Contribution of Nutritional, Lifestyle, and Metabolic Risk Factors to Parkinson's Disease.

BACKGROUND: Modifiable risk factors for Parkinson's disease (PD) are poorly known. OBJECTIVES: The aim is to evaluate independent associations of different nutritional components, physical activity, and sedentary behavior and metabolic factors with the risk of PD. METHODS: In this population-based prospective cohort study using the data of the United Kingdom Biobank (from 2006-2010), 502,017 men and women who were free from PD (International Classification of Diseases 10th edition; "G20") at baseline were included. We implemented a Cox proportion hazard's model to evaluate the associations of different levels of physical activity, sitting time, sleep habits, diet quality, alcohol and coffee consumption, smoking, and body mass index with PD risk, adjusting for several confounding variables. RESULTS: During a median follow-up of 12.8 years, lifestyle factors including vigorous physical activity (hazard ration [HR] = 0.84; 95% confidence interval [CI], 0.75-0.94), low-to-moderate sitting time (HR = 0.89; 95% CI, 0.81-0.97), and high sleep quality (HR = 0.89; 95% CI, 0.80-0.99) were associated with a reduced risk of PD. Small amounts of coffee (HR = 0.88; 95% CI, 0.82-0.95), red meat (HR = 0.86; 95% CI, 0.76-0.97), and current smoking (HR = 0.65; 95% CI, 0.56-0.75) were also associated with a lower risk of PD, whereas alcohol intake (HR = 1.29; 95% CI, 1.06-1.56) with higher PD risk. Secondary analysis, including metabolic risk factors, confirmed these findings and highlighted the potential protective effect of plasma vitamin D and uric acid, but of low-density lipoprotein-cholesterol, triglycerides, and C-reactive protein as well. CONCLUSIONS: Vigorous physical activity, reduced sitting time, good sleep quality together with small coffee intake and vitamin D supplementation are potentially neuroprotective lifestyle interventions for the prevention of PD. © 2024 International Parkinson and Movement Disorder Society.

Improving stress management, anxiety, and mental well-being in medical students through an online Mindfulness-Based Intervention: a randomized study.

Pressures and responsibilities of medical school put a strain on medical student's personal wellbeing, leading among all to high rates of anxiety, emotional discomfort and stress. In this work we evaluated the effectiveness of a comprehensive Mindfulness-Based Intervention (MBI) in reducing this load. The intervention comprised 10 twice-a-week Integral Meditation classes, dietary advice, and brief yoga sessions. We performed a randomized trial on two cohort of medical students from Italian universities: 239 in cohort 1 (106 treated and 133 controls), and 123 in cohort 2 (68 treated and 55 control) for a total sample of 362 students. Nine questionnaires for evaluating the effectiveness of our intervention on stress (PSS), state anxiety (STAIX-1), well-being (WEMWBS), mind-wandering (MW-S), overall distress (PANAS), emotion regulation (DERS), resilience (RS-14), and attentional control (ACS-C and ACS-D) were collected both pre and post intervention. Linear mixed effect models were run on the whole sample showing that, after multiple testing correction, our intervention was effective in reducing perceived stress (ß = - 2.57 [- 4.02; - 1.12], p = 0.004), improving mental well-being (ß = 2.82 [1.02; 4.63], p = 0.008) and emotional regulation (ß = - 8.24 [- 12.98; - 3.51], p = 0.004), resilience (ß = 3.79 [1.32; 6.26], p = 0.008), reducing the tendency to wander with the mind (ß = - 0.70 [- 0.99; - 0.39], p = 0.0001), ameliorating the ability to maintain attention (AC-S (ß = - 0.23 [- 0.44; - 0.02], p = 0.04) and AC-D (ß = - 0.19 [- 0.36; - 0.01], p = 0.04)), and the overall distress (ß = 1.84 [0.45; 3.23], p = 0.02).

