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Herbal Supplements, which ones work? Jim Painter PhD, RD Professor, Eastern Illinois University

Herbal Supplements, which ones work? Jim Painter PhD, RD Professor, Eastern Illinois University. Top 10 H erbal S upplements B y S ales. Cavaliere, C., et al.(2008).Herbal Supplement Sales in United States. Basic Four Food Groups. Everything that is good for you tastes bad.

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Herbal Supplements, which ones work? Jim Painter PhD, RD Professor, Eastern Illinois University

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  1. Herbal Supplements, which ones work?Jim Painter PhD, RDProfessor, Eastern Illinois University

  2. Top 10 Herbal Supplements By Sales Cavaliere, C., et al.(2008).Herbal Supplement Sales in United States

  3. Basic Four Food Groups Everything that is good for you tastes bad Everything that is bad for you tastes good Was good for you but not any more If you eat that it you will kill you

  4. Popular Herbal Supplements • Garlic • Rosemary • Ginger • Soy, isoflavones • Grapes, Resveratrol • Black Cohosh • Saw Palmetto • Kava • St Johns Wort • Valerian • Cinnamon • Turmeric • Ginseng • Cranberry • Ginkgo • Glucosamine & Condroitin

  5. I. GingerZingiber officinale

  6. Ginger • Contains powerful antioxidants • Gingerols, Shogaols, zingerones • Use - prevent or ease nausea - Reduce motion sickness - Reduce morning sickness - Reduce post surgery nausea

  7. N/V in Motion Sickness Nausea Score

  8. N/V in Pregnancy Nausea Intensity Study by Ozgoli, Goli & Simbar, 2009

  9. N/V Post-surgery 80 70 60 Percentage reporting POV symptoms 50 40 30 20 10 0 Ginger Placebo Study by Bone, et al., 1990.

  10. II. Soy/ legumes • Low in saturated fat • Contains protein and other compounds that help lower blood cholesterol Effect = reduced risk of heart disease

  11. Effects: Meta-analysis of Soy protein on Serum Lipids • 38 clinical studies; 730 people over 2 decades: • - 20 studies used soy protein isolate • - 15 used textured vegetable protein • Lowering of serum cholesterol in 34/38 studies • No effect in 4 studies • In all studies, cholesterol averaged <185 mg./dl. James W. Anderson, M.D., Bryan M. Johnstone, Ph.D., and Margaret E. Cook-Newell, M.S., R.D. N Engl J Med 1995; 333:276-282

  12. Reduction of Total Cholesterol by Soy >335 259-332 201-255 (mg/dl) Initial Cholesterol 127-198 0 20 40 60 Average Total Cholesterol Reduction (mg/dl)

  13. Reduction of Blood Cholesterol with Soy Consumption 30 25 20 15 Reduction in Blood Cholesterol mg. 10 5 0 25 50 75 Soy Intake (grams)

  14. Sources: Soy Protein Source: United Soybean Board

  15. III. Garlic • Garlic has been used in traditional and folk medicine for over 4,000 years • Garlic contains sulfur compounds • Eating one clove of garlic per day may help decrease blood cholesterol levels

  16. Effects: Garlic • Prevents platelet “stickiness” • Inhibits constriction of arteries • Reduces LDL oxidation (leads to clotting) • Prevents high blood pressure • Reduces blood lipids Ackermann et al., 2001, Arch Intern Med, 161: 813-24. Butt et al., 2009, Crit Rev Food Sci Nutr, 49(6): 538-51

  17. Component Responsible for Lipid Lowering • Allicin, a sulfur compound • Volatile sulfur compounds are not present in intact cells • Release by: • chopping • steaming • crushing

  18. Garlic Compounds and the Effect on HMG-CoA Reductase Liu & Yeh, 2002, J Nutr 132: 1129-1134

  19. Recommendations: Garlic • Experts still researching optimal dose • Conservative estimate = 1-3 cloves per day

  20. IV. Cinnamon Cinnamon • Source of Manganese, iron, calcium, and fiber • Cinnamaldehyde (Reduces stickiness of platelets) • Cinnamyl acetate (Antioxidant) • Cinnamyl alcohol (Antioxidant)

  21. Cinnamon – True Ceylon Cinnamon • Arthritis – Reduces uric acid production • Heart Health – reduce lipids/platelet adhesion • Type 2 Diabetes – lower blood glucose • Blood Pressure – Reduced blood pressure

  22. Meta-analysis: Cinnamon & A1C Allen, R. W., Schwartzman, E., Baker, W. L., Coleman, C. I., & Phung, O. J. (2013). Cinnamon Use in Type 2 Diabetes: An Updated Systematic Review and Meta-Analysis. Annals Of Family Medicine, 11(5), 452-459. doi:10.1370/afm.1517

