Introduction to Turmeric
Turmeric is a plant from the ginger family known as Curcuma longa. It’s widely used in cooking and has a rich history in traditional medicine, especially in Asian countries [1]. But what’s the secret ingredient that makes turmeric so special? It’s called curcumin!
Curcumin: The Active Ingredient in Turmeric
Curcumin is the main active ingredient in turmeric and a powerful polyphenol! It’s known for its numerous health benefits, including antioxidant, anti-inflammatory, antimutagenic, antimicrobial, and anticancer properties. Scientists are just starting to understand how it works and identify its bioactive components [2, 3]. Excited to see what turmeric can do for you? Let’s look into its properties!
Properties of Turmeric
Turmeric has some amazing properties including:
– Antioxidant [1]
– Anti-inflammatory [4]
– Antimicrobial [5, 6]
These properties make turmeric a powerhouse! But what are the real-life health benefits?
Health Benefits of Curcumin
Curcumin tackles multiple health issues with its superpowers! It can:
– Reduce inflammation [7]
– Help manage metabolic syndrome [8]
– Relieve pain [9]
– Support eye health [10,11]
– Benefit kidney function [12]
Most of these benefits come from curcumin’s antioxidant and anti-inflammatory effects [2, 7]. But there’s a catch – curcumin isn’t easily absorbed by the body. How can we fix this? Let’s explore the solutions further.
Bioavailability Challenges and Solutions
One major challenge with curcumin is its poor bioavailability, meaning it’s not easily absorbed by the body. This happens because it’s rapidly metabolized and quickly eliminated [13]. But there’s good news! Combining curcumin with piperine, an active component of black pepper, can increase its bioavailability by 2000% [14,15]! This combo makes curcumin supplements much more effective.
Curcumin is available in many forms, including capsules, tablets, ointments, energy drinks, soaps, and cosmetics [2]. But is it safe to use? Let’s find out!
Safety and Approval of Curcumin
Good news! Curcuminoids, including curcumin, have been approved by the US Food and Drug Administration (FDA) as “Generally Recognized As Safe” (GRAS) [2]. Clinical trials have shown that curcumin is well-tolerated even at high doses, up to 12,000 mg per day [16,17]. Isn’t that reassuring? Ready to learn about the science behind curcumin’s effects? Here we go!
Mechanisms of Action
Antioxidant Activity of Turmeric (Curcumin)
Curcumin’s antioxidant and anti-inflammatory properties are key to its many health benefits [18,19]. Research shows that curcumin can improve markers of oxidative stress, a condition where harmful free radicals overwhelm the body’s antioxidants [20]. For example, curcumin can increase the activity of important antioxidants like superoxide dismutase (SOD), an enzyme that helps break down potentially harmful oxygen molecules in cells [21,22,23]. Want to know more about these enzymes? Keep reading!
Superoxide dismutase (SOD) is an enzyme that plays a crucial role in protecting cells from damage caused by oxidative stress. It catalyzes the conversion of superoxide radicals, which are highly reactive molecules produced during normal cellular metabolism, into oxygen and hydrogen peroxide. By doing so, SOD helps prevent the formation of harmful reactive oxygen species (ROS) that can damage DNA, proteins, and lipids within cells.
A systematic review and meta-analysis of Randomized Controlled Trials (RCTs) found that curcumin significantly improved various oxidative stress parameters. These include increased plasma activities of SOD and catalase, an enzyme that converts hydrogen peroxide into water and oxygen, and higher serum concentrations of glutathione peroxidase (GSH), an antioxidant enzyme that protects the body from oxidative damage, as well as lipid peroxides, which are markers of oxidative stress [20]. Importantly, all studies in the meta-analysis used formulations to enhance curcumin’s bioavailability, with four out of six using piperine, a compound from black pepper that enhances absorption.
