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Black elderberry (Sambucus nigra) supplementation effectively treats upper respiratory symptoms: A meta-analysis of randomized, controlled clinical trials.

1. Complement Ther Med. 2019 Feb;42:361-365. doi: 10.1016/j.ctim.2018.12.004. Epub 2018 Dec 18. Black elderberry (Sambucus nigra) supplementation effectively treats upper respiratory symptoms: A meta-analysis of randomized, controlled clinical trials. Hawkins J(1), Baker C(2), Cherry L(2), Dunne

Feasibility and Preliminary Efficacy of American Elderberry Juice for Improving Cognition and Inflammation in Patients with Mild Cognitive Impairment.

2. Int J Mol Sci. 2024 Apr 15;25(8):4352. doi: 10.3390/ijms25084352. Feasibility and Preliminary Efficacy of American Elderberry Juice for Improving Cognition and Inflammation in Patients with Mild Cognitive Impairment. Curtis AF(1), Musich M(2), Costa AN(1)(3), Gonzales J(4)(5), Gonzales H(6),

Synergistic Virus Neutralizing Activities of European Black Elderberry Fruit Extract and Iota-Carrageenan Against SARS-CoV-2, Influenza A Virus and Respiratory Syncytial Virus.

3. Nutrients. 2026 Apr 10;18(8):1205. doi: 10.3390/nu18081205. Synergistic Virus Neutralizing Activities of European Black Elderberry Fruit Extract and Iota-Carrageenan Against SARS-CoV-2, Influenza A Virus and Respiratory Syncytial Virus. Setz C(1), Setz M(1), Rauch P(1), Schleicher O(1), Platt

Synergistic Antiviral Activity of European Black Elderberry Fruit Extract and Quinine Against SARS-CoV-2 and Influenza A Virusa.

4. Nutrients. 2025 Mar 29;17(7):1205. doi: 10.3390/nu17071205. Synergistic Antiviral Activity of European Black Elderberry Fruit Extract and Quinine Against SARS-CoV-2 and Influenza A Virusa. Setz C(1), Rauch P(1), Setz M(1), Breitenberger S(2), Plattner S(2), Schubert U(1). Author information:

Interaction of vitamin C and flavonoids in elderberry (Sambucus nigra L.) during juice processing.

5. Plant Foods Hum Nutr. 1998;52(3):187-98. doi: 10.1023/a:1008069422202. Interaction of vitamin C and flavonoids in elderberry (Sambucus nigra L.) during juice processing. Kaack K(1), Austed T. Author information: (1)Department of Food Science and Technology, Aarslev, Denmark. A field experime

Evaluation of the Effects of an Immune-Boosting Food Supplement on the Severity and Frequency of Pediatric Respiratory Tract Infections: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial.

1. Children (Basel). 2026 Mar 20;13(3):428. doi: 10.3390/children13030428. Evaluation of the Effects of an Immune-Boosting Food Supplement on the Severity and Frequency of Pediatric Respiratory Tract Infections: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial. Calapai F(1)(2), Ammendolia I(1)(3), Mannucci C(2), Bulferi G(4), Pauletto L(4), Togni H(4), La Paglia R(5), Raso F(6), Currò M(1), Calapai G(3). Author information: (1)Department of Clinical and Experimental Medicine, University of Messina, 98166 Messina, Italy. (2)Department of Biomedical, Dental, Morphological and Functional Imaging Sciences, University of Messina, 98125 Messina, Italy. (3)Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, 98166 Messina, Italy. (4)Regulatory and Scientific Affairs Department, Schwabe Pharma Italia, 39044 Egna, Italy. (5)Italian National Health Service, Azienda Sanitaria Provinciale 5, 98123 Messina, Italy. (6)Associazione Farmaceutici Industria, 20149 Milano, Italy. Background: Respiratory tract infections (RTIs) are common in children and represent one of the main reasons for pediatric consultations. Although generally benign, pediatric RTIs can lead to medical complications and significant socioeconomic burden. The objective of this trial was to evaluate the efficacy of a food supplement intended to support the immune system in reducing the rate and severity of pediatric RTIs. Methods: A randomized, double-blind, placebo-controlled, parallel-group clinical trial was conducted to assess the efficacy and safety of a food supplement based on vitamins, minerals, herbal extracts, and Lactobacillus rhamnosus CRL1505 (Pegaso® Immuno Junior). A daily dose was administered for approximately 60 days within a three-month period to children aged 3-10 years with at least four RTI episodes in the previous year. RTI frequency, illness days, days with fever, cough, and rhinitis, and antipyretic and antibiotic use per episode were recorded over four months. Results: A total of 110 children completed the study. Compared with the placebo, the active supplement significantly reduced the mean number of RTI episodes per child (2.41 ± 0.84 vs. 4.13 ± 1.66; RR = 0.745, 95% CI 0.583-0.953) as well as the number of illness days, days with fever, cough, and rhinitis, and days with antipyretic or antibiotic use. The supplement was well-tolerated. Conclusions: The patented supplementation based on vitamins, minerals, herbal extracts, and Lactobacillus rhamnosus CRL1505 (Pegaso® Immuno Junior), taken over a three-month period, may reduce the frequency and severity of RTIs in children aged 3-10 years. DOI: 10.3390/children13030428 PMCID: PMC13024742 PMID: 41897140 Conflict of interest statement: GB, HDT, and LP were employees of the trial sponsor at the time the trial was conducted. FR was an employee of the trial sponsor at the beginning of the trial. The other authors have received remuneration for their specific trial-related tasks. The authors who are employees of the company participated in drafting the protocol and reviewing the paper. The staff who conducted the study have access to the raw data, monitored the entire study, and conducted independently the statistical analysis, report, and conclusions of the research.

