Menthacarin, a Proprietary Peppermint Oil and Caraway Oil Combination, Improves Multiple Complaints in Patients with Functional Gastrointestinal Disorders: A Systematic Review and Meta-Analysis.

INTRODUCTION: This systematic review summarizes published data on Menthacarin, the proprietary combination of peppermint oil and caraway oil, in the treatment of functional gastrointestinal disorders. Efficacy was assessed by meta-analysis of placebo-controlled trials. METHODS: We searched PubMed, the Cochrane Library, and the manufacturer's information system for clinical studies investigating the safety and efficacy of Menthacarin. Efficacy analyses included change from baseline of epigastric pain and general improvement of the patients' condition. RESULTS: Five randomized trials involving 580 patients were found, demonstrating significant effects of Menthacarin on symptoms of functional dyspepsia (FD) compared to placebo or similar effects compared to a reference drug. Seven other studies reported favorable results on therapeutic application in FD patients with concomitant Helicobacter pylori infection, in irritable bowel syndrome (IBS), and on tolerability in FD patients from 12 years of age. Three trials in FD with 249 patients were eligible for meta-analysis. Results demonstrate a significant reduction in pain intensity (standardized mean difference: 0.80; 95% confidence interval (CI): 0.39-1.21) and in item 2 of the Clinical Global Impression Scale (risk ratio: 2.65; 95% CI: 1.81-3.87) for Menthacarin. CONCLUSIONS: Menthacarin was shown to be effective and safe for the treatment of FD and represents a promising option for symptoms of IBS.

Menthacarin for long-term treatment of functional dyspepsia - Results from a clinical trial follow-up.

BACKGROUND: Menthacarin was shown to be effective and safe in clinical trials in patients with functional dyspepsia (FD). Long-term treatment results have not been reported yet. METHODS: An open-label, 11-month follow-up (FU) was offered to FD patients who had undergone treatment with Menthacarin (1 gastro-resistant capsule b.i.d. vs. placebo (PL)) in a 4-week, double-blind, clinical trial. During FU, all patients (former verum and PL) were treated with 1 gastro-resistant capsule Menthacarin b.i.d. Main outcomes were the changes in pain intensity and severity of sensation of pressure, heaviness, and fullness from original baseline and global improvement. RESULTS: 70 patients were included in the analyses (former Menthacarin group: 36, former PL group: 34). At the end of the PL-controlled study phase, all 3 main efficacy variables were statistically significantly improved in the Menthacarin group compared to PL. In the FU phase, former PL patients started to improve under Menthacarin treatment towards the outcomes seen in the former Menthacarin group (alignment at approximately 6 months), while former Menthacarin patients showed sustained or even continuously improved outcomes by month 12. At study end, more than 90% of patients were "much or very much improved" in both groups. Menthacarin treatment was well tolerated. CONCLUSIONS: The favorable effects seen in the FU period suggest that Menthacarin is a valuable treatment option in FD patients who require symptomatic treatment also in the longer term for up to 12 months.

Effectiveness of Menthacarin on symptoms of irritable bowel syndrome.

Irritable bowel syndrome (IBS) and functional dyspepsia (FD) are common functional gastrointestinal disorders with overlapping symptoms. Effectiveness and safety of Menthacarin (Menthacarin® is the active ingredient of the product Carmenthin® [Dr. Willmar Schwabe GmbH & Co. KG, Karlsruhe, Germany]) in FD treatment were already demonstrated. We assessed the effectiveness of Menthacarin in reducing concomitant IBS-associated symptoms in FD patients. A systematic search to identify eligible double-blind, randomized controlled trials (RCTs) investigating Menthacarin in FD patients and focusing on IBS-associated symptoms was performed. Three out of five identified RCTs included a total of 111 eligible subjects, which allowed for summary statistics and inclusion into subgroup analysis for FD patients with IBS-associated symptoms. With pain intensity values decreasing by 50-75% on average during 28 days of treatment in patients with accompanying IBS, the subgroup analysis indicates beneficial treatment effects of Menthacarin that are similar to those found for FD patients in the primary analyses. The reduction of IBS-associated symptoms in FD patients suggests Menthacarin as a treatment option for IBS patients.

No effect of the farming system (organic/conventional) on the bioavailability of apple (Malus domestica Bork., cultivar Golden Delicious) polyphenols in healthy men: a comparative study.

BACKGROUND: The organic food sales have been increasing during the recent years. It has been hypothesised that organically grown fruits are healthier based on their higher content of phytochemicals. However, data on the bioavailability of phytochemicals from organically or conventionally produced plant foods are scarce. METHODS: Two human intervention studies were performed to compare the bioavailability of polyphenols in healthy men after ingestion of apples from different farming systems. The administered apples were grown organically and conventionally under defined conditions and characterised regarding their polyphenol content and antioxidant capacity. No significant differences in the polyphenol content and the antioxidant capacity from the organic and conventional farming system were observed. RESULTS: In the short-term intervention study, six men consumed either organically or conventionally produced apples in a randomized cross-over study. After intake of 1 kg apples, phloretin (C (max) 13 + or - 5 nmol/l, t (max) 1.7 + or - 1.2 h) and coumaric acid (C (max )35 + or - 12 nmol/l, t (max) 3.0 + or - 0.8 h) plasma concentrations increased significantly (P < 0.0001) in both intervention groups, without differences between the two farming systems. In the long-term intervention study, 43 healthy volunteers consumed organically or conventionally produced apples (500 g/day; 4 weeks) or no apples in a double-blind, randomized intervention study. In this study, 24 h after the last dosing regime, the apple intake did not result in increasing polyphenol concentrations in plasma and urine compared to the control group suggesting no accumulation of apple polyphenols or degradation products in humans. CONCLUSION: Our study suggests that the two farming systems (organic/conventional) do not result in differences in the bioavailability of apple polyphenols.

