Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Dr Archana Dambal

"Journal of clinical and diagnostic research is a welcome change in publishing practices. It aims to reach out to the grass-root level researchers who do not lack in experience, clinical material and ideas, but lack in their knowledge in English language and statistics. The journal achieves it's aim by supporting in these exact domains.
It also gives due credit to all research designs like descriptive and qualitative studies while many journals ignore these important study designs. The rigorous review process does not allow any compromise in quality
It is indexed in many indexing agencies and the articles are available under creative commons licence free of cost
The frequency of publication supports many aspiring authors from India and other countries.
It's wide scope welcomes articles across various specialities in medicine. In an era when there is an unscientific insistence on speciality specific research by regulatory bodies in medical education, JCDR supports collaborative research across specialities. I wish the publisher all the best in his future endeavors."



Dr. Archana Dambal
Department of General Medicine,
Belgaum Institute of Medical Sciences,Belgaum, Karnataka,INDIA,
On 30 Nov 2018




Dr Bhanu K Bhakhri

"The Journal of Clinical and Diagnostic Research (JCDR) has been in operation since almost a decade. It has contributed a huge number of peer reviewed articles, across a spectrum of medical disciplines, to the medical literature.
Its wide based indexing and open access publications attracts many authors as well as readers
For authors, the manuscripts can be uploaded online through an easily navigable portal, on other hand, reviewers appreciate the systematic handling of all manuscripts. The way JCDR has emerged as an effective medium for publishing wide array of observations in Indian context, I wish the editorial team success in their endeavour"



Dr Bhanu K Bhakhri
Faculty, Pediatric Medicine
Super Speciality Paediatric Hospital and Post Graduate Teaching Institute, Noida
On Sep 2018




Dr Mohan Z Mani

"Thank you very much for having published my article in record time.I would like to compliment you and your entire staff for your promptness, courtesy, and willingness to be customer friendly, which is quite unusual.I was given your reference by a colleague in pathology,and was able to directly phone your editorial office for clarifications.I would particularly like to thank the publication managers and the Assistant Editor who were following up my article. I would also like to thank you for adjusting the money I paid initially into payment for my modified article,and refunding the balance.
I wish all success to your journal and look forward to sending you any suitable similar article in future"



Dr Mohan Z Mani,
Professor & Head,
Department of Dematolgy,
Believers Church Medical College,
Thiruvalla, Kerala
On Sep 2018




Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."



Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018




Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."



Dr Kalyani R
Professor and Head
Department of Pathology
Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018




Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
‘Knowledge is treasure of a wise man.’ The free access of this journal provides an immense scope of learning for the both the old and the young in field of medicine and dentistry as well. The multidisciplinary nature of the journal makes it a better platform to absorb all that is being researched and developed. The publication process is systematic and professional. Online submission, publication and peer reviewing makes it a user-friendly journal.
As an experienced dentist and an academician, I proudly recommend this journal to the dental fraternity as a good quality open access platform for rapid communication of their cutting-edge research progress and discovery.
I wish JCDR a great success and I hope that journal will soar higher with the passing time."



Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
Lucknow
On Sep 2018




Dr. Arunava Biswas

"My sincere attachment with JCDR as an author as well as reviewer is a learning experience . Their systematic approach in publication of article in various categories is really praiseworthy.
Their prompt and timely response to review's query and the manner in which they have set the reviewing process helps in extracting the best possible scientific writings for publication.
It's a honour and pride to be a part of the JCDR team. My very best wishes to JCDR and hope it will sparkle up above the sky as a high indexed journal in near future."



Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata




Dr. C.S. Ramesh Babu
" Journal of Clinical and Diagnostic Research (JCDR) is a multi-specialty medical and dental journal publishing high quality research articles in almost all branches of medicine. The quality of printing of figures and tables is excellent and comparable to any International journal. An added advantage is nominal publication charges and monthly issue of the journal and more chances of an article being accepted for publication. Moreover being a multi-specialty journal an article concerning a particular specialty has a wider reach of readers of other related specialties also. As an author and reviewer for several years I find this Journal most suitable and highly recommend this Journal."
Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
Muzaffarnagar.
On Aug 2018




Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".



Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".



Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."



Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011

Important Notice

Original article / research
Year : 2011 | Month : April | Volume : 5 | Issue : 2 | Page : 316 - 319

The effects of a Nutritional Supplement (eXfuze Seven+) on blood glucose; a double-blind, randomized study

SANDRA H. LEE, GARY M. BOOTH

Brigham Young University

Correspondence Address :
Gary M. Booth, Professor of Plant and Wildlife Sciences,
Brigham Young University, Provo, Utah.
Email: gary_booth@byu.edu, Phone: (801)422-2458 (Office), (801)
636-6363 (Mobile).

Abstract

This report is an analysis of a randomized, double-blind study which was conducted to determine whether eXfuzeTM Seven+, a nutritional supplement, could lower the blood glucose levels. All volunteers (n = 883) from the Huntsman Senior World Games who were participants at St. George, UT, were to consume randomly, either the eXfuzeTM Seven+ drink, (treatment A) or a commercially obtained grape juice (treatment B; placebo). We used Bayer’s CONTOUR® blood glucose monitoring units to measure before and after blood glucose levels. All the participants voluntarily consented to be a part of the study and their ages and genders were also noted down for further analysis. A SigmaPlot11.0 ®statistical program was used to compare the treatment A (n = 496) and the placebo (n =387) by using t-tests which showed that treatment A had a blood glucose lowering trend as compared to the placebo (p-value = 0.024). Further analysis showed that gender did not affect the treatments (p-valuefemales = 0.120, p-valuemales= 0.063). Also, age did not affect the data (p-value = 0.2). When analyzing the treatment data of the individuals with a change which was greater than or equal to 0, the p-value was found to be less than 0.001, thus indicating that treatment A appeared to cause less spiking of the blood glucose than the placebo. By graphing these data, we saw a pattern where the treatment A data-points tended to aggregate closer to zero than the treatment B data-points. Therefore, this study strongly suggests that the eXfuzeTM Seven+ treatment causes a downward trend in the blood glucose levels as compared to the placebo.

Background: eXfuzeTM Seven+ (eXf+) is a health supplement containing various botanical fruit extracts which have purported health benefits.

Aim: To determine the effects of eXfuzeTM Seven+ on the blood glucose levels.

Materials and Methods:Treatment cups (one-ounce) which were labeled as ‘treatment A’ (eXf+) and ‘treatment B’ (placebo) were given to 883 participants from the 2009 Huntsman Senior World Games which were held at St. George, Utah; each participant received a cup containing one ounce of a particular drink. The pretreatment and post-treatment blood glucose levels of the volunteers were measured by using Bayer’s blood glucose monitoring units. Furthermore, the ages, genders, sports, and before and after dosing-times of the participants were noted. All the participants voluntarily agreed to participate in the study as a part of the health screen which was provided by the Huntsman Senior World Games. The participants were asked to return within a 30-60 minute time interval to take a final glucose measurement. There was no attempt to control the participants’ consumption of food or drink before the treatment, but they were encouraged to avoid simple carbohydrates after drinking the treatment or placebo. A total of 296 valid data points were collected from the individuals who consumed eXfuzeTM Seven+ (treatment A), and a total of 287 valid data points were collected from those who consumed commercially the available grape juice (treatment B; placebo). SigmaPlot 11.0®was used to determine the t-tests and the homogeneity of the variance. Further analysis was done by using the statistics programme called SAS®.

Results: The p-values from both the statistical programmes showed the same levels of significance, differing only slightly due to a difference in the number of data points which were used for the analysis. An initial comparison between all the treatment A and placebo data resulted in a statistically significant difference (p=0.024). The overall mean change for treatment A was -1.77 mg% of blood glucose, whereas the mean change for treatment B was +1.88 mg% of blood glucose. Hence, treatment A, with its decreasing trend, was significantly different than the placebo’s increasing trend. The analyses of gender versus treatment and age versus treatment resulted in no significant differences (p=0.9119 and p = 0.680 respectively).

Conclusions: The data clearly show that eXfuzeTM Seven+ causes a significant decreasing trend in the blood glucose levels.