Elderberry (Sambucus nigra L.): an ethnopharmacological, phytochemical and biological review for a prospective nutraceutical plant.

2. Inflammopharmacology. 2026 Mar;34(3):1539-1586. doi: 10.1007/s10787-025-02017-0. Epub 2026 Feb 10. Elderberry (Sambucus nigra L.): an ethnopharmacological, phytochemical and biological review for a prospective nutraceutical plant. Khalil AM(1), Kamal RM(2), El-Shiekh RA(3), Elbanna AH(1)(4), Hamdy SA(1). Author information: (1)Faculty of Pharmacy, Pharmacognosy Department, Cairo University, Cairo, 11562, Egypt. (2)Faculty of Pharmacy, Pharmacognosy Department, Cairo University, Cairo, 11562, Egypt. rania.ahmed@pharma.cu.edu.eg. (3)Faculty of Pharmacy, Pharmacognosy Department, Cairo University, Cairo, 11562, Egypt. riham.adel@pharma.cu.edu.eg. (4)Department of Pharmaceutical Sciences, College of Pharmacy, Gulf Medical University, 4184, Ajman, United Arab Emirates. BACKGROUND: Elderberry (Sambucus nigra L.) has been traditionally implemented in diverse preparations such as herbal teas, syrups or juices as remedies for respiratory, febrile and other health conditions. Phytochemical and chromatographic analyses of different organs mapped their metabolite profiles and allowed identification, and sometimes isolation, of their main bioactive compounds. AIM OF THE STUDY: Inspired by the rich and effective literature of S. nigra, this review article aims to summarize and highlight its reported biological (traditional and research-based) and chemical profiles. METHODS: The Keywords used in the search included biological activities, pharmacological reports, phytochemistry, isolated compounds, taxonomy, botanical data, single or combination; traditional, traditionally, ethnopharmacology, folk uses, toxicity, LD50, interactions, side effects, clinical studies, elderberry, elder, Sambucus nigra. Using different bibliographic databases, Google Scholar, PubMed, Web of Science, Springer Link, and Science Direct with no specific limits. RESULTS: In this context, elderberry is deemed a rich source for a myriad of bioactive compounds, mainly phenolics, and was proven to exhibit a variety of health benefits, including antioxidant, anti-inflammatory, anticancer, anti-influenza, antimicrobial, antidiabetic, cardioprotective, and neuroprotective properties. This review also covers different analysis approaches applied for S. nigra characterization in addition to literature studies attempted to optimize its extract(s) preparation process in terms of different extraction solvents, temperatures or methodologies to enrich prepared extracts in beneficial and bioactive metabolites. CONCLUSION: Overall, elderberry holds substantial potential as a rich dietary source of bioactive metabolites. Future research into its application in functional foods and nutraceuticals may provide innovative strategies for the prevention and management of various chronic diseases. CLINICAL TRIAL NUMBER IN THE MANUSCRIPT: Not applicable. © 2026. The Author(s). DOI: 10.1007/s10787-025-02017-0 PMCID: PMC12995950 PMID: 41665742 [Indexed for MEDLINE] Conflict of interest statement: Declarations. Competing interests: The authors declare no competing interests. Animal ethics declaration: Not applicable.

