Review: Efficacy of Natural Supplements and Foods in Decreasing Inflammation and Increasing Recovery of Damaged Muscles

Background: There is available literature examining the anti-inflammatory properties of foods and the utilization of these foods to reduce muscle damage through diet. However, the available research does not compare the outcomes of many different types of foods and their effects. This review examines various foods and their efficacy regarding anti-inflammatory properties and pain reduction, following exercise-induced muscle damage. These foods all show promising evidence in the reduction of muscle soreness and inflammation following exercise-induced muscle damage, suggesting their ability to act as a clinical modality. Methods: Literature was gathered using various key searches like “exercise induced muscle damage and anti-inflammatory foods”. Databases searched included EBSCO host, Google Scholar, and PubMed. Randomized controlled trials, double-blind studies, meta-analyses, and systematic reviews with full texts published between 2012 and 2022, were included. Results: Four tart cherry articles found decreased scores in delayed onset muscle soreness or VAS scores, which was assessing pain following exercise. They also saw decreased scores in cherry groups compared to placebos. Four tart cherries studies all saw significantly increased scores in muscular voluntary isometric contractions with cherry use compared to the placebos. Tart cherries also saw improved levels of interleukin-6 and C-reactive protein in the intervention group. Another cherry study saw improvements in creatine kinase following exercise that induced muscle damage. Blueberry supplementation saw decreased pain level scores, increased maximal torque, and maximal torque average post-exercise-induced muscle damage. Creatine kinase levels were lower in blueberry groups while interleukin-6 showed increased levels in the blueberry groups. Pomegranate juice saw higher maximal weight scores and total weight lifted. Pomegranate groups also saw decreased delayed onset muscle soreness scores with blood biomarkers showing no significant change. Omega-3 studies saw improvements in at least one inflammation biomarker compared to placebo groups. One omega-3 study did not see improvements in physical markers but improved perceived muscle soreness while another omega-3 study saw decreased delayed onset muscle soreness scores. Conclusion: Tart cherries, pomegranate, blueberries, and omega-3 supplements all appear to be effective anti-inflammatory treatment options.

Ethan Balogh, James Geiselman DC, MS, DACBN, CCSP, ICSC, CES, CNC, NREMT, EMT-P

Review: Dietary and Lifestyle Modifications for PCOS

Polycystic Ovarian Syndrome affects millions of women across the world yet limited research on the topic of treatment options remains. In many cases, lifestyle modifications and complementary and alternative medicines are preferred first-line therapy. There are numerous signs and symptoms evident, however the most significant and common include insulin resistance, infertility, menstrual disturbances, inability to lose weight, and obesity. The current most researched dietary recommendations are the Mediterranean diet and low carb diets, such as the Ketogenic diet. There are a few researched supplements which may show a benefit to PCOS symptoms including, but limited to, inositol, vitamin D, magnesium, probiotics, and zinc. Even with these recommendations and the current literature, there is much more to learn and discover on this topic. It is the general consensus that more research is warranted to determine the best course of dietary and supplemental recommendations that support efficacy, safety, and sustainability for the patient as a univocal therapy for PCOS does not currently exist.

Katherine Giacobbe, Bethany A. Aponte, DC, DACBN, CFMP

Review: Weight Loss Using a Ketogenic Diet for Adults with Type II Diabetes

The ketogenic diet was introduced over a hundred years ago as a potential treatment for epilepsy. It was used as an alternative to fasting and is more effective due to the levels of ketonemia produced and the ability to be sustained for longer periods of time. As of late researchers have been focusing on the diet for Type II diabetes and weight loss. Using the Graceland Libraries and PubMed databases studies a literature review was performed using specific search terms with inclusion and exclusion criteria. Randomized controlled trials taking very-low-carbohydrate ketogenic diets and comparing them to diets using normal, smaller reductions in fat intake (less than 30 percent kcal from fat) for at least a year, found that ketogenic diets provided more weight loss for patients than the other reduced-fat diets. A ketogenic diet for adults with Type II diabetes when compared to typical dieting was shown to be effective. Factors that can improve the effectiveness of this include daily exercise and sufficient rest and practicing behavioral adherence strategies. This may be a substantial approach to treating obesity in adults with Type II diabetes.

Talia Martinez, Melanie Mason, DAT, LAT, ATC, CES, PES, James Geiselman, DC, MS, DACBN, CCSP, ICSC, CES, CNC, NREMT, EMT-P

Case Report: Supplementation and Dietary Modification for Histamine Intolerance

This is the account of a 24-year-old Caucasian female diagnosed with histamine intolerance by a chiropractic physician. This case should be of interest as it is not a condition which is routinely considered. Following years of a variety of seemingly diverse symptomatology, including suspected cerebrovascular accidents which were unable to be confirmed medically, objective data in the form of an advanced intestinal barrier assessment and a dietary antigen test were obtained. These tests provided objective verification that the patient had both elevated serum histamine and low diamine oxidase (DAO), both signs of an issue with histamine metabolism. The patient was placed on a low histamine diet, as well as supplemental diamine oxidase, and Histoplex®. After several months of following the recommended treatment, the patient experienced a reduction in her symptoms. Histamine intolerance has the potential to be causative of a wide range of symptoms, and as this case demonstrates can be overlooked by physicians of all disciplines. Consideration of histamine intolerance may need to be added to the list of differential diagnoses in patients that are not responding to other recommended treatments.

Rachel A. Kordonowy, Sean T. Norkus DC, MS, DIBCN, DIBE

Review: A Vicious Cycle: Using Nutrition to Combat the Behavioral Impact of Premenstrual Syndrome and Premenstrual Dysphoric Disorder.

Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD) are mood disorders experienced by women of child-bearing age who are regularly experiencing their menstrual cycles. Symptoms experienced negatively impact women cognitively, socially, emotionally, and physically. A literature review was performed relevant to the behavioral effects of PMS and PMDD and symptomology. Nutritional and lifestyle interventions with evidence were analyzed and reviewed. Studies indicated that intestinal dysbiosis, the Western diet, inadequacies in omega-3 fatty acids, vitamin D, vitamin B6, iron, sun exposure, smoking, alcohol, and physical activity are linked to symptomology associated with PMS and PMDD. Addressing micronutrient and essential fatty acid deficiencies, intestinal dysbiosis, smoking avoidance, limiting alcohol consumption, promoting physical activity and sunlight exposure, and providing education on PMS and PMDD may improve symptoms associated with these conditions.

Alexandra Trezza, Jeffrey P. Krabbe DC MPH MS DACBN FACN CISSN CSCS

Original Research: Nutritional Knowledge of NAIA Collegiate Women’s Volleyball Athletes.

This observational study analyzed and surveyed the nutritional knowledge of collegiate female volleyball athletes. Participants were required to complete a survey which tested sport nutrition knowledge, track food consumption over a three-day period in a food diary, and share anthropometric data (height, weight, age). Resting energy expenditure (REE) was collected, which al-lowed the calculation of their active energy expenditure (AEE). Collection of this data allowed for understanding of nutritional knowledge, eating patterns, and anthropometrics in women’s collegiate volleyball. Diary entries showed a lack of caloric intake, and in addition, insufficient macronutrient consumption. Survey results reported knowledge was low based on incorrect or inability to answer. Upon review of diary entries and survey results, it was concluded that there is a lack of nutritional knowledge within collegiate female volleyball athletes. Diary entries showed a lack of caloric intake, insufficient macronutrient consumption, and survey results were unsatisfactory.

Tyler LaRosa, Liam Smith, Dr. James Geiselman, DC, MS, DACBN, CCSP, ICSC, CES, CNC, NREMT, EMT-P, Bryan Gatzke, PhD, CSCS, PES, CES

Review: Comparison of the effect of whey protein and soy protein supplementation combined with resistance training.

The current research directly comparing whey to soy protein supplementation following resistance training and its effect on muscle protein synthesis (MPS) is limited. Existing literature comparing the difference between whey and soy protein is equivocal. The purpose of this review is to examine research directly comparing whey to soy protein supplementation regarding muscle protein synthesis following resistance training. A literature review was performed utilizing specific search terms with inclusion and exclusion criteria. It is suggested that differences between whey and soy protein on MPS with resistance training are apparent in experienced resistance training athletes and when the duration of training is 12 weeks or longer.

Thomas Jensen CSCS, Jeffrey P. Krabbe DC MPH MS DACBN FACN CISSN CSCS

Review: The Role of Calcium and Vitamin D in the Treatment of Premenstrual Syndrome

Background: Premenstrual syndrome (PMS) is a wide spectrum of symptoms that affects roughly 75% of women of reproductive age. Methods: A literature review was performed relevant to the effects of calcium and vitamin D on PMS symptoms. Nutritional interventions with evidence were analyzed and reviewed. Results: Studies showed that vitamin D has anti-inflammatory effects and can contribute to healthier stress levels and decreased anxiety and depression. Calcium can help maintain mineral balance and uterine function leading to a reduction in overall luteal phase symptoms. Conclusions: A combination of supplementation with calcium and vitamin D may improve the symptoms of PMS.

Lizmary Rivera Dávila, Marc Lucente DC, MA, DIANM

Review: Evidence-based Recommendations for the Treatment and Management of Ulcerative Colitis

Background: Ulcerative Colitis (UC) is a chronic inflammatory bowel disease involving the mucosa of the rectum that commonly affects those between the ages of 15 and 30 years and is characterized by exacerbations and remissions. Methods: A literature review was performed relevant to the clinical practice of UC utilizing a functional approach to treatment. Nutritional interventions with evidence were analyzed and reviewed. Results: Treatment goals should focus on a combination of symptomatic remission and mucosal healing through correction of nutritional inadequacies and targeted supplementation with sufficient evidence. Support for interventions including a low FODMAP diet, restoration of gut microbiota through probiotic supplementation, and mind-body therapies were discussed. Conclusions: A functional management strategy for UC is suggested that is guided by nutritional interventions that are evidence-based

Derek DeCagna, Jeffrey P. Krabbe DC, MS, DACBN, FACN, CISSN, CSCS

Review: Small Intestinal Bacterial Overgrowth – Concepts and Considerations

Background: Small Intestinal Bacterial Overgrowth (SIBO) is a condition characterized by a change in the number or quality of microorganisms present in the small intestine. It is associated with functional diseases of the gastrointestinal tract, such as irritable bowel syndrome. Methods: Factors affecting the microbiota present as possible risk sources as well as potential treatment approaches. Nutritional intervention could be effectively employed as a treatment protocol for SIBO. Results: A nutritional approach should include restoring the intestinal lining, enhancing nutritional status, and preventing recurrence. Use of the Bi-Phasic Diet Protocol, herbal therapy, and probiotic supplementation is suggested. Conclusions: Nutritional therapy for SIBO should be complex and individualized. A functional approach may be a valid method to treat the condition.

Jennifer Vannoy, Marc Lucente DC, MA, DIANM