The effects of ginger supplementation on common gastrointestinal symptoms in patients with relapsing-remitting multiple sclerosis: a double-blind randomized placebo-controlled trial.

BACKGROUND: Gastrointestinal (GI) symptoms affect more than 80% of individuals with relapsing-remitting multiple sclerosis (RRMS). Ginger is widely known for its GI relieving properties. Therefore, we investigated the effect of ginger supplementation on common GI symptoms in RRMS patients. METHODS: This study was a 12-week double-blind parallel randomized controlled trial with a 3-week run-in period. The intervention (n = 26) and control (n = 26) groups received 500 mg ginger and placebo (as corn) supplements 3 times a day along with main meals, respectively. At the beginning and end of the trial, the frequency and severity of constipation, dysphagia, abdominal pain, diarrhea, bloating, belching, flatulence, heartburn, anorexia, and nausea were assessed using the visual analogue scale ranging from 0 to 100 mm. Totally, 49 participants completed the study. However, data analysis was performed on all 52 participants based on the intention-to-treat principle. RESULTS: In comparison with placebo, ginger supplementation resulted in significant or near-significant reductions in the frequency (-23.63 ± 5.36 vs. 14.81 ± 2.78, P < 0.001) and severity (-24.15 ± 5.10 vs. 11.39 ± 3.23, P < 0.001) of constipation, the frequency (-12.41 ± 3.75 vs. 3.75 ± 1.82, P < 0.001) and severity (-13.43 ± 4.91 vs. 6.88 ± 2.69, P = 0.001) of nausea, the frequency (-9.31 ± 4.44 vs. 1.56 ± 4.05, P = 0.098) and severity (-11.57 ± 5.09 vs. 3.97 ± 3.99, P = 0.047) of bloating, and the severity of abdominal pain (-5.69 ± 3.66 vs. 3.43 ± 3.26, P = 0.069). CONCLUSION: Ginger consumption can improve constipation, nausea, bloating, and abdominal pain in patients with RRMS. TRIAL REGISTRATION: This trial was prospectively registered at the Iranian Registry of Clinical Trials ( www.irct.ir ) under the registration number IRCT20180818040827N3 on 06/10/2021.

The effects of spirulina supplementation on serum iron and ferritin, anemia parameters, and fecal occult blood in adults with ulcerative colitis: A randomized, double-blinded, placebo-controlled trial.

BACKGROUND & AIMS: The present clinical trial aimed to evaluate the efficacy of spirulina administration on serum iron, ferritin, anemia parameters, and fecal occult blood test (FOBT) in adults with ulcerative colitis (UC). METHODS: Eighty participants with UC were randomly assigned to take, either 1 g/day (two 500 mg capsules) spirulina (n = 40) or placebo (n = 40) in a double-blinded clinical trial for eight weeks. Dietary intake, physical activity status, serum iron and ferritin levels, anemia parameters, and FOBT were assessed in each participant at baseline and following the intervention. Seventy-three participants completed the trial. RESULTS: Our results indicated significantly increased (p = 0.04) serum iron after eight weeks of spirulina supplementation compared to the placebo group. The spirulina group also demonstrated significantly increased mean corpuscular volume (p = 0.004) whereas red blood cell count (p = 0.01) and hematocrit (p = 0.03) were significantly lowered in the placebo group. No significant changes in FOBT outcomes were seen between groups at baseline (p = 0.12) and the end of the trial (p = 0.34). Eight weeks of 1 g/day spirulina supplementation improved anemia parameters in adults with UC compared to placebo. CONCLUSIONS: These outcomes suggest that spirulina administration may be beneficial in the management of anemia in UC. Further clinical trials of longer duration are necessary to corroborate and expand our findings. Registered at: http://www.IRCT.ir (code: IRCT20170802035460N3).

The effect of ginger (Zingiber officinale) supplementation on clinical, biochemical, and anthropometric parameters in patients with multiple sclerosis: a double-blind randomized controlled trial.

