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Glaucoma is a chronic condition that progressively damages the optic nerve, leading to vision loss and potential blindness. Because increased intraocular pressure (IOP) can contribute to optic nerve damage, a primary goal in glaucoma management is to lower IOP. IOP-lowering eyedrops are first-line therapy, and surgery is indicated in more advanced cases. Few other options exist to slow the progression of glaucoma.

Chronic inflammation accompanies most chronic diseases, and diabetes is no exception. Vitamin D has been shown to play a role in glycemic control and reducing the risk of diabetes. Increasing evidence points to its anti-inflammatory effect as the primary mechanism of action. For example, vitamin D has demonstrated (in human and animal studies) to improve insulin sensitivity by inhibiting cytokine-induced apoptosis of beta cells. Because of mixed results from cross-sectional and clinical trials, however, there is no consensus on the effect of vitamin D supplementation on inflammation in diabetes. 

Exercise and muscle performance are influenced by nutritional status and might be improved by nutrient supplementation. Short-term studies of up to 7 days have found that L-citrulline malate supplementation improves skeletal muscle metabolism and that the combination of L-citrulline and reduced glutathione (GSH) boosts plasma levels of L-citrulline, L-arginine, and nitric oxide metabolites—compounds that support muscle mass. 

Subjective cognitive decline refers to the self-reported decline in cognitive function without evidence of mild cognitive impairment (MCI) or Alzheimer’s disease (AD). Subjective cognitive decline increases the risk for future dementia and provides a window of opportunity to target modifiable risk factors. Diet and nutritional supplementation are important aspects of risk modification.

Previous prospective studies have found that green leafy vegetables offer more protection against cognitive decline than any other vegetables. To further explore this association and to evaluate individual nutrients in green leafy vegetables, researchers conducted another prospective study, which was published in 2018 in the journal Neurology.

Cognitive function often declines after a stroke, and the prevalence of dementia in stroke survivors is approximately 30%. In a multicenter, randomized, controlled trial, researchers investigated the effects of Ginkgo biloba extract on neurological deficits and cognitive decline after acute stroke.

Supporting immune function may reduce the frequency of upper respiratory infections (URIs), and probiotics are known to balance both the innate and adaptive immune responses. A randomized controlled trial, published in the European Journal of Nutrition 2011, showed that taking a combination of Lactobacillus plantarum and Lactobacillus paracasei reduced the frequency and severity of the common cold in healthy adults. Researchers at the Beijing Chaoyang Hospital then conducted a 12-week intervention trial to further evaluate the effects of probiotic supplementation in adults with frequent URIs.  

Polycystic Ovarian Syndrome (PCOS) is marked by ovarian cysts, hirsutism, menstrual irregularities, impaired fertility, and mood dysfunction. The biochemical imbalances of PCOS, which include hyperandrogenism, insulin resistance, oxidative stress, and chronic inflammation, increase a woman’s risk for diabetes and cardiovascular disease. Like most metabolic diseases, lifestyle changes and nutritional support are foundational in reducing the risk of disease progression, complications, and comorbidities.

Silybum marianum (milk thistle) seed has a long tradition of use to support liver and gastrointestinal health. Silymarin is a standardized extract of milk thistle seeds, which contains antioxidant and anti-inflammatory constituents. Because oxidative stress plays a role in the pathophysiology of type 2 diabetes, it is biologically plausible that silymarin might improve the metabolic parameters of this disease.

Vitamin D is thought to be required for cardiovascular health, with mechanistic studies showing that vitamin D may affect endothelial function, fibrosis, and inflammation. Meta-analyses of observational studies have determined that serum vitamin D (25OHD) is inversely related to cardiovascular mortality in healthy individuals, but studies among patients with cardiovascular disease have produced inconsistent results. 

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