Beneficial Effects of an Online Mindfulness-Based Intervention on Sleep Quality in Italian Poor Sleepers during the COVID-19 Pandemic: A Randomized Trial.

Sleep of inadequate quantity and quality is increasing in the present 24 h society, with a negative impact on physical and mental health. Mindfulness-based interventions (MBIs) generate a state of calm behavior that can reduce hyperactivity and improve sleep. We hypothesized that our specific MBI, administered online, may improve sleep quality and foster emotion regulation and mindfulness. The Pittsburgh Sleep Quality Index (PSQI), Sleep Condition Indicator (SCI), Arousal Predisposition Scale (APS), Ford Insomnia Response to Stress Test (FIRST), Sleep Hygiene Index (SHI) and Insomnia Severity Index (ISI) were used to measure sleep quality and stability. Emotion regulation and mindfulness were measured via the Emotion Regulation Questionnaire (ERQ) and Five Facet Mindfulness Questionnaire (FFMQ). Our MBI included 12 biweekly integral meditation (IM) classes, recorded IM training for individual practice, and dietary advice to promote sleep regulation. Fifty-six voluntary poor sleepers with a PSQI score of >5 were randomly allocated to treated (n = 28) and control (n = 28) groups. Linear mixed models were used to estimate the effectiveness of the intervention. Statistically significant results were observed in the FFMQ sub-domain non-reactivity to inner experience (ß = 0.29 [0.06; -0.52], p = 0.01), PSQI (ß = -1.93 [-3.43; -0.43], p = 0.01), SCI (ß = 3.39 [0.66; 6.13], p = 0.02) and ISI (ß = -3.50 [-5.86; -1.14], p = 0.004). These results confirm our hypothesis regarding the beneficial effects of our intervention on sleep quality.

A 60-Day Green Tea Extract Supplementation Counteracts the Dysfunction of Adipose Tissue in Overweight Post-Menopausal and Class I Obese Women.

Menopause is characterized by weight gain and increased visceral fat, which acts as an endocrine organ secreting proinflammatory adipocytokines, with consequent increased risk of metabolic disorders. The aim of this double-blind, placebo-controlled randomized trial was to evaluate the effects of a 60-day dietary supplementation using Camellia sinensis leaf extract on adipose tissue dysfunction in overweight or class I obese post-menopausal, sedentary women. Primary endpoints were the respiratory quotient (RQ), the percentage of carbohydrates (%CHO), the percentage of fat oxidation (%FAT), and the resting energy expenditure (REE) measured by indirect calorimetry. Secondary endpoints included body composition, by dual x-ray absorptiometry (DXA), glucose profile, lipid profile, inflammatory state, liver and kidney function, hormonal status regarding satiety, and status of catecholamines. Twenty-eight women were randomized into two groups: 14 (BMI 31.1 ± 3.5) were supplemented and 14 (BMI 31.9 ± 2.2) received placebo. In regards to the between-group differences over time (ß), a statistically significant difference between the supplemented and placebo group was observed for: RQ (ß = -0.04, p = 0.009), % fat oxidation (ß = 11.04, p = 0.0006), insulin (ß = -1.74, p = 0.009), HOMA (ß = -0.31, p = 0.02), waist circumference (ß = -1.07, p = 0.007), REE (ß = 83.21, p = 0.009), and CRP (ß = -0.14, p = 0.02). These results demonstrate that a 60-day green tea extract supplementation counteracts the dysfunction of adipose tissue in overweight post-menopausal and class I obese women.

Online Short-Term Mindfulness-Based Intervention During COVID-19 Quarantine in Italy: Effects on Wellbeing, Stress, and Anxiety.

