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Executive Summary

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Write an executive summary in the form of a blog article on the topic of "Research into Chinese medicine treatment for CAD" summarising the research below and using language that can be easily understood by patients and avoiding medical jargon using a professional and caring tone of voice.

Write an executive summary in the form of a blog article on the topic of "Researched Chinese medicine treatments for CAD" summarising the research below in an objective and easy to understand way, and using language that can be easily understood by patients. Group the article into Chinese medicine treatments first, followed by nutrition and other treatments. Avoid using medical jargon and use a professional and caring tone of voice.

Write me a concise but easy to understand executive summary on the topic of "Chinese medicine treatments for CAD" based on the following research that I will give you. Your summary should be 2 paragraphs long in Australian English spelling and include references to the studies.

A Randomised Controlled Trial published in 2023 in the journal Nutrients found that Consumption of unripe avocado extract in the diet may lower postprandial insulin levels in overweight adults with previously elevated insulin levels. In this study, a double-blinded, randomised controlled trial was performed on 60 non-diabetic adults (with a majority of 47 being women, average age 48 years, BMI 34.0 kg/m). The participants were stratified by sex and randomised into two groups. One group daily consumed an extract from unripe avocado (10 g finely ground, freeze-dried unripe avocado), while the other took a placebo (10 g finely ground cornmeal supplemented with 5% spinach powder) over a period of 12 weeks. The primary outcome measured was the change in glucose area under the curve (AUC) in response to a 75 g oral glucose tolerance test. The results showed no significant differences between both groups in terms of glucose AUC, insulin AUC, or cardiovascular outcomes. However, in a subgroup analysis focusing on participants with above median baseline postprandial insulin levels, there was a notable reduction in insulin AUC in those who consumed the avocado extract compared to the placebo. This suggests that the daily consumption of an unripe avocado extract, enriched in MH, might not significantly impact glucose tolerance or insulin sensitivity in obese non-diabetic adults. Nonetheless, there seems to be a potential benefit of this intervention on postprandial insulin levels in individuals with initially elevated insulin responses.

A Meta-Analysis published in 2023 in the journal Journal of Clinical Medicine found that Omega-3 fatty acid supplements can effectively alleviate symptoms of dry eye disease, especially when consumed in high doses for a long term and with high eicosapentaenoic acid levels. The methodology of this study involved an intensive review of data from multiple reliable sources like PubMed, Embase, and others covering the timespan from 2013 to 2023. The focus was on randomized clinical trials that studied the impact of omega-3 fatty acids on patients with dry eye disease and provided accessible pre- and post-intervention data. Studies with overlapping participants were excluded, as were studies without omega-3 supplementation or not featuring a placebo control or quantitative assessments. Independent reviewers extracted data pertaining to dry eye symptom scores and other related metrics. The results showed that patients who were administered omega-3 treatment demonstrated considerable improvement in symptoms of dry eye disease compared to those on a placebo treatment. The meta-regression analysis deduced positive correlations between the daily dose of omega-3, duration of omega-3 intake, and percentage of eicosapentaenoic acid, with a reduction in dry eye symptom scores. Similar trends were observed with other dry eye related metrics. These findings provide substantial evidence on the beneficial effect of omega-3 fatty acid supplements in managing dry eye disease. However, due to the diversity in patient characteristics and the heterogeneity in study results, care should be taken in widely applying these findings.

A Cohort Study published in 2023 in the journal The Journal of Nutrition found that Avocado consumption is linked to better glucose regulation, with metabolomic biomarkers of avocado intake showing even stronger associations with lower glycemia. The study used baseline data from 6224 multi-ethnic older adults, including self-reported avocado intake, fasting glucose and insulin. Untargeted plasma proton nuclear magnetic resonance contributed to metabolomic features, with data available for a subset of 3438 participants. The researchers then assessed the incidence of type 2 diabetes over approximately an 18-year follow-up period. They conducted a metabolome-wide association study comparing avocado consumers to nonconsumers and examined the features' associations with glycemia, both cross-sectionally with fasting insulin and glucose, and longitudinally with the incidence of type 2 diabetes. The research identified three highly-correlated spectral features associated with avocado intake at metabolome-wide significance levels and grouped into a single biomarker. These features didn't demonstrate any strong associations with overall dietary quality or any of the 47 other food groups, reinforcing their validity as an avocado intake biomarker. While avocado intake had a modest effect on lowering fasting insulin, this effect was not significant when adjusting for participants' body mass index. However, the avocado intake biomarker was noticeably related to lower fasting glucose, lower fasting insulin, and a lower incidence of type 2 diabetes, even after adjusting for BMI. This illustrates the considerable influence of metabolomic insights in determining diet-health relationships and the importance of considering individual metabolic differences for health outcomes.

A Review Article published in 2023 in the journal Nutrients found that Vitamin D deficiency could accelerate depressive symptoms and suicide risks, and vitamin D supplementation may mitigate these effects. The paper examines the links between vitamin D deficiency, depression, and suicide from various studies. It hypothesizes that vitamin D could enhance serotonin synthesis and modulate proinflammatory cytokines, both factors in depression and suicide. The paper reviews this hypothesis in the context of the broader health issue of suicide, which is among the leading causes of death worldwide. This paper then discusses the potential benefits of vitamin D supplementation. Drawing upon indirect evidence suggesting that vitamin D deficiencies may be a risk factor for depression—one of the most common factors in suicide attempts—the paper postulates that vitamin D supplementation could play a role in helping to reduce the risk of depression and thus suicide. The beneficial mechanisms of vitamin D, such as enhancing serotonin synthesis and modulating proinflammatory cytokines, which are associated with depression and suicide, stand as the central contributing factors in this hypothesis.

A Clinical Study published in 2023 in the journal PLOS One found that Avocado consumption correlates with a wider variety of healthier food choices, offering potential benefits for weight control strategies. The study created a comprehensive database of avocado-containing foods and drinks based on the AUSNUT 2011-13 food composition structure. The data pulled from four food-based clinical trials consisted of the usual food intake information from overweight and obese volunteers. The Apriori algorithm of association rules was employed as a two-step descriptive methodology to identify the associations between avocado consumption and choices of various foods at each mealtime using a nested hierarchical food group classification scheme. The findings revealed 34 separate avocado and avocado-inclusive foods and beverages. Avocado intake was prevalent within the studied cohort, with more than half consuming avocados regularly. Avocados were invariably associated with other food groups in main meal occasions, and during breakfast, lunch, and dinner, 68 food items containing avocados were identified for avocado consumers. This avocado-specific database offers insights into the variety of foods and beverages that incorporate avocados, reflecting broad food choices among regular avocado consumers.