Glutathione peroxidase (GSH) is another important antioxidant enzyme found in cells throughout the body. It helps protect cells from damage caused by reactive oxygen species (ROS) by catalyzing the reduction of hydrogen peroxide and organic hydroperoxides to harmless water and alcohol molecules. GSH also plays a critical role in detoxification processes, helping to remove harmful substances from the body. Curcumin helps boost the activity of GSH, aiding in its antioxidant function [20].
Curcumin combats free radicals, which are unstable molecules that can damage cells, in several ways. It can scavenge different forms of free radicals, such as reactive oxygen species (ROS) and reactive nitrogen species (RNS) [22]. Curcumin also modulates the activity of enzymes like GSH, catalase, and SOD that neutralize free radicals, helping them work more efficiently [18,19]. Also, it inhibits enzymes that generate ROS, such as lipoxygenase, cyclooxygenase, and xanthine oxidase, which produce harmful compounds during cell metabolism [18]. Want to know how curcumin stops free radicals in their tracks? Here’s how!
Curcumin’s ability to dissolve in fats, known as its lipophilic nature, makes it an effective scavenger of peroxyl radicals, a type of free radical. This action is similar to that of vitamin E, making curcumin a chain-breaking antioxidant, which means it stops the chain reaction of free radical formation [24].
Anti-Inflammatory Action of Turmeric (Curcumin)
Oxidative stress plays a significant role in many chronic diseases and is closely linked to inflammation, as one can easily trigger the other. Inflammation occurs when the body’s immune cells release reactive molecules at the site of injury or infection, leading to oxidative stress [25]. But did you know how inflammation and oxidative stress are connected?
Certain reactive molecules can start a signalling process within cells, ramping up the expression of pro-inflammatory genes. This inflammatory response is implicated in various chronic conditions, ranging from Alzheimer’s disease and Parkinson’s disease to cardiovascular issues and cancer [8, 17, 26,27]. Here’s a key player in this process!
One key player in inflammation is tumour necrosis factor-alpha (TNF-α), a potent mediator involved in many diseases. Its activity is tightly regulated by a transcription factor called nuclear factor-kappa B (NF-κB). Interestingly, TNF-α not only activates NF-κB but is also regulated by it. NF-κB is triggered by various inflammatory signals, including cytokines, bacteria, viruses, and environmental factors. Agents that can inhibit NF-κB and its downstream targets hold promise for treating these diseases.
Curcumin, the active compound in turmeric, has been found to inhibit the activation of NF-κB induced by different inflammatory stimuli. It effectively blocks this key pathway involved in inflammation [8]. Isn’t it fascinating how curcumin can target these pathways?
In summary, curcumin shows promise as a natural anti-inflammatory agent, targeting key pathways involved in chronic inflammatory conditions.
Health Benefits of Turmeric
Action of Turmeric (Curcumin) on Arthritis
One disease strongly associated with inflammation, both chronic and acute, is osteoarthritis, a chronic joint condition affecting over 250 million people worldwide [28,29]. It leads to increased healthcare costs, difficulties in daily activities, and ultimately reduced quality of life. While osteoarthritis was once considered purely degenerative, it’s now recognized to have inflammatory aspects, including elevated levels of certain cytokines, and may even be linked to systemic inflammation [30,31]. But what can be done about it?
Traditional treatments for osteoarthritis, while available, often come with high costs and unwanted side effects. This has led to growing interest in alternative treatments like dietary supplements and herbal remedies [32]. Curcumin, the active compound in turmeric, has shown promise in this regard.
Studies have demonstrated the anti-arthritic effects of curcumin in both osteoarthritis and rheumatoid arthritis [33,34,35,36]. In a randomised controlled trial involving subjects with knee osteoarthritis, those who received curcumin experienced significant reductions in pain and improvements in function compared to those on placebo. Notably, curcumin supplementation also led to decreases in systemic oxidative stress, indicating its potential to combat inflammation [9]. Isn’t that amazing?
