A small study looking at 30 patients aged six to 17 years old randomized these children into groups receiving beclomethasone (250 ug BID) for asthma treatment. One group also received a probiotic containing Lactobacillus reuteri (10^8 colony-forming units (CFU)). After 60 days of treatment, the patients were reassessed with the Asthma Control test, spirometry and self-reported symptoms associated with asthma. The study found that compared to beclomethasone alone, the addition of the probiotics resulted in improved Asthma Control Test scores, and a reduction symptom expression. These results show promise in the inclusion of probiotics in the supplemental treatment of children/adolescents with asthma.

There are several ovulation inducing drugs used in fertility treatments for patients with polycystic ovarian syndrome (PCOS). In this study, patients with PCOS were randomized to receive letrozole plus N-acetylcysteine (NAC) (intervention group) or letrozole alone. 317 patients were included in the study. The results revealed a 14.6% pregnancy rate in the intervention group vs. 7.5% in the control. These results indicate that patients with PCOS receiving letrozole plus NAC demonstrated a statistically significant fertility rate compared to the control group receiving letrozole alone. 

This randomized controlled trial assessed 80 nurses on the level of sleepiness and alertness during the night shift work following inhalation of rosemary essential oil (EO). Based on previous literature, authors hypothesized rosemary EO could increase alertness given its stimulating effects on the autonomic nervous system (i.e. elevated heart and respiratory rate, raised blood pressure). Eligible nurses included those who had been working a minimum of six rotations of 12-hour shifts each month. Nurses were randomly allocated into the intervention or control group, receiving one drop of either rosemary EO or distilled water in their surgical masks. Researchers assessed the nurses once over the duration of one 12-hour shift, directing nurses to complete an alertness questionnaire before and after wearing the surgical masks for 10-15 minutes. This cycle was repeated every 2 hours. Masks were worn for a short period to prevent adaptation of the olfactory nerves to the scent of rosemary EO. Alertness was assessed after each cycle using the Karolinska Sleep Scale (KSS), a self-report 9-point Likert scale assessing level of sleepiness, as well as the Epworth Sleepiness Survey (ESS), a 3-point self-questionnaire rating the likelihood of dozing off in particular situations. Statistical analysis revealed significantly higher mean difference alertness scores and lower sleepiness scores in the intervention group following inhalation of rosemary EO (P < 0.0001). The results of this study suggest the stimulating scent of rosemary EO can help to improve cognition and reduce drowsiness, thereby reducing the risk for medical errors during shift work. Researchers did not test for long-term use of rosemary essential EO; however, a similar study was referenced in the article suggesting greater cognitive benefits with longer exposure.

Exergaming (a portmanteau of “exercise” and “gaming”) is defined as a digital game that requires body movement and physical activity to play, ranging from light to moderate intensity. There has been increased research on its therapeutic and cardiovascular effects. This study was conducted in Japan where the lifetime prevalence of low back pain is 83%. The study consisted of 40 patients, ranging from age 27-82, experiencing nonspecific chronic low back pain. These participants were split into two groups: a Nintendo Ring Fit Adventure (RFA) exergame group and a control group. The RFA group continued to take prescribed medication and started intervention treatment with RFA exercise gaming for 40 minutes each day for eight weeks. The control group received no exergaming/exercise therapy and continued prescribed medication. The groups were interviewed every two weeks to monitor pain levels; if pain relief was not adequate, NSAIDS, tramadol and duloxetine were prescribed gradually. RFA exergaming was found to reduce low back pain and buttock pain and enhanced patients’ sense of control over their pain, but no improvement was seen in lower limb numbness, kinesiophobia or pain catastrophizing. Exergaming was concluded to be an effective treatment for chronic low back pain with the potential to develop further (1).

In their systematic review and meta-analysis, Korman et al. (2020) reviewed intervention studies on high-intensity interval training (HIIT) for people with severe mental illness (SMI). People with SMI have low cardiorespiratory function (CRF), high cardiometabolic risk and in turn premature mortality. Exercise has been shown to be an adequate intervention that can increase CRF in people with SMI, therefore, the authors searched and assessed the literature for physical and psychiatric outcomes within the SMI population. The results show that both HIIT, but also moderate intensity continuous training (MCT) are feasible options for those participants with minimal safety concerns. Another finding suggests that people with SMI show improvements in CRF with MCT and HIIT (with a positive relationship potentially being conferred with extended program duration), although there appeared to be minimal metabolic impact (confounding factors includes diet and side effects of medications). Furthermore, a significant antidepressant effect followed HIIT, which had a modest advantage over MCT interventions especially in being most promising for reducing negative psychiatric symptoms. The authors suggest that future study designs consider incorporating motivational strategies, personal preference, and capability to improve adherence and promote sustainability.

