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The purpose of this study was to systematically review the scientific literature about the effects of supplementation with Ashwagandha (Withania somnifera) on maximum oxygen consumption (VO2max), as well as to provide directions for clinical practice. A systematic search was conducted in three electronic databases following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Guidelines (PRISMA). The inclusion criteria were: (a) VO2max data, with means ± standard deviation before and after the supplement intervention, (b) the study was randomized controlled trial (RCT), (c) the article was written in English. The quality of evidence was evaluated according to the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. A meta-analysis was performed to determine effect sizes. Five studies were selected in the systematic review (162 participants) and four were included in the meta-analysis (142 participants). Results showed a significant enhancement in VO2max in healthy adults and athletes (p = 0.04). The mean difference was 3.00 (95% CI from 0.18 to 5.82) with high heterogeneity. In conclusion, Ashwagandha supplementation might improve the VO2max in athlete and non-athlete people. However, further research is need to confirm this hypothesis since the number of studies is limited and the heterogeneity was high.
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nutrients
Communication
Eects of Ashwagandha (Withania somnifera) on
VO2max: A Systematic Review and Meta-Analysis
Jorge Pérez-Gómez 1, Santos Villafaina 2,* , JoséCarmelo Adsuar 1,
Eugenio Merellano-Navarro 3and Daniel Collado-Mateo 4
1HEME Research Group, Faculty of Sport Sciences, University of Extremadura, 10003 Caceres, Spain;
jorgepg100@gmail.com (J.P.-G.); jadssal@unex.es (J.C.A.)
2Physical Activity and Quality of Life Research Group (AFYCAV), Faculty of Sport Science, University of
Extremadura, 10003 Cáceres, Spain
3Facultad de Educación, Universidad Autónoma de Chile, Talca 3460000, Chile; emerellano@gmail.com
4Centre for Sport Studies, Rey Juan Carlos University, Fuenlabrada, 28943 Madrid, Spain;
danicolladom@gmail.com
*Correspondence: svillafaina@unex.es; Tel.: +34-927-257-460
Received: 15 March 2020; Accepted: 14 April 2020; Published: 17 April 2020


Abstract:
The purpose of this study was to systematically review the scientific literature about the
eects of supplementation with Ashwagandha (Withania somnifera) on maximum oxygen consumption
(VO
2max
), as well as to provide directions for clinical practice. A systematic search was conducted
in three electronic databases following the Preferred Reporting Items for Systematic Reviews
and Meta-Analyses Guidelines (PRISMA). The inclusion criteria were: (a) VO
2max
data, with
means
±
standard deviation before and after the supplement intervention, (b) the study was
randomized controlled trial (RCT), (c) the article was written in English. The quality of evidence was
evaluated according to the Grading of Recommendations, Assessment, Development and Evaluation
(GRADE) approach. A meta-analysis was performed to determine eect sizes. Five studies were
selected in the systematic review (162 participants) and four were included in the meta-analysis
(142 participants). Results showed a significant enhancement in VO
2max
in healthy adults and
athletes (p=0.04). The mean dierence was 3.00 (95% CI from 0.18 to 5.82) with high heterogeneity.
In conclusion, Ashwagandha supplementation might improve the VO
2max
in athlete and non-athlete
people. However, further research is need to confirm this hypothesis since the number of studies is
limited and the heterogeneity was high.
Keywords: ergogenic aids; maximum oxygen consumption; performance sports; physical fitness
1. Introduction
Maximum oxygen consumption (VO
2max
) is a physiological parameter that defines the aerobic
capacity of a person. It is an indicator of the cardiorespiratory fitness that describes health status [
1
] and
sport performance [
2
]. Focusing on competitive sports, the VO
2max
, together with running economy
and the anaerobic threshold, is one of the main factors that determine success in endurance activities [
3
],
and also contributes to increase the team sports performance by increasing work intensity, distance
covered, and number of sprints completed [
4
]. However, from the point of view of the physical training,
there are still controversies about the best training intensity to enhance the VO2max [5,6].
Apart from sport performance, VO
2max
has special interest in the field of health. Low values of
VO
2max
(<17.5 mL
·
min
-1·
kg
-1
) are associated with an increased risk of mortality and loss of independent
lifestyle in adults and elderly [
7
], while high values of cardiorespiratory fitness have been associated
with a reduced risk of cardiovascular diseases [
8
,
9
]. The VO
2max
level is also important in children,
where a higher aerobic capacity is related to better quality of life [10].