A Systematic Review published in 2022 in the journal Journal of the Academy of Nutrition and Dietetics found that Avocado consumption may lead to a reduction in total cholesterol and low-density lipoprotein cholesterol levels in people with high cholesterol without impacting body weight. The study reviewed the impact of diets containing avocado on cardiometabolic risk factors compared with diets containing no or low amounts of avocado. Five electronic databases were searched aiming to identify studies published between 1990 and 2021. The selected studies included randomized controlled trials of three weeks or more and prospective cohort studies. In total, ten studies, nine controlled trials, and one observational study, met the inclusion criteria. Risk of bias was evaluated, and overall quality of the evidence was inspected. Meta-analyses were performed when there were three or more studies of the same design reporting the same outcome. Upon reviewing the results, the study found a minor, noteworthy reduction in total cholesterol levels in the avocado group as opposed to the control groups. There was no significant difference found in low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, or triglycerides. However, in populations with hypercholesterolemia, avocado consumption demonstrated significant reductions in both total cholesterol and low-density lipoprotein cholesterol levels. It is also worth noting that consumption of avocados did not negatively affect body weight or composition.

A Animal Study published in 2022 in the journal Food Research International found that Pu-erh tea and its ingredient theabrownin improve liver, jejunum, and adipose tissue functions in metabolic syndrome mice, modulating circadian rhythm, glycerophospholipid, and linoleic acid metabolism. In this study, varied technological applications such as metagenomics, transcriptomics, and metabolomics were utilized to explore the anti-metabolic syndrome mechanism of Pu-erh tea and theabrownin in mice with metabolic syndrome. These scientific technologies allowed the researchers to understand and explore improvements in the physiological functions of liver, jejunum, and adipose tissues in the metabolic syndrome mice as a result of Pu-erh tea and theabrownin interventions. The investigation also focused on changes to the hepatic transcriptome, revealing that both of these interventions had the capacity to regulate the circadian rhythm pathway. The results showcased that both interventions succeeded in the modulation of glycerophospholipid and linoleic acid metabolism, this was established through a comprehensive analysis of serum and brain metabolome. Further analysis of faecal metagenome demonstrated an increase in the relative abundance of certain bacterium and a decrease in others due to both interventions. However, in comparison to Pu-erh tea, theabrownin exhibited a more pronounced influence as regards upregulating hepatic antioxidants and downregulating hepatic inflammatory factors, although there was only a slight reduction in obesity-linked short-chain fatty acids in faeces of the metabolic syndrome mice. Overall, the experiment provided essential insights into the various ways these two elements function and provide treatment for metabolic syndrome.

A Experimental Study published in 2022 in the journal Food Chemistry found that Pu-erh tea, through the increase of Cinnabarinic acid, can improve obesity induced by circadian rhythm disorders by enhancing fat metabolism and altering gut microbes. In this study, a CRD-induced obesity model in mice was developed and Pu-erh tea was used as an intervention. The effect of Pu-erh tea on obesity was observed and determined to come from its production of Cinnabarinic acid (CA). CA was found to promote adipose tissue lipolysis and heat generation response, increasing the sensitivity of fat cells to hormones and neurotransmitters. This was accomplished by targeting the expression of specific receptor proteins in adipose tissue. These processes improved mitochondrial activity in the fat cells and expedited metabolic processes in the adipose tissue, thereby speeding up glucose and fat metabolism. In the final stage of the study, CA was found to make changes in the gut microbiota and short-chain fatty acids which further helped to improve the lipid accumulation mediated by CRD. The researchers concluded that the increase in CA, caused by drinking Pu-erh tea and reaching the fat tissue through blood circulation, could be a crucial mechanism to reduce obesity induced by circadian rhythm disorders.

A Review Article published in 2022 in the journal Clinical Therapeutics found that Nutraceuticals like zinc, vitamin D, l-arginine, mucuna, ashwagandha, tribulus, and ω3 fatty acids, along with lifestyle changes, can mildly improve male testosterone levels and sperm parameters. A comprehensive scoping review was undertaken to investigate the effectiveness of nonpharmacologic interventions such as dietary supplements, herbal remedies, diverse diets, sleep patterns, and various forms of physical exercise. The study was aimed to understand their potential in enhancing male health by improving testosterone levels and sperm parameters, especially in men with hypogonadism or fertility issues. Results indicated that among a multitude of nutraceuticals and functional nutrients that claim to stimulate testosterone production, only a select few, including zinc, vitamin D (in cases of its deficiency), l-arginine, mucuna, and ashwagandha, based on well-conducted randomized clinical trials, showed positive results in men with low testosterone levels and related complications. Except for l-arginine, these and other natural substances like tribulus and omega-3 fatty acids showed potential to enhance sperm parameters in infertile men. Implementing proper diet, ensuring adequate sleep and regular exercise are considered crucial, particularly in obese patients. It's also highlighted that androgen receptor content is potentially more significant in muscle hypertrophy than endogenous androgens. While the impact of nonpharmacologic interventions on testosterone levels are modest and do not translate into significant clinical benefits, some supplements and herbal medicines could serve as adjunctive approaches in testosterone and sperm health management. However, proper use of nutraceuticals involves personalised consideration by care providers.

A Randomised Controlled Trial published in 2022 in the journal Journal of the American Heart Association found that Despite previous suggestions, daily avocado consumption for six months did not decrease visceral adipose tissue volume in individuals with elevated waist circumference. The HAT Trial was a multicenter, randomized, controlled study designed to observe the effects of consuming one large avocado per day for six months on free-living individuals with an increased waist circumference. The primary measure of effect was the change in visceral adipose tissue volume, which was measured through magnetic resonance imaging. Other conditions related risk factors associated with cardiometabolic disorders were surveyed as secondary and additional endpoints. In results analysis, there was no significant alteration in visceral adipose tissue volume between the Avocado Supplemented and Habitual Diet Groups. No noteworthy differences were noticed in the secondary outcomes including hepatic fat fraction and certain components of the metabolic syndrome. Of the extra outcome measures, small but significant reductions were seen in total and low-density lipoprotein cholesterol in the Avocado Supplemented compared to the Habitual Diet Group. Changes in body weight, body mass index, insulin concentration and other measured factors were very similar between both groups, showing no considerable change due to avocado consumption.

