National University of Natural Medicine

Exercise is a recommended non-pharmacological approach to treat multiple sclerosis (MS) symptoms. Mind-body movement interventions (MBMIs) offer a multi-component exercise option that integrates movement, breathwork, and mindfulness. Using an umbrella review, we assessed the current best evidence on MBMIs (ai chi, dance, Pilates, qigong, tai chi, and yoga) for managing MS symptoms. MBMIs significantly improved balance, equal to or superior to active controls (AC) or usual care (UC). Ai chi/tai chi/qigong significantly improved depression. Analyzed with other mind-body therapies, yoga reduced pain compared to AC/UC. Mixed results were found for fatigue. Physical function and quality of life were comparable to AC/UC. The certainty of evidence was low to very low for most MBMIs. Most reviews were “critically low” quality. MBMIs are commonly included in MS exercise reviews and may improve balance, pain, and depression. However, larger trials with active comparators and comprehensive reporting are needed to improve quality and certainty.

Xanthohumol (XN), a dietary flavonoid from hops (Humulus lupulus), possesses anti-inflammatory and microbiome-modulatory properties with potential therapeutic benefits for Crohn's disease (CD). To investigate the effects of XN on the gut environment in CD, we conducted a randomized, placebo-controlled clinical trial-the XN Microbiome and Signature (XMaS) trial (NCT4590508). 19 participants with clinically active CD completed the study. They were randomized to receive 24 mg/day of XN or placebo for 8 weeks, with clinical assessments at baseline and every 2 weeks. We assessed changes to Crohn's disease activity index (CDAI) scores, systemic inflammation, gut barrier function, profiling of microbial metabolism of XN, and gut microbiota composition and metabolism. Integration analysis of gut microbiota abundance, fecal metabolites, and inflammatory markers with CDAI scores revealed a pattern in which reductions in secondary bile acids and increases in IL-10 were associated with improved CDAI score in XN-treated individuals. These findings suggest that XN beneficially modulates the gut environment in CD by influencing microbial bile acid metabolism and host inflammatory response, thereby improving symptoms in individuals with severe innate immune activation.

Introduction:Qualitative methods are fundamental for studying patient preferences, particularly to understand how people perceive and manage pain that is unresponsive to standard treatment. Yet there is limited literature describing how formative qualitative research can inform quantitative studies on chronic pain. Integrating patient perspectives from qualitative research helps ensure that quantitative protocols and pain measures are grounded in patients' lived experiences.This paper details how our team, as part of a center focused on appropriate care for spinal pain, collected qualitative data about how chiropractic patients perceived pain chronicity, and how we used these findings to inform a national quantitative study. Methods:In this exploratory sequential mixed methods study, we conducted 40 semi-structured interviews and deployed a mixed methods survey to 108 chiropractic patients with spinal pain. We conducted thematic analysis of the qualitative data, and we summarized those findings in a visual framework. The visual framework, in turn, informed the inclusion criteria and survey items for a quantitative, observational survey of 2,025 chronic pain patients from 125 chiropractic clinics in the United States. Results:Qualitative research revealed that many patients viewed chronic pain as permanent. Patients who defined chronicity this way shifted from seeking a cure to utilizing longer-term pain management and coping strategies; in this way, patients' understandings about chronicity influenced their care-seeking and satisfaction. This set of findings challenged our team's initial assumption that chronicity was primarily understood in terms of pain duration or intensity, and that all patients expected a cure. Conclusions:Qualitative findings shaped the methods and interpretation of our quantitative observational research. This process led to a conceptual framework of chronic pain, more informative surveys and a shared understanding of the diverse beliefs that drive care-seeking behaviors among chronic pain patients.

BackgroundGrowing translational evidence indicates that the physiologically relevant effects of dietary (poly)phenols are largely mediated by gut microbial metabolism, resulting in bioactive microbial-derived (poly)phenol metabolites (MPMs). However, clinical evidence linking specific MPMs to defined health outcomes has not been comprehensively synthesized.ObjectiveThis scoping review characterizes clinical studies assessing associations between MPMs and human health and disease.MethodsWe systematically searched MEDLINE (PubMed), Embase (Elsevier), Web of Science (SCIE, ESCI), Scopus, ProQuest Health and Medical, the Cochrane Library, and ClinicalTrials.gov. Eligible studies quantified specific MPMs (e.g., urolithins, phenolic acids) in human biological specimens and assessed associations with biological or clinical outcomes. Two reviewers independently screened and extracted data using standardized forms. Findings were synthesized qualitatively.ResultsSeventy studies across cardiometabolic, inflammatory/oxidative stress, neurological, gastrointestinal, cancer, musculoskeletal, epigenetic, and respiratory domains were included. Evidence was most concentrated in cardiometabolic outcomes (n = 38), with recurrent associations involving urolithins and phenolic acid derivatives. This was followed by inflammatory/oxidative stress (n = 15) and neurological outcomes (n = 11). Musculoskeletal, epigenetic, and respiratory outcomes were least represented. Substantial heterogeneity in study design, metabolite measurement, and outcome reporting limited cross-study comparability.ConclusionSpecific MPMs may contribute to inter-individual variability in diet-related health responses. Standardized metabolite assessment and prospective trials evaluating direct supplementation of specific microbial metabolites, particularly in individuals with limited systemic exposure, are needed to clarify their role in human health and inform precision nutrition strategies.

Introduction Chronic pain is a leading public health problem, impacting over 1.5 billion people worldwide. Standard-of-care includes pharmaceutical medication, surgery and physical therapy, yet many patients experience continued symptoms. Investigation into lifestyle-based approaches such as dietary interventions has increased in recent years, including intermittent fasting, due to known impacts on inflammation and neurotransmitters.Methods and analysis This systematic review and meta-analysis will be conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The literature search will include the PubMed/MEDLINE, Embase (Ovid), Web of Science (Core Collection) and LILACS (VHL) databases. The Google Scholar, ClinicalTrials.gov, PROSPERO, Open Science Forum and MedRXiv platforms will also be searched. Randomised, controlled trials investigating the impact of intermittent fasting interventions in adult humans with any chronic pain condition will be included. The primary outcomes will be self-reported pain or function and the secondary outcome will be rescue medication use. Study screening, data extraction and risk of bias assessment will be conducted independently in duplicate. The Cochrane Risk of Bias-2 tool will be used to assess bias at the study level, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidelines will be used to assess bias at the outcome level. The meta-analysis will use random effects, with heterogeneity assessed using the I2 statistic. For studies that report rescue medication use, we will analyse the impact of intermittent fasting on pain or function, adjusting for rescue medication use, using established methods. Subgroup and sensitivity analyses will be conducted to explore heterogeneity.Ethics and dissemination As this project involves analysis of publicly available data, no ethical oversight was or is required. The results of this review will be disseminated by publication in a peer-reviewed journal.PROSPERO registration number CRD #420261395061.