Introduction: different lines of evidence have shown that ginger administration may be beneficial for patients with multiple sclerosis (MS). Therefore, we aimed to investigate the effect of ginger supplementation on disability, physical and psychological quality of life (QoL), body mass index (BMI), neurofilament light chain (NfL), interlukin-17 (IL-17), matrix metalloproteinase-9 (MMP-9), and neutrophil to lymphocyte ratio (NLR) in patients with relapsing-remitting MS. Methods: this was a 12 week double-blind parallel randomized placebo-controlled trial with a 3 week run-in period. The treatment (n = 26) and control (n = 26) groups received 500 mg ginger and placebo (corn) supplements 3 times daily, respectively. Disability was evaluated using the Expanded Disability Status Scale (EDSS). QoL was rated using the Multiple Sclerosis Impact Scale (MSIS-29). BMI was calculated by dividing weight by height squared. Serum levels of NfL, IL-17, and MMP-9 were measured using the enzyme-linked immunosorbent assay. NLR was determined using a Sysmex XP-300™ automated hematology analyzer. All outcomes were assessed before and after the intervention and analyzed using the intention-to-treat principle. Results: in comparison with placebo, ginger supplementation caused a significant reduction in the EDSS (-0.54 ± 0.58 vs. 0.08 ± 0.23, P < 0.001), the MSIS-29 physical scale (-8.15 ± 15.75 vs. 4.23 ± 8.46, P = 0.001), the MSIS-29 psychological scale (-15.71 ± 19.59 vs. 6.68 ± 10.41, P < 0.001), NfL (-0.14 ± 0.97 vs. 0.38 ± 1.06 ng mL-1, P = 0.049), IL-17 (-3.34 ± 4.06 vs. 1.77 ± 6.51 ng L-1, P = 0.003), and NLR (-0.09 ± 0.53 vs. 0.53 ± 1.90, P = 0.038). Nevertheless, the differences in BMI and MMP-9 were not significant between the groups. Conclusion: ginger supplementation may be an effective adjuvant therapy for patients with relapsing-remitting MS.

The effectiveness of nano-curcumin on patients with COVID-19: A systematic review of clinical trials.

The main aim of the current study was to summarize the findings of available clinical studies to assess nano-curcumin's influence on COVID patients. A comprehensive online search was performed in Scopus, PubMed, ISI Web of Science, and Google Scholar until March 2022 to identify trials that investigated the effects of nano-curcumin in patients with COVID-19. Eight studies comprising 569 patients were included in this review. Compared with placebo, nano-curcumin had no significant effect on C-reactive protein (CRP) and high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6). However, gene expression of IL-6 and gene expression as well as secretion of interleukin-1 beta (IL-1ß) significantly decreased following nano-curcumin intervention. Nano-curcumin had beneficial effects on fever, cough, chills, myalgia, and olfactory and taste disturbances. The duration of hospitalization and mortality rate were significantly lower in the nano-curcumin group compared with the control group. Lymphocyte count was significantly increased after curcumin supplementation. Nano-curcumin also had favorable effects on O2 saturation, sputum, chest pain, wheeze, and dyspnea in patients with COVID-19. No major adverse effects were reported in response to nano-curcumin supplementation. In summary, the results of this systematic review of clinical trials suggested that nano-curcumin supplementation has beneficial effects on inflammation, respiratory function, disease manifestations, and complications in patients with COVID-19 viral infection.

The effect of pro-/synbiotic supplementation on the brain-derived neurotrophic factor: a systematic review and meta-analysis of randomized controlled trials.

There is growing interest in supplementation with pro-/synbiotics for brain and mental health. Animal studies have reported that pro-/synbiotic administration can increase the brain-derived neurotrophic factor (BDNF), a key regulator of neuronal function. Nevertheless, the results obtained from human studies are inconsistent and conflicting. Therefore, we aimed to conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) to investigate the impact of pro-/synbiotic supplementation on BDNF levels. Scopus, Medline, Web of Science, Cochrane Library, and Google Scholar were searched up to July 10, 2022 to find eligible RCTs. The weighted mean difference (WMD) and 95% confidence interval (CI) were computed for BDNF using a random-effects model. In the present study, 10 RCTs with 12 treatment arms consisting of 652 participants were included. The meta-analysis revealed that supplementation with pro-/synbiotics significantly increased BDNF concentrations in comparison with the placebo (WMD: 0.20 ng mL-1, 95% CI: 0.06 to 0.34, I2 = 86.6%). Moreover, subgroup analysis showed that the target population, ethnicity and the mean age of participants, the number and type of probiotic strains, administration form, and the dose and duration of pro-/synbiotic supplementation were the potential sources of heterogeneity between RCTs. In conclusion, pro-/synbiotic administration can be considered as a BDNF enhancer and a possible brain booster.