A Randomised Controlled Trial published in 2022 in the journal CyTA - Journal of Food found that Avocado honey, rich in bioactive compounds, can serve as a natural sweetener without negatively impacting anthropometric and biochemical parameters. In this study, the researchers assessed the impact of consuming 25 grams of avocado honey daily for a period of four weeks on a group of 13 healthy individuals aged between 25 and 50 years, with Body Mass Indexes less than 25 kg/m2. The participants were divided into two groups, one acting as a control and the other as the honey consumption group. Despite the dietary addition of avocado honey, there were no significant deviations in the subjects' Body Mass Index and body fat percentage. Furthermore, it didn't affect biochemical parameters including fasting blood glucose, triglycerides, total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol. Consequently, avocado honey may be considered an effective functional food or natural sweetener.

A Experimental Study published in 2022 in the journal Journal of Agricultural and Food Chemistry found that Pu-erh tea may prevent circadian rhythm disorders by promoting tryptophan metabolism and signaling interactions in the gut-liver-brain axis. Healthy mice were administered water or 0.25% Pu-erh tea over a period of seven weeks, and then subjected to a disruption of their light/dark cycle for forty days. The assessment of effects was based on changes in neurotransmitter secretion and gene oscillations, intestinal inflammation, and the balance of intestinal microbes and metabolites. Results indicated that Pu-erh tea had beneficial impacts in regulating neurotransmitter secretion and clock gene oscillations, especially indole and 5-hydroxytryptamine pathways, a key process involving the gut-liver-brain axis. Moreover, the tea's metabolites improved release of brain hormones, thus enhancing hepatic glycolipid metabolism and lowering intestinal oxidative stress. Further observed beneficial effects included promotion of liver lipid metabolism and reduction of intestinal inflammation, via the enterohepatic circulation.

A Cohort Study published in 2022 in the journal Journal of the American Heart Association found that Eating more avocados, specifically two servings a week, is associated with a significantly lesser risk of cardiovascular disease and coronary heart disease. The research analysis included 68,786 women from the Nurses' Health Study and 41,701 men from the Health Professionals Follow-up Study, who were free of cancer, coronary heart disease, and stroke at the start. Their diet was assessed using validated food frequency questionnaires at the start and then every four years. The researchers used Cox proportional hazards regressions to estimate hazard ratios. Over three decades of follow-up, 14,274 new cases of cardiovascular disease were documented, including 9,185 coronary heart disease events and 5,290 strokes. After adjusting for lifestyle and other dietary factors, it was found that compared to non-consumers, those who had higher avocado intake exhibited a lower risk of cardiovascular disease and coronary heart disease. No significant associations for stroke were detected. Furthermore, it was noted that replacing half a serving per day of certain fatty foods with equivalent amounts of avocado was linked with lower risk of cardiovascular disease.

A Clinical Study published in 2022 in the journal Journal of Cosmetic Dermatology found that Daily oral consumption of one avocado enhances the elasticity and firmness of the facial skin in healthy women. Thirty-nine healthy overweight women ranging from 27 to 73 years of age, with skin types classified as Fitzpatrick II-IV, were involved in an 8-week study. They were grouped into two: one group ate an avocado daily while the other maintained their usual diet. The assumption was to examine if the daily intake of avocado could alleviate skin aging. Clinical assessments, specifically concerning facial skin characteristics such as firmness, pigmentation, and hydration, were done using a testing tool, called a cutometer, at specific points on the face (forehead and under the eye). The minimal erythema dose was also determined using a standard systematic approach at the inner arm. In analyzing the results, it was observed that skin firmness and elasticity, specifically on the forehead, improved significantly for those who consumed an avocado daily over the 8-week trial period when compared to their state at the beginning. No noticeable changes were recorded in skin hydration, pigmentation, or resistance to UVB radiation amongst the women in the avocado group relative to the control group. That being said, over time, variations in skin conditions such as melanin, sebum, and erythema were observed in both groups.

A Experimental Study published in 2022 in the journal Frontiers in Pharmacology found that PIASCLEDINE-ExpASU®, a type of avocado/soybean unsaponifiable product, displays superior pharmacological activity due to its unique composition, including a high inhibitory effect on pro-inflammatory factors. The study began with the characterisation of the lipid content of seven different avocado/soybean unsaponifiable (ASU) products through gas chromatography analysis performed on a VARIAN 3400 chromatograph. In parallel, the effects of these products were tested on human osteoarthritis chondrocytes (cartilage cells) cultured in alginate beads. The researchers focused on the effects of these ASU products on aggrecan, key interleukins, and matrix metalloproteases. In terms of results, PIASCLEDINE-ExpASU® stood out due to a specific profile involving unique chromatographic peaks and the presence of specific compounds like alkyl furan fraction, alkyl triols, and squalene. Remarkably, this product showed heightened efficacy in inhibiting production of nitric oxide, interleukins, and catabolic factors. Meanwhile, excepting two products, the remaining ASUs showed varied capacity in increasing aggrecan production, a positive factor in the context of osteoarthritis treatment.

A Review Article published in 2021 in the journal Nutrients found that Fresh Hass avocados have been found to reduce cardiovascular disease risk, assist weight loss, improve cognitive function, and promote colonic microbiota health. The methodology used in this comprehensive review entailed conducting 19 clinical trials, five observational studies, and examination of several biological mechanisms. These focused on understanding and identifying the primary health effects of Hass avocados in different population groups such as healthy overweight or obese adults, older normal-weight adults, and overweight or obese women. The effects were thoroughly measured in terms of cardiovascular health, body weight, cognitive function, and colonic microbiota health. The primary health effects of Hass avocados were then linked to its unique nutritional properties - the unsaturated to saturated fat ratio, the presence of multifunctional prebiotic and viscous fiber, its low energy density, and the increase in carotenoid absorption facilitated by its oleic acid and water emulsion, particularly when combined with low-fat fruits and vegetables. The results indicated significant positive effects from consuming Hass avocados, especially when incorporated into a healthy dietary plan like the Mediterranean diet. Consumption of avocados was found to lead to reduced cardiovascular disease risk in healthy overweight or obese adults, primarily by undesirable cholesterol profiles and promoting vascular health. For overweight or obese women, it helped in weight reduction and lessened visceral fat tissue. The consumption of avocados improved cognitive function in both older normal-weight adults and young to middle age overweight adults, particularly their executive function. It was also found to enhance colonic microbiota health in overweight or obese individuals by fostering healthier microflora and fecal metabolites.