Effect of Dietary Supplementation with Lutein, Zeaxanthin, and Elderberries on Dry Eye Disease (DED) and Immunity: A Randomized Controlled Trial.

3. Nutrients. 2024 Dec 18;16(24):4366. doi: 10.3390/nu16244366. Effect of Dietary Supplementation with Lutein, Zeaxanthin, and Elderberries on Dry Eye Disease (DED) and Immunity: A Randomized Controlled Trial. Goh KM(1)(2), Tan ESS(3), Lim CSY(4), Tan PY(5), Biswas S(6), Lew LA(2)(7), Tan CK(3). Author information: (1)New Product Development Department, Ecolite Biotech Manufacturing, Yong Peng 83400, Malaysia. (2)Product Development Department, Xmegami Manufacturing, Puchong 47170, Malaysia. (3)Faculty of Medicine and Health Sciences, UCSI University, Kuala Lumpur 56000, Malaysia. (4)Faculty of Applied Sciences, UCSI University, Kuala Lumpur 56000, Malaysia. (5)Faculty of Environment, University of Leeds, Leeds LS2 9JT, UK. (6)School of Optometry, College of Health and Life Sciences, Aston University, Birmingham B4 7ET, UK. (7)Faculty of Food Science and Technology, Universiti Putra Malaysia, Serdang 43400, Malaysia. BACKGROUND/OBJECTIVES: Dry eye disease (DED) significantly impairs quality of life, affecting physical, social, and psychological well-being, as well as reducing workplace productivity. While lutein and zeaxanthin supplements have been shown to improve ocular health, existing research often overlooks the efficacy of lower dosages and shorter durations of supplementation. This study investigated the effects of combined supplementation with lutein, zeaxanthin, and elderberries in 110 voluntary participants through a randomized controlled trial. METHODS: Participants took 6 mg of lutein and 1 mg of zeaxanthin, along with 100 mg elderberry extract once daily for a duration of 20 days. Ocular health was assessed using the Ocular Surface Disease Index (OSDI), while immune status was evaluated with the Immune Status Questionnaire (ISQ). RESULTS: Results showed that combined supplementation significantly (p < 0.05) reduced the OSDI scores in the intervention group from 38.15 ± 11.14 to 18.26 ± 5.57, reflecting a 52.2% reduction. A similar trend was observed with the Visual Analog Scale (VAS), indicating significant (p < 0.05) improvement from 5.31 ± 1.62 to 6.73 ± 1.74, equivalent to a 26.7% improvement. Although the intervention group showed a 15.9% improvement in ISQ scores by the study's end, this was not significantly different from the placebo group, suggesting that higher dosages or longer durations may be needed to observe a meaningful effect. Additionally, findings from the Food Frequency Questionnaire revealed that the average dietary intake of lutein and zeaxanthin among participants was only 663.49 µg, equating to just 5.5% of the suggested optimal daily intake. This low consumption is concerning, as it is inversely correlated with the risk of ocular diseases. CONCLUSIONS: Collectively, these findings support the use of combined supplementation as an adjuvant approach to improving ocular health. DOI: 10.3390/nu16244366 PMCID: PMC11679324 PMID: 39770987 [Indexed for MEDLINE] Conflict of interest statement: Author Kok Ming Goh was employed by the company Ecolite Biotech Manufacturing. Authors Kok Ming Goh and Li Ann Lew were employed by the company Xmegami Manufacturing. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

SYNBIO(®) Probiotic and Antioxidant Dietary Supplementation: Clinical Trial Evaluation of Potential Effects on Airline Flight Crew Members' Well-Being.