The role of selenium in depression: a systematic review and meta-analysis of human observational and interventional studies.

The results of human studies are inconsistent regarding selenium and depressive disorders. Therefore, we aimed to conduct a systematic review and meta-analysis of observational and interventional studies and provided an overview of the role of selenium in depression. Three databases including Medline, Scopus, and Web of Science were searched on June 30, 2020 and updated on April 12, 2021. Also, we searched in electronical databases of WHO Global Index Medicus and ClinicalTrials.gov. No time or language restrictions were used for the search. A random effects model was used to pool effect sizes. In total, 20 studies were included in the systematic review, and 15 studies were included in the meta-analysis. There were no significant differences in serum selenium levels between patients with depression and healthy subjects (WMD: 2.12 mg/L; 95% CI: - 0.11, 4.36; I2 = 98.0%, P < 0.001). Also, no significant correlation was found between serum levels of selenium and depression scores (r: - 0.12; 95% CI: - 0.33, 0.08; I2 = 73.5%, P = 0.010). Nevertheless, there was a significant negative association between high selenium intake and the risk of postpartum depression (OR: 0.97; 95% CI: 0.95, 0.99; I2 = 0.0%, P = 0.507). In addition, selenium supplementation significantly reduced depressive symptoms (WMD: - 0.37; 95% CI: - 0.56, - 0.18; I2 = 0.0%, P = 0.959). Taken these results together, selenium seems to have a protective role against postpartum depression and can be considered as a beneficial adjuvant therapy in patients with depression. Further studies are necessary to draw definitive conclusions.

The effect of grape (Vitis vinifera) seed extract supplementation on flow-mediated dilation, blood pressure, and heart rate: A systematic review and meta-analysis of controlled trials with duration- and dose-response analysis.

The objective of this systematic review and meta-analysis of controlled trials was to assess the long-term effect of grape seed extract (GSE) supplementation on flow-mediated dilation (FMD), systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) in adults. Web of Science, Scopus, Medline, Cochrane Library, and Google Scholar were searched up to May 24, 2021. Nineteen trials were included in this study. Weighted mean difference (WMD) and 95% confidence interval (CI) were calculated using a random-effects model. GSE supplementation significantly reduced DBP (WMD: -2.20 mmHg, 95% CI: -3.79 to -0.60, I2 = 88.8%) and HR (WMD: -1.25 bpm, 95% CI: -2.32 to -0.19, I2 = 59.5%) but had no significant effects on FMD (WMD: 1.02%, 95% CI: -0.62 to 2.66, I2 = 92.0%) and SBP (WMD: -3.55 mmHg, 95% CI: -7.59 to 0.49, I2 = 97.4%). Subgroup analysis revealed that the dose and duration of GSE administration and the characteristics of study participants could be sources of between-study heterogeneity. Significant non-linear relationships were found between DBP and the duration of GSE supplementation (P = 0.044) and its dose (P = 0.007). In conclusion, GSE may be beneficial for individuals with or at risk of cardiovascular disease because it may have hypotensive and HR-lowering properties.

Extra-Virgin Olive Oil Improves Depression Symptoms Without Affecting Salivary Cortisol and Brain-Derived Neurotrophic Factor in Patients With Major Depression: A Double-Blind Randomized Controlled Trial.