A Randomised Controlled Trial published in 2021 in the journal Nutrients found that High avocado intake significantly reduces the intake of energy and various macro and micronutrients in Hispanic/Latino families. In this research, Seventy-two Hispanic/Latino families without severe chronic disease and not following specific diets were selected. These families, each with at least three members and all residing in the same household, were divided into two groups. One group received a low allotment of avocados (three per week) and the other received a high allotment (fourteen per week). Along with the prescribed amounts of avocado, both groups underwent twelve bi-weekly nutrition education sessions over a period of six months. The study investigated the change in the families' total intake of energy, as well as macro and micronutrients as the primary outcomes. These assessments were made by comparing mean changes between groups at the end of the six months, while abiding by the intention-to-treat concept. The results showed a significant reduction in not just energy intake, but also the intake of carbohydrates, animal and vegetable protein, fats (including saturated and polyunsaturated fats), and micronutrients such as calcium, magnesium, sodium, potassium, iron, and vitamin D in the high avocado allotment group. Interestingly, the high allotment group reported a reduction of self-reported energy intake by a notable margin, much higher when compared to the decrease in the low allotment group. The study underscores the potential of culturally-appropriate plant-based interventions for improving nutritional status of at-risk families.

A Randomised Controlled Trial published in 2021 in the journal Contemporary Clinical Trials found that Consumption of one avocado per day can potentially reduce visceral adiposity and subsequently decrease the risk of diabetes and cardiovascular disease. The Habitual Diet and Avocado Trial was a multicenter, randomized, controlled study that evaluated the impact of daily avocado consumption over a period of six months. The experiment involved a large and diverse cohort. Participants were required to incorporate a daily avocado into their diet as a substitute for their regular dietary intake, notably those devoid of avocado consumption. Their progress was measured using magnetic resonance imaging (MRI) to ascertain the potential decrease in visceral adiposity, with individuals with increased waist circumference being the primary focus of the study. Additional measures such as hepatic lipid content, plasma lipid profiles, blood pressure and high sensitivity C-reactive protein were also part of the evaluation. The study showed promising results in terms of weight control and reduction of visceral adiposity among participants. Initial results suggest that the sense of satiety post avocado consumption may subsequently lead to an overall decrease in energy intake. Moreover, the daily consumption of avocados was observed to not only reduce visceral fat but also display potential benefits impacting cardiometabolic disease risk. The benefits of avocado consumption were notably apparent among a cohort with an increased waist circumference, thus confirming the potential health benefits of avocados in weight management and risk reduction of obesity-related diseases.

A Cohort Study published in 2021 in the journal Frontiers in Nutrition found that The consumption of avocado is associated with better cognitive function in older adults. In the methodology, the researchers conducted a cross-sectional study involving 2,886 participants aged 60 or older from the National Health and Nutrition Examination Survey 2011–2014. These participants were classified into two groups: those who consumed avocado or guacamole, and those who did not. Cognitive performance was evaluated using tests for immediate and delayed recall, the Animal Fluency test, and the Digit Symbol Substitution Test, with education-dependent z-scores calculated for each participant as the education level can impact cognitive function. To control for potential influencing factors, comparisons were made between consumers and non-consumers with independent sample t-tests and advanced statistical methods like ANCOVA. The study found that those who consumed avocado showed significantly better scores across every cognitive test and the global cognitive score compared to non-consumers. Even after adjustments for potential confounders, the positive differences persisted. These findings support the conclusion that consumption of avocado correlates positively with improved cognitive function amongst elderly adults.

A Systematic Review published in 2021 in the journal Food and Chemical Toxicology found that Cocoa flavanols exhibit health and aging benefits and may act as powerful agents in preventing chronic diseases such as cardiovascular and metabolic disorders, and cancer. This research primarily relies on a comprehensive review of numerous human studies conducted over the past two decades. These studies provided significant data related to the health effects of cocoa intake and its impact on various chronic diseases. The studies encompassed different demographics and health conditions. Though most studies indicate beneficial effects of cocoa on health and prevention of chronic diseases, the results exhibit some inconsistency. Different studies suggest various mechanisms of action for cocoa, but these potential pathways are still not completely understood. Also, crucial issues like recommending cocoa consumption to healthy subjects or patients, determining the appropriate dosage, or the period of intake remain unresolved. Despite these unclarities, the potential of cocoa use to decrease the risk for certain chronic diseases and improve general health and quality of life is emphasized.

A Systematic Review published in 2021 in the journal Nutrition, Metabolism and Cardiovascular Diseases found that Consumption of certain foods like rapeseed/canola oil, avocados, and turmeric can lead to moderate to large reductions in LDL cholesterol levels. The research was carried out by conducting a systematic evaluation of existing guidelines, systematic reviews, and Randomised Control Trials (RCTs); we have only referred to the latter for studies on coffee intake. This was done on databases such as PubMed, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials, alongside a search on the Trip database for guidelines. The time frame for the study was from its inception up until June 2019 and October 2019 respectively. Studies were included if they were at least 13 days in duration and were in English. Using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) method, 37 guidelines, 108 systematic reviews, and 20 RCTs were evaluated to analyze the strength of evidence in the context of food impacts on LDL cholesterol levels. The results of the research reveal that foods high in unsaturated and low in saturated and trans fatty acids such as rapeseed or canola oil, those with added plant sterols/stanols, and those high in soluble fibre like oats, barley and psyllium cause moderate reductions in LDL cholesterol. A moderate to a large increase was observed with unfiltered coffee though. Soy protein, tomatoes, flaxseeds, and almonds cause small reductions. Meanwhile, foods like avocados and turmeric cause moderate to large reductions with a moderate level of evidence supporting this observation. Other foods like pulses, hazelnuts, walnuts, high-fiber/wholegrain foods, green tea result in small to moderate reductions, and sugar causes a small increase. Several foods identified were either neutral or had low or very low evidence regarding their effects on LDL cholesterol levels.