Keywords

eXfuze, blood-glucose, fruit juice extract, hypoglycaemia

How to cite this article :

SANDRA H. LEE,GARY M. BOOTH. THE EFFECTS OF A NUTRITIONAL SUPPLEMENT (EXFUZE SEVEN+) ON BLOOD GLUCOSE; A DOUBLE-BLIND, RANDOMIZED STUDY. Journal of Clinical and Diagnostic Research [serial online] 2011 April [cited: 2019 Feb 21 ]; 5:316-319. Available from
http://www.jcdr.net/back_issues.asp?issn=0973-709x&year=2011&month=April&volume=5&issue=2&page=316-319&id=1284

eXfuzeTM produces a new nutritional drink (eXfuze Seven+) with an innovative blend of seven tropical fruits which are often referred to as superfoods. These superfoods include noni, gac, goji, açai, mangosteen, seabuckthorn, and brown seaweed (1). There have been anecdotal reports that the eXfuzeTM products may reduce or stabilise the blood sugar levels. Indeed, maintaining a preprandialblood glucose level at 70-130 mg/dl is important for sustaining a healthy body. Excessive or insufficient levels may lead to fatigue or other complications. Rising levels of glucose is an increasing problem in the global community today and it is becoming critical to be able to maintain a balanced diet that will not cause fluctuation of one’s blood glucose levels drastically.

Therefore, foods withhypoglycaemic characteristics should be beneficial to the general population. However, to date, there have been no scientific studies to test the hypothesis that eXfuzeTM products can reduce blood sugar. The objective of this study was to test this hypothesis by using a double blind, randomized, experimental design.

Material and Methods

The participants in this study ranged from 18 to 90 years of age, with a mean age of 64.3 years. The individuals were randomly selected from the athletes who participated at the Huntsman Senior World Games at St. George, UT, in cooperation with Brigham Young University’s Health Assessment Programme. The participation was completely random and so there was no attempt to exclude or include a certain subset of the athlete population. All the participants (n=883) volunteered and gave their consent to participate in the study. Each athlete was given either treatment A or treatment B. Treatment A was a commercial product, eXfuze Seven+, which was manufactured by exfuzeTM. The placebo, treatment B, was a commercially available grape juice which was chosen primarily because it was pure juice with the same colour and tasted quite similar to treatment A. The glucose levels were determined by using a Bayer’s CONTOUR® hand-held glucosometer.

Cups containing either treatment A or treatment B were separated on a table in an allocated area and were labeled as either “A” or “B”. The drinks were poured by a head technician who was behind a curtain and out of sight of the participants. Each athlete had his/her baseline blood glucose recorded, and was then asked to consume either treatment A (n=496) or B (n = 387). Neither the participant nor the technicians who measured the blood glucose levels had prior knowledge about the treatment details. Once all the athletes had their baseline levels measured and had also consumed their drinks, they were asked to return within a 30-60 minutes interval to allow for a final blood glucose measurement. There was no attempt to control what the participants ate or drank prior to the baseline measurement; however, after being treated, they were encouraged to refrain from consuming simple carbohydrates.

The data were entered into the SigmaPlot 11.0® statistical programme and were analysed by using an unpaired comparison ttest. A descriptive statistics software (mean and standard deviation) was used to perform the t-test for each group of data. A confirming data analysis was conducted independently by using the SAS© statistical programme, which utilized a mixed model analysis of variance. All of the data were reported by considering p values of ≤0.05 as significant and p values of ≤0.01 as highly significant.

Results

The baseline measurements were successfully recorded from a total of 883 individuals who returned for a post-treatment glucose measurement; 496 individuals (53.6% males and 46.4% females) were treated with eXfuzeTM Seven+, while 387 individuals (59.2% males and 40.8% females) were treated with the grape juice placebo. The volunteer’s name, type of sport, age, gender, the time the drink was consumed, and the time he/she returned was also noted down (Table/Fig 1).