Bioavailability and nutritional effects of carotenoids from organically and conventionally produced carrots in healthy men.

It has been hypothesised that organically grown vegetables are healthier than conventionally produced ones due to a higher content of phytochemicals. However, few data from controlled human studies exist. The aim of the present study was to compare the carotenoid content and antioxidant capacity of organically and conventionally produced carrots under defined conditions. Furthermore, a human intervention study was conducted to compare bioavailability, plasma antioxidant capacity, endogenous DNA strand breaks and immune parameters in healthy men ingesting carrots from different agricultural systems. Thirty-six volunteers consumed either organically or conventionally produced blanched carrots (200 g/d; 2 weeks) or no carrots in a double-blind, randomised intervention study. No statistically significant differences were observed in the total carotenoid contents (121 (sd 7) microg/g organic v. 116 (sd 13) microg/g conventional) and the antioxidant capacities (0.43 (sd 0.08) mumol Trolox equivalents/g organic v. 0.32 (sd 0.07) mumol Trolox equivalents/g conventional) of the carrots administered to the volunteers. Intake of organically or conventionally produced carrots significantly increased (P < 0.001) plasma alpha- and beta-carotene concentrations in both intervention groups without differences in plasma carotenoid concentrations. Consumption of carrots did not lead to significant changes in the plasma antioxidant status, endogenous DNA strand breaks and parameters of the immune system in all groups. Therefore, these results indicate that the agricultural system has neither an effect on the carotenoid content, the antioxidant capacity of carrots, nor on the bioavailability of carotenoids and on antioxidant, antigenotoxic and immunological effects as assessed in a human intervention study.

Effect of consumption of organically and conventionally produced apples on antioxidant activity and DNA damage in humans.

The present study was performed to compare the effects on antioxidant activity and on DNA damage of organic and conventionally produced apples grown under controlled conditions in human peripheral blood lymphocytes. Six healthy volunteers consumed either organically or conventionally grown apples (Golden Delicious, 1000 g) from two neighboring commercial farms in a double-blinded, randomized, cross-over study. The average content of total identified and quantified polyphenols in the organically and conventionally produced apples was 308 and 321 microg/g fresh weight, respectively. No statistically significant differences in the sum of phenolic compounds or in either of the polyphenol classes were found between the agricultural methods. Consumption of neither organically nor conventionally grown apples caused any changes in antioxidant capacity of low-density lipoproteins (lag time test), endogenous DNA strand breaks, Fpg protein-sensitive sites, or capacity to protect DNA against damage caused by hydrogen peroxide. However, a statistically significant decrease in the levels of endonuclease III sensitive sites and an increased capacity to protect DNA against damage induced by iron chloride were determined 24 h after consumption in both groups of either organic or conventionally grown apples, indicating the similar antigenotoxic potential of both organically and conventionally grown apples.

Influence of the production method on phytochemical concentrations in whole wheat (Triticum aestivum L.): a comparative study.

The present study was performed to evaluate the concentrations of phytochemicals (carotenoids and phenolic acids) in wheat varieties grown under comparable organic and conventional conditions over three years as part of a long-term field trial. Phenolic acids of the hydroxybenzoic acid and hydroxycinnamic acid group were quantified by HPLC-DAD after extraction as free, soluble conjugated, and bound forms. Furthermore, the carotenoids lutein and zeaxanthin were determined by HPLC-DAD. There were no statistically significant differences between the two farming systems (sum of carotenoids (microg/g) for 2003, 0.91 +/- 0.55 organic vs 0.96 +/- 0.34 conventional; for 2005, 1.61 +/- 0.22 organic vs 1.33 +/- 0.19 conventional; for 2006, 0.87 +/- 0.33 organic vs 0.83 +/- 0.11 conventional; sum of phenolic acids (microg/g) for 2003, 448.4 +/- 151.1 organic vs 327.3 +/- 232.8 conventional; for 2005, 502.8 +/- 168.3 organic vs 484.4 +/- 111.2 conventional; for 2006, 659.1 +/- 112.5 organic vs 945.9 +/- 353.6 conventional). However, statistically significant year-to-year differences up to 55% were observed. Taken together, these results indicate that climate factors have a greater impact on the phytochemical concentrations in whole wheat than the production method (organic/conventional).

Three-year comparison of the polyphenol contents and antioxidant capacities in organically and conventionally produced apples ( Malus domestica Bork. Cultivar 'Golden Delicious').

The present study was performed to evaluate the polyphenol content and antioxidant capacity of apples (cv. ;Golden Delicious') grown under defined organic and conventional conditions. Apples were harvested at five comparable commercial farms over the course of three years (2004-2006). In 2005 and 2006 the antioxidant capacity was 15% higher (p < 0.05) in organically produced apples than in conventionally produced fruits. In 2005 significantly higher polyphenol concentrations were found in the organically grown apples. In 2004 and 2006 no significant differences were observed (2004, 304 +/- 68 microg/g organic vs 284 +/- 69 microg/g conventional, p = 0.18; 2005, 302 +/- 58 micro/g organic vs 253 +/- 41 microg/g conventional, p = 0.002; 2006, 402 +/- 100 microg/g organic vs 365 +/- 58 microg/g conventional, p = 0.17). Year-to-year variations in the antioxidant capacity and the polyphenol content of up to 20% were more significant than the production method found within one year. Finally, flavanols and flavonols were major determinants of the antioxidant capacities in these apples. Overall, the production method had a smaller impact on the variation in the polyphenol content and antioxidant capacity of apples than the yearly climate.