Pharmaconutrition in the Clinical Management of COVID-19: A Lack of Evidence-Based Research But Clues to Personalized Prescription.

A scientific interest has emerged to identify pharmaceutical and nutritional strategies in the clinical management of coronavirus disease 2019 (COVID-19). The purpose of this narrative review is to critically assess and discuss pharmaconutrition strategies that, secondary to accepted treatment methods, could be candidates in the current context of COVID-19. Oral medicinal doses of vitamin C (1-3 g/d) and zinc (80 mg/d elemental zinc) could be promising at the first signs and symptoms of COVID-19 as well as for general colds. In critical care situations requiring parenteral nutrition, vitamin C (3-10 g/d) and glutamine (0.3-0.5 g/kg/d) administration could be considered, whereas vitamin D3 administration (100,000 IU administered intramuscularly as a one-time dose) could possess benefits for patients with severe deficiency. Considering the presence of n-3 polyunsaturated fatty acids and arginine in immune-enhancing diets, their co-administration may also occur in clinical conditions where these formulations are recommended. However, despite the use of the aforementioned strategies in prior contexts, there is currently no evidence of the utility of any nutritional strategies in the management of SARS-CoV-2 infection and COVID-19. Nevertheless, ongoing and future clinical research is imperative to determine if any pharmaconutrition strategies can halt the progression of COVID-19.

Vinegar (acetic acid) intake on glucose metabolism: A narrative review.

Vinegar intake is considered a food item that improves blood glucose in humans. This review aimed to discuss studies that investigated the impact of vinegar intake on the glycemic profile in humans and the putative mechanistic cellular pathways in both human and animal models. A search of literature was performed on the Cochrane, MEDLINE and Web of Science databases for articles published between 1995 and 2018. There is considerable support for vinegar having a positive acute effect on blood glucose levels when combined with carbohydrate-rich meals. Conversely, there are few chronic interventions analyzing the impact of vinegar intake on blood glucose. Based on available evidence, we hypothesize three pathways by which vinegar may improve blood glucose: The inhibition of α-amylase action; increased glucose uptake; and mediation by transcription factors. When evaluating the current body of literature, daily vinegar intake in amounts of ∼10-30 mL (∼2-6 tablespoons) appear to improve the glycemic response to carbohydrate-rich meals; however, there is a paucity of studies investigating chronic effects of vinegar intake.

To what extent does cinnamon administration improve the glycemic and lipid profiles?

BACKGROUND & AIMS: Cinnamon is a condiment used in cooking and by some in large quantities as a supplement with purported hypoglycemic and lipid-lowering potential. The current literature review aims to discuss the evidence of cinnamon administration regarding its hypoglycemic and lipid-lowering effects, summarizing clinical recommendations. METHODS: Electronic databases including PubMed, Cochrane library, Science Direct and Web of Science were searched with the scientific name of the plant as well as the common name. The search for articles was based on following keywords: "cinnamon diabetes", "cinnamon diabetes type 2", "cinnamon and diabetes type 2", "Cinnamomum aromaticum", "Cinnamomum cassia", "Cinnamomum verum", "Cinnamomum zeylanicum". We carried out inclusion criteria between 2003 and 2018 focusing on human studies. RESULTS: Concerning glycemic profile, in individuals with type II diabetes mellitus the fasting blood glucose reduced from 12.9 to 52.2 mg/dL and HbA1c from 0.27 to 0.83%, whereas serum insulin decreased in few studies. Research papers ranged from 6 to 17 weeks in duration. The lipid lowering potential, in turn, is most controversial compared to anti-hyperglycemic potential. Also cinnamon administration has been claimed to reduce fat mass and raise serum antioxidants, but the studies used inaccurate methods. Two species are most investigated, C. cassia/aromaticum, and C.zeylanicum/verum. CONCLUSIONS: About 1-6 g of these cinnamon species mainly in powder seems to be an adjunct drug treatment for type 2 diabetes mellitus and other conditions of glycemic impairment. However, more controlled clinical trials are needed.