Clinical effects of Hibiscus sabdariffa Linn. on obesity treatment: A systematic review and meta-analysis of randomized controlled trials.

INTRODUCTION: Obesity is associated with many chronic non-communicable diseases, including hypertension, diabetes, cardiovascular and cerebrovascular diseases, cancer, gallbladder disease, bone and joint disorders, skin diseases, fatty liver disease, etc. (Wharton et al., 2020)1 The recent report revealed that overweight and obesity were prevalent in 60 % of the adult population. Several studies have been published to determine the effect of Hibiscus sabdariffa Linn. on obesity treatment, but the findings are still inconclusive. The purpose of this study was to determine the efficacy and safety of H. sabdariffa Linn in the treatment of obesity. METHODS: We searched PubMed, EMBASE, and CENTRAL from inception to February 2024. Randomized controlled trials (RCTs) were included if they explored the effect of H. sabdariffa on one of the following outcomes: body weight, body mass index (BMI), waist circumference, and waist-to-hip ratio. A random-effects model was used to meta-analyze the data. I2 was used to quantify statistical heterogeneity among the included RCTs. PROSPERO registered protocol: CRD42023408880. RESULTS: A total of six RCTs with 339 participants were included. Four trials used H. sabdariffa extract in capsules as the intervention of interest compared to placebo, while the other two trials used H. sabdariffa tea compared to black or green tea. Our meta-analyses showed that the mean difference in weight reduction between H. sabdariffa and control was - 0.27 kg (95 % confidence interval (CI); - 1.98 to 1.42, I2 = 0.0 %). The mean differences for BMI and waist circumference reduction were - 0.06 kg/m2 (95 % CI; - 0.58 to 0.47, I2 = 0.0 %) and - 0.20 centimeters (95 % CI; - 2.06 to 1.66, I2 = 0.00 %). No safety concerns were reported in the included studies. CONCLUSION: Our study did not show a clinical benefit of H. sabdariffa extract in obesity treatment. However, further high-quality RCTs with a longer treatment duration and a standard dose are still warranted.

Potential effects of propolis and honey in COVID-19 prevention and treatment: A systematic review of in silico and clinical studies.

BACKGROUND: Propolis and honey have been studied as alternative treatments for patients with coronavirus disease 2019 (COVID-19). However, no study has yet summarized the full body of evidence for the use of propolis and honey in COVID-19 prevention and treatment. OBJECTIVE: This study systematically reviews the mechanisms of propolis and honey against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and current evidence for the use of propolis and honey in COVID-19 prevention and treatment. SEARCH STRATEGY: A systematic search was conducted of electronic databases including PubMed, Scopus, ScienceDirect, and Cochrane Library from their inceptions to April 2021. INCLUSION CRITERIA: Studies that evaluated the effect of propolis or bee products against SARS-CoV-2 using in silico methods, clinical studies, case reports and case series were included. DATA EXTRACTION AND ANALYSIS: A standardized data extraction form was used, and data were extracted by two independent reviewers. Narrative synthesis was used to summarize study results concerning the use of propolis or honey in COVID-19 prevention and treatment and their potential mechanisms of action against SARS-CoV-2. RESULTS: A total of 15 studies were included. Nine studies were in silico studies, two studies were case reports, one study was a case series, and three studies were randomized controlled trials (RCTs). In silico studies, using molecular docking methods, showed that compounds in propolis could interact with several target proteins of SARS-CoV-2, including angiotensin-converting enzyme 2, the main protease enzyme, RNA-dependent RNA polymerase, and spike protein. Propolis may have a positive effect for clinical improvement in mild and moderate-to-severe COVID-19 patients, according to case reports and case series. The included RCTs indicated that propolis or honey could probably improve clinical symptoms and decrease viral clearance time when they were used as adjuvant therapy to standard of care. CONCLUSION: In silico studies showed that compounds from propolis could interact with target proteins of SARS-CoV-2, interfering with viral entry and viral RNA replication, while clinical studies revealed that propolis and honey could probably improve clinical COVID-19 symptoms and decrease viral clearance time. However, clinical evidence is limited by the small number of studies and small sample sizes. Future clinical studies are warranted.

Efficacy and Safety of Ginger regarding Human Milk Volume and Related Clinical Outcomes: A Systematic Review of Randomized Controlled Trials.

BACKGROUND: Ginger has been used as a galactagogue in Southeast Asian countries. However, limited evidence of its effect has been reported. This systematic review summarizes the efficacy and safety of ginger regarding human milk volume. METHODS: A systematic review was conducted. Randomized controlled trials (RCTs) which studied the effect of ginger on human milk volume were included. The primary outcome was 24-h human milk volume. RESULTS: We found five RCTs. Two studies reported ginger as a single intervention, while three studies reported ginger in a combination with other herbs. We found that ginger could enhance human milk volume in mothers with vaginal births. It failed to improve human milk volume in mothers with cesarian section (C-section). Ginger in several combination products has been shown to be effective in enhancing human milk volume, including ginger with pandan, with turmeric and fenugreek, and with Xiong-gui-tiao-xue-yin. No adverse effect directly related to ginger was reported. DISCUSSION: Ginger could be used to enhance human milk volume in mothers with vaginal births, but not in mothers with C-section. Combined ginger products could also be considered to improve human milk volume. These findings could guide healthcare providers or mothers to consider using ginger to increase human milk production.

The clinical effect of glutathione on skin color and other related skin conditions: A systematic review.

BACKGROUND: Glutathione is one of agents which is commonly used to lighten skin color in Asia as a dietary supplement. Previous studies suggest its potential effect of glutathione on skin color. However, the clinical efficacy of glutathione in oral form is still questionable due to its limited absorption and bioavailability. AIM: To determine the clinical effects of glutathione on skin color and related skin conditions. PATIENTS/METHODS: A systematic review was conducted using PubMed, CINAHL, Scopus, EMBASE and Cochrane library were searched from inceptions to October 2017. All clinical studies evaluating the effect of glutathione on any skin effects in healthy volunteer were included. RESULTS: A total of four studies were included. Three studies were RCTs with placebo control, while one was a single-arm trial. One study used topical form, while others used oral form of glutathione with 250 to 500 mg/day. We found that both oral glutathione with the dosage of 500 mg/day and topical 2.0% oxidized glutathione could brighten skin color in sun-exposed area measured by skin melanin index. No significant differences in the reduction in skin melanin index were observed in sun-protected area for any products. In addition, glutathione also has a trend to improve skin wrinkle, skin elasticity, and UV spots. Some adverse events but nonserious were reported. CONCLUSIONS: Current evidence of the skin whitening effect of glutathione is still inconclusive due to the quality of included studies and inconsistent findings. However, there is a trend that glutathione might brighten skin color at skin-exposed area.