meeting and Exhibition, please visit www.mlanet.org.

Natural Standard Featured CE/CME: Echinacea

Natural Standard's featured CE/CME for the month of April is Echinacea: Safety & Effectiveness.

Echinacea species are perennials that belong to the Asteraceae (aster) family and originated in eastern North America. Natural medicine experts frequently recommend oral extracts of echinacea for the treatment of the common cold and for other conditions requiring immune stimulation. It is occasionally recommended for topical treatment of wounds.

Natural Standard offers CE/CME modules for multidisciplinary healthcare professionals. Students and other users may take courses for training purposes without generating credit certificates. Continuing Education requirements differ based on discipline, license and location. If you are unsure of your specific needs, please contact your local agency.

FDA Proposes Adding Selenium to Infant Formula Nutrient Requirements

The U.S. Food and Drug Administration (FDA) is proposing to update current regulations on infant formula with the addition of selenium to the list of required nutrients.

Selenium is an essential trace mineral found in soil, water and some foods. It is a component of the amino acids cysteine and methionine. Selenium is required for functioning of the body's antioxidant enzymes and for cell growth and survival.

According to the Federal Food, Drug, and Cosmetic Act (FFDCA), infant formula is defined as food that serves a special dietary purpose as a complete or partial substitute of human breast milk. The FDA requires infant formula to have minimum amounts of 29 nutrients and also maximum amounts of nine of these nutrients. In addition, there are many components that are also added to enhance the beneficial effects of infant formula, such as emulsifiers and stabilizers, docosahexaenoic acid (DHA), arachidonic acid (ARA), probiotics, prebiotics, taurine, L-carnitine, choline, inositol and biotin (vitamin B7).

In the recently proposed rule, the FDA states that at the time nutrient regulations for infant formula were initially established, selenium was not recognized as an essential nutrient. Currently, selenium is known to be a nutritional trace mineral that plays an important role in detoxification and antioxidant defense in the body. While selenium is not currently a required nutrient in infant formula, all formals that are manufactured in the United States do include the mineral. Additionally, the Food and Nutrition Board of the National Research Council established a Recommended Dietary Allowance (RDA) for selenium for infants in 1989.

After reviewing the available evidence on selenium intake in infants, the FDA proposes that a minimum of 2 micrograms selenium be required per 100 kilocalories of infant formula, with a maximum of 7 micrograms per 100 kilocalories of formula. This proposal would also add selenium to the list of nutrients that must be included on nutrition labels of infant formula.

By updating the regulations, the FDA hopes to maintain safe nutrient levels for both formula products made in the United States and international products that aim to enter the US market.

To read the full proposal, please visit www.federalregister.gov.

For more information about selenium, please visit Natural Standard's Foods, Herbs & Supplements Database.

Antioxidant-Rich Diet May Lower Heart Failure Risk

A recent study suggests that maintaining a diet high in antioxidants may reduce the risk for heart failure.

Antioxidants are molecules that work to prevent damage that occurs in cells and body tissues due to both normal bodily processes and exposure to some chemicals. The potential medical benefit of antioxidants may reside in their ability to prevent or slow the oxidation of molecules in the microscopic parts of the body, such as DNA or proteins.

Early research on antioxidants investigated their possible use in preventing edible fats from becoming rancid due to oxidation. Vitamins A, C and E were some of the first antioxidants identified by medical science as possibly beneficial to human health. In addition to being available in a variety of fruits and vegetables, antioxidants are available as supplements. They are one of the most popular categories of supplements available today. Antioxidants are proposed to play a role in preventing many common health disorders, such as Alzheimer's disease, heart disease and some types of cancers.

In a new study, researchers evaluated data on 33,713 women from the Swedish Mammography Corhort. Total antioxidant capacity estimates were collected through questionnaires. Heart failure data was then collected through 2009 from health registries.

Eight-hundred and ninety-four cases of heart failure were identified throughout the 11.3 year follow-up period. The researchers found that women who reported diets with the highest total antioxidant capacity had a 42 percent reduced risk of heart failure when compared to those with the lowest total antioxidant capacity.

The authors concluded that these findings support the view that maintaining a diet rich in antioxidants may lower the risk for heart failure. While promising, further research is warranted.

Antioxidants are found in varying amounts in foods such as vegetables, fruits, grain cereals, legumes and nuts. Some antioxidants such as lycopene and ascorbic acid can be destroyed by long-term storage or prolonged cooking. Other antioxidant compounds are more stable, such as the polyphenolic antioxidants in foods such as whole-wheat cereals and tea. In general, processed foods are thought to contain less antioxidants than fresh and uncooked foods since preparation processes may expose the food to oxygen.