Nutrients 2020,12, 1119; doi:10.3390/nu12041119 www.mdpi.com/journal/nutrients
Nutrients 2020,12, 1119 2 of 11
Ashwagandha (Withania somnifera) is a plant in the Solanaceae family. The extract of the
Ashwagandha root has many biological implications due to its diverse phytochemicals [
11
], so it
has been used, singly or in combination with other natural plants, in many research studies for its
properties: anti-diabetic [
12
], anti-inflammatory [
13
], anti-microbial [
14
], anti-tumor [
15
], anti-stress [
16
],
cardioprotective [
17
], or neuroprotective [
18
]. It also displays enhanced endothelial function [
11
],
reduces reactive oxygen species [
13
], regulates apoptosis [
19
], and modulates mitochondrial
function [
11
], showing to be eective to treat aging eects [
20
], anxiety and stress [
21
], arthritis [
22
],
cognitive functions and memory [
23
], diabetes [
12
], epilepsy [
24
], fatigue [
25
], neurodegenerative
diseases [26], pain [27], thyroid function [28], and skin diseases [29].
In spite of the relevant benefits of supplementation with Ashwagandha, only four meta-analyses
have been carried out evaluating its ecacy on anti-inflammatory eects [
30
], on impotence and
infertility treatment [
31
], on neurobehavioral disorders [
32
] and anxiety [
33
]. However, there are no
meta-analyses that analyze the eect of Ashwagandha on physical performance. Therefore, the purpose
of this study was to systematically review the scientific literature about the eects of supplementation
with Ashwagandha on VO
2max
and to provide practical recommendations. Besides, a meta-analysis
was carried out to determine the eect sizes of Ashwagandha on VO2max.
2. Methods
The review was conducted following the statements of the Preferred Reporting Items for Systematic
Reviews and Meta-Analyses Guidelines (PRISMA).
2.1. Literature Search
To find the studies reported in the meta-analysis, several electronic databases were screened:
PubMed (Medline), Web of Science (which includes other databases such as Current Contents Connect,
Derwent Innovations Index, Korean Journal Database, Medline, Russian Science Citation Index, and
Scielo Citation Index) and Google Scholar. The search was conducted in September 2019. The search
terms were: (a) the type of treatment (Ashwagandha or “withania somnifera”) and (b) the outcome
variable (“oxygen consumption” or “aerobic” or “VO
2
”). The search was conducted using the treatment
and the outcome variables, separated by the Boolean operator “and”.
2.2. Study Selection
The inclusion criteria were: (a) VO
2max
data, with means
±
standard deviation (SD) before and
after the supplement intervention; (b) the study was a randomized controlled trial (RCT); (c) the article
was written in English. Two independent authors selected the potentially eligible articles from the
databases. There were no disagreements.
2.3. Quality of the Evidence and Risk of Bias
The quality of the evidence was categorized using the Grading of Recommendations, Assessment,
Development and Evaluation (GRADE) approach. The risk of bias was assessed by the Cochrane
Collaboration’s tool for assessing risk of bias. This tool classified the selection, performance, detection,
attrition, and reporting bias into low, high, or unclear risk of bias.
2.4. Data Collection
Two authors independently extracted data from the studies. The information included: participants,
interventions, comparisons, outcomes, and study design (PICOS), following the recommendations
from the PRISMA statement. Table 1shows age, sex, sample size, and condition of the participants.
Table 2presents intervention and the comparison groups, including type of supplementation with the
doses, duration of the study, and the daily frequency of the supplementation. Figure 3 displays results
for the dierent outcomes. Study design was not included in any table because all studies were RCT.
Nutrients 2020,12, 1119 3 of 11
Table 1. Characteristics of the sample.
RCT Weeks Groups,
Sample Size and Sex Age (Years) Country Population
Shenoy 2012 8 AS: 20 (M and F)
CG: 20 (M and F) 18–27 India Elite cyclists
Malik 2013 8 AS: 16 (M)
CG: 16 (M) 16–19 India Hockey players
Choudhary 2015 12 AS: 25 (M and F)
CG: 25 (M and F) 20–45 India Athletes
Tripathi 2016 2 AS: 10 (M)
CG: 10 (M) 18–45 India Healthy adults
Sandhu 2010 8 AS: 10 (M and F)
CG: 10 (M and F) 18–25 India Healthy adults
RCT: randomized controlled trial; AS: Ashwagandha group; M: males; F: females; CG: control group.
Table 2. Characteristics of the interventions.