BACKGROUND: Many patients with depression are reluctant to take psychiatric medications. Hence, complementary therapies such as nutritional considerations could be advantageous. The antidepressant potential of olive oil has been proved in observational studies. OBJECTIVE: The effect of extra-virgin olive oil (EVOO) on depression symptoms and cortisol and brain-derived neurotrophic factor (BDNF) levels in patients with depression was examined. DESIGN AND PARTICIPANTS: This was a double-blind randomized controlled trial conducted on 73 patients suffering from major depressive disorder in Shiraz, Iran, in 2016. INTERVENTION: The patients were randomly assigned to intervention (EVOO) and control (sunflower oil) groups and consumed 25 mL/d of the corresponding oil for 52 days. MAIN OUTCOME MEASURES: Depression symptoms were assessed by Beck Depression Inventory-II (BDI-II) and 7-item Hamilton Depression Rating Scale (HAMD-7). Salivary cortisol levels were determined immediately after awakening and 30 minutes later. Cortisol awakening response and the area under the curve with respect to ground and increase were computed. Serum BDNF concentrations were also measured. STATISTICAL ANALYSES PERFORMED: Statistical analysis was conducted based on intention-to-treat and per-protocol approaches. Within-group changes were examined with repeated measures (for BDI-II and HAMD-7) and with paired t test (for other variables). Between-group comparisons were performed with analysis of covariance after adjustment for confounding factors. RESULTS: In intention-to-treat analysis, HAMD-7 score was the only variable with significant changes within and between groups, the latter as a greater decline in EVOO group (P = .001). BDI-II score did not show significant change in either group but the between-group comparison revealed a significant difference (P = .021). EVOO showed antidepressant effect in severely depressed patients (P = .017 for BDI-II and 0.008 for HAMD-7) but not in mild/moderate depression category. Serum BDNF concentrations, salivary cortisol levels at immediately after awakening (T0) and 30 minutes later, cortisol awakening response, the area under the curve with respect to ground and increase did not change within or between groups. Results of per-protocol analysis were not different. CONCLUSIONS: The results of this study suggested beneficial effects of EVOO on depression symptoms in patients with severe depression but not in those with mild to moderate depression. The effects were significant from both statistical and clinical points of view.

The effect of red pepper/capsaicin on blood pressure and heart rate: A systematic review and meta-analysis of clinical trials.

Several studies have assessed the effect of red pepper on blood pressure (BP) and heart rate (HR) and reported controversial results. The aim of this study was to perform a systematic review and meta-analysis of clinical trials that evaluated the effect of red pepper/capsaicin consumption on BP and HR. Medline, Scopus, Cochrane Library, and Google Scholar were systematically searched, from database inception to August 2020, to ascertain clinical trials that evaluated the effects of red pepper or capsaicin on systolic blood pressure (SBP), diastolic blood pressure (DBP), or HR. Pooled effect size was calculated using a random-effects method. We performed subgroup analyses to discern probable sources of between-study heterogeneity. Meta-analysis showed no significant effect of red pepper/capsaicin on SBP (0.43 mmHg, 95% CI: -1.15 to 2.01), DBP (-0.45 mmHg, 95% CI: -2.14 to 1.24), and HR (-0.60 bpm, 95% CI: -1.97 to 0.78). Although between-study heterogeneity was high for SBP and DBP, we could not discern the potential sources of heterogeneity. In conclusion, red pepper/capsaicin had no effect on BP and HR. The findings should be interpreted with caution because between-study heterogeneity was high. Further well-designed and high-quality studies are required to investigate the efficacy and safety of red pepper/capsaicin supplement on BP and HR.

The effect of grape seed extract supplementation on oxidative stress and inflammation: A systematic review and meta-analysis of controlled trials.

BACKGROUND: Grape seed extract (GSE) seems to have antioxidant and anti-inflammatory properties due to its high polyphenolic content. Nevertheless, the scientific literature in this field is controversial and inconclusive. Therefore, we aimed to conduct a systematic review and meta-analysis of controlled trials to evaluate the effect of supplementation with GSE on biomarkers of oxidative stress and inflammation. METHODS: Medline, Scopus, Cochrane Library, Google Scholar and Web of Science databases were searched up to 10 September 2020 using appropriate keywords without restrictions. In the systematic review phase, all biomarkers of oxidative stress and inflammation were considered as outcomes. In the meta-analysis phase, six biomarkers were selected as outcomes, and weighted mean difference (WMD) or standardised mean difference (SMD) with 95% confidence interval (CI) was calculated for them using a random-effects model. RESULTS: Twenty-three studies were included in the systematic review, and 19 studies were included in the meta-analysis. GSE supplementation caused a significant decrease in malondialdehyde (SMD: -1.04, 95% CI: -1.65, -0.42), oxidised low-density lipoprotein (SMD: -0.44, 95% CI: -0.75, -0.13) and high-sensitivity C-reactive protein (WMD: -0.48 mg/L, 95% CI: -0.94, -0.03) and a marginally significant increase in total antioxidant capacity (SMD: 0.49, 95% CI: -0.05, 1.04) but did not significantly influence C-reactive protein (WMD: -0.36 mg/L, 95% CI: -1.02, 0.30) and white blood cell count (WMD: 0.12 × 109 /L, 95% CI: -0.25, 0.48). CONCLUSION: It appears that GSE supplementation can remarkably modulate the body's redox system, particularly through the inhibition of lipid peroxidation, but has neutral or mildly beneficial effects on inflammatory responses.