4. Microorganisms. 2023 Apr 2;11(4):924. doi: 10.3390/microorganisms11040924. SYNBIO(®) Probiotic and Antioxidant Dietary Supplementation: Clinical Trial Evaluation of Potential Effects on Airline Flight Crew Members' Well-Being. Coman MM(1), Micioni Di Bonaventura MV(2), Cifani C(2), Silvi S(3), Verdenelli MC(1). Author information: (1)Synbiotec S.r.l., Spin-Off of UNICAM, Via Gentile III Da Varano, 62032 Camerino, Italy. (2)School of Pharmacy, Pharmacology Unit, University of Camerino, 62032 Camerino, Italy. (3)School of Biosciences and Veterinary Medicine, University of Camerino, 62032 Camerino, Italy. The irregular lifestyle of airline crew members, wide/adverse job-related exposures, and the impact of temporary hypoxia on gut microbiota well-being have increased concern about the daily recommended dose of certain nutrients among flight crew. The aim of this study was to determine if daily consumption of a SYNBIO® probiotics-elderberry extract supplement (ACTIVE) may contribute to the well-being of flight attendants. Forty healthy crew members enrolled in a double-blind, randomized, placebo-controlled study consumed one ACTIVE capsule/day or placebo for 30 days. Bowel well-being, health-related quality of life, and gastrointestinal tolerance were assessed by validated questionnaires. Saliva and fecal samples were analyzed to determine secretory immunoglobulin-A (sIgA) levels and to characterize gut microbiota composition, respectively. ACTIVE subjects presented a physiological improvement and a statistically significant higher Psychological General Well-Being Index (PGWBI) global score compared to PLACEBO subjects. The ACTIVE subjects showed significantly increased levels of lactobacilli and bifidobacteria compared to the PLACEBO group, while a significant increase in lactobacilli and a significant reduction in Enterobacteriaceae were registered when compared with the beginning of supplementation, confirming the persistence of probiotics in the gastrointestinal tract and the direct antagonism and competitive exclusion effects. Additionally, sIgA levels were significantly higher in the ACTIVE group compared to the baseline and to the PLACEBO group at the end of supplementation. The ACTIVE supplementation might be beneficial to airline crew members, improving their physiological state, their immune defenses, and the strength and efficiency of their gastrointestinal tract when responding to stressful conditions. DOI: 10.3390/microorganisms11040924 PMCID: PMC10145893 PMID: 37110347 Conflict of interest statement: The authors declare no conflict of interest.

Use of Nutraceuticals in Elderly to Fight Inflammation and Immuno-Senescence: A Randomized Case-Control Study.

5. Nutrients. 2022 Aug 24;14(17):3476. doi: 10.3390/nu14173476. Use of Nutraceuticals in Elderly to Fight Inflammation and Immuno-Senescence: A Randomized Case-Control Study. Maselli Del Giudice A(1), La Mantia I(2), Barbara F(3), Ciccarone S(1), Ragno MS(1), de Robertis V(1), Cariti F(1), Barbara M(1), D'Ascanio L(4), Di Stadio A(2). Author information: (1)Department Otorhinolaryngology, Hospital of Barletta, 76121 Barletta (BT), Italy. (2)Department GF Ingrassia, University of Catania, 95123 Catania, Italy. (3)Department Otorhinolaryngology, University Hospital of Bari, 70126 Bari, Italy. (4)Department Otorhinolaryngology, Azienda Ospeliera Riunita Marche Nord (AORMN), 61032 Fano (PU), Italy. Elderly people are at high risk of suffering from infection and being affected by severe forms of disease because their immunosystem suffers from aging. The alteration of normal immune functions causes the increase of pro-inflammatory cytokines which can expose these people to increased risk of developing pathologies as cancer, diabetes, and/or arthritis. Some supplements could be helpful for restoring normal immune functions. We conducted a case-control study to evaluate the efficacy of a supplement containing Sambucus nigra, zinc, tyndallized Lactobacillus acidophilus (HA122), arabinogalactans, vitamin D, vitamin E, and vitamin C to improve the inflammatory levels (IL-6 and CRP) and to modulate the lymphocytes growth. Additionally, we analyzed wellness by self-questionnaire. This study had two control group: a young group and an elderly one. Our study showed that treating elderly patients with the supplement for 30 days improved IL-6, CRP, and lymphocytes levels; the result was independent from the dosage of the supplements used. Elderly patients, despite the improvement, were not able to reach the same conditions of young patients; however, most of the patients (>70%) claimed to “feel better” after the use of the supplement. The use of this supplement should be considered at a low dosage for a prolonged period to reduce inflammation and modulate immune senescence in patients over 60 years old. DOI: 10.3390/nu14173476 PMCID: PMC9459752 PMID: 36079732 [Indexed for MEDLINE] Conflict of interest statement: The authors declare no conflict of interest.

Primary care experience on Stimunex(®) gocce in children with recurrent respiratory infections: a real-world study during the COVID-19 pandemic era.