The treatment subjects started at an average baseline glucose level of 109.65 mg%, and they decreased by -1.76 points to a value of 107.89 mg%. The control subjects had an average baselineof 108.04 mg% and they increased by a +2.12 point change to 110.12 mg%, thus creating an opposite trend from the treatment. The conclusions from both the statistical programmes were identical. The results showed that the decreasing trend of the treatment was significantly different (p = 0.0128) from the increasing trend of the placebo.

We observed that there was a 0.169 mg % increase in the blood glucose levels per year of age, meaning that in general, the older volunteers had an increasing trend of having higher glucose levels. However, there was no significant difference between age and treatment (p = 0.680). There was also no significant gender difference between the two treatments (p = 0.063) and no treatment differences with time (p = 0.457) and gender (p = 0.912). In general, males had higher blood glucose levels than females by about seven points (Table/Fig 3).

Discussion

eXfuze Seven7+ (eXf+) has a unique blend of fruits that uses a proprietary method to extract and fuse the fruits together. This particular blend of fruits may be the key to its overall effect in lowering the blood glucose levels. Although there are extensive literature reports on the health effects of some components of eXfuze Seven7+ (eXf+ such as seabuckthorn and brown seaweed), there are only a few studies which have reported on a mixture of multiple fruits and none on eXf+ (2), (3).

Torronenet al. (4) and Baechler et al. (5) studied a mixed berry puree and a multi-phytonutrient supplement. Their first experiment showed that berries which were rich in polyphenols can lower the postprandial plasma glucose levels. They showed further, that a liquid multi-phytonutrient supplement has DNA protective qualities. Similarly, eXf+ includes a berry which is known as the seabuckthorn, a fruit which was originally found in Eurasia. Its seed and leaf extracts seem to have significant antioxidant properties. It appears that the supplementation of the seabuckthorn seed residues might be a helpful in preventing hyperlipidaemia and oxidative stress (6), (7). Seabuckthorn leaf extracts apparently have cytoprotective properties which can help in modulating chromium induced oxidative stress injuries. In addition, the cytoprotective properties of the seabuckthorn flavones have been attributed to their antioxidant activities (8). A recent study on seabuckthorn shows that it has stabilizing effects on insulin and glucose levels after a high glucose meal (9). Evidently, seabuckthorn has significant hypoglycaemic effects, which may make it one of the main contributors of eXf+’s overall hypoglycaemic effect.

Noni (Morindacitrifolia), a traditional Tahitian medicinal fruit, has conflicting data which is relative to its possible role in reducing the blood glucose levels. For example, Soon and Tan showed that the dried roots of Morindaofficinalis have hypoglycaemic, hyperglyacemic, and antioxidant properties. Furthermore, its antioxidant properties can be traced to two specific chemical constituents: neolignan and americanin (Su et al. (10)). Other studies suggest that noni reduces oxidative stress by decreasing the superoxide anion radicals and the lipid hydroperoxides which contribute to hypoglycaemia (11). However, Sabitha et al. (12) reported that the postprandial blood glucose levels across the placebo and the treatment group were statistically significant, although comparisons within the separate groups were insignificant.Thus, they concluded that noni’s effecton the glucose levels and on the plasma lipid levels were inconclusive.

Goji (Lyciumbarbarum) has also been shown to have some antioxidant properties. Amagaseet al. (13) showed that the use of a Lyciumbarbarum preparation beyond 30 days reduced the free radicals. Also, when an extracted polysaccharide from goji was tested on DNA-damaged rats with non-insulin dependent diabetes mellitus (NIDDM), it was found to significantly decrease the blood glucose levels. Wu H et al. (14) showed that NIDDM rats who were tagged with superoxidedismutase and malondialdehyde oxidative stress markers controlled the blood glucose levels and modulated glucose metabolism—thus significantly improving these stress markers. Wu SJ et al. (15) concluded that Lyciumbarbarum could be an excellent dietary supplement for those who needed a good source of antioxidants and that it may help in reducing oxidative stress and inalleviating some hypoglycaemic complications. By the inclusion of this fruit the drink, it may be a possible link to the drink’s hypoglycaemic activity.