To limit the first spread of COVID-19 in March 2020, the Italian government imposed strict lockdown measures to the population. Despite necessary to reduce the virus transmission and the burden to the hospitals, social isolation has caused detrimental effects on psychological wellbeing and mental health. Moreover, during this period, it was also difficult to deliver psychological treatments and psychiatric assistance. A short (a weekly session for 9 weeks) mindfulness-based meditation program, named Integral Meditation (IM), was administered entirely online to healthy adults from Italy. This is a two-groups pre-post-quasi-experimental study in which the two groups, treated and control, were not randomized. Through matching procedures aimed at overcoming the absence of randomization, we analyzed a sample of 84 subjects (42 for each group). By applying linear mixed effect models, we tested the hypothesis of a beneficial effect of IM on wellbeing, perceived stress, and state anxiety, as measured by three self-reported questionnaires (WEMWBS, PSS, and STAI-X1, respectively), assuming that this effect could be different according to the level of baseline trait anxiety, as measured by STAI-X2. The results showed a statistically significant effect of STAI-X1 (ß = -8.24 [95%CI -15.39; -1.09], p = 0.02) and WEMWBS (ß = 4.61 [95%CI 0.94; 8.29], p = 0.01) in the higher trait anxiety subgroup only. No statistically significant effect of IM was observed for PSS. These results suggest that our IM, delivered online, may increase mental wellbeing and decrease anxiety specifically in subjects with higher trait anxiety.

Positive Effects of a Lecithin-Based Delivery Form of Boswellia serrata Extract in Acute Diarrhea of Adult Subjects.

Acute diarrhea is a frequent problem worldwide, mostly due to gastrointestinal infections or food poisoning. Boswellia serrata could be active in the treatment of acute diarrhea due to its anti-inflammatory, antispasmodic, and antimicrobial activity. In this randomized, double-blind, placebo-controlled clinical study, 49 adults with acute diarrhea were randomly allocated to receive 250 mg of a lecithin-based delivery form of Boswellia serrata (CASP) or placebo for 5 days. The time it took to become healthy with stoppage of diarrhea (primary end point) was significantly shorter in the intervention group (3.08 vs. 4.44 days: p-value < 0.0001). The probability of subjects treated with CASP to recover sooner was equal to 80.2%. A significantly lower number of stools was observed in the CASP group over time (ß = −0.17, p-value < 0.0001). A significant difference was observed between the two groups for abdominal pain, nausea, and GAE (global assessment of efficacy). In conclusion, the lecithin-based delivery form of Boswellia serrata extract could be a useful addition to the treatment of acute diarrhea in adults. CASP is safe and reduces the time it takes to become healthy, the frequency of stools, the abdominal pain and nausea of subjects with acute diarrhea. Further studies are needed to confirm these promising results.

Beneficial Effects on Abdominal Bloating with an Innovative Food-Grade Formulation of Curcuma longa and Boswellia serrata Extracts in Subjects with Irritable Bowel Syndrome and Small Bowel Dysbiosis.

Bloating is a symptom frequently reported by subjects with irritable bowel syndrome (IBS) and small bowel dysbiosis, and Low FODMAP's diet (LFD) has been used to treat them. Extracts of Curcumalonga and Boswelliaserrata share anti-inflammatory and antimicrobial effects that could be useful in the management of these clinical conditions. The aim of this study was to evaluate the efficacy of curcumin and boswellia extracts (as Curcumin Boswellia Phytosome, CBP) and LFD on the relief of abdominal bloating in IBS subjects with small bowel dysbiosis, in comparison to LFD alone, in a 30-day supplementation, randomized trial. IBS participants were randomized to either the intervention (500 mg bid of CBP and LFD) or control arm (LFD). Small bowel dysbiosis has been defined by an increase of urinary indican with normal urinary skatole. A total of 67 subjects were recruited. The intervention group (33 subjects) showed a significant decrease (p < 0.0001) of bloating, abdominal pain, and indican values at the end of the study, when compared to the control group (34 subjects). Moreover, the subjects of the intervention group showed a significantly better (p < 0.0001) global assessment of efficacy (GAE) as compared to controls. In conclusion, in subjects with IBS and small bowel dysbiosis, abdominal bloating can be successfully reduced with a supplementation with CBP and LFD.