A Randomised Controlled Trial published in 2021 in the journal Journal of Complementary and Integrative Medicine found that Avocado/soy unsaponifiables effectively treat osteoarthritis by controlling the balance between oxidant and antioxidant molecular markers. The methodology used in this study was a double-blind, randomized, placebo-controlled, cross-over trial. Forty osteoarthritis patients were classified into two groups: one received avocado/soy unsaponifiables (ASU) for three months followed by three months of placebo, and the other group received a placebo first for three months followed by three months of ASU. The patients' oxidant status was evaluated by measuring their serum malonldialdehyde (MDA). Other measures such as total antioxidant capacity, reduced glutathione, and antioxidant enzymes like superoxide dismutase and catalase were also assessed. After three months of treatment, all patients who were given avocado/soy unsaponifiables exhibited a significant decrease in their serum MDA levels, indicating lower oxidative stress. In comparison, these levels were higher at baseline and after placebo treatment. Furthermore, the treatment with avocado/soy unsaponifiables resulted in positive changes in the patients' antioxidant levels. Analysis also showed that the effect of avocado/soy unsaponifiables was consistent, regardless of the sequence in which the medication was received. These findings demonstrate that avocado/soy unsaponifiables can contribute effectively to the treatment of osteoarthritis by regulating the balance between oxidant and antioxidant molecular markers.

A Systematic Review published in 2021 in the journal Annals of Medicine found that The existing evidence, although with low level of confidence, suggests that walnut intake may have a beneficial effect on cognition-related outcomes, including cognitive function, mood, and stroke. The existing evidence, although with low level of confidence, suggests that walnut intake may have a beneficial effect on cognition-related outcomes, including cognitive function, mood, and stroke. Limitations in study design and comparability render the available evidence insufficient to draw a firm conclusion regarding the effects of walnut on cognition in adults. High quality studies and standardized interventions and measurement tools are necessary to determine the role of walnut intake in cognitive health.

A Systematic Review published in 2021 in the journal Evidence-Based Complementary and Alternative Medicine found that Acupuncture combined with rehabilitation was more effective in improving the motor function and the ability of daily living. The mechanism for the effects of acupuncture in the improvement of motor function and activity of daily life may be explained by two reasons. First, acupuncture can directly enhance the motor function and daily life of stroke patients. Acupuncture has been shown to lead to a higher improvement in motor function than conventional treatment. Acupuncture when combined with rehabilitation may have a positive effect on motor function, activity of daily life, neurological deficits, and spasticity. Indeed, the meta-analysis concluded that no matter what kind of acupuncture therapy was combined with rehabilitation, it was better than the rehabilitation group when it came to significantly improving the activity of daily life of patients after ischaemic stroke. Second, acupuncture may indirectly improve the motor function and daily living ability of stroke patients by improving the symptoms of unilateral neglect and making them aware of their limbs. Acupuncture points may be the more intensive parts of the sensory organs that produce needle sensation. Acupuncture sensation is continuously transmitted to the central nervous system through the peripheral receptors of acupuncture point of contact, which facilitates new cognitive neural pathways for effective information, processing, and analysis, which may be one of the mechanisms for improving the perception of an injured hemisphere and alleviating the symptoms of unilateral neglect in patients.

A Experimental Study published in 2020 in the journal Evidence-Based Complementary and Alternative Medicine found that The ethanol extract of avocado seeds demonstrates an anti-endometriosis effect, potentially providing a new alternative treatment for endometriosis. Methodology: The study involved inducing endometriosis in female Wistar rats by grafting uterine fragments onto their peritoneum. Upon successful transplantation, these rats were orally treated with differing doses of an ethanol extract from Lauraceae seeds over a span of 7 days. Key benchmark measures included endometrial implant volume, as well as serum and lesion estradiol and progesterone levels. The study also analyzed the oxidative status of endometriosis lesions and carried out histological analysis of the lesions, uterus, and ovaries. Discussion of Results: The treatment with the ethanol extract of Lauraceae seeds resulted in a decrease in endometrial implant volume and a reduction in both serum levels and lesion levels of estradiol and progesterone. The oxidative status reflected an increased presence of key antioxidants in the endometriosis lesions. Histologically, the endometrium height was reduced, with an increase in the number of antral follicles and corpora lutea, alongside a decrease in luteinized unruptured follicles. Therefore, the study concluded the ethanol extract displayed a pronounced antiendometriosis effect.

A Review Article published in 2020 in the journal Frontiers in Nutrition found that Incorporating avocados into the Mediterranean diet may enhance its benefits, offering greater health flexibility and adaptability for non-Mediterranean residents. The research approach starts with an evaluation of the nutritional value of a Mediterranean diet, which is traditionally rich in fruits, vegetables, and oleic-acid-rich olive oil. This diet has been associated with lower risks of several chronic diseases. Simultaneously the paper introduces the subject of rising obesity rates globally. The study then evaluates the potential benefits of modifying the Mediterranean diet to include non-traditional fruits and vegetables that could provide more variety in food choices and greater adaptability for those living outside the Mediterranean region. The avocado, a fruit native to the Mediterranean climate and rich in beneficial nutrients like oleic acid and fiber, is proposed as a potential addition. Discussion of the study reveals an interesting proposition: including avocado in the traditional Mediterranean diet, which is not commonly done. The avocado's health benefits and nutritional value are then analysed in depth, drawing from existing research studies, to substantiate the recommendation for incorporating this fruit into the Mediterranean dietary pattern. The discussion concludes by highlighting the potential enhanced health benefits that can result from this inclusion, thereby presenting a compelling case for the suggested adjustment.

A Systematic Review published in 2020 in the journal Complementary Therapies in Medicine found that Acupuncture appears to be an effective and safe method to alleviate persistent myofascial head and neck pain. To investigate the impact of acupuncture on persistent myofascial head and neck pain, only randomized controlled clinical trials were considered. These studies were hunted in a variety of databases, including PubMed, Ovid Medline, Embase, Google Scholar, and the Cochrane Library, in addition to a manual search. The main metric used for outcome measurement was the comparison of the mean pain intensity score on the Visual Analogue Scale (VAS) between the acupuncture and sham-needling/no intervention groups. Additionally, safety data and adherence rate were looked into. The key findings from the gathered randomized controlled clinical trials showed a decrease in the Visual Analogue Scale pain intensity scores in the acupuncture group when compared with the sham-needling/no intervention group. Only four trials were included in the concluding meta-analysis, which showed a substantial difference in pain intensity between the acupuncture and sham-needling/no intervention groups. Overall, the results demonstrated promising safety levels, evidenced by low side effects/withdrawal rates. However, the studies were inconsistent in the way they reported outcomes.