6. Allergol Immunopathol (Madr). 2022 May 1;50(3):8-14. doi: 10.15586/aei.v50i3.562. eCollection 2022. Primary care experience on Stimunex(®) gocce in children with recurrent respiratory infections: a real-world study during the COVID-19 pandemic era. Giannattasio A(1), Poggi E(1), Trapani G(2), Muia C(2), Zanino L(3), Landi M(3), Ciprandi G(4). Author information: (1)Paediatric Primary Care, ASL 3 Genovese, Genoa, Italy. (2)Paediatric Primary Care, ASL 1 Imperiese, Sanremo, Italy. (3)Paediatric Primary Care, ASL Turin, Turin, Italy. (4)Allergy Clinic, Villa Serena, Genoa, Italy; gio.cip@libero.it. BACKGROUND: Respiratory infections (RI) significantly burden society, mainly when there are recurrent respiratory infections (RRI). Thus, there is a need to prevent RI in clinical practice. In this regard, the modulation of the immune system and resolution of the inflammatory cascade could represent an ideal way to prevent RI. Stimunex® gocce, a multicomponent food supplement, contains Sambucus nigra extract, β-glucan, Zinc, and Vitamin D3. This study investigated its ability to prevent RRI in children using a real-world setting: the pediatric primary care. MATERIALS AND METHODS: Two hundred and ninety-eight children with RRI were enrolled in the current study. The food supplement was randomly prescribed to 160 children with RRI daily for 4 months (Active group); the remaining 138 children with RRI were treated only with standard therapy for RI (Control group). The number and duration of RI, parental perception of symptom severity and treatment efficacy, use of medications, and school and working absence were evaluated. RESULTS: Children treated with Stimunex® gocce had significantly less RI than the Control group, both concerning upper and lower RI (p˂0.001 and 0.003, respectively) during the follow-up period. Moreover, children in the Active group experienced shorter RI duration during the treatment and follow-up phases (p˂0.001 for both). In addition, parents of treated children perceived less severe symptoms and better treatment efficacy during the first and follow-up phases (p˂0.001 for all). The food supplement was well tolerated and there was no adverse event. CONCLUSIONS: The current real-world study demonstrated that Stimunex® gocce supplementation in children with RRI might safely prevent RI episodes and reduce RI duration. These outcomes should be highlighted as obtained during the COVID-19 pandemic era, characterized by a dramatic reduction of RI. DOI: 10.15586/aei.v50i3.562 PMID: 35527651 [Indexed for MEDLINE] Conflict of interest statement: The authors state that there was no conflict of interest.

Immunomodulatory role and potential utility of various nutrients and dietary components in SARS-CoV-2 infection.

7. Int J Vitam Nutr Res. 2022 Jan;92(1):35-48. doi: 10.1024/0300-9831/a000715. Epub 2021 Jun 8. Immunomodulatory role and potential utility of various nutrients and dietary components in SARS-CoV-2 infection. Yaseen MO(1), Jamshaid H(1)(2), Saif A(1), Hussain T(1). Author information: (1)Institute of Pharmaceutical Sciences, University of Veterinary & Animal Sciences, Lahore, Pakistan. (2)Department of Pharmacy, Quaid-e-Azam University, Islamabad, Pakistan. Recently, the outbreak of severe acute respiratory syndrome cornoavirus-2 (SARS-CoV-2), causing coronavirus disease 2019 (COVID-19), has become a great perturbation all around the globe and has many devastating effects on every aspect of life. Apart from the oxygen therapy and extracorporeal membrane oxygenation, Remdesivir and Dexamethasone have been proven to be efficacious against COVID-19, along with various vaccine candidates and monoclonal antibody cocktail therapy for Regeneron. All of these are currently at different stages of clinical trials. People with weak immunity are more prone to a severe infection of SARS-CoV-2. Therefore, early and judicious nutritional supplementation along with pharmacological treatment and clinician collaborations are critical in restituting the current situation. Nutritional supplements help in acquiring strong immunity to prevent the progression of disease any further. Vitamin C, vitamin D, selenium, zinc and many other nutritional and dietary supplements inhibit the production of inflammatory cytokines during a viral infection and prevents several unwanted symptoms of infection. Many dietary components like citrus fruits, black elderberry, ginger, and probiotics have the ability to attack viral replication. These supplements can also tame the overriding immune system during coronavirus infection. Keeping in view these facts, nutritional and dietary supplements can be used along with other management modalities. These nutritional and dietary supplements are potential candidates to curb the convulsive unfolding of novel COVID-19, in combination with other standard treatment protocols. In this review, various search engines were used to exploit available literature in order to provide a comprehensive review on nutritional and dietary supplements with respect to the viral infections. It will also provide a brief overview on some of the clinical trials that are in progress to assess the role of nutritional supplements, either alone or in combination with other pharmacological drugs, in fight against COVID-19. DOI: 10.1024/0300-9831/a000715 PMID: 34100300 [Indexed for MEDLINE]

Difensil Immuno Reduces Recurrence and Severity of Tonsillitis in Children: A Randomized Controlled Trial.