A short Mindfulness retreat can improve biological markers of stress and inflammation.

OBJECTIVE: Mindfulness practice, a form of meditation, has shown benefit for psychological and physical health. In this study, we investigated the effect of an intensive period of Mindfulness practice on some biological mediators of stress and inflammation during a 3-day residential retreat. METHODS: A total of 95 healthy individuals (aged 18-67) were recruited and randomized to a Mindfulness retreat arm or an active control arm. Before (t0) and after (t1) the intervention, all the participants were assessed for salivary cortisol levels and for a panel of pro- and anti-inflammatory cytokines measured in saliva. Psychometric measures on stress, anxiety and awareness were carried out using PSS, STAI-Y and MAAS questionnaires, respectively. RESULTS: As to the within-group differences, we observed a statistically significant decrease in perceived stress (ß = -8.85, p < 0.0001), and anxiety scores (ß = -12.39, p < 0.0001), while awareness increased (ß = 15.26, p < 0.0001) between t0 to t1 in retreat participants. In the mindfulness intervention group, we also observed a statistically significant reduction in the levels of pro-inflammatory cytokines IL-6 (ß = -0.94 p = 0.001) and IL-8 (ß = -176.40, p < 0.0001), and an increase in anti-inflammatory IL-10 (ß = 0.89 p < 0.0001) levels at the end of the retreat. At t1 we observed a highly significant correlation between cortisol levels and both anxiety (r = 0.56, p < 0.0001) and perceived stress (r = 0.92, p < 0.0001) scores. CONCLUSIONS: Mindfulness retreat participants showed a significant reduction in perceived stress and anxiety levels, as well as an improved balance of some key mediators of inflammatory states. Our data provide evidence that a mindfulness retreat may be effective in improving physical and mental health. Future studies with larger numbers of subjects and follow-up periods may examine mindfulness practice as a non-pharmacological alternative to promote stress reduction and overall health and wellbeing.

Mindfulness meditation training in an occupational setting: Effects of a 12-weeks mindfulness-based intervention on wellbeing.

BACKGROUND: Mindfulness-based interventions (MBIs) are known for their beneficial effects on positive and negative psychological factors. When applied in an occupational context, MBIs might help workers to cope with stress, increase their professional outcomes and wellbeing. OBJECTIVE: In this two-groups pre-post experimental design we tested the effect of our MBI, called Integral Meditation (IM), among the employers of an Italian service company by measuring positive and negative aspects of psychological wellbeing related to mindfulness and workplace functioning through eight self-report questionnaires (CORE-OM, FFMQ, WEMWBS, MAIA, PSS, PANAS, STAI-X1, SCS). METHOD: Forty-two voluntary non-clinical employers of the company, randomly assigned to the experimental or the control group, were analyzed. The experimental group underwent our IM program, which consists of 12 weekly meditation classes given after the afternoon shift, while the control group did not receive any intervention. Data was analyzed via linear mixed models. RESULTS: Statistically significant results were obtained for FFMQ observing subscale (ß= 0.49, p = 0.014), WEMWBS (ß= 5.31, p = 0.02), PSS (ß= -3.31, p = 0.03), the whole scale of SCS (ß= 0.47, p = 0.01) and self-judgment (ß= 0.68, p = 0.003) and isolation (ß= -0.66, p = 0.01) SCS subscales. Statistically significant results were also found in four out of eight subscales of MAIA: emotional awareness (ß= 1.26, p < 0.001), self-regulation (ß= 1.28, p < 0.001), body listening (ß= 1.08, p < 0.001) and trusting (ß= 1.1, p < 0.001). CONCLUSION: Our intervention has demonstrated to bring beneficial effects in a mindfulness subdomain, in perceived stress, self-compassion, interoception and psychological wellbeing. Based on our results, we conclude that our intervention was effective in increasing the positive aspects of wellbeing and in reducing stress.