RCT
Ashwagandha Group Control Group Dose
(mg)
Duration
of the
Study
Daily
Frequency
Total
Dose (g)
Type of
Supplementation
Type of
Supplementation
Shenoy 2012 Ashwagandha in
gelatin capsules
Capsules containing
starch powder 500 8 weeks twice 56
Malik 2013 Roots of WS
Sugar power was
filled in gelatin
capsules
500 8 weeks once 28
Choudhary
2015
One capsule of KSM-66
Ashwagandha
Identical capsules
containing sucrose 300 12 weeks twice 50.4
Tripathi 2016
WS aqueous extract in
the capsule form Maize starch capsule 330 2 weeks once 4.62
Sandhu 2010 WS filled in gelatin
capsules
Capsules filled with
flour 500 8 weeks once 28
RCT: randomized controlled trial; KSM-66: commercial name of an Ashwagandha extract; WS: Withania Somnifera.
Total dose was calculated as: total dose (g) =(dose (mg) ×daily frequency ×study duration (days))/1000.
2.5. Statistical Analysis
The main outcome of this meta-analysis was VO
2max
. The meta-analysis was conducted using
the Revision Manager (RevMan) software (version 5.3) obtained from Cochrane Collaboration web.
Post-intervention mean and SD were extracted and used for meta-analyses. All articles reported VO
2
max as mL/kg/min. Mean dierence was calculated using a random model. The heterogeneity between
the studies was calculated using Tau
2
, I
2
, and Chi
2
tests. Although there is no consensus about the
definition of “mild”, “moderate”, or “severe” heterogeneity, Higgins and Thompson [
34
] suggested
that values for I
2
higher than 56% would mean large heterogeneity while values lower than 31% would
be related to low heterogeneity.
3. Results
3.1. Study Selection
The PRISMA flow diagram is showed in Figure 1. A total of 129 records were identified, 9 of
which were removed because they were duplicated. Of the remaining 120 articles, 92 were excluded
because they were not related with the topic, 4 studies were not written in English, and 4 were reviews.
After reading the remaining 20 articles, another 15 studies did not meet the inclusion criteria and were
excluded. Therefore, 5 studies were included in the systematic review. However, the article by Sandhu
et al. [
35
] was excluded from meta-analysis due to the odd results. In this regard, they evaluated
healthy young males and females aged between 18 and 25 with body mass index between 18 and 25.
Their mean peak VO
2max
was lower than 14mL/kg/min, which is so much lower than expected for
healthy young people and less than half the mean of the rest of the included studies (46.18 mL/kg/min).
Nutrients 2020,12, 1119 4 of 11
We tried to contact with the authors in order to obtain a reason for that, but at the time this article was
considered for publication, we did not receive a response. Considering that in the article authors did
not explain an incremental test to obtain the VO
2max
, we believe that they measured the gas exchange
at rest, reporting the oxygen consumption (VO
2
). Therefore, this article was included in systematic
review but not in the meta-analysis.
Figure 1. Flow chart delineating the complete systematic review process.
3.2. Quality of Evidence and Risk of Bias
The evidence of the eects on VO
2max
was initially classified as “high quality” due to all the
selected articles were RCT, but the evidence dropped twice because of the small sample size and due
to the high degree of heterogeneity. Therefore, the final quality of the evidence was low. The Cochrane
Collaboration’s tool for assessing risk of bias (Figure 2) showed that the poorer scores were obtained in
the performance and detection bias due to unclear reporting.
3.3. Study Characteristics
Study characteristics are summarized in Table 1. The total number of participants included in this
systematic review were 162. Of these, 81 belonged to the Ashwagandha group and 81 were the placebo
(control) group. The age ranged from 16 to 45 years old. The sample was comprised exclusively of
healthy adults and athletes.
Nutrients 2020,12, 1119 5 of 11
Figure 2. The Cochrane Collaboration’s tool for assessing risk of bias.
3.4. Interventions
The characteristics of the Ashwagandha supplementation and placebo group are displayed in
Table 2. The doses varied from 300 to 500 mg and the daily frequency intake was once or twice a day.
The total duration of the intervention varied from 2 to 12 weeks.
3.5. Outcome Measures
The study of Choudhary et al. [
36
] found a significant group*treatment interaction in the VO
2max
.
The remaining four articles only found within-group improvement in VO
2max
after the supplement
intervention [35,3739].