Further research suggests that curcumin may exert its anti-inflammatory effects locally, rather than systemically. Long-term studies have shown significant improvements in osteoarthritis symptoms and inflammation markers with curcumin supplementation.
In fact, one study found that curcumin was as effective as ibuprofen, a common NSAID (Non-Steroidal Anti-Inflammatory Drug), in relieving osteoarthritis symptoms [10]. Moreover, curcumin supplementation was associated with fewer gastrointestinal side effects compared to NSAIDs, making it a potentially safer alternative for osteoarthritis patients. Isn’t it great to have a natural option?
Overall, evidence suggests that curcumin can alleviate arthritis symptoms, particularly pain and inflammation-related symptoms, comparable to standard medications like ibuprofen and diclofenac sodium. Therefore, turmeric extracts and curcumin may be recommended for managing arthritis symptoms, especially osteoarthritis [37].
Action of Turmeric (Curcumin) on Metabolic syndrome
Metabolic syndrome (MetS) is a health condition marked by several metabolic abnormalities like insulin resistance, high blood sugar, hypertension, and abnormal lipid levels. It’s often linked to chronic inflammation, which can lead to serious issues like diabetes and heart disease.
Curcumin, found in turmeric, has been studied for its potential to improve various aspects of MetS. It helps in following health aspects:
Health Outcome | How Curcumin helps |
Improving Insulin Sensitivity [38,39] | Enhances insulin sensitivity, aids in better glucose utilization, reduces blood sugar levels |
Suppressing Adipogenesis (fat cells) [40] | Inhibits fat cell formation, reduces fat accumulation, combats obesity |
Addressing Hypertension [41] | Helps regulate blood pressure, contributes to cardiovascular health |
Combating Inflammation and Oxidative Stress [42,43,44] | Possesses anti-inflammatory properties, exhibits antioxidant effects, reduces inflammation and oxidative damage |
Modulating Lipid Metabolism [45,46,47,48] | Regulates cholesterol levels, lowers LDL cholesterol and triglycerides, increases HDL cholesterol |
Curcumin and Metabolic Syndrome (MetS)
In a study involving individuals with Metabolic Syndrome (MetS), those who took curcumin experienced significant reductions in inflammatory markers like Tumour Necrosis Factor-alpha (TNF-α), Interleukin-6 (IL-6), Transforming Growth Factor-beta (TGF-β), and Monocyte Chemoattractant Protein-1 (MCP-1) compared to those who didn’t. Curcumin also showed promise in lowering cholesterol levels, particularly Low-Density Lipoprotein Cholesterol (LDL-C), total cholesterol, and triglycerides, while increasing High-Density Lipoprotein Cholesterol (HDL-C) [45,46,47,48]. Isn’t it amazing how one compound can have such wide-ranging benefits?
Another study found that curcumin supplementation led to improvements in markers of oxidative stress, suggesting its ability to combat inflammation and tissue damage. Additionally, curcumin helped regulate certain inflammatory cytokines, such as Interleukin-1 beta (IL-1β), Interleukin-4 (IL-4), and Vascular Endothelial Growth Factor (VEGF), which play a role in immune function [49]. This shows just how multifaceted curcumin’s benefits can be!
In a separate trial involving obese adults, curcumin supplementation led to a notable decrease in serum triglyceride levels [45]. However, it didn’t have a significant impact on other lipid parameters or body composition, possibly due to factors like the short duration of the study. These findings suggest that curcumin could be a valuable natural intervention for managing inflammation, cholesterol levels, and oxidative stress in individuals with MetS. Incorporating curcumin into lifestyle strategies may offer additional benefits for improving metabolic health and reducing the risk of related complications.