Effectiveness of Rice Germ Supplementation on Body Composition, Metabolic Parameters, Satiating Capacity, and Amino Acid Profiles in Obese Postmenopausal Women: A Randomized, Controlled Clinical Pilot Trial.

Rice germ (RG) may be a safe and effective dietary supplement for obesity in menopause, considering its high protein content and considerable amounts of essential amino acids, good fatty acids, and fiber. This pilot randomized, blinded, parallel-group, placebo-controlled pilot trial investigated the effectiveness of 4-weeks RG supplementation (25 g twice a day) on body composition, as primary outcome, measured by Dual Energy X-Ray Absorptiometry (DXA), and metabolic parameters, as secondary outcomes, like amino acid profiles and satiating capacity, in obese postmenopausal women following a tailored hypocaloric diet (25-30% less than daily energy requirements). Twenty-seven women were randomly assigned to the supplemented group (14) or placebo group (13). There was a significant interaction between time and group for body mass index (BMI) (p < 0.0001), waist (p = 0.002) and hip circumferences (p = 0.01), total protein (0.008), albumin (0.005), Homeostasis Model Assessment index score (p = 0.04), glycine (p = 0.002), glutamine (p = 0.004), and histidine (p = 0.007). Haber's means over time showed a clearly greater feeling of satiety for the supplemented compared to the placebo group. These findings indicate that RG supplementation in addition to a tailored diet counterbalanced the metabolic changes typical of menopause, with improvements in BMI, body composition, insulin resistance, amino acid profiles, and satiety.

Bergamot phytosome improved visceral fat and plasma lipid profiles in overweight and obese class I subject with mild hypercholesterolemia: A randomized placebo controlled trial.

Bergamot has been traditionally used for the relief of diseases related to oxidative stress. Our aim was to investigate the effect of bergamot phytosome on visceral adipose tissue (VAT) and on metabolic profile, in overweight and obese subjects with mild hypercholesterolemia. A total of 64 participants were randomized into two groups for 12 weeks: a supplemented group (33 individuals, BMI 27 ± 3 kg/m2 receiving 500 mg of bergamot phytosome, two daily tablets) and placebo group (31 subjects, BMI 28 ± 3 kg/m2 , two daily tablets). As to the within differences, the parameters of VAT, total and LDL-cholesterol were significantly decreased in the bergamot phytosome group, but not in the placebo group. As to between-group differences, a statistically significant interaction between time and group, that is, the change in score over time differs between the two groups was observed 30 days after supplementation for VAT (p-value = .005), total cholesterol (p-value <.0002), and LDL (p = .004) in respect to placebo. The other parameters (glucose, insulin, Homeostasis Model Assessment, high-density lipoprotein cholesterol, triglycerides, fat free mass, fat mass) were not significant. In conclusion, this clinical study gives evidence that bergamot phytosome provides beneficial effects, such as decrease of VAT and modulation of metabolic alterations, after just 30 days of supplementation, resulting a very promising protection of cardiovascular health.

Short-Term Meditation Training Fosters Mindfulness and Emotion Regulation: A Pilot Study.