Regarding meta-analysis results, a significant (p=0.04) mean dierence was observed. Figure 3
showed a mean dierence of 3.00 (95% CI from 0.18 to 5.82). The heterogeneity level was large
according to the I
2
=84%. The quality of the evidence was low according to the GRADE classification.
Nutrients 2020,12, 1119 6 of 11
Figure 3. Meta-analysis results of the eects of Ashwagandha supplementation on VO2max.
Nutrients 2020,12, 1119 7 of 11
4. Discussion
The purpose of this study was to systematically review the scientific literature about the eects of
supplementation with Ashwagandha on VO
2max
and to carry out a meta-analysis to determine the
overall eect. After 20 articles were assessed for eligibility, 15 articles were excluded since they did not
report VO
2 max
. A total of 5 articles were included in the systematic review [
35
39
]. However, one article
was excluded from the meta-analysis [
35
] since the reported mean VO
2max
was abnormally low for
healthy young people and less than half the mean of the rest of the included studies (46.18 mL/kg/min),
which may indicate that they were not actually reporting VO
2max
but VO
2
at rest. The results of this
meta-analysis showed that supplementation with Ashwagandha may be useful to improve VO
2max
in
athletes [
36
,
38
,
39
] and healthy adults [
37
]. Table 2displayed the amount of Ashwagandha used in
each study, which varied from 330 up to 1000 mg/day, which is inside the limits, 750 to 1250 mg/day,
found to be well tolerated and safe [40]. In this regard, none of the five articles reported any relevant
side eect as a consequence of the treatment, achieving a high compliance with the treatment and very
low number of dropouts.
The two studies that achieved the highest treatment eect and eect size [
36
,
39
] were those with
the highest Ashwagandha intake (>50 g in the whole program). Therefore, it seems like the higher the
dose, the higher the improvement in VO
2
. However, the study by Tripathi, Shrivastava, Ahmad Mir,
Kumar, Govil, Vahedi, and Bisen [
14
] did not observe any significant dierence between the eects of a
330 mg intake and the eects of a 500 mg intake after 2 weeks. Therefore, further studies comparing
the eect of dierent doses, as well as studies with longer duration are needed.
In general terms, the overall eects were better in those studies with a sample comprised of
athletes [
36
,
38
,
39
] compared with the studies with healthy adults [
14
,
39
]. This is interesting since, as
expected, baseline levels were higher in athletes and, consequently, larger improvements were expected
in non-athlete healthy adults. It could be that the eects of supplementation with Ashwagandha might
be linked to the physical activity levels of the participants, promoting and increasing the physiological
adaptations to physical exercise. However, this hypothesis should be explored in future studies.
The VO
2max
defines the body’s ability to transport and utilize oxygen, so this physiological parameter
is associated with endurance performance. Many factors contribute to the VO
2max
values, including
genetic predisposition [
41
], enzymes [
42
], muscle fiber type [
43
], or training [
44
]. It is also known that
nutritional supplementation can improve the eects of training and reach higher performance [
45
].
Previous studies with Ashwagandha administration observed improvement in working capacity test
in rats by increasing the swimming endurance test [
46
]. As endurance performance is determined
by mitochondrial function, some reasons for the Ashwagandha to improve cardiorespiratory fitness
can be the significant eects observed on mitochondrial and energy levels, by reducing the succinate
dehydrogenase enzyme activity in the mitochondria and benefiting Mg-ATPase activity [
47
]. Previous
studies showed that Ashwagandha significantly enhanced the hemoglobin concentration and red blood
cells in animals [
48
] and also in humans [
38
], with the subsequent increase in the capacity to transport
oxygen to the muscles. Moreover, it should be considered that Ashwagandha has shown to have
anti-fatigue [
49
,
50
] and anti-stress [
51
] actions. This could be connected to the significant improvement
in the time to exhaustion of the experimental group that could be observed in the study of Shenoy,
Chaskar, Sandhu, and Paadhi [
39
]. Some of the chemical constituents of Whitania somnifera [
52
] such as
flavonoids, alkaloids, and steroidal lactones (withanolides) or the antioxidants (superoxide dismutase,
catalase, and glutathione peroxidase) could be behind the improvements of VO
2max
. Therefore, further
studies are needed to explore which are the chemical constituents and mechanism that may explain
the potential improvement in the VO2max.
Although all mechanisms by which Ashwagandha can improve the VO
2max
have not been
described yet and future studies are needed to elucidate that improvement, it is known that
Ashwagandha exhibits little or no associated toxicity [
53
], so it seems that this Ayurvedic herb
“Ashwagandha” (Withania somnifera) can be safely used for improving cardiovascular fitness in healthy
Nutrients 2020,12, 1119 8 of 11
adults and also in athletes, oering an additional alternative as a nutritional supplement to enhance
VO2max.