Brown seaweed (Laminaria japonica) is another ingredient that contains antioxidants such as pigments and polyphenols. These components apparently inhibit lipid peroxidation and scavenging reactive oxygen radicals, thus making brown seaweed a potential candidate for lowering the blood glucose levels in vivo16. Experimental studies on diabetic rats showed a decrease in the blood glucose levels when the Laminaria japonica extract was given to the animals (17). Thus, the current studies demonstrate that brown seaweed may also be a contributing factor in lowering hyperglycaemia and in preventing possible vascular complications (17). Other researchers have suggested that fucoidan (a component of brown seaweed) is a good antioxidant (18). However, unpublished data from our laboratory suggest that the antioxidant level of brown seaweed (9300 μmol TE/ 100g) is the lowest among the seven tropical fruits which are found in eXf+. Hence, the antioxidant/hypoglycaemic value of brown seaweed is still open to questions. Some studies have shown that certain isolated compounds from Laminaria japonica inhibit free radical chain reactions. This was concluded by Zhao et al (19) in their study, about a low molecular weight sulfated polysaccharide which was extracted from Laminaria japonica.

Research on the açai berry has shown that it has significant antioxidant levels in human healthy volunteers (20), but that there are no significant publications on its effects on the blood glucose levels. There are also no well-defined research articles on the effects of mangosteen on the blood glucose levels.

Considering this discussion, it is not surprising to find that a mixture of these foods in eXf+ causes a decreasing trend in the blood glucose levels, since some of the individual components have been shown to contribute to hypoglycaemia. It was however unexpected that this nutritional supplement caused a glucose lowering trend within just one hour post-treatment. In Table/Fig 2, we can see that the plot of all the data may at first glance, seem to be simply a cluster of insignificant data points. However, when we take the top 20% of both the treatments and count as to how many individuals had a change of blood glucose levels of 23 mg% or higher, we can see that there are twice as many in the placebo group (treatment B, 64 individuals) than in the eXf+ treatment group (treatment A, 31 individuals). These data support the analysis and the conclusion of the treatment A data by showing a significant decreasing trend of -1.76 mg%.

Often, health professionals will recommend the control the blood glucose levels through diet and exercise before prescribing drugs to treat severe hyperglycaemia. For example, the American Diabetes Association3 recommends that the normal blood glucose levels by using the AIC test (the average glucose for the past 2-3 months) must be less than 7.0% and that the preprandial plasma glucose levels (before a meal) must be 70-130 mg/dl (5.0-7.2 μmol/L). In addition, it recommends that the postprandial plasma glucose (afafter a meal) must be less than 180 mg/dl (<10.0 μmol/L). The signs of hyperglycaemia include a blood glucose level over 240 mg/dl and the presence of ketones in the urine. Therefore, if this dietary supplement has a blood glucose lowering effect, many people who struggle with hyperglycaemia could benefit by adding this nutritional supplement to their diet. Still, there is much that we don’t understand about the precise mechanisms of how these fruit-derived, anti-hyperglycaemic chemicals work. (Table/Fig 2)

Investigations are continuing in our laboratory on these mechanisms, while we are also trying to determine whether there is any synergistic hypoglycaemic activity when the fruits are mixed together, one at a time, in an appropriate experimental design.

Key Message

1. There was a significant decreasing trend in the blood glucose levels when one ounce of the treatment drink (eXfuzeTM Seven+) was consumed. 2. Age and gender did not significantly affect the results. 3. There was an increasing trend in the blood glucose levels when one ounce of the control (grape juice) was consumed. 4. This study shows the positive short-term health effects of consuming eXfuzeTM Seven+.

Acknowledgement

We would like to acknowledge the support and cooperation of all the committees which are associated with the Huntsman Senior World Games, which are held each year in St. George, Utah. We express our appreciation for all the senior athletes who have participated in our research. We would like to acknowledge the contribution which was given by eXfuzeTM for providing the drink. Also, we express our appreciation to Professor Dennis Eggett who confirmed our statistical analysis. Lastly, we would like to acknowledge the support of Don and Elaine Davis and Brigham Young University and the Department of Plant and Wildlife Sciences for financial assistance, space and equipment.

References

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