A Randomised Controlled Trial published in 2020 in the journal International Journal of Psychophysiology found that Daily avocado consumption improves attentional inhibition and increases serum lutein concentrations, irrespective of changes in lutein status, in adults with obesity. The study involved a randomized-controlled trial with 84 adults aged 25-45 years suffering from overweight or obesity. The participants were divided into a treatment group and a control group. Those in the treatment group consumed a daily meal with fresh Hass avocado for 12 weeks while the control group was given an isocaloric meal. The xanthophyll status was evaluated by measuring serum lutein and macular pigment optical density, and cognitive functions such as attention and inhibition were evaluated using the Flanker, Oddball, and Nogo tasks. Regarding the results, the treatment group showed improved serum lutein concentrations and better performance in the Flanker task demonstrating improved attentional inhibition. However, they found no correlation between improvements in performance and changes in lutein status and no significant changes in macular pigment optical density. Therefore, it suggests that the cognitive benefits from avocado intake were not due to changes in lutein status but may involve other unknown mechanisms.

A Review Article published in 2020 in the journal Food Reviews International found that Bioactive compounds found in avocado waste products exhibit various biological properties, with potential applications in the food and pharmaceutical industries. In this study, we delved into the archived scientific research concerning bioactive compounds and their sources, particularly focusing on avocado waste products such as leaves, peels, and seeds. We identified the primary compounds found in these parts to include carotenoids, tocopherols, phytosterols and a group of natural organic structures known as polyphenols. In the results discussion, we found that the compounds discovered in avocado waste products have credible biological activities that have distinct health implications. The wastes extracts demonstrated antimicrobial properties, along with anti-inflammatory characteristics. Additionally, they showed potential anticancer, antidiabetic and antihypertensive capabilities. These findings infer that the bioactive compounds from avocado wastes may be successfully used in the food and pharmaceutical industries.

A Review Article published in 2020 in the journal Biomolecules found that Avocado and soybean unsaponifiables may effectively reduce inflammation and symptoms related to osteoarthritis, autoimmune diseases, and menopause. The research involves summarizing various studies on the biological effects of the avocado-soybean unsaponifiables (ASU), highlighting its potent anti-inflammatory properties. The extracted ASU are a combination of elements derived from the fruits and seeds of avocados and soybeans. To understand its impact, the researchers categorized the applications of ASU in treating different conditions such as osteoarthritic pain, hip and knee osteoarthritis, autoimmune diseases, and menopause-related symptoms amongst postmenopausal women. The discussion revealed significant links between avocado and soybean unsaponifiables and symptom improvement in areas of osteoarthritic pain, autoimmune conditions, and postmenopause. Particularly notable is the ASU mixture's potential role as an adjunct treatment, meaning it’s meant to supplement primary treatments for such conditions. Its benefits were not only limited to physical reduction of inflammation and associated pain, but also improved mood and quality of life for postmenopausal women by significantly reducing menopause-related symptoms. The study also delves into the safety, toxicological considerations, and regulatory practices related to the use of ASU.

A Network Pharmacology published in 2020 in the journal Research in Pharmaceutical Sciences found that Pomegranate fruit extract significantly enhances cartilage gene expression and chondrogenesis in human adipose-derived stem cells compared to Avocado/Soybean Unsaponifiable. Human adipose-derived stem cells were first isolated, expanded in monolayer culture, and identified, and then seeded on fibrin scaffolds. These cell-impregnated scaffolds were divided into 4 groups: a control group, an Avocado/Soybean unsaponifiable (ASU) group, a Pomegranate Fruit extract (PFE) group, and a mixed ASU/PFE group. Each group was subjected to induction for two weeks with the corresponding substances, except the control group which only received chondrogenic medium. The levels of cell viability, cartilage gene expression, matrix staining density, and collagen type II proteins in the PFE samples were found to be noticeably greater than other groups. Histological assessments further highlighted higher chondrogenic centers in the PFE group. This indicates that PFE significantly enhances chondrogenesis and cartilage gene expression in these cells, suggesting potential use in cartilage tissue engineering.

A Review Article published in 2020 in the journal Antioxidants in Fruits: Properties and Health Benefits found that Avocado, particularly the Hass variety, has substantial health benefits due to its rich contents of nutrients, fiber, and bioactive constituents including antioxidants. The methodology of the paper involves a comprehensive overview of avocado, focusing on the extensively cultivated Hass variety. The research explored various components of the avocado which include not only the fruit, but also the seeds, leaves, and skin. These parts were analyzed for their nutritional and bioactive constituents such as phytochemicals, phytosterols, vitamins and minerals. Furthermore, the use of avocado leaves in traditional medicine, the rich composition of the peel and seeds, and the potential health benefits of avocado oil were investigated. The discussion of results revealed that avocados, particularly Hass avocados, are a substantial source of beneficial nutrients, fiber, and bioactive components. It was found that leaves of the avocado have antioxidant properties and are used in traditional medicine. The peel and seeds showed a rich content of phenolic compounds, starch, and fiber. The research also determined that avocado oil presents health advantages and can be used as a good alternative substitute for olive oil. Avocados are largely consumed as a vegetable, often in combination with other ingredients.

A Review Article published in 2019 in the journal Antioxidants found that Avocado's nutritional and therapeutic properties show potential for novel drug discovery in prevention and treatment of prevalent diseases such as cancer, diabetes, and cardiovascular issues. The methodology utilized in this review was an extensive summary and assessment of research conducted in recent decades with emphasis on avocado's nutritional and therapeutic properties, along with its unique biochemical profile. Special focus was given to the major metabolites of avocado, their antioxidant properties, as well as their bioavailability and pharmacokinetic features. The discussion of results involved highlighting the potential of avocado in novel drug discovery for the prevention and treatment of a variety of diseases like cancer, microbial, inflammatory, diabetes, and cardiovascular diseases. Emanating from the unique bioactive compounds and antioxidant contents of avocado, it’s clear that the fruit has much more to offer in terms of medicinal value than is currently explored today.