Some limitations in the present meta-analysis can be mentioned. The first one is related to the
search strategy, only articles published in English were included and a few databases were used.
Another limitation can be the large heterogeneity in the included articles. Dierent doses, levels of
physical activity, or the inclusion of both women and men in the protocols make it very dicult
to achieve a high level of evidence. In addition, the systematic review and meta-analysis was not
prospectively registered in any public database. Furthermore, in order to have a better understanding
of long-term ergogenic benefit and potential side eects from Ashwagandha root extract, longer
duration studies are needed.
5. Conclusions
Ashwagandha supplementation might improve the VO
2max
in athlete and non-athlete people.
The analyzed studies used oral administration of Ashwagandha which varied between 2 and 12
weeks with intakes between 300 to 1000 mg/day. Due to the limited number of studies included in
this systematic review and meta-analysis, further research is needed to confirm the eects and the
recommended dose.
Author Contributions:
Conceptualization, J.P.-G., J.C.A. and D.C.-M.; methodology, J.P.-G., S.V., E.M.-N. and
D.C.-M.; software, J.C.A., and D.C.-M.; formal analysis, J.P.-G., S.V., J.C.A., E.M.-N., and D.C.-M.; investigation,
J.P.-G., S.V., J.C.A., E.M.-N., and D.C.-M.; data curation, J.P.-G., J.C.A. and S.V.; writing—original draft preparation,
J.P.-G., S.V. and D.C.-M.; writing—review and editing, J.P.-G., S.V., J.C.A., E.M.-N. and D.C.-M.; supervision, J.P.-G.,
S.V., J.C.A., E.M.-N. and D.C.-M. All authors have read and agreed to the published version of the manuscript.
Funding:
S.V. is supported by a grant from the regional Department of Economy and Infrastructure of the
Government of Extremadura and European Social Fund (PD16008).
Conflicts of Interest: The authors declare no conflict of interest.
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... Clinical trials have demonstrated various effects of ashwagandha, such as improved sleep quality [75][76][77]; improved cognitive performance [78], quality of life, and mental alertness [76] in elderly subjects; decreased HAM-A scores in subjects with anxiety [79,80] and high stress [81]; increased VO 2max in healthy adults and athletes [82,83]; decreased Perceived Stress Scale scores and serum cortisol in stressed adults [78,82,84]; and improved depression and anxiety scores [85] and Perceived Stress Scale scores [86] in individuals with schizophrenia or schizoaffective disorder. Due to its stress-reducing effects, ashwagandha is considered an adaptogen, a substance that helps the body respond and adapt to stress and environmental changes [84]. ...
... Clinical trials have demonstrated various effects of ashwagandha, such as improved sleep quality [75][76][77]; improved cognitive performance [78], quality of life, and mental alertness [76] in elderly subjects; decreased HAM-A scores in subjects with anxiety [79,80] and high stress [81]; increased VO 2max in healthy adults and athletes [82,83]; decreased Perceived Stress Scale scores and serum cortisol in stressed adults [78,82,84]; and improved depression and anxiety scores [85] and Perceived Stress Scale scores [86] in individuals with schizophrenia or schizoaffective disorder. Due to its stress-reducing effects, ashwagandha is considered an adaptogen, a substance that helps the body respond and adapt to stress and environmental changes [84]. ...
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Herbal and dietary supplement (HDS) use has grown exponentially in the United States. Unfortunately, the incidence of HDS-related liver injury has proportionally increased. Despite the potential for certain HDSs to cause clinically significant liver injury, they are not regulated by the Food and Drug Administration. Recent efforts have been made to regulate HDSs but are far removed from the scrutiny of prescription medications. Scant literature exists on HDSs and their risks of causing liver injury. In this comprehensive review, we examine trends of HDS use in the United States and the pathophysiologic mechanisms of drug-induced liver injury (DILI) of certain HDSs. Finally, we review usage rates; benefits, if any; purported pathophysiology of DILI; and propensity for progression to fulminant hepatic failure of nine HDSs linked to clinically significant DILI.
... It is further reported to boost the immune system, increase the production of vital fluids, lymph blood, semen, cells, memory power and possesses immunomodulatory, hemopoietic, rejuvenation and antineoplastic effects [13]. W. somnifera enhances human physical performance, including strength and oxygen use during exercise [14][15][16]. The food supplements comprising extracts of this plant have been shown to increase male fertility by increasing testosterone level, sperm concentration, semen volume, and sperm motility [17,18]. ...