For more information about antioxidants, including beta-carotene, lycopene, rutin, vitamin E and others, please visit Natural Standard's Foods, Herbs & Supplements Database.

Drinking Black Tea May Lower Blood Pressure Variation

Drinking black tea may reduce blood pressure variation at night, according to a new study.

Black tea is made from the dried leaves of Camellia sinensis, a shrub native to southeastern Asia. Green tea, black tea and oolong tea all come from the same plant. Black tea is a traditional beverage in Britain. The quality of tea depends on the age of the tea leaves.

Black tea is a source of caffeine, which stimulates the heart and central nervous system, relaxes smooth muscle in the lungs and promotes urination. One cup of tea contains about 50 milligrams of caffeine, depending on the strength and size of the cup, while coffee contains 65-175 milligrams of caffeine per cup. Tea also contains vitamins, a compound called tannin, and antioxidants called polyphenols.

In a new study, researchers randomly assigned 11 individuals with systolic blood pressure of 115-150 millimeters of mercury to drink three cups daily of black tea or a caffeine-containing flavonoid-free control drink for six months to evaluate the potential effects of black tea on blood pressure variation. Blood pressure variation measurements were collected throughout the study.

The researchers found that individuals in the tea group had significantly lower blood pressure variation at night by about 10 percent, but not during the day, when compared to the control group. The authors noted that these effects were present on day one of the study and were maintained at each check point throughout the study.

The authors concluded that other components of black tea, not just caffeine, may beneficially lower blood pressure variability at night.

In addition to black tea, several studies suggest that green tea may have an effect on blood pressure. Furthermore, multiple human trials have reported small reductions in blood pressure with intake of omega-3 fatty acids. DHA may have greater benefits than EPA. However, high daily intakes of omega-3 fatty acids may be necessary to obtain clinically relevant effects, and at high dose levels, there is an increased risk of bleeding. Therefore, a qualified healthcare provider should be consulted prior to starting treatment with supplements.

For more information on integrative therapies for high blood pressure, please visit Natural Standard's Comparative Effectiveness Database.

For more information about black tea, please visit Natural Standard's Foods, Herbs & Supplements Database.

Mercury Exposure Linked to Diabetes Risk

A recent study suggests that mercury exposure in young adulthood may be linked to an increased risk for diabetes later in life.

Mercury is a neurotoxin, meaning it affects the nervous system. Mercury exposure may lead to excessive mercury levels in the body that can permanently damage or fatally injure the brain and kidneys. Mercury can also be absorbed through the skin and cause allergic reactions. Health problems caused by mercury depend on how much has entered the body, how it entered the body, how long the individual has been exposed to it, and how the individual's body responds to the mercury. People are at risk when they consume mercury-contaminated fish and when they are exposed to spilled mercury.

In a new study, researchers evaluated data on 3,875 non-diabetic individuals who were 20-32 years-old at the beginning of the study. Toenail mercury levels and data on glucose levels were collected throughout the study from 1987-2005

Throughout the 18 year follow up period, 288 cases of diabetes were identified. After adjusting the data for other potential factors, such as age, sex, alcohol consumption and family history, the researchers found that higher mercury exposure was linked to an increased risk for developing diabetes, noting that those with the most exposure had a 65 percent increased risk of diabetes when compared to those with the lowest.

According to the authors, these findings confirm previous laboratory research suggesting a potential association. However, further research is warranted.

Theoretical data suggests that some integrative therapies, such as algin, may reduce the absorption of toxins, including mercury. A preliminary study of apple pectin in children exposed to mercury showed that pectin may be effective in mercury intoxication treatment. Further research is required in this field.

For more information about mercury poisoning or diabetes risk factors, please visit Natural Standard's Medical Conditions Database.

Natural Standard Attending Eastern States Residency Conference

Natural Standard is attending the upcoming 32nd Annual Eastern States Conference for Pharmacy Residents and Preceptors May 13-15, 2013 at the Hershey Lodge in Hershey, Pennsylvania.

Current Natural Standard Residents, Marina Shkayeva, PharmD and Carla Eisenstein, PharmD, will be presenting a poster presentation with group one during the first half of the conference.

For more information, please visit www.easternstates.org.

Featured Audio: Lactobacillus acidophilus

Natural Standard is pleased to announce the availability of NEW multi-media audio recordings of over 200 evidence-based English Bottom Line Monographs. Audio will be available for all English Foods, Herbs & Supplement topics in the coming months.

