I nutraceutici Arrigo F G Cicero Presidente Soc

I nutraceutici Arrigo F. G. Cicero Presidente Soc. It. Nutraceutici Dip. di Scienze Mediche e Chirurgiche Alma Mater Studiorum Università di Bologna

Definizione • Principi attivi di origine naturale, usualmente contenuti in alimenti o estratti vegetali, con proprietà farmacologiche dimostrate ed azione correlata sull’organismo umano • Possono avere funzioni riconoscibili nell’uomo se biodisponibili e dosati in modo adeguato

Possibili punti d’azione della nutraceutica in riabilitazione - Riduzione dolore/infiammazione - Riduzione stress ossidativo - Supporto articolare - Supporto muscolare - Supporto motivazionale

Glucosamina solfato

Eur J Med Res. 2015; 20(1): 24.

Condroitin solfato

Chondroitin sulfate efficacy: a meta-analysis of RCTs Open Rheumatol J. 2012; 6: 183– 189.

Alpha-lipoic acid

Standardized mean differences for the administration of orally administered alphalipoic acid vs. placebo in the treatment of neuropathic pain Int J Endocrinol. 2012; 2012: 456279

Alpha lipoic acid in the treatment of chronic low back pain: a trial on 98 adult patients with chronic (≥ 12 weeks) LBP with or without radiculopathy and without neoplastic or inflammatory pathologies Eur J Phys Rehabil Med. 2013 Oct; 49(5): 659 -64.

Le carnitine

Patients receiving ALC showed significantly more reduction in VAS scores than those receiving placebo: a meta-analysis of RCTs PLo. S One. 2015; 10(3): e 0119479.

Effect of PLC on harmonized peak walking distance: a meta-analysis of RCTs Vasc Med 2013; 18(1): 3– 12

Coenzyme Q 10

Ubiquinol – For a better Quality of Life for Senior (>80) after 6 months 100 mg/day Ø Improvement of QOL scores in low initial scores subjects Deguchi et al. J Clin Therap Med 24, 233– 238, 2008

Ubiquinol – Chronic Fatigue Syndrome with 20 CFS patients Ubiquinol supplementation improves CFS with positive effects on Ø depressive syndromes Ø sleeping hours (p=0. 59, P=0. 01) Ø correct rate in the cognitive task Ø decrease oxidative stress Ubiquinol Fukuda S. et al. , 7 th conference of ICQA (2012)

UBIQUINOL enhances PEAK POWER Production in ATHLETES Randomized, Double-Blind vs Placebo study Subjects: 100 young (53 male, 47 female) German well trained athletes - Age: 19. 9 ± 2, 3 years in preparation for the Olympic Games in London 2012 Test: + Athletes had to perform a maximum power output test on a cycling ergometer + Before (T 0) and after 6 weeks (T 6) of supplementation Performance in W/kg of bodyweight was measured at the 4 mmol lactate threshold Supplementation: Athletes received daily either 300 mg Ubiquinol or placebo for 6 weeks. Performance power output W/kg bw + 2, 5% + 0, 08* CONCLUSION: Ubiquinol significantly enhanced physical performance in healthy trained Olympic athletes measured as maximum power output by +0. 08 W/kg bw(+2, 5%)(p<0. 03) D. Alf et al. , JISSN April 2013

Ubiquinol-efficacy on anaerobic performances Method: 10 s 2 min 10 s P Rest Double blind study Subjects: 21 female athletes (basketball players) Ubiquinol supplementation: 100 mg/day, 4 weeks POWER (Mean) POWER (Peak) 455 p<0. 05 370 （ｗ） 380 P: full power pedaling (anaerobic exercise) P N. S. T=0 365 T=4 weeks 360 p<0. 01 450 445 N. S. T=0 440 T=4 weeks 435 355 430 350 425 placebo ü Both Mean power and Peak power are improved Ubiquinol also has positive impact on mental health (anger, mental instability) Japanese Society of Physical Education - 59 th Annual meeting

Curcumina

Reduction of delayed onset muscle soreness by Curcumin: a RCT Percent of subjects with MRI evidence of muscular injury. ART, anterior right thigh; PRT, posterior right thigh; MRT, medial right thigh; ALT, anterior left thigh; PLT, posterior left thigh; MLT, medial left thigh. *p<0. 05 for curcumin vs placebo. Patient-reported pain intensity in the right thigh (RT), left thigh (LT), right leg (RL), left leg (LL) and total pain score (the sum of the scores of each lower limb). Drobnic et al. J Int Soc Sports Nutr 2014; 11: 31

Reduction of delayed onset muscle soreness by Curcumin: a RCT Drobnic et al. J Int Soc Sports Nutr 2014; 11: 31

Curcumin: antinflammatory and anticatabolic effects Cicero AF, et al. Pharmacol Res. 2016; 107: 234 -242.

Efficacy of curcumin in pain and postoperative fatigue after laparoscopic cholecystectomy: a double-blind, randomized placebo-controlled study Surg Endosc (2011) 25: 3805– 3810

Analgesic Efficacy and Safety of Curcuminoids in Clinical Practice: A Systematic Review and Meta-Analysis of Randomized Controlled Trials Forest plot detailing standardized mean difference and 95% confidence intervals for the impact of curcuminoid supplementation on the severity of pain. Pain Medicine 2015; 0: 1– 11

Analgesic Efficacy and Safety of Curcuminoids in Clinical Practice: A Systematic Review and Meta-Analysis of RCTs Mixed-effect meta-regression plots of the association between pain-relieving effects of curcuminoids and dose and duration of supplementation. The size of each circle is inversely proportional to the variance of change. Pain Medicine 2015; 0: 1– 11

Curcumin effect on depressive symptoms: a meta-analysis of RCTs Phytother. Res. 30: 175– 183 (2016)

Visual analog scale (VAS) score at t = 0 and after 4 and 8 treatment weeks in participants with a diagnosis of lumbar sciatica Journal of Pain Research 2013: 6 497– 503

Aminoacidi essenziali Amminoacido mg/kg peso corporeo mg per 70 kg mg per 100 kg • Istidina 10 700 1000 • Isoleucina 20 1400 2000 • Leucina 39 2730 3900 • Lisina 30 2100 3000 • Metionina + 15 (totale) 1050 1500 Cisteina • Fenilalanina + 25 (totale) 1750 2500 Tirosina • Treonina 15 1050 1500 • Triptofano 4 280 400 • Valina 26 1820 2600 Azioni: - Preservazione massa muscolare - Preservazione massa ossea (!) - Azione antianemica (istidina)

Dietary manipulation with leucine enriched essential amino acids (EAA) and creatine warrant further investigation in critical care; EAA has demonstrated improvements in body composition and nutritional status in other groups with muscle wasting illness. J Hum Nutr Diet. 28, 313– 330

Some similarities between the effects of exercise therapy and those following EAA supplementation Biomed Res Int. 2014; 2014: 341603.