... Although melanin pig- Tousif et al. Process Biochemistry xxx (xxxx) [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] ment protects the mammalian skin from harmful UV radiations, [53] but over production of melanin leads to hyperpigmentation and causes melasma, freckles, age spots, or senile lentigines [54]. Tyrosinase is a copper-containing enzyme that catalyzes melanin synthesis and is held responsible for hyperpigmentation in human skin [55][56][57]. ...
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Withania somnifera (L.) Dunal has been identified as a miracle herb, thus the present study was carried out to investigate W. somnifera growing in Cholistan Desert for its secondary metabolic profile and various biological activities. The WS-C fraction of methanolic extract (WS-M) of W. somnifera was found rich in phenolics (39.96±0.90 mg GAE/g extract), and it exhibited significant DPPH (30.69±0.78 mg TE/g extract) and ABTS (113.60±2.41 mg TE/g extract) free radical inhibitory activities, cupric (Cu⁺²) and ferric (Fe⁺³) reducing potential as 157.51±2.10 and 124.60±0.34 mg TE/g extract. The same fraction also exhibited strong total antioxidant capacity (1.39±0.01 mmol TE/g extract) in phosphomolybdenum assay. Other fractions displayed relatively lower potential. In metal-chelating assay, WS-M, WS-E and WS-B showed nearly equal potential with values of 22.35±0.62, 20.96±0.12 and 22.10±0.75 mg EDTAE/g of the extract, while in AChE, BChE and tyrosinase inhibitory assay, again WS-C fraction was most active (7.50±0.21, 8.01±0.53 mg GALAE/g extract and 36.81±0.20 mg KAE/g extract, respectively). In α-amylase and α-glucosidase inhibitory assay, WS-C showed significant potential with values as 0.74±0.01 and 1.14±0.004 mmol ACAE/g extract, respectively. UHPLC-MS analysis of WS-C fraction leads to identify 100 secondary metabolites of phenolic, withanolide, terpenoid, steroid, lignin, flavonoid and limonoid classes of compounds. This profile makes W. somnifera a fascinating plant. These findings were validated by computational studies, which revealed that selected compounds exhibited high binding free energy and inhibition constants with the enzymes tested. Pearson correlation analysis clearly established that the phenols in the tested extracts were the main players as antioxidants and enzyme inhibitors, which was also substantiated through Principal Component Analysis (PCA). These results suggest that chloroform might be suitable for preparing further applications with W. somnifera extracts, and this plant can be placed in the list of top-selling herbs, and may become source of commercial assets.
... Pérez-Gómez et al.(2020) [7] worked on the study entitled "Effects of Ashwagandha (Withania somnifera) on VO 2max : A Systematic Review and Meta-Analysis." During their work, they concluded that its supplementation might improve maximum oxygen consumption (VO 2 max) in athletes and non-athletes[7].Balkrishna et al. (2020) [8] have worked on "Withanone from Withania somnifera may inhibit Novel Coronavirus (COVID-19) Entry by disrupting Interactions between Viral S-Protein Receptor Binding Domain and Host ACE2 Receptor" and based on their study, they concluded that this herb may be helpful in controlling the infection of COVID-19[8].Ng et al. ...
... Pérez-Gómez et al.(2020) [7] worked on the study entitled "Effects of Ashwagandha (Withania somnifera) on VO 2max : A Systematic Review and Meta-Analysis." During their work, they concluded that its supplementation might improve maximum oxygen consumption (VO 2 max) in athletes and non-athletes[7].Balkrishna et al. (2020) [8] have worked on "Withanone from Withania somnifera may inhibit Novel Coronavirus (COVID-19) Entry by disrupting Interactions between Viral S-Protein Receptor Binding Domain and Host ACE2 Receptor" and based on their study, they concluded that this herb may be helpful in controlling the infection of COVID-19[8].Ng et al. ...
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... A systematic review and meta-analysis of four RCTs reported that ASW significantly increased maximum oxygen consumption in healthy adults [97]. Rahman et al. [98] examined the potential for renal toxicity of ASW in albino rats. ...
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... Sandhu et al. conducted a double-blind placebo-controlled study of W. somnifera with various parameters, such as increased power, velocity, VO 2 max, and augmented VO 2 max, and observed a significant reduction in the resting systolic blood pressure [94] In this study, normal healthy subjects received standardized WSREt in the form of capsules with a proper dose for a particular period and were evaluated for cardiovascular protection and cardiorespiratory endurance. Results confirmed that W. somnifera showed a prominent effect as a cardioprotective [95]. ...