Short- and long-term effects of capsaicin supplementation on glycemic control: a systematic review and meta-analysis of controlled trials.

BACKGROUND & AIMS: Animal studies have shown that capsaicin exerts beneficial effects on glucose metabolism. However, the findings of human studies are contradictory. Therefore, we aimed to conduct a systematic review and meta-analysis of controlled trials to assess the effect of capsaicin administration on glycemic indices. METHODS: Medline, Scopus, Cochrane Library, and Google Scholar were searched from the database inception to January 14, 2021. The weighted (WMD) or standardized (SMD) mean difference with 95% confidence interval (CI) was calculated using a random-effects model. RESULTS: Fourteen trials were included in this study. Long-term capsaicin supplementation did not show significant effects on fasting blood glucose (WMD: 0.03 mmol L-1, 95% CI: -0.05 to 0.12, I2 = 40.5%) and fasting insulin (SMD: 0.09, 95% CI: -0.04 to 0.22, I2 = 0.0%). Short-term capsaicin supplementation had no significant effects on 2-hour postprandial blood glucose (WMD: 0.06 mmol L-1, 95% CI: -0.34 to 0.47, I2 = 92.5%) and 2-hour postprandial insulin (WMD: 1.70 µIU mL-1, 95% CI: -3.46 to 6.86, I2 = 72.4%). Subgroup analysis revealed that the dose and ingestion form of capsaicin could be sources of between-study heterogeneity. CONCLUSIONS: Capsaicin supplementation seems to have neither acute nor chronic beneficial or detrimental effects on blood glucose and insulin levels.

Benefits and harms of ginseng supplementation on liver function? A systematic review and meta-analysis.

OBJECTIVE: Existing evidence on the possible effects of ginseng on liver function has not been fully established. Therefore, the present review was undertaken to evaluate the overall effects of ginseng supplementation on liver enzymes in adults. METHODS: A systematic computerized literature search of PubMed, Scopus, Web of Science, Cochrane Library and Google scholar databases was conducted up to May 2019. All RCTs using ginseng supplements in adults were included in this systematic review and meta-analysis. RESULTS: Overall, 14 randomized trials (with 20 arms) including 992 subjects were identified. Pooled analysis did not illustrate any significant changes in alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP), and albumin (ALB) levels, however, it showed a minor significant increase in bilirubin (BIL) levels. Subgroup analysis by dosage and study population revealed significant increase of bilirubin after ginseng supplementation ≥3 g/day or in unhealthy individuals. CONCLUSION: Ginseng appears to have neither hepatoprotective nor hepatotoxic effects in conventional doses and duration. It is noteworthy that this seems applicable only for individuals with healthy liver function. Further largescale studies are warranted to confirm present findings.

Effects of phytosterols supplementation on blood pressure: A systematic review and meta-analysis.

Several reports have indicated a positive effect of phytosterols on blood pressure (BP), nevertheless these findings have been controversial. Therefore, a systematic review and meta-analysis of randomized controlled trials (RCTs) was aimed to investigate the effects of phytosterol supplementation on BP. An online search was carried out in PubMed, Scopus, ISI Web of Science, Cochrane library and Google Scholar up to May 2019. Weighted Mean difference (WMD) with 95% confidence intervals (CIs) were calculated using a fixed-effects model. The present meta-analysis of 19 RCTs showed that supplementation with phytosterols can decrease both systolic BP (WMD: -1.55 mmHg, 95% CI: -2.67 to -0.42, p = 0.007) and diastolic BP (WMD: -0.84 mmHg, 95% CI: -1.60 to -0.08, p = 0.03). Dose-response analysis revealed that phytosterol intake change SBP significantly based on treatment dose in nonlinear fashion. Subgroup analysis based on duration showed a significant effect of phytosterol on SBP and DBP in subsets of <12 weeks. In addition, a significant effect of phytosterol was observed in dosage of ≥2000 mg for SBP and <2000 mg for DBP. Based on current findings supplementation with phytosterol may be a beneficial adjuvant therapy in hypertensive patients as well as a complementary preventive option in prehypertensive and normotensive individuals. However, this issue is still open and requires further investigation in future studies.

The effect of nettle (Urtica dioica) supplementation on the glycemic control of patients with type 2 diabetes mellitus: A systematic review and meta-analysis.

