Echinacea plant preparations are used for common colds. This high-level research identified pertinent studies that tested whether or not it was effective (1). The others found 24 trials with 4631 participants that were applicable. The individual studies were of varying quality. The main results were that a relative risk reduction of 10 to 20% occurred. However, of the seven treatment trials reporting data on the duration of colds, only one showed a significant effect of Echinacea over placebo. The authors conclude that Echinacea products have not been shown to provide benefit for treating colds, although it is possible there is a weak benefit from some Echinacea products. The results of individual prophylaxis trials consistently shows positive trends, although effects are of questionable clinical relevance.

It is important to quantify the risks and benefits of any treatment approach. Chiropractic has in the past been criticized from a safety perspective due to an increased risk of stroke, and as a result has been extensively studied. This particular article looked at Medicare beneficiaries aged 66 to 99 years with neck pain (1). This study was a retrospective cohort analysis, looking at people who visited chiropractors or primary care physicians for neck pain. The results of the study showed that a proportion of subjects with any type of stroke in the chiropractic cohort was 1.2 per 1000 at 7 days and 5.1 per 1000 at 30 days. Compared to primary care cohort, which was 1.4 per 1000 at 7 days and 2.8 per 1000 at 30 days. Overall, the risk of stroke decreased from chiropractic during the 7 days, but increased over the 30 days from a slight elevation. The authors conclude that the risk of vertebrobasiliar stroke due to chiropractic was extremely low.

Many Naturopathic Doctors routinely consider additional vitamin B12 supplementation to treat depressive symptoms. This article examined if there was an association between the serum folate and vitamin B12 status and the depressive symptoms in postmenopausal women (1). The study included 95 women and the CES-D (a validated scale) was used to measure their depressive symptoms. The women were categorized into 2 groups and compared based on their vitamin B12 and folic acid levels. The results showed that the folate and vitamin B12 levels did not significantly correlate to frequency of depressive symptoms. Thus, the authors conclude that the supplementation of folic acid and vitamin B12 for postmenopausal women does not seem to be an effective intervention. It is important to note that this study only looked for an association, rather than testing supplemental folic acid or B12. Thus, it is possible that supplemental B12, or optimizing B12 levels in depressive women may be helpful.

Sleep deprivation is common in hospitalized patients. Lavender aromatherapy was tested by inhaling 100% lavender oil and testing the patient's vital signs and perceived sleep quality in an intermediate care unit (1). 50 patients were included in the randomized controlled trial. The treatment group has 3mL of 100% pure lavender oil in a glass jar placed along their bedside from 10pm until 6am. They completed the Richard Campbell Sleep Questionnaire to assess quality of sleep. The results showed that blood pressure was lower at nighttime and that the mean overall sleep score was higher in the treatment group. The authors conclude that lavender aromatherapy may be an effective way to improve sleep quality.

Hawthorn extract has been used for cardiovascular disease for a long time. It has shown to be effective for heart failure and for lowering blood pressure. The blood pressure lowering effects are linked to nitric oxide-mediated vasodilation. This study examined dose and artery flow mediated dilation (FMD) (1). The hawthorn extract used was standardized to 50mg oligomeric procyanidin per 250mg extract. Randomly sequenced doses of 1000mg to 2500mg were used. Doses were taken twice daily for 3.5 days and a 4 day washout period before proceeding to the next dose. The results showed that there was no evidence of a dose-response effect for FMD. The authors conclude that there was no dose-response effect and thus hawthorn may not be linked to nitric oxide at all.

A study was recently published that tested the regulatory effects of acupuncture on exercise tolerance in patients with chronic obstructive pulmonary disease (COPD) (1). Thirty cases of COPD were randomly divided into a treatment group or placebo group. Based on specified aerobic exercise, acupuncture was applied in the treatment group and placebo acupuncture was used in the placebo group. The needles did not penetrate skin for the placebo group. Multiple indexes of exercise tolerance were measured, including exercise time, maximum oxygen uptake, and breathing measures. The results showed that the maximum oxygen uptake was increased after the treatment, as well as exercise time and walking distance. The authors conclude that acupuncture could improve exercise tolerance in these groups of patients.