8. Nutrients. 2020 Jun 2;12(6):1637. doi: 10.3390/nu12061637. Difensil Immuno Reduces Recurrence and Severity of Tonsillitis in Children: A Randomized Controlled Trial. Di Stadio A(1), Della Volpe A(2), Korsch FM(2), De Lucia A(2), Ralli M(3), Martines F(4), Ricci G(1). Author information: (1)Department of Otolaryngology, University of Perugia, 06129 Perugia, Italy. (2)Otology and Cochlear Implant Unit, Santobono-Pausilipon Children's Hospital, 80129 Naples, Italy. (3)Sense Organs Department, Sapienza University of Rome, 00161 Rome, Italy. (4)Biomedicine, Neuroscience and Advanced Diagnostics Department, University of Palermo, 90127 Palermo, Italy. Oral supplements (OS) support the immune system in fighting upper airways infection. This study aimed to analyze the effect of Difensil Immuno (DI) on the recurrence of tonsillitis and fever in children. A multicentric randomized clinical trial was conducted. One-hundred and twenty children with chronic tonsillitis were randomly assigned to group A, B or control. Patients in group A were treated with 10 mL of DI for 90 consecutive days, patients in group B underwent treatment with 15 mL of DI for 45 consecutive days. The following data were collected at baseline (T0), T1 and T2: tonsillitis and fever episodes, tonsillar volume, blood test results. One-way ANOVA was used to analyze within and between variances. Patients in group A and B statistically improved their clinical parameters (episode of tonsillitis and fever, tonsillar volume) when compared to control group both at T1 and T2. However, T1 variances were more consistent in group A than in group B. All patients in the study groups improved their clinical outcomes. No statistically significant variances were observed in blood parameters both at T1 and T2. Our results suggest that children treated with DI had fewer episodes of tonsillitis and fever and a reduction in their tonsillar volume. DOI: 10.3390/nu12061637 PMCID: PMC7352765 PMID: 32498216 [Indexed for MEDLINE] Conflict of interest statement: The authors declare no conflict of interest.

Elderberry Supplementation Reduces Cold Duration and Symptoms in Air-Travellers: A Randomized, Double-Blind Placebo-Controlled Clinical Trial.

9. Nutrients. 2016 Mar 24;8(4):182. doi: 10.3390/nu8040182. Elderberry Supplementation Reduces Cold Duration and Symptoms in Air-Travellers: A Randomized, Double-Blind Placebo-Controlled Clinical Trial. Tiralongo E(1)(2), Wee SS(3)(4), Lea RA(5). Author information: (1)School of Pharmacy, Griffith University, Gold Coast campus, Queensland 4222, Australia. e.tiralongo@griffith.edu.au. (2)Menzies Health Institute Queensland, Griffith University, Gold Coast campus, Queensland 4222, Australia. e.tiralongo@griffith.edu.au. (3)Menzies Health Institute Queensland, Griffith University, Gold Coast campus, Queensland 4222, Australia. s.wee@griffith.edu.au. (4)School of Allied Health Sciences, Griffith University, Gold Coast campus, Queensland 4222, Australia. s.wee@griffith.edu.au. (5)Genomics Research Centre, Institute of Health and Biomedical Innovation, Queensland University of Technology, Queensland 4000, Australia. rodney.a.lea@gmail.com. Intercontinental air travel can be stressful, especially for respiratory health. Elderberries have been used traditionally, and in some observational and clinical studies, as supportive agents against the common cold and influenza. This randomized, double-blind placebo-controlled clinical trial of 312 economy class passengers travelling from Australia to an overseas destination aimed to investigate if a standardised membrane filtered elderberry (Sambucus nigra L.) extract has beneficial effects on physical, especially respiratory, and mental health. Cold episodes, cold duration and symptoms were noted in a daily diary and assessed using the Jackson score. Participants also completed three surveys containing questions regarding upper respiratory symptoms (WURSS-21) and quality of life (SF-12) at baseline, just before travel and at 4-days after travel. Most cold episodes occurred in the placebo group (17 vs. 12), however the difference was not significant (p = 0.4). Placebo group participants had a significantly longer duration of cold episode days (117 vs. 57, p = 0.02) and the average symptom score over these days was also significantly higher (583 vs. 247, p = 0.05). These data suggest a significant reduction of cold duration and severity in air travelers. More research is warranted to confirm this effect and to evaluate elderberry's physical and mental health benefits. DOI: 10.3390/nu8040182 PMCID: PMC4848651 PMID: 27023596 [Indexed for MEDLINE]

Anthocyanins do not influence long-chain n-3 fatty acid status: studies in cells, rodents and humans.