This study assessed the effectiveness of bioactive collagen peptides for activity related joint pain in 218 healthy physically active men and women between 18 and 30 years of age. Participants were excluded if they had any injuries, osteoarthritis, rheumatoid arthritis or knee joint diseases. They were randomized to a group given placebo or 5 g of specific collagen peptides per day over a period of 12 weeks. The primary outcomes were changes in the visual analogue scale and physical examination of the knee joint. The mobility of the knee joint and use of alternative therapies were also recorded. It was found that supplementation with the specific collagen peptides derived from the type I collagen had a significantly higher reduction of exercise-induced knee pain compared with the placebo group (p=0.024). The authors concluded that the oral intake of bioactive collagen peptides can improve knee discomfort in young adults with activity-related joint pain.

In a double-blind randomized placebo controlled 12-week trial, researchers investigated the efficacy and safety of 5-hydroxytryptophan (5-HTP) in conjunction with the conventional treatment fluoxetine for OCD. It included 60 patients who met the diagnosis of moderate-severe OCD according to the DSM-5 and had a Yale-Brown Obsessive Compulsive Scale (Y-BOCS) score of >21. Participants were randomized to receive either fluoxetine with 5-HTP (100 mg twice daily) or fluoxetine with placebo. The fluoxetine in both groups was given at a dose of 20 mg/day for the first 4 weeks and then 60 mg/day for the rest of the trial. It was found that both groups had improvements in Y-BOCS scores (p <0.001). Even though patients in the 5-HTP group did experience significantly more abdominal pain and constipation than the placebo group, there was no difference in discontinuation between groups. Overall, the 5-HTP group showed higher partial (p=0.032) and complete treatment (p=0.001) rates versus the placebo group according to the Y-BOCS total scores.

In a 2-month randomized clinical trial[1], co-administration of prebiotics and probiotics (“symbiotic”) demonstrated a significant effect at reducing subjective ratings of anxiety and depression, and objective markers of inflammation in 96 patients with coronary artery disease compared to placebo and compared to the administration of either probiotics or prebiotics alone. The probiotic used was 1.9 × 109 colony-forming unit (CFU) of Lactobacillus Rhamnosus G per day with 15g per day of inulin.

In a triple-blind placebo-controlled study[2], researchers looked at the combination of symbiotic supplementation along with low-calorie restriction in 76 post-menopausal, overweight, hormone receptor positive breast cancer patients compared to placebo. Women were separated into two groups to receive either 109 CFU per day of a symbiotic supplement or placebo (n = 38 each group) for eight weeks. Both groups consumed a low-calorie diet program. Compared to the placebo group, patients taking the symbiotic had significantly increased adiponectin and decreased the levels of both inflammatory markers (TNF)-α and hs-CRP. These biomarkers are related to an increased risk of recurrence of breast cancer in this population, therefore symbiotic therapy may be considered as an adjunctive intervention for secondary prevention plan in overweight individuals with a history of breast cancer

In a recent open-label pilot study[1], a group of researchers from the Center of Neuroscience Studies and department of Psychiatry at Queen's university conducted an intervention on a group for 10 patients diagnosed with Major Depressive Disorder (MDD). The treatment lasted 8 weeks and consisted of a probiotic supplement containing Lactobacillus helveticus R0052 and Bifidobacterium longum at a dose of 3 × 10⁹ CFU once per day. Data was collected at baseline, week 4 and week 8. Results were measured with several clinical depression scales, and self-report questionnaires. At 4 weeks there were significant improvements in affective clinical symptoms, and these effects were sustained by week 8. There were also significant improvements in sleep quality by week 8, and no adverse effects from supplementation. While the sample size is small, these findings suggest groundwork for larger placebo-controlled clinical trials on the use probiotics for symptoms of depression. What is unique is that this study investigated probiotics as a standard, monotherapy for individuals not taking antidepressants.

Curcumin has well established anti-inflammatory and antioxidant properties. This study examined if a bioavailable form of curcumin could reduce the damage from oxidative stress and inflammation caused by exercise. It was a randomized, placebo controlled double blind study with 30 participants split into a treatment group, which received 500 mg of bioavailable curcumin per day, or the control group, which received placebo. Muscle damage from exercise was induced by 45 minutes of treadmill running with suitable modifications to ensure eccentric muscle injury. All subjects received a nutritional supplement containing 2-4 g of protein and 25-30 g of carbohydrate 1 hour before the exercise and 500 mL of water. They found that those in the bioavailable curcumin group had significantly reduced pain (p<0.0001), slightly reduced creatine kinase concentrations (p=0.1873) and increased VO2 max values (p=0.0009) compared to placebo. No serious adverse events were reported. The authors concluded that the bioavailable curcumin used was a safe and effective supplement to improve post workout muscle recovery.  