This month's featured audio recording is Lactobacillus acidophilus. L. acidophilus is a common probiotic, a small organism that is used to promote health. Probiotics are different from prebiotics, which are sugars that are used to promote "good" bacteria in the intestines. L. acidophilus is thought to be safe, with few side effects. However, people who have intestinal damage, immune problems, or too much bacteria in the intestines should avoid L. acidophilus, due to risk of organ failure.

Access to the full audio recording is now available here.

Natural Standard Research Collaboration Award

The Natural Standard Research Collaboration is offering an award for subscribing academic institutions to present to an exemplary 2013 graduating class member for perpetuating multidisciplinary, evidence-based research practices, healthcare communications or information. Each healthcare discipline and journalism school within a university is eligible for one award per department.

Natural Standard would like to congratulate all of the recent award recipients, including Sandra Naegele from Midwestern University; Ashley Webber from University of Wisconsin; and Nicholas Ladikos from University of Florida College of Pharmacy.

Each award recipient will be granted the following:

Natural Standard Award Certificate

Natural Standard Professional Database: one-year personal subscription

Natural Standard Mobile Version: one-year personal subscription

To offer this award at your institution, please email memberservices@naturalstandard.com.

Recipe of the Month: Red quinoa and avocado salad

Natural Standard's featured healthy recipe for the month of April is Red quinoa and avocado salad.

Celebrate the beginning of spring with this fresh, high fiber, vegan recipe.

Natural Standard's new Recipe Database features a wide range of healthy recipes in the following categories: Beans & Legumes, Dairy, Eggs, Fruit, Meat, Pasta, Poultry, Rice & Grains, Seafood, Vegetables and Nuts, Fats & Oils.

Natural Standard welcomes submissions of non-copyrighted healthy recipes for inclusion in the Recipe Database. If you would like to submit a recipe, please email recipes@naturalstandard.com.

For more information, please visit Natural Standard's Recipe Database.

Natural Standard Featured in The Wall Street Journal

The Wall Street Journal (WSJ) recently consulted Natural Standard to discuss the available scientific evidence on valerian.

Valerian is an herb native to Europe and Asia that currently grows in most parts of the world. The use of valerian as a sedative and anti-anxiety treatment has been reported for more than 2,000 years. Related species have been used in traditional Chinese and Indian Ayurvedic medicine. Preparations for use on the skin have been used to treat sores and acne, and valerian by mouth has been used for other conditions such as gas and other stomach problems, congestive heart failure, urinary tract disorders, and chest pain.

Valerian extracts became popular in the United States and Europe in the mid-1800s and remains popular in North America, Europe and Japan. It is widely used to treat insomnia and anxiety. Although the active ingredients in valerian are not known, preparations are often standardized to the content of valerenic acid.

Although studies suggest that valerian may reduce anxiety in rats, results from human research remain unconvincing. The WSJ article emphasized that valerian has been given an evidence grade of C by Natural Standard for the treatment of insomnia and anxiety, indicating that the scientific evidence is still unclear. Preparations of the herb and amounts of valerenic acid used in the studies tend to vary. Additionally, some trials used valerian in combination with other integrative therapies such as lemon balm, making it difficult to draw firm conclusions on the effects of valerian alone.

Valerian may cause side effects such as headaches or tiredness, and should not be taken together with medications that may cause drowsiness, as the effects may be additive.

To read the full article please visit http://online.wsj.com.

For more information about valerian, please visit Natural Standard's Foods, Herbs & Supplements Database.

Researchers Evaluate Safety of Saw Palmetto Extract

Saw palmetto extract may be safe when used to treat lower urinary tract symptoms caused by benign prostatic hyperplasia (BPH) at high doses for 18 months, a study reports.

Saw palmetto (Serenoa repens, Serenoa serrulata) is used popularly in Europe to treat symptoms of enlarged prostate. Although it is not considered the standard of care in the United States, it is the most popular herbal treatment for this condition. More than two million American men use saw palmetto for enlarged prostate, and it is commonly recommended as an alternative treatment by the U.S. Food and Drug Administration (FDA).

BPH is a normal, gradual enlargement of the prostate caused by hormonal fluctuations. BPH usually beings in middle age and does not lead to cancer. BPH does not generally cause pain, but discomfort (a feeling of pressure) in the groin area is generally found. As the prostate enlarges, it presses against the urethra and interferes with urination. At the same time, the bladder wall becomes thicker and irritated and begins to contract, even when it contains small amounts of urine, which causes more frequent urination. And, as the bladder continues to weaken, it may not empty completely leaving some urine behind. Blocking or narrowing of the urethra by the prostate and partial emptying of the bladder cause many of the problems associated with BPH.