  23. V. Black CohoshActaea racemosa L.

  24. Fast Facts Main use: ease menopausal symptoms like hot flashes or night sweats Most popular brand is Remifemin- it is a standardized extract Commonly given in 20 mg pills, twice a day

  25. Effect of Black Cohosh on Menopausal Symptoms 50 40 30 Average Kupperman Menopausal Index (KMI) Score 20 10 0 Week 0 Week 4 Week 8 Week 12 KMI score is out of 51 points and scores the following symptoms: hot flushes, paraesthesia, insomnia, nervousness, melancholia, vertigo, weakness, arthralgia or myalgia, headache, palpitations, and formication. Study by Vermes et al., 2005

  26. Pilot Test of BC for hot flashes 100 90 80 Daily hot flash scores (mean of all participants) 70 60 50 40 30 20 10 0 Baseline Week 1 Week 2 Week 3 Week 4 Hot flash score is frequency of hot flashes X severity Study by Pockaj et al., 2004.

  27. Summary: Black cohosh is probably effective but may not work for everyone- try it for a few months to see if it works for you!

  28. VI. Turmeric: • Long used as a yellow food coloring and spice. • A principal ingredient in curry powder(28%). • Contains three major curcuminoids, which are responsible for the yellow color of the herb. • Curcumin (diferuloylmethane) is the most significant curcuminoid.

  29. Effect of Turmeric on lung cancer in MicePercentage that developed cancer Curcumin & Taxol Curcumin Taxol Placebo 0 20 40 60 80 100 MD Anderson Study

  30. VII. Saw Palmetto Main use: relief from urinary symptoms associated with BPH

  31. BPH diagrams

  32. BPH Prevalence in Males

  33. Does it work?- Peak Urinary Flow Rate 12.4 12.2 12 11.8 Saw Palmetto Peak Urinary Flow Rate (mL/min) Placebo 11.6 11.4 11.2 11 Month 3 Month 6 Month 9 Month 12 Study by Bent et al., 2006.

  34. SP effect on DHT 6000 5000 4000 Testosterone Pg/g 3000 DHT (dihydrostes tosterone) 2000 1000 0 Untreated Permixon Study by Di Silverio, et al., 1998.

  35. Maximal Urinary Flow Rate Maximal Urinary Flow Rate (mL/sec)

  36. VIII. Kava KavaPiper Methysticum Witte, D. Loew, D. & Gaus, W. (2005). Meta-analysis of the efficacy of the acetonic kava-kava extract WS 1490 in patients with non-psychotic anxiety disorders. Phytotherapy Research. 19, p. 183-188.

  37. Drug Interactions-Effective Uses Sedative Anxiolytic Muscle Relaxant Mood stabilization Reduce mild nervous anxiety Restlessness & Agitation Tension & Stress Mild anti-inflammatory actions

  38. Dosage • Oral Use • Supplied by: • Capsules: 100 -500mg • Liquid: 1:1, 1:2 • Tea • Daily Dosage: • Capsules: Root extract: 150mg-300mg twice daily, with a daily dosage of Kava pyrones 50mg-240mg. • Tincture: Taken as 30 drops with water 3 times daily • Infusion: Take ½ cup twice daily

  39. Results Study by Witte, D. Loew, D. & Gaus, W. (2005). Geier [3] Kinzler [4] Lehrl [5] Malsch [7] Volz [11] Warnecke [12] -15 -10 -5 0 5 10 15 20 25 30 HAMA Difference

  40. Results Study by Witte, D. Loew, D. & Gaus, W. (2005). Younger Older Male Female All 0 -10 -5 0 5 10 15 20 25 30 HAMA Difference

  41. IX. Valerian RootValeriana Officinalis

  42. Dosage Daily dosage: 100mg-1800mg Total internal daily dose: 15g root powder, for restlessness 220mg three times daily, & for sleep aid 400mg-900mg of extract

  43. Dichotomous Outcomes for Sleep Quality (Sleep improved or not) Jansen Leathwood (1982) Vorbach Cerny Kamm-Kohl Jacobs 0.1 1.0 10.0 100.0 Relative Risk Study by Bent. S. et. Al. (2006).

  44. X. St John’s Wort Hypericum Perforatum

  45. Quick Facts • Main Use: treatment for mild to moderate depression, • Extract is standardized to 0.3% hypericin; 300-600mg 3x/day • Treatment of depression requires 2-6 weeks of treatment, and for full therapeutic dose use up to 6months

  46. SJW & Mild to Moderate Depression Total Score HAM-D (mean) Kasper,S. et al, 2006

  47. SJW vs. Standardized Depression Medication Total Score HAM-D (mean) Phillip,M. et al, 1999

  48. XI. Ginkgo Biloba

  49. What is Ginkgo biloba? • Dietary Supplement • Composition • Extract, flavonoid glycosides (composition?), terpene lactones and ginkgolic acid • Main Uses: Improves cognitive function, anti-inflammatory effects, and vascular effects

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