A Systematic Review published in 2019 in the journal International Journal of Rheumatic Diseases found that Avocado-soybean unsaponifiables treatment is effective in reducing knee osteoarthritis symptoms without increasing adverse events, contrary to those with hip osteoarthritis. To assess avocado-soybean unsaponifiables (ASU) effectiveness and safety, a systematic review and meta-analysis of randomized controlled trials involving patients with hip or knee osteoarthritis was conducted. Various scientific databases, including Medline, SCOPUS, Web of Science, and Google Scholar, were thoroughly searched for suitable trials. Selection criteria consisted of randomized placebo-controlled trials wherein the effect of orally administered ASU on knee or hip osteoarthritis symptoms were evaluated, primarily using the Lequesne index, visual analog scale, and joint space width. The meta-analysis revealed a significant reduction in pain as assessed by the visual analog scale for those under Avocado-soybean unsaponifiables therapy, particularly for patients with knee osteoarthritis, indicated by a decrease in both the visual analogue scale and Lequesne index. However, no such significant effect was found for patients with hip osteoarthritis. In terms of safety, there were no significant differences in adverse events between patients receiving ASU and those given a placebo, confirming ASU's relative safety as a treatment option.

A Randomised Controlled Trial published in 2019 in the journal International Journal of Basic & Clinical Pharmacology found that Avocado oil supplement combined with exercise improves joint function in osteoarthritis over traditional treatments like NSAIDS and multivitamins with exercise. In this study, 90 osteoarthritis patients were randomly sorted into three groups for different treatments: one group took multivitamins associated with exercise, the second group took NSAIDS, and the third, avocado oil combined with strengthening exercises. The pain and knee functionality of each participant were measured using the Visual Analogue Scale and Oxford Knee score respectively. Throughout the three-month treatment course, the group that used avocado oil alongside exercises outperformed the others. They had the highest Oxford Knee scores, indicating better knee functionality, and also had higher average Pain Threshold scores from the Visual Analogue Scale. Hence, this study postulates that avocado oil, coupled with muscle exercises, offers a more effective solution for managing osteoarthritis over NSAIDS and multivitamins.

A Systematic Review published in 2019 in the journal BMC Complementary Medicine and Therapies found that Acupuncture shows promise in improving endometrial receptivity and fertility outcomes in infertile women, but further high-quality research is needed to establish its effectiveness definitively. This systematic review aimed to assess the effectiveness of acupuncture in improving endometrial receptivity (ER) based on randomized controlled trials (RCTs). The review included RCTs of infertile women with low ER and excluded other causes of infertility or non-RCTs. The researchers conducted an extensive search through various databases up to August 2018 without language restrictions. After analyzing the collected data, they found evidence indicating that acupuncture may enhance pregnancy rate, embryo transfer rate, trilinear endometrium, endometrial thickness, and decrease resistive index, pulse index, and peak systolic velocity/end-diastolic blood velocity when compared with medication, sham acupuncture, or physiotherapy. However, the overall level of evidence was mostly very low or low. Despite the statistically significant results, the authors emphasize the need for more large-scale, long-term RCTs with robust methodologies to further validate the efficacy and safety of acupuncture for women with low ER

A Systematic Review published in 2019 in the journal Journal of Functional Foods found that Consumption of virgin avocado oil, rich in monounsaturated fatty acids and bioactive components, may help manage chronic diseases like hypertension, diabetes, and lower cardiometabolic risk. The research paper is a review that explores various extraction methods developed for producing virgin avocado oil (VAO) and the oil yields for these methods. It additionally details the physicochemical composition of VAO, focusing specifically on its high concentration of monounsaturated fatty acids and bioactive components, such as α-tocopherol and β-sitosterol. The results discussed indicate that VAO, which is mainly composed of oleic, palmitic, and linoleic acids, can be utilized as a functional oil offering potential health benefits. In particular, the intake of avocado oil could aid in managing conditions like hypercholesterolemia, hypertension, diabetes, and fatty liver disease, taking advantage of its rich composition. Furthermore, it was noted that the oil could also reduce cardiometabolic risks and exhibit properties that can combat microbial activity.

A Systematic Review published in 2018 in the journal Acupuncture in Medicine found that Acupuncture showed a more favourable effect in the treatment of lumbar disc herniation than lumbar traction, ibuprofen, diclofenac sodium and meloxicam. Thirty RCTs involving 3503 participants were included in the study. Meta-analysis showed that acupuncture had a higher total effective rate than lumbar traction, ibuprofen, diclofenac sodium and meloxicam. Acupuncture was also better than lumbar traction and diclofenac sodium in terms of visual analogue scale (VAS) scores, and better than lumbar traction with respect to Japanese Orthopaedic Association (JOA) scores. In addition, the total effective rate in five individual trials was greater for acupuncture than for mannitol plus dexamethasone and mecobalamin, ibuprofen plus fugui gutong capsule, loxoprofen, mannitol plus dexamethasone and huoxue zhitong decoction, respectively. Additionally, two individual trials showed a superior effect of acupuncture in VAS scores comparedwith ibuprofen or mannitol plus dexamethasone, respectively.

A Systematic Review published in 2018 in the journal Clinical Rehabilitation found that Current evidence suggests that traditional manual acupuncture integrated with rehabilitation therapy is more effective in alleviating pain, improving limb movement and activities of daily living. A total of 20 studies involving 1918 participants were included in this study. Compared to rehabilitation therapy alone, the combined therapy significantly reduced pain on the visual analogue scale and improved limb movement on the Fugl–Meyer Assessment scale and the performance of activities of daily living (ADL) on the Barthel Index scale or Modified Barthel Index scale. Of these, the visual analogue scale score changes were significantly higher favoring the combined therapy after treatment, with severe heterogeneity.

A Systematic Review published in 2017 in the journal Phytotherapy Research found that Avocado, with its lipid-lowering, antihypertensive, antidiabetic, anti-obesity, and cardioprotective effects, can potentially manage metabolic syndrome more efficaciously than synthetic treatment options. The methodology used in this research involved a systematic review of several studies investigating the pharmacological effects of avocado on different components of metabolic syndrome. This included studies on the lipid-lowering, antihypertensive, antidiabetic, anti-obesity, antithrombotic, antiatherosclerotic, and cardioprotective effects of avocado. Further, the review also encompassed researches based on the effects of avocado's various parts like the flesh, seed, peel, and leaves in metabolic syndrome. Upon evaluation of collected studies, the researchers found that the avocado, a rich source of carotenoids, minerals, phenolics, vitamins, and fatty acids, demonstrates strong potential in managing metabolic syndrome. Its antidiabetic, antihypertensive, anti-obesity, lipid-lowering, and cardioprotective properties specifically align with the key risk factors of metabolic disease, including high blood sugar, dyslipidemia, hypertension, and obesity. These qualities suggest that avocado might present a more efficient and less adverse alternative to synthetic treatments.