Type 2 diabetes mellitus (T2DM) is a major health problem, worldwide, that is associated with increased morbidity and mortality. Several randomized controlled clinical trials (RCTs) have investigated the effect of nettle (Urtica dioica) supplementation on markers of glycemic status in patients with T2DM, with conflicting results. Therefore, the present study assessed the effect of nettle on some glycemic parameters in patients with T2DM. A comprehensive search was conducted in PubMed, Scopus, Cochrane Library, and Web of Science, from database inception up to June 2019, to identify RCTs investigating the effect of nettle supplementation on glycemic markers, including fasting blood sugar (FBS) concentrations, insulin levels, homeostasis model assessment-estimated insulin resistance index, and glycosylated hemoglobin percentage in adults with T2DM. The Cochrane Collaboration tool was used to assess the methodological quality of the included studies. Results of this meta-analysis were reported based on the random effects model. Eight RCTs, comprising 401 participants, were included in the present systematic review and meta-analysis. Based on the Cochrane Collaboration risk of bias tool, five studies were considered as good quality, one was fair, and two studies were poor, respectively. The results of the meta-analysis revealed a significant reduction in FBS concentrations (weighted mean difference [WMD]: -18.01 mg/dl, 95% confidence interval [CI]: -30.04 to -5.97, p < .001, I2 = 94.6%) following nettle supplementation. However, no significant reduction was observed in insulin levels (WMD: 0.83 Hedges' g, 95% CI: -0.26 to 1.92, p = .13, I2 = 89.4%), homeostasis model assessment-estimated insulin resistance index (WMD: -0.22, 95% CI: -0.83 to 0.40, p = .49, I2 = 69.2%), or glycosylated hemoglobin percentage (WMD: -0.77%, 95% CI: -1.77 to 0.22, p = .12, I2 = 83.0%). The findings of the present study suggest that nettle supplementation may be effective in controlling FBS for T2DM patients. However, further studies are needed to confirm the veracity of these results.

Thylakoids: A Novel Food-Derived Supplement for Obesity - A Mini-Review.

Nowadays, overweight and obesity are major epidemic health problems that can bring about some other health issues such as cardiovascular disease which is the first cause of mortality worldwide. Thylakoids are disc-like membranes responsible for photosynthetic light reactions in chloroplasts of green plants. Although only a few animal and human studies have been conducted regarding the impact of thylakoids on overweight- and obesity-related factors, all of them have resulted in positive outcomes. These outcomes are as follows: increment of satiety response; suppression of hunger sensations, particularly hedonic hunger; reduction of body weight and fat; promotion of glucose homeostasis; decrease in serum lipids; attenuation of oxidative stress and inflammation; and modulation of gut microbiota, notably by increasing some helpful bacteria such as Lactobacillus reuteri. It seems that some of these useful effects are related to retarded absorption of dietary fat and carbohydrate caused by thylakoids. There is still a need for more well-designed studies.

Effects of Spirulina supplementation on obesity: A systematic review and meta-analysis of randomized clinical trials.

OBJECTIVE: Evidence has suggested that Spirulina supplementation may affect anthropometric indices. Therefore, a systematic review and meta-analysis was performed to summarize published randomized clinical trials which assess the effect of Spirulina supplementation on obesity. SETTING: Pertinent studies were identified using Embase, Scopus, ISI Web of Science, PubMed and Cochrane library databases up to May 2019. Mean Differences (MD) were pooled using a random-effects model. Heterogeneity, sensitivity analysis and publication bias were reported using standard methods. RESULTS: Results of 5 studies (7 treatment arms) showed a significant reduction in weight (MD: -1.56 Kg, 95% CI: -1.98 to -1.14) after Spirulina supplementation. Subgroup analysis based on health status revealed that weight change in obese subjects (MD: -2.06 Kg, 95% CI: -2.45 to -1.68) was greater than overweight participants (MD: -1.28 Kg, 95% CI: -1.62 to -0.93) following Spirulina supplementation. Also, pooled analysis showed that Spirulina supplementation led to a significant reduction in body fat percent (MD: -1.02, 95% CI: -1.49 to -0.54) and waist circumference (MD: -1.40, 95% CI: -1.40 to -1.39), but not in body mass index and waist to hip ratio. CONCLUSION: Spirulina supplementation significantly reduces body weight, especially in obese individuals.