Action of Turmeric (Curcumin) on Diabetic Foot
In a study examining the effectiveness of topical turmeric ointment for diabetic foot ulcers, researchers found promising results. Turmeric, long known for its medicinal properties, contains curcumin, its active ingredient. The study, which involved seventy-six patients, revealed a significant reduction in ulcer size after five weeks of using the turmeric ointment, regardless of blood sugar levels [51]. This suggests that curcumin could be a beneficial and independent treatment for diabetic foot ulcers, offering hope for better wound healing and patient well-being. It’s fascinating how turmeric’s benefits extend beyond just internal health!
Action of Turmeric (Curcumin) on Non-Alcoholic Fatty Liver Disease (NAFLD)
In a recent study investigating turmeric’s effects on Non-Alcoholic Fatty Liver Disease (NAFLD), participants who received turmeric supplements for eight weeks experienced notable improvements in their liver health. Specifically, their blood tests showed reduced levels of liver enzymes like Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT), and Gamma-Glutamyl Transferase (GGT), indicating less stress on the liver. They also showed lower levels of triglycerides and Low-Density Lipoprotein (LDL) cholesterol [53]. These findings suggest that incorporating turmeric into their daily regimen could be helpful for NAFLD patients to support their liver function and overall health. Isn’t it wonderful how turmeric can support liver health too?
Action of Turmeric (Curcumin) on Glycemic Control
In a study analyzing the effects of curcumin/turmeric on glycemic control, researchers found promising results. They looked at insulin resistance, fasting glucose, glycated haemoglobin, and fasting insulin levels in 3,879 participants aged 26 to 70. After reviewing 59 randomised trials, they discovered that curcumin/turmeric supplementation led to improvements in these biomarkers, though the evidence certainty was deemed low [54]. This suggests that incorporating curcumin/turmeric into one’s routine could potentially help with glycemic control, offering a natural approach to managing blood sugar levels. Isn’t it exciting to think about how curcumin could help manage blood sugar?
From reducing inflammation and cholesterol levels to improving wound healing and liver health, curcumin continues to show its remarkable versatility and potential in enhancing our well-being. Why not consider adding a bit of turmeric to your daily routine?
Curcumin: A Natural Support for Healthy Living
Healthy individuals can benefit from the remarkable properties of curcumin, found abundantly in turmeric. Even though it’s challenging to study its effects on those without diagnosed health conditions, research unveils promising insights into its potential for enhancing overall well-being. Who wouldn’t want a natural boost to their health?
Curcumin for Cardiovascular Health
A study administering 80 mg/day of curcumin to healthy adults aged 40-60 revealed significant reductions in triglyceride levels, potentially supporting cardiovascular health [46]. It’s amazing how a simple supplement can help keep your heart healthy!
Cognitive Function and Mood Enhancement
In a randomized controlled trial involving healthy adults aged 60-85, curcumin supplementation significantly enhanced sustained attention and working memory tasks, indicating potential cognitive benefits [50]. Imagine staying sharp and focused with a natural aid!
Exercise Recovery and Muscle Soreness
Following eccentric exercise-induced muscle soreness, healthy subjects receiving curcumin experienced smaller increases in markers of inflammation, suggesting a role in facilitating exercise recovery [52]. Faster recovery means you can get back to your workouts with ease!
Combating Anxiety in Healthy Individuals
Among obese but otherwise healthy adults, curcumin supplementation led to a significant reduction in anxiety levels, highlighting its potential as a natural intervention for mood management [55]. A calmer, more balanced mind is within reach!
Curcumin holds promise for promoting health and vitality in individuals without diagnosed health conditions. From cardiovascular support to cognitive enhancement and mood regulation, its multifaceted benefits underscore its value as a supplement for everyday wellness. Now, let’s explore how you can add a bit of turmeric to your daily routine with some of our recipes below:
Recipes
Turmeric Rice with Spicy Roasted Chickpeas
– Turmeric Rice Ingredients:
– 1 cup long-grain white rice
– 2 cups water or vegetable broth
– 1 teaspoon turmeric powder
– ½ tsp Black pepper powder
– Salt, to taste
– Spicy Roasted Chickpeas Ingredients:
– 1 cup of chickpeas, drained and rinsed
– 1 tablespoon olive oil
– 1 teaspoon paprika
– ½ tsp Turmeric powder
– ¼ tsp Black pepper powder
– ½ teaspoon cumin
– ¼ teaspoon cayenne pepper (adjust to taste)
– Salt, to taste
Instructions:
1. Turmeric Rice:
1. Rinse the rice under cold water until the water runs clear.
2. In a pot, combine rice, water or broth, turmeric powder, and salt.
3. Bring to a boil over medium-high heat, then reduce the heat to low, cover, and simmer for 15-20 minutes, or until the liquid is absorbed and the rice is tender.
4. Fluff the rice with a fork before serving.
2. Spicy Roasted Chickpeas:
1. Preheat the oven to 400°F (200°C).
2. Pat dry the rinsed chickpeas with paper towels to remove excess moisture.
3. In a bowl, toss the chickpeas with olive oil, paprika, cumin, turmeric powder, black pepper powder, cayenne pepper, and salt until evenly coated.
4. Spread the seasoned chickpeas in a single layer on a baking sheet lined with parchment paper.
5. Roast in the preheated oven for 20-25 minutes, shaking the pan halfway through, until the chickpeas are crispy and golden brown.
Serve the turmeric rice alongside the spicy roasted chickpeas for a flavorful and nutritious meal.
Turmeric Honey Glazed Carrots
– Ingredients:
– 4-5 large carrots, peeled and sliced into sticks
– 2 tablespoons olive oil
– 1 tablespoon honey
– 1 teaspoon turmeric powder
– ¼ tsp of Black pepper
– Salt and pepper, to taste
– Instructions:
1. Preheat the oven to 400°F (200°C).
2. In a bowl, toss the carrot sticks with olive oil, honey, turmeric powder, salt, and pepper until evenly coated.
3. Spread the carrots in a single layer on a baking sheet lined with parchment paper.
4. Roast in the preheated oven for 20-25 minutes, or until the carrots are tender and caramelized, stirring halfway through cooking.
Fihi Nutrition Special Recipes
Fihi Nutrition Turmeric Adaptogen Chocolate Energy Balls
– Ingredients:
– 1 cup rolled oats
– ½ cup almond butter
– ¼ cup honey or maple syrup
– ½ cup Fihi Nutrition Turmeric Orange Adaptogen Chocolate
– ¼ cup shredded coconut (optional, for coating)
– Instructions:
1. In a mixing bowl, combine rolled oats, almond butter, honey or maple syrup, and Fihi Nutrition Turmeric Adaptogen Chocolate until well mixed.
2. Roll the mixture into small balls using your hands.
3. Optional: Roll each ball in shredded coconut to coat.
4. Place the energy balls on a baking sheet lined with parchment paper and refrigerate for at least 30 minutes to firm up. Enjoy as a healthy snack!
Fihi Nutrition Turmeric Adaptogen Chocolate Bark
– Ingredients:
– 1 cup of Fihi Nutrition Turmeric Orange Adaptogen Chocolate
– ¼ cup mixed nuts (such as almonds, cashews, walnuts), roughly chopped
– ¼ cup dried fruit (such as cranberries, raisins, or apricots), chopped
– Optional: Sea salt flakes for sprinkling
– Instructions:
1. Line a baking sheet with parchment paper or a silicone baking mat.
2. In a microwave-safe bowl, melt the Fihi Nutrition Turmeric Adaptogen Chocolate in 30-second intervals, stirring in between, until fully melted and smooth.
3. Pour the melted chocolate onto the prepared baking sheet and use a spatula to spread it out into an even layer, about 1/4 inch thick.
4. Sprinkle the chopped mixed nuts and dried fruit evenly over the melted chocolate, pressing them gently into the chocolate to adhere.