10. J Nutr Biochem. 2015 Mar;26(3):211-8. doi: 10.1016/j.jnutbio.2014.09.005. Epub 2014 Oct 7. Anthocyanins do not influence long-chain n-3 fatty acid status: studies in cells, rodents and humans. Vauzour D(1), Tejera N(2), O'Neill C(2), Booz V(2), Jude B(2), Wolf IM(3), Rigby N(4), Silvan JM(5), Curtis PJ(2), Cassidy A(2), de Pascual-Teresa S(5), Rimbach G(3), Minihane AM(2). Author information: (1)Department of Nutrition, Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, NR4 7TJ, United Kingdom. Electronic address: D.Vauzour@uea.ac.uk. (2)Department of Nutrition, Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, NR4 7TJ, United Kingdom. (3)Institute of Human Nutrition and Food Science, Christian-Albrechts-University, D-24118 Kiel, Germany. (4)Institute of Food Research, Norwich Research Park, Norwich NR4 7UA, United Kingdom. (5)Deparment of Metabolism and Nutrition, Instituto de Ciencia y Tecnología de Alimentos y Nutrición (ICTAN), CSIC, José Antonio Novais 10, 28040 Madrid, Spain. Increased tissue status of the long-chain n-3 polyunsaturated fatty acids (LC n-3 PUFA), eicosapentaenoic (EPA) and docosahexaenoic acid (DHA) is associated with cardiovascular and cognitive benefits. Limited epidemiological and animal data suggest that flavonoids, and specifically anthocyanins, may increase EPA and DHA levels, potentially by increasing their synthesis from the shorter-chain n-3 PUFA, α-linolenic acid. Using complimentary cell, rodent and human studies we investigated the impact of anthocyanins and anthocyanin-rich foods/extracts on plasma and tissue EPA and DHA levels and on the expression of fatty acid desaturase 2 (FADS2), which represents the rate limiting enzymes in EPA and DHA synthesis. In experiment 1, rats were fed a standard diet containing either palm oil or rapeseed oil supplemented with pure anthocyanins for 8 weeks. Retrospective fatty acid analysis was conducted on plasma samples collected from a human randomized controlled trial where participants consumed an elderberry extract for 12 weeks (experiment 2). HepG2 cells were cultured with α-linolenic acid with or without select anthocyanins and their in vivo metabolites for 24 h and 48 h (experiment 3). The fatty acid composition of the cell membranes, plasma and liver tissues were analyzed by gas chromatography. Anthocyanins and anthocyanin-rich food intake had no significant impact on EPA or DHA status or FADS2 gene expression in any model system. These data indicate little impact of dietary anthocyanins on n-3 PUFA distribution and suggest that the increasingly recognized benefits of anthocyanins are unlikely to be the result of a beneficial impact on tissue fatty acid status. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved. DOI: 10.1016/j.jnutbio.2014.09.005 PMCID: PMC4336242 PMID: 25573539 [Indexed for MEDLINE]

Phenolic metabolites of anthocyanins following a dietary intervention study in post-menopausal women.