The practice of meditation has been historically linked to beneficial effects, not only in terms of spirituality but also in terms of well-being, general improvement of psychophysiological conditions and quality of life. The present study aims to assess the beneficial effects of a short-term intervention (a combination of 12 practical 1-h sessions of meditation, called Integral Meditation, and lectures on neuroscience of meditation) on psychological indicators of well-being in subjects from the general population. We used a one-group pretest-posttest quasi-experimental design, in which all participants (n = 41, 17 men and 24 women, with a mean age of 41.1 years) underwent the same intervention. Out of these, 24 had already experienced meditation practice, but only 12 in a continuative way. Effects were assessed by the standardized Italian version of three self-report questionnaires: Core Outcome in Routine Evaluation-Outcome Measure (CORE-OM), Five-Facet Mindfulness Questionnaire (FFMQ), and Emotion Regulation Questionnaire (ERQ). The questionnaires were filled in at baseline and immediately after the last meditation session. Linear mixed effect models were used to evaluate pre-post treatment changes on each outcome. Participants showed a general, close to a statistically significant threshold, improvement in the total score of CORE-OM and its different domains. The total score of FFMQ (ß = 0.154, p = 0.012) indicates a statistically significant increase in the level of mindfulness as well as in the domains acting with awareness (ß = 0.212, p = 0.024), and non-judging of inner experiences (ß = 0.384, p < 0.0001). Lastly, we observed a statistically significant improvement in the cognitive reappraisal ERQ domain (ß = 0.541, p = 0.0003). Despite some limitations (i.e., small sample size, lack of a randomised control group and sole use of "soft" measurements, such as self-report questionnaires), this study offers promising results regarding the within-subject effectiveness of our intervention that includes a meditation practice on psychological indicators, thus providing interesting preliminary results.

Boosting Psychological Well-Being through a Social Mindfulness-Based Intervention in the General Population.

The benefits of mindfulness meditation among clinical and non-clinical populations have been largely reported in literature. Existing mindfulness-based programs are particularly useful in targeting specific populations while researchers have pointed out the possibility of developing programs adapted to the audience and the context. In this two-groups pre-post experimental design we developed a mindfulness-based social intervention program to target individuals from the general population. Here we present a two-groups pre-post experimental design to investigate its effectiveness on participants' psychological functioning assessed by eight self-reported questionnaires (CORE-OM, FFMQ, SWLS, PANAS, PSS, SCS, WEMWBS, SHS) which encompass different domains of well-being, mindfulness and emotional functioning. Participants, recruited on voluntary basis, were randomly allocated to treated or passive control groups and were aware of group allocation. The intervention comprises a 12-week meditation training in a big group that represents the social aspect of meditation. Data were analysed via a linear mixed effect model and intention to treat. Statistically significant results were obtained for global score of CORE-OM (ß = -0.20 [-0.30; -0.10], p = 0.0002), FFMQ (ß = 0.20 [0.12; -0.28], p < 0.0001), SWLS (ß = 1.43 [0.42; 2.45], p = 0.006), positive PANAS (ß = 1.99 [0.95; 3.04], p = 0.0002), negative PANAS (ß = -1.67 [-2.92; -0.43], p = 0.009), PSS (ß = -2.98 [-4.25; -1.71], p < 0.0001), WEMWBS (ß = 4.38 [2.93; 5.83], p < 0.0001) and SHS (ß = 1.43 [0.42; 2.45], p = 0.006). Our intervention is causally associated with an improvement of the psychological functioning and hence can be considered as a preventive measure that may potentially reduce the risk of developing psychological problems and improve the subject's general well-being. Given the voluntary recruitment, our inference only applies to those individuals who have decided to experience meditation as a way to well-being and not to a random person from the general population.

The Metabolic Effects of Cynara Supplementation in Overweight and Obese Class I Subjects with Newly Detected Impaired Fasting Glycemia: A Double-Blind, Placebo-Controlled, Randomized Clinical Trial.