In the current study, researchers set out to determine the safety of saw palmetto extract when used over an extended period. They included information from 357 people who had participated in the Complementary and Alternative Medicine for Urological Symptoms (CAMUS) trial. The subjects were randomized to 320, 640, or 960 milligrams of saw palmetto extract or a placebo daily at six-month intervals for a total of 18 months. The research team assessed the participants' vital signs, blood, urine, and any side effects experienced.

The scientists found that significant differences between the treatment and placebo groups were lacking in terms of serious or non-serious side effects, changes in vital signs, or prostate exam results. They reported that evidence of side effects related to dosing was also lacking.

The team concluded that the saw palmetto extract used in the CAMUS trial may be safe at doses of three times the usual clinical dose over 18 months. However, more research is needed to confirm these findings.

Many studies report that saw palmetto may be as effective as the hormonal agent finasteride (Proscar®) and may cause fewer side effects when used to treat bladder problems. Most research has focused on the saw palmetto product Permixon®. However, results are still mixed, and further research is needed. Saw palmetto has also been used for low sperm count, low sex drive, hair loss, bronchitis, diabetes, inflammation, migraine, and prostate cancer, although there is limited evidence supporting its effectiveness for these conditions.

Other integrative therapies that have been used for BPH or related urinary conditions include pygeum, which is supported by strong scientific evidence, and beta-sitosterol and selenium, which are supported by good evidence.

For more information about saw palmetto, please visit Natural Standard's Foods, Herbs & Supplements Database.

Harmful Effects Linked to Bitter Orange and Caffeine

Some products sold as sports or weight loss supplements may contain synephrine, which may enhance the effects of caffeine, according to the Federal Institute for Risk Assessment (BfR).

Synephrine is a compound found in plants such as bitter oranges (Citrus aurantium). Bitter orange comes from a flowering, fruit-bearing evergreen tree native to tropical Asia, but is now widely cultivated in the Mediterranean region and elsewhere. Bitter oranges have been used in ancient Chinese medicine to treat constipation, improve energy, and calm nerves in cases of insomnia and shock. Amazon rainforest tribes have used bitter orange tea as a laxative and to relieve nausea, stomach pains, indigestion, gas, and constipation.

According to BfR, sports or weight loss supplements often contain caffeine in addition to synephrine and are often referred to as food supplements or dietetic foods by manufacturers. Because caffeine and synephrine both affect the heart and blood pressure, they may increase each increase the other's effects when taken together. Most notably, taking caffeine and synephrine together may increase heart rhythm and blood pressure. Other ingredients contained in bitter orange extracts may also add to the effects of synephrine on the heart.

The BfR recommends that quantities of these compounds ingested through such products should be limited to food intake levels from oranges and bitter oranges. The institute advised that no more than 6.7 milligrams of synephrine be taken daily in the form of a food supplement. This quantity of synephrine may help ensure that even frequent consumers do not exceed a total daily intake of more than 25.7 milligrams of synephrine.

Due to dosage levels, some products that are currently available on the market may be classified as unsafe. The effects of these products on the heart may be more intense in people who are already putting increased strain on the heart due to physical activity or being overweight.

It is claimed that bitter orange is an effective aid to weight loss and a safe alternative to ephedra, a plant that contains compounds that may stimulate the nervous system. In 2004, the U.S. Food and Drug Administration (FDA) issued a final rule prohibiting the sale of dietary supplements containing ephedra because such supplements present an unreasonable risk of illness or injury. Due to the ban on ephedra in the United States, some products previously containing ephedra have been reformulated to include Citrus aurantium.

For more information about bitter orange, please visit Natural Standard's Foods, Herbs & Supplements Database.

Garlic May Help Reduce Long-Term Diabetes Complications

Garlic may help control high levels of C-reactive protein and adenosine deaminase in obese people with diabetes, according to a study.

C-reactive protein is a marker of inflammation, while adenosine deaminase is an enzyme that is involved in metabolism. Previous research has linked high C-reactive protein and adenosine deaminase levels to long-term complications in people with uncontrolled diabetes.

Researchers set out to determine if garlic may help control levels of C-reactive protein and adenosine deaminase in obese people with type 2 diabetes. They enrolled 60 subjects who were given either metformin tablets with garlic capsules or metformin tablets alone after meals. They measured the participants' blood glucose, adenosine deaminase levels, and cholesterol at the beginning of the study, then conducted a 12-week follow-up to continue monitoring these factors.