A Systematic Review published in 2016 in the journal Evidence-Based Complementary and Alternative Medicine found that Oral ginger could be an effective treatment for menstrual pain in dysmenorrhea. Ginger appeared more effective for reducing pain severity than placebo. The weighted mean difference on a 10 cm visual analogue scale was 1.55 cm (favoring ginger). No significant difference was found between ginger and mefenamic acid (an NSAID). The standardized mean difference was 0 (95% CI -0.40 to 0.41). Available data suggest that oral ginger could be an effective treatment for menstrual pain in dysmenorrhea. Findings, however, need to be interpreted with caution because of the small number of studies, poor methodological quality of the studies, and high heterogeneity across trials. The review highlights the need for future trials with high methodological quality.

A Review Article published in 2014 in the journal CARTILAGE found that A dietary supplement Avocado/Soybean Unsaponifiables aids in treating Osteoarthritis by preventing cartilage degradation and promoting cartilage repair, thereby reducing pain and enhancing joint functionality. Avocado/Soybean Unsaponifiables was studied for its effects on Osteoarthritis. The methodology highlighted its functions, which include inhibiting the release and activity of molecules and pathways that are implicated in OA, as well as those that prevent cartilage degradation. These functions are principally through the prohibition of matrix metalloproteinases and the increase of tissue inhibitors of the catabolic enzymes in question. Additionally, ASU was found to inhibit fibrinolysis by stimulating the expression of plasminogen activator inhibitor. Moreover, its anabolic properties were credited with promoting cartilage repair by stimulating collagen and aggrecan synthesis while inhibiting inflammatory cytokines. ASU's chondroprotective effects were noted as well; these effects are brought about by correcting growth factor abnormalities, and by simultaneously increasing Transforming Growth Factor-Beta in synovial fluid while decreasing vascular endothelial growth factor. Additionally, it was observed to inhibit cholesterol absorption and biosynthesis, which further contribute to its beneficial role by moderating reactive oxygen species pathology in chondrocytes. Results indicated that the dietary supplement has significant therapeutic value for those suffering from Osteoarthritis. It reduces pain and stiffness while improving joint function, resulting in less dependency on painkillers. It was found that ASU's preventative measures towards cartilage degradation and its promotion of cartilage repair play essential roles in its efficiency as a treatment for OA.

A Systematic Review published in 2014 in the journal Nutrition Journal found that Ginger could be considered a harmless and possibly effective alternative option for women suffering from nausea and vomiting during pregnancy. This review suggests potential benefits of ginger in reducing nausea symptoms in pregnancy (bearing in mind the limited number of studies, variable outcome reporting and low quality of evidence). Ginger did not significantly affect vomiting episodes, nor pose a risk for side-effects or adverse events during pregnancy. Based on evidence from this systematic review, ginger could be considered a harmless and possibly effective alternative option for women suffering from nausea and vomiting during pregnancy.

A Systematic Review published in 2014 in the journal BMC Complementary Medicine and Therapies found that Acupuncture and herbal medicine show promise in alleviating premenstrual syndrome and premenstrual dysphoric disorder symptoms, with over 50% relief and proven safety. The passage discusses a review of studies focusing on the efficacy of acupuncture and herbal medicine in treating premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD). The review identified and analyzed 19 randomized controlled trials (RCTs) involving acupuncture and herbal interventions. Acupuncture treatments encompassed various techniques, including traditional acupuncture, hand acupuncture, and moxibustion, while herbal interventions included Vitex Agnus castus, Hypericum perforatum, and other herbal remedies. Results showed that both acupuncture and herbal treatments led to a 50% or greater reduction in symptoms compared to baseline. The studies suggested that acupuncture and herbal treatments could alleviate physical and psychological symptoms of PMS/PMDD. The safety of acupuncture and herbal interventions was generally established, with minimal reported adverse events. However, the review emphasized the need for larger-scale, well-controlled trials to further validate these findings and guide clinical recommendations for specific symptom relief.

A Review Article published in 2013 in the journal British Journal of Clinical Pharmacology found that Cocoa and chocolate, rich in antioxidant molecules like epicatechin, enhance brain health, stimulate brain perfusion, and reduce the risk of Alzheimer's disease and stroke. The study involved taking a comprehensive look at the substances contained in cocoa powder and chocolate, their absorption into the brain, and their resulting stimulatory effects on multiple areas of the brain, particularly those connected to comprehension and memory. It also delved into the beneficial effects of epicatechin, a flavonoid found abundantly in cocoa and chocolate, which showed improvements in cognition in both animals and humans. Interestingly, the research showed that the consumption of chocolate could induce mood enhancement, elaborating on its common consumption during times of emotional stress. The study further investigated flavonoids' preservation of cognitive abilities in rats during aging, noting the reduced risk of developing Alzheimer's disease and the decreased likelihood of stroke in humans, demonstrating their wider effects beyond just mood enhancement. The research then looked into flavonoids' interactions within the various signaling pathways related to proteins and lipids in the brain, shedding light on how they inhibit neuron death from neurotoxic elements like oxygen radicals, all while promoting neuron survival and synaptic plasticity. The overall intent of the research was to gather and examine the available data regarding the effects of cocoa and chocolate on brain health and cognitive capacities.

A Randomised Controlled Trial published in 2013 in the journal Annals of the Rheumatic Diseases found that The daily use of avocado-soybean unsaponifiable-expanscience (ASU-E) reduces the progression of joint space narrowing in patients with hip osteoarthritis. The conducted trial was a prospective, randomised, double-blind study with parallel groups under placebo control over three years. The participants included symptomatic hip osteoarthritis patients having experienced pain for a minimum of one year and featuring a joint space width (JSW) between 1 and 4 mm in the affected hip. Participants were assigned randomly to a daily intake of 300 mg ASU-E or a placebo. Annual pelvic radiographs in standing position were performed, with the primary focus on the change in JSW at the end of year three. Despite no significant difference in mean JSW loss between the ASU-E group and placebo, fewer progressors (patients with JSW loss of 0.5mm or more) were recorded in the ASU-E group, marking a 20% decrease compared to the placebo group. This indicates a potential therapeutic effect of ASU-E on the structural integrity of hip joints in osteoarthritis patients. However, clinical outcome comparisons did not yield any significant differences between the groups. The safety profile of ASU-E was determined to be excellent.

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