Health Canada has revised the non-prescription status of vitamin D from 1000 International Units (IU) per day to 2500 IU (62.5 µg) per day effective February, 24, 2021. This applies to both cholecalciferol (D3) and ergocalciferol (D2). This follows requests from consumers, physicians and industry to increase the non-prescription limit along with many product licence applications for vitamin D with higher doses. Additionally, the volume of scientific research on this vitamin has greatly increased since the previous restriction initiated in 1997. Safety assessments were performed by Health Canada’s Food Directorate to determine the safety of vitamin D at 2500 IU and it was determined that this dose is safe for children 9 years and older, adolescents and adults. The upper tolerable intake level remains to be set at 4000 IU per day for these populations. The new maximum dosage of 2500 IU is not recommended for all subpopulations including children, adults older than 70, and those pregnant and lactating with specific dosages outlined in the document.

Findings from the Yamagata study suggest that laughter may be associated with decreased risk of cardiovascular disease and all-cause mortality. The study included 17,152 subjects all over 40 years old who participated in an annual health check where they self-reported daily frequency of laughter. The patient follow-up occurred over a median of 5.4 years during which time 257 subjects died and 138 experienced cardiovascular events. Statistical analysis was adjusted to reflect age, gender, history of hypertension, smoking and alcohol use and showed that all-cause mortality was significantly higher in those who laughed less than once per month than those that laughed more than once per week. Similarly, risk of cardiovascular events was higher in subjects who laughed ≥1 time/month but <1 time/week than in subjects who laughed ≥1 time/week.

This systematic review and meta-analysis investigated the effects of dill seed (Anethum Graveolens Linn) on the length of labour. Participants were required to be 18-35 years old at gestational age 37–42 week, singleton pregnancy with cephalic presentation, estimated fetus weight of 2500-4000 gr, primiparous, and normal BMI. The search strategy was conducted on Cochrane Library, PubMed, Scopus and Web of Science using terms: Dill (Anethum graveolens Linn.), childbirth, uterine contractions and duration of labour. This yielded 4 eligible studies, 2 RCTs and 2 cohort studies, with a total of 691 participants. In the RCTs, compared to routine care, dill seed was found to significantly reduce the first stage (MD = -43.66 minutes, 95% [-52.99, -34.33]), second stage (MD = -15.76 min, 95% CI [-20.06, -11.47]), and third stage of labour (MD = -1.79 min, 95% CI [2.62, -0.95]). The cohort studies showed a similar significant reduction in the first and second stages of labour. The authors suggest that dill can be used in low-risk pregnant women to reduce the duration of labour. 

A study published in December 2020 out of Sweden and Norway looked at the impact of supplementing Selenium and CoQ10 on elderly patients with chronic kidney disease who were deficient in these nutrients. In a randomized double-blind placebo controlled prospective trial consisting of 215 individuals with mean age of 71 years, one group received 200ug/day of selenium yeast and 200mg/day of CoQ10, while the control group received a placebo. Measures of renal function were assessed at the start, at 48 months and after 5 years. Changes in renal function were measured via creatinine, cystatin-C and the Chronic Kidney Disease Epidemiological Collaboration (CKD - EPI) algorithm and eGFR. The intervention group showed significantly lower serum creatinine and cystatin-C concentration compared to the placebo group at both follow-up intervals (p < 0.0001), with more significant improvement in renal function at the five-year follow-up. 

COVID-19 is estimated to be three times more contagious than influenza, SARS and MERS. Variants in symptoms range from mild illness to significant hypoxia. The gastrointestinal (GI) tract is a notable site of infection, producing symptoms such as diarrhea, nausea, and vomiting; however, the virus can be present in the GI tract and persist asymptomatically. SARS-CoV-2 uses a spike (S) protein to inhibit angiotensin-converting enzyme 2 (ACE2), which is present on epithelial cells lining the lungs and GI tract. This enzyme is an important regulator in the GI tract for innate immunity, microbiome ecology, and susceptibility to inflammatory conditions; therefore, the inhibition of ACE2 can result in intestinal inflammation. Kim, H. S. (2021) suggests that gut health at the time of infection is a critical indicator of symptom development. In patients with disrupted gut barriers such as “leaky gut” syndrome, SARS-CoV-2 binds to ACE2 in the GI tract and can enter the blood stream, producing systemic symptoms. Patients with healthy gut barrier and flora did not exhibit GI symptoms and excreted the virus in their feces. Healthy GI tracts have higher numbers of Treg cells, which are activated by butyrate. Proposed treatments include increasing beneficial gut bacteria with next-generation probiotics and butyrate-producing microbes. Additionally, increasing dietary fibre, which can be utilized by beneficial gut bacteria to produce butyrate, can significantly improve gut health.