A study was recently published about N-acetylcysteine (NAC), a redox-active glutathione precursor that decreases inflammatory cytokines, modulates glutamate, promotes neurogenesis, and decreases apoptosis (1). All of these factors are purported to contribute to major depression. In this study, participants were treated with NAC or placebo in addition to treatment as usual for 12 weeks. The results showed that among those with high scores on the depression rating scale, NAC started to show benefit at weeks 6 and on of treatment. NAC was superior to placebo for secondary readouts of function and clinical impression. Remission and response were greater in the NAC group. The NAC group had a greater rate of gastrointestinal and musculoskeletal adverse events. The authors conclude that the study provides only limited support for NAC in the treatment of depression.

A highly powered study called a Cochrane review was recently published that examined the evidence on vitamin D supplementation and its link to mortality in adults (1). The authors searched a number of databases and selected articles, specifically randomized trials that compared vitamin D with placebo. Six authors independently extracted data and performed analyses. They found that 56 trials provided usable data and included 95,000 participants. They found that 150 people needed to be treated over five years to prevent one additional death. Vitamin D3 also statistically decreased cancer mortality by 12%. The authors conclude that vitamin D decreased mortality in elderly people living independently or in institutional care, but that it was difficult to make many other beneficial conclusions at this point.

Childhood obesity is a major concern worldwide, due to the over consumption of energy-rich foods. Purslane (Portulaca oleracea L.) has been studied for antioxidant and heart health promoting effects. In a recent study, it was examined to see if it could help with cholesterol in obese adolescents ⁽¹⁾. It was a triple-blinded randomized placebo-controlled clinical trial. Participants took one capsule of powdered Purslane (500 mg) two times a day for one month, and the control group took an identical lactose capsules. Many health parameters were measured. The results showed that total cholesterol, LDL, and triglycerides showed significant changes over the month, but the results were only significant for LDL and triglycerides. Overall, the authors conclude that Purslane may have positive effects on serum lipids due to its polyphenolic and antioxidant compounds. The herb is well tolerated in the adolescent population.

Gastrointestinal disorders are very common and standard treatments tend to be unsatisfactory. A recent study examined mindfulness-based therapies as an alternative treatment ⁽¹⁾, since mindfulness-based therapies have shown to benefit chronic pain, mood, and somatization disorders. A meta-analysis was conducted that included searching various medical databases. Eight articles describing seven studies met the inclusion criteria. In six studies, significant improvements were achieved or maintained by the end of the intervention. Effects were significant for IBS severity and quality of life. The authors conclude that mindfulness therapies may provide benefit in functional gastrointestinal disorders, but that substantial improvements in the research processes are required.

A recent study examined the herb Tribulus terrestris, a dicotyledonous herbal plant of the Zygophyllaceae family ⁽¹⁾. In ancient medicine, extracts of the aerial parts and fruits have been used for its diuretic, tonic, and aphrodisiac properties. Now, Tribulus is widely used by athletes and bodybuilders based on the belief, fueled by claims in marketing information, that it can enhance testosterone concentrations. In this study, an electronic literature search out using seven. Randomized control trials, which included healthy human subjects ingesting Tribulus as sole or combined supplement, along with animal studies with Tribulus as a sole treatment across a number of species were included. Eleven studies met the inclusion criteria. The results showed that trials varied in duration, dosage and supplementation with Tribulus as sole or combined treatment. A limited number of animal studies displayed a significant increase in serum testosterone levels after Tribulus administration, but this effect was only noted in humans when Tribulus was part of a combined supplement administration. Literature available for the effectiveness of Tribulus on enhancing testosterone concentrations is limited. Evidence to date suggests that Tribulus is ineffective for increasing testosterone levels in humans, thus marketing claims are unsubstantiated. The authors conclude that the nitric oxide release effect of Tribulus may offer a plausible explanation for the observed physiological responses to Tribulus supplementation, independent of the testosterone level.