Impaired fasting glucose (IFG) is a condition that precedes diabetes and increases the risk of developing it. Studies support the hypoglycemic effect of Cynarascolymus (Cs) extracts due to the content of chlorogenic acid, which is a potent inhibitor of glucose 6-phosphate translocase and of dicaffeoylquinic acid derivatives that modulate the activity of alpha-glucosidase. Given this background, we investigated whether a new highly standardized Cs extract could improve glycemic control, insulin sensitivity and other metabolic parameters (total cholesterol (TC), low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C) Triglycerides, Apolipo protein B (ApoB), Apolipo protein A (ApoA), waist circumference, visceral adipose tissue (VAT) by dual-energy X-ray absorptiometry (DXA) in overweight subjects with newly diagnosed IFG. Fifty-four subjects (females/males 26/28, mean ± SD age 51.5 ± 6.2) were randomly assigned to the supplemented group (n = 27) and placebo (n = 27). After multiple testing correction, statistically significant interactions between time and group were observed for the primary endpoint glycemia (ß = 0.36, p < 0.0001) and for the secondary endpoints HDL (ß = -0.10, p < 0.0001), total cholesterol/HDL (ß = 0.27, p < 0.0001), LDL (ß = 0.15, p = 0.005), LDL/HDL (ß = 0.23, p = 0.001), insulin (ß = 1.28, p = 0.04), glycated hemoglobin (ß = 0.21, p = 0.0002), A1c-derived average glucose (ß = 0.34, p = 0.0002), ApoB (ß = 6.00, p = 0.01), ApoA (ß = -4.50, p = 0.04), ApoB/ApoA (ß = 0.08, p = 0.003), waist circumference (ß = 1.89, p = 0.05), VATß = 222.37, p = 0.005). In conclusion, these results confirm that Cs supplementation has a significant effect on metabolic parameters in IFG patients.

The Use of a New Food-Grade Lecithin Formulation of Highly Standardized Ginger (Zingiber officinale) and Acmella oleracea Extracts for the Treatment of Pain and Inflammation in a Group of Subjects with Moderate Knee Osteoarthritis.

PURPOSE: To evaluate the efficacy of a new food-grade lecithin formulation of standardized extracts of Zingiber officinale and Acmella oleracea on pain and inflammation. PATIENTS AND METHODS: Pilot study with one-group pretest-posttest quasi-experimental design in which 50 subjects with moderate knee osteoarthritis (OA) (mean age: 62.46±8.45) were supplied for four weeks with two tablets/day. RESULTS: Primary outcomes were 1) the evaluation of pain intensity, by a 30-day visual analogue scale (VAS) and 2) the assessment of knee function by WOMAC (Western Ontario and McMaster Universities Arthritis) Index and by Tegner Lysholm Knee Scoring collected at baseline, at 15 and 30 days after treatment. Secondary outcomes were 3) health-related quality of life, by the ShortForm36 (SF-36); 4) inflammation grade by C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR); and 5) body composition by dual-energy X-ray absorptiometry (DXA) measured at baseline and 30 days after treatment. Data showed significant effects of supplement intake for WOMAC (ß=-3.27, p<0.0001), Lysholm (ß=1.06, p=0.0003), CRP (ß=-0.13, p=0.006), ESR (ß=-3.09, p=0.004), physical activity (ß=4.3, p=0.009) and fat-free mass (ß=376.7, p=0.046). A significant VAS's decrease over time was observed in ï»¿both knees (left: ß=-0.08, p<0.0001; right: ß=-0.07, p<0.0001). CONCLUSION: The tested formulation seems to be effective and also free of side effects.

Citation patterns and trends of systematic reviews about mindfulness.

OBJECTIVES: We performed a citation analysis of the literature about mindfulness aimed at describing the most significant topics and the impact of more relevant papers. METHODS: We classified 128 systematic reviews about mindfulness-based intervention retrieved in Scopus according to their object, the population included and the type of mindfulness proposed. The citation counting was reported. The cumulative citation numbers per chronological years and article life were analyzed thorough a linear regression model. RESULTS: 1) We observed a general increase in the number of reviews published from 2003 to 2016; 2) two reviews collected the 33% of the overall citations; 3) citation counting for clinical and mixed population collected the 90% of total citations; 4) clinical reviews had higher cumulative citation per publication/year growth. CONCLUSIONS: As mindfulness research advances, higher attention should be given to the mechanisms by which mindfulness interventions work so as to provide fruitful insights for future research.