11. Mol Nutr Food Res. 2014 Mar;58(3):490-502. doi: 10.1002/mnfr.201300322. Epub 2013 Oct 30. Phenolic metabolites of anthocyanins following a dietary intervention study in post-menopausal women. de Ferrars RM(1), Cassidy A, Curtis P, Kay CD. Author information: (1)Department of Nutrition, Norwich Medical School, University of East Anglia, Norwich, UK. SCOPE: Numerous studies feeding anthocyanin-rich foods report limited bioavailability of the parent anthocyanins. The present study explores the identity and concentration of the phenolic metabolites of anthocyanins in humans. METHODS AND RESULTS: Anthocyanin metabolites were quantified in samples collected from a previously conducted 12-wk elderberry intervention study in healthy post-menopausal women. Individual 1-, 2- and 3-h post-bolus urine samples and pooled plasma samples following acute (single bolus) and chronic (12-wk supplementation) anthocyanin consumption (500 mg/day) were analysed using HPLC-ESI-MS/MS. Twenty-eight anthocyanin metabolites were identified in urine and 21 in plasma (including sulfates of vanillic, protocatechuic and benzoic acid). Phenolic metabolites reached peak concentrations of 1237 nM in plasma, while anthocyanin conjugates only reached concentrations of 34 nM. Similarly, in urine, phenolic metabolites were detected at concentrations of 33,185 ± 2549 nM/mM creatinine, while anthocyanin conjugates reached concentrations of 548 ± 219 nM/mM creatinine. There was no evidence that chronic exposure had any impact on either the profile or quantity of metabolites recovered relative to acute exposure. CONCLUSION: An extensive range of phenolic metabolites of anthocyanin was identified following elderberry consumption in humans, including 11 novel metabolites, which were identified at much higher concentrations than their parent compounds. © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim. DOI: 10.1002/mnfr.201300322 PMID: 24170677 [Indexed for MEDLINE]

A systematic review of the efficacy and safety of herbal medicines used in the treatment of obesity.

12. World J Gastroenterol. 2009 Jul 7;15(25):3073-85. doi: 10.3748/wjg.15.3073. A systematic review of the efficacy and safety of herbal medicines used in the treatment of obesity. Hasani-Ranjbar S(1), Nayebi N, Larijani B, Abdollahi M. Author information: (1)Endocrinology and Metabolism Research Center, and Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Comment in World J Gastroenterol. 2010 Oct 14;16(38):4880-2. doi: 10.3748/wjg.v16.i38.4880. This review focuses on the efficacy and safety of effective herbal medicines in the management of obesity in humans and animals. PubMed, Scopus, Google Scholar, Web of Science, and IranMedex databases were searched up to December 30, 2008. The search terms were "obesity" and ("herbal medicine" or "plant", "plant medicinal" or "medicine traditional") without narrowing or limiting search elements. All of the human and animal studies on the effects of herbs with the key outcome of change in anthropometric measures such as body weight and waist-hip circumference, body fat, amount of food intake, and appetite were included. In vitro studies, reviews, and letters to editors were excluded. Of the publications identified in the initial database, 915 results were identified and reviewed, and a total of 77 studies were included (19 human and 58 animal studies). Studies with Cissus quadrangularis (CQ), Sambucus nigra, Asparagus officinalis, Garcinia atroviridis, ephedra and caffeine, Slimax (extract of several plants including Zingiber officinale and Bofutsushosan) showed a significant decrease in body weight. In 41 animal studies, significant weight loss or inhibition of weight gain was found. No significant adverse effects or mortality were observed except in studies with supplements containing ephedra, caffeine and Bofutsushosan. In conclusion, compounds containing ephedra, CQ, ginseng, bitter melon, and zingiber were found to be effective in the management of obesity. Attention to these natural compounds would open a new approach for novel therapeutic and more effective agents. DOI: 10.3748/wjg.15.3073 PMCID: PMC2705729 PMID: 19575486 [Indexed for MEDLINE]

An observational study and quantification of the actives in a supplement with Sambucus nigra and Asparagus officinalis used for weight reduction.

13. Phytother Res. 2008 Jul;22(7):913-8. doi: 10.1002/ptr.2415. An observational study and quantification of the actives in a supplement with Sambucus nigra and Asparagus officinalis used for weight reduction. Chrubasik C(1), Maier T, Dawid C, Torda T, Schieber A, Hofmann T, Chrubasik S. Author information: (1)Institute of Forensic Medicine, University of Freiburg, Freiburg, Germany. The aim of the study was to obtain information on the content of co-active compounds of a food supplement recommended as a weight reduction diet and on its short-term effectiveness and safety as a starter for lifestyle change. Eighty participants completed the protocol. The Sambucus nigra L. berry juice enriched with flower extract and tablets containing berry powder and flower extract provided a total of 1 mg anthocyanins, 370 mg flavonol glycosides and 150 mg hydroxycinnamates per day; the Asparagus officinalis L. powder tablets provided 19 mg saponins per day. After the diet, the mean weight, blood pressure, physical and emotional well-being and the quality of life had significantly improved (ITT analysis). The effectiveness and tolerability of the regimen were rated as very good or good by most of the completers. It remains to be established if any particular compounds contribute to the efficacy of the diet. DOI: 10.1002/ptr.2415 PMID: 18350516 [Indexed for MEDLINE]