A study was recently published that examined human trials with the herb Withania somnifera, better known as ashwagandha, in the treatment of anxiety ⁽¹⁾. A systematic review of the research was done. The results showed that five human trials met the inclusion criteria. Three studies compared several dosage levels of ashwagandha extract with placebos using versions of the Hamilton Anxiety Scale, with two demonstrating significant benefit of ashwagandha versus placebo, and the third demonstrating beneficial effects that approached but did not achieve significance. A fourth study compared naturopathic care with ashwagandha versus psychotherapy by using Beck Anxiety Inventory scores as an outcome (scores decreased by 56.5% in the ashwagandha group and decreased 30.5% for psychotherapy. A fifth study measured changes in Perceived Stress Scale scores in ashwagandha group versus placebo (there was a 44.0% reduction in scores in the ashwagandha group and a 5.5% reduction in the placebo group). The authors conclude that all five studies resulted in greater score improvements (significantly in most cases) than placebo in outcomes on anxiety or stress scales.

A study was recently published that evaluated the use of pomegranate juice supplementation in young healthy males during exhaustive exercise ⁽¹⁾. The study was conducted in Iran and comprised of 28 healthy subjects aged 18 to 24. They were randomly divided into control and supplement groups. One cup of pomegranate juice and one cup of tap water were given for two weeks. Fasting blood samples were taken at baseline and at the end of the intervention. The subjects were given one exhaustive exercise and then fasting blood samples were taken for multiple measures. The results showed that levels of total antioxidant capacity after exhaustive exercise in the supplemented group were significantly increased. The authors conclude that regular intake of pomegranate juice significantly modulates serum levels of inflammatory factors and protects against exercise-induced oxidative injury.

A meta-analysis was conducted of named diet programs ⁽¹⁾. A meta-analysis is typically considered the highest level of evidence because it incorporates the results of many high-quality studies. In this case, the authors investigated the weight loss outcomes for popular diets based on their diet class. They searched 6 electronic databases and used studies that only involved overweight or obese adults that were using diets for 3 months or longer. The results showed that they utilized a total of 48 unique randomized trial in their analysis. The largest weight loss was seen with low carb diets at 6 month follow-ups and low fat diets. People experienced different amounts of behavioral support and exercise when followed-up at 12 months, with differing effects on weight loss. The authors conclude that significant weight loss was observed with any low-carbohydrate or low-fat diet. Weight loss differences between individual named diets were small. This supports the practice of recommending any diet that a patient will adhere to in order to lose weight.

A new study was published that examined self-monitoring and self-titration of antihypertensives in a high risk group ⁽¹⁾. A primary care, unblinded, randomized clinical trial involving 552 patients who were aged at least 35 years with a history of stroke, coronary heart disease, diabetes, or chronic kidney disease and with baseline blood pressure of at least 130/80 mm Hg being treated at 59 UK primary care practices was conducted. Self-monitoring of blood pressure combined with an individualized set of self-titration rules. Control patients received usual care consisting of seeing their health care clinician for routine blood pressure measurement and adjustment of medication if necessary. The results showed that the mean baseline blood pressure was 143.1/80.5 mm Hg in the intervention group and 143.6/79.5 mm Hg in the control group. After 12 months, the mean blood pressure had decreased to 128.2/73.8 mm Hg in the intervention group and to 137.8/76.3 mm Hg in the control group, a difference of 9.2 mm Hg in systolic and 3.4 mm Hg in diastolic blood pressure following correction for baseline blood pressure. The authors conclude that among patients with hypertension at high risk of cardiovascular disease, self-monitoring with self-titration of antihypertensive medication compared with usual care resulted in lower systolic blood pressure at 12 months.