... During aerobic exercise, VO2Max is very important to determine and track a person's cardiorespiratory physiological fitness 14,15 .The higher a person's VO2Max, the better the level of cardiorespiratory fitness, so it has the potential to increase performance in the world of sports [16][17][18] . The ability to predict VO2Max with the development of a test instrument based on sensor technology has the potential to provide an opportunity to obtain valuable information about cardiorespiratory fitness more effectively. ...
... Gómez et al. (2020) [7] worked on the study entitled "Effects of Ashwagandha (Withania somnifera) on VO 2max : A Systematic Review and Meta-Analysis." During their work, they concluded that its supplementation might improve maximum oxygen consumption (VO 2 max) in athletes and non-athletes[7].Balkrishna et al. (2020) [8] have worked on "Withanone from Withania somnifera may inhibit Novel Coronavirus (COVID-19) Entry by disrupting Interactions between Viral S-Protein Receptor Binding Domain and Host ACE2 Receptor" and based on their study, they concluded that this herb may be helpful in controlling the infection of COVID-19[8].Ng et al. (2020) presented a systematic review on the clinical use of W. somnifera(Ashwagandha) to ameliorate cognitive dysfunction[9].Khanchandani et al. (2019) ...
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The Chemistry inside Spices & Herbs: Research and Development brings comprehensive information about the chemistry of spices and herbs with a focus on recent research in this field. The book is an extensive 2-part collection of 20 chapters contributed by experts in phytochemistry with the aim to give the reader deep knowledge about phytochemical constituents in herbal plants and their benefits. The contents include reviews on the biochemistry and biotechnology of spices and herbs, herbal medicines, biologically active compounds and their role in therapeutics among other topics. Chapters which highlight natural drugs and their role in different diseases and special plants of clinical significance are also included. Part II continues from the previous part with chapters on the treatment of skin diseases and oral problems. This part focuses on clinically important herbs such as turmeric, fenugreek, ashwagandha (Indian winter cherry), basil, Terminalia chebula (black myrobalan). In terms of phytochemicals, this part presents chapters that cover resveratrol, piperine and circumin. Audience: This book is an ideal resource for scholars (in life sciences, phytomedicine and natural product chemistry) and general readers who want to understand the importance of herbs, spices and traditional medicine in pharmaceutical and clinical research.
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Background: Ashwagandha (Withania somnifera (L.) Dunal) is a herb traditionally used to reduce stress and enhance wellbeing. The aim of this study was to investigate its anxiolytic effects on adults with self-reported high stress and to examine potential mechanisms associated with its therapeutic effects. Methods: In this 60-day, randomized, double-blind, placebo-controlled study the stress-relieving and pharmacological activity of an ashwagandha extract was investigated in stressed, healthy adults. Sixty adults were randomly allocated to take either a placebo or 240 mg of a standardized ashwagandha extract (Shoden) once daily. Outcomes were measured using the Hamilton Anxiety Rating Scale (HAM-A), Depression, Anxiety, and Stress Scale -21 (DASS-21), and hormonal changes in cortisol, dehydroepiandrosterone-sulphate (DHEA-S), and testosterone. Results: All participants completed the trial with no adverse events reported. In comparison with the placebo, ashwagandha supplementation was associated with a statistically significant reduction in the HAM-A (P = .040) and a near-significant reduction in the DASS-21 (P = .096). Ashwagandha intake was also associated with greater reductions in morning cortisol (P < .001), and DHEA-S (P = .004) compared with the placebo. Testosterone levels increased in males (P = .038) but not females (P = .989) over time, although this change was not statistically significant compared with the placebo (P = .158). Conclusions: These findings suggest that ashwagandha's stress-relieving effects may occur via its moderating effect on the hypothalamus-pituitary-adrenal axis. However, further investigation utilizing larger sample sizes, diverse clinical and cultural populations, and varying treatment dosages are needed to substantiate these findings.