The results suggested that both metformin with garlic and metformin alone helped significantly reduce blood sugar. However, a drop in total cholesterol, low density lipoprotein (LDL or "bad") cholesterol, and triglyceride appeared to be more significant in the group given metformin and garlic. The metformin and garlic group also had a greater decrease in C-reactive protein and adenosine deaminase levels, compared to the subjects given only metformin.

The research team concluded that garlic may be valuable in helping to control blood sugar and prevent long-term complications associated with type 2 diabetes and obesity. However, more studies are needed in this area before further conclusions on the potential benefits of garlic can be made.

Diabetes is associated with long-term complications that affect almost every part of the body. The disease often leads to blindness, heart and blood vessel disease, stroke, kidney failure, amputations, and nerve damage. Uncontrolled diabetes can complicate pregnancy, and birth defects are more common in babies born to women with diabetes. Pregnant women can temporarily develop gestational diabetes, a type of diabetes that begins late in pregnancy. In 2007, an estimated 20.8 million children and adults in the United States, or 7% of the population, had diabetes mellitus. An estimated 14.6 million have been diagnosed with diabetes (both type 1 and type 2), while 6.2 million people (or nearly one-third) are unaware that they have type 2 diabetes.

Garlic is a culinary herb that is widely used for the treatment and prevention of cardiovascular disease and cancer. Numerous controlled trials have examined the effects of oral garlic on serum lipids. Long-term effects on lipids or cardiovascular morbidity and mortality remain unknown. Other preparations (such as enteric-coated or raw garlic) have not been well studied.

Small reductions in blood pressure (<10 millimeters of mercury), inhibition of platelet aggregation, and enhancement of fibrinolytic activity have been reported, and may exert effects on cardiovascular outcomes, although evidence is preliminary in these areas.

Alpha lipoic acid (ALA) is another integrative therapy that has been studied for use in diabetes, and is supported by strong scientific evidence for this purpose. This compound is made naturally in the body and may protect against cell damage in a variety of conditions. Food sources rich in alpha lipoic acid include spinach, broccoli, and yeast. According to a survey of 685 herbalists, alpha lipoic acid was one of the 10 most frequently recommended dietary supplements due to its efficacy in reducing high blood sugar levels. The therapeutic use of alpha lipoic acid is not approved by the U.S. Food and Drug Administration (FDA) or corresponding regulatory agencies in other countries.

For more information about garlic, please visit Natural Standard's Foods, Herbs & Supplements Database.

Risk of Lower Muscle Strength Linked to Type 2 Diabetes

Exercise programs may be needed to help maintain muscle strength and functional capacity in older type 2 diabetics, a study reports.

Type 2 is the more common type of diabetes, in which the body does not make or use insulin properly. Without enough insulin, sugar stays in the blood and may lead to long-term complications that affect almost every part of the body. The disease may result in blindness, heart and blood vessel disease, stroke, kidney failure, amputations, and nerve damage.

Muscle strength refers to the amount of physical force an individual can exert at one time. This can be determined by how much weight a person can lift using certain muscles. Individuals in poor shape have an increased risk of developing many life-threatening health conditions including heart disease, high blood pressure, stroke, obesity, diabetes, osteoporosis, and cancer. Regular exercise may help improve posture because it strengthens the muscles needed for good posture. Regular exercise in the elderly may help prevent fall injuries by strengthening the muscles and improving balance.

Previous research suggests that the development of type 2 diabetes may be linked to a faster decline in muscle mass and strength. In the current study, the scientists evaluated functional capacity in a group of 60 diabetic men and healthy controls with an average age of 71 years. They tested participants' fitness with muscle mass assessments, strength exercises, and reaction time performance.

The results suggested that leg muscle mass and skeletal muscle mass were significantly lower in older men with type 2 diabetes, compared to control subjects with normal blood sugar. Leg extension strength was also significantly lower among the diabetics, as was functional performance and handgrip strength. However, significant differences in muscle fiber size and reaction time were lacking between the two groups.

The research team concluded that exercise programs may need to focus on older type 2 diabetics to help them maintain their muscle mass and strength. More studies are needed before firm conclusions can be made.

In addition to exercise, a number of integrative therapies may help improve exercise performance in type 2 diabetics. There is strong scientific evidence supporting the use of caffeine and creatine for enhancing athletic performance. Whey protein is backed by good scientific evidence for its role in enhancing both muscle mass and strength. Vitamin D has been studied for its effects in preventing falls in the elderly, and it is supported by good evidence for this purpose.

For more information about type 2 diabetes, please visit Natural Standard's Medical Conditions database.