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Background Accumulating evidence shows that a propensity towards a pro-inflammatory status in the brain plays an important role in schizophrenia. Anti-inflammatory drugs might compensate this propensity. This study provides an update regarding the efficacy of agents with some anti-inflammatory actions for schizophrenia symptoms tested in randomized controlled trials (RCTs). Methods PubMed, Embase, the National Institutes of Health website ( http://www.clinicaltrials.gov ), and the Cochrane Database of Systematic Reviews were systematically searched for RCTs that investigated clinical outcomes. Results Our search yielded 56 studies that provided information on the efficacy of the following components on symptom severity: aspirin, bexarotene, celecoxib, davunetide, dextromethorphan, estrogens, fatty acids, melatonin, minocycline, N-acetylcysteine (NAC), pioglitazone, piracetam, pregnenolone, statins, varenicline, and withania somnifera extract. The results of aspirin [mean weighted effect size (ES): 0.30; n = 270; 95% CI (CI) 0.06–0.54], estrogens (ES: 0.78; n = 723; CI 0.36–1.19), minocycline (ES: 0.40; n = 946; CI 0.11–0.68), and NAC (ES: 1.00; n = 442; CI 0.60–1.41) were significant in meta-analysis of at least two studies. Subgroup analysis yielded larger positive effects for first-episode psychosis (FEP) or early-phase schizophrenia studies. Bexarotene, celecoxib, davunetide, dextromethorphan, fatty acids, pregnenolone, statins, and varenicline showed no significant effect. Conclusions Some, but not all agents with anti-inflammatory properties showed efficacy. Effective agents were aspirin, estrogens, minocycline, and NAC. We observed greater beneficial results on symptom severity in FEP or early-phase schizophrenia.
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Maximal oxygen uptake (V̇O2max) and muscle mass decreases with age. The loss of cardiorespiratory fitness and muscle strength is accelerated with physical inactivity and has well‐documented consequences for morbidity and all‐cause mortality. Participation in exercise training programs will improve one or more of the cardio‐metabolic risk factors, but the long‐term effect of such programs are questionable. Here we re‐examined 25 old (72 ± 4 yr.) men and women who considered him/her‐self as “success‐full agers” and were participants in a 3‐month alpine skiing training program six years earlier. The program focused on healthy aging and included health questionnaires, measurement of lipids and glycemic parameters in blood and a VO2max test. Thirteen and twelve subjects were in the intervention (IG) and the control group (CG), respectively. In response to the training program, subjects improved their cardio‐metabolic risk factors. However, after six years all positive effects had disappeared. Approximately 80% of the subjects had total cholesterol and LDL cholesterol above and HDL cholesterol below the recommended values, but these subjects remained the most metabolically deteriorated, including an increase in fasting glucose concentrations. We conclude that people seem to follow their individual trajectory in terms of cardio‐metabolic risk factors, and participation in a relatively short lasting exercise training program with emphasis on healthy aging does not change that. Long‐lasting change of lifestyle probably requires a continued attentional focus, goal setting and feedback. This article is protected by copyright. All rights reserved.
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Background: Rheumatoid Arthritis (RA) is a devastating disease characterized by continual addition of leukocytes and T cells within the articular cavity causing inflammation and cartilage destruction. Withania somnifera is one of the most precious medicinal herbs, reported to have antioxidant, anti-inflammatory, and immunomodulatory properties. Objective: The purpose of this study was to evaluate anti-inflammatory activity of aqueous extract of Withania somnifera roots (WSAq) in Collagen Induced Arthritic (CIA) rats. Methods: To achieve this, we assessed the level of inflammatory cytokines such as Tumor Necrosis Factor (TNF)-α, IL-1β, IL-6 and IL-10 in CIA rats. Further, transcription factor, oxidative stress parameters and CD+8 expressions were also analyzed in CIA rats. Results: Arthritic rats showed a greater increase in the levels of pro inflammatory cytokines such as TNF-α, IL-1β, IL-6, transcription factor NF-κB and a decrease in IL-10 concentration than controls rats. Oral administration of WSAq at a dose of 300mg/kg.wt. (WSAq300) appreciably attenuated the production of these pro inflammatory cytokines. This anti-inflammatory activity of WSAq300 might be partly mediated through an increase in the secretion of IL-10 and inhibition of NF-κB activity. Further, arthritic rats also show increased oxidative stress as compared to control rats. This increased oxidative stress in the arthritic rats appears to be the outcome of both an activated pro-oxidant and a poor antioxidant defense system. Treatment with WSAq300 strongly ameliorates all these ROS parameters significantly to near normal. Additional, metalloproteinase MMP-8 levels were also measured and found to be increased in CIA rats, which after treatment with WSAq300 came down to near normal. Conclusion: From the above results, it can be concluded that the use of WSAq300 may be a valuable supplement which can improve human arthritis.
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