5. If desired, sprinkle a pinch of sea salt flakes over the top for a sweet and salty contrast.
6. Place the baking sheet in the refrigerator for about 1 hour, or until the chocolate has hardened completely.
7. Once set, break the Fihi Nutrition Turmeric Adaptogen Chocolate bark into smaller pieces using your hands or a knife.
8. Store the chocolate bark in an airtight container in the refrigerator until ready to serve.
Curcumin’s Safety
Curcumin is widely recognized as safe for consumption, according to regulatory agencies like JECFA (The Joint United Nations and World Health Organization Expert Committee on Food Additives) and EFSA (European Food Safety Authority). With a recommended daily intake of 0–3 mg/kg body weight, it’s considered safe. Numerous studies on healthy individuals also confirm its safety [56].
Possible Side Effects
– Reported Issues: Despite its overall safety, some users have reported adverse effects. In a study, participants experienced symptoms like diarrhoea, headache, rash, and changes in stool colour when taking doses ranging from 500 to 12,000 mg [17]. It’s always good to know what to watch out for!
– Nausea and Diarrhoea: Another study noted instances of nausea, diarrhoea, and changes in serum enzyme levels among users taking doses ranging from 0.45 to 3.6 g/day over one to four months [57]. It’s important to listen to your body and adjust accordingly.
Curcumin attracts global attention for its diverse health benefits, mainly due to its antioxidant and anti-inflammatory properties. These benefits are enhanced when combined with ingredients like piperine.
Health Applications
– Managing Health Conditions: Curcumin shows promise in managing various conditions associated with inflammation and oxidative stress, such as arthritis, anxiety, and high cholesterol. It’s like a natural multi-tool for your health!
– Post-Exercise Recovery: Its ability to reduce exercise-induced inflammation and muscle soreness aids in faster recovery and improved performance for active individuals. Imagine bouncing back quicker after workouts!
Conclusion
Curcumin emerges as a versatile supplement with significant health benefits, thanks to its potent antioxidant and anti-inflammatory properties. Whether you’re looking to support heart health, enhance cognitive function, or reduce post-exercise soreness, curcumin offers a natural solution worth considering. Why not give it a try and see the benefits for yourself?
Disclaimer and Medical Advice Note
Disclaimer: This website is for informational purposes only and does not provide medical advice. Always consult with a healthcare professional, such as a doctor or dietitian, before making any changes to your diet, lifestyle, or health practices. The information provided should not be considered as a substitute for professional medical advice, diagnosis, or treatment.
Love Fihi Nutrition’s adaptogen chocolates? Tell us what you think or ask us anything in the comments below. Our team, including our nutritionist, is here to chat and help you out. Let’s talk about tasty and healthy chocolates together!
Want more adaptogen chocolate updates? Follow Fihi Nutrition on @fihinutrition on Instagram https://www.instagram.com/fihinutrition?igsh=MWZ0OXFjNWI2aG5ybA== to see our newest flavors, recipes and special deals. Join our community of chocolate and health fans. Enjoy the goodness of adaptogen chocolates with Fihi Nutrition!
References
1. Priyadarsini K. I. (2014). The chemistry of curcumin: from extraction to therapeutic agent. Molecules (Basel, Switzerland), 19(12), 20091–20112. https://doi.org/10.3390/molecules191220091
2. Gupta, S. C., Patchva, S., & Aggarwal, B. B. (2013). Therapeutic roles of curcumin: lessons learned from clinical trials. The AAPS journal, 15(1), 195–218. https://doi.org/10.1208/s12248-012-9432-8
3. Aggarwal, B. B., Kumar, A., & Bharti, A. C. (2003). Anticancer potential of curcumin: preclinical and clinical studies. Anticancer research, 23(1A), 363–398.
4. Lestari, M. L., & Indrayanto, G. (2014). Curcumin. Profiles of drug substances, excipients, and related methodology, 39, 113–204. https://doi.org/10.1016/B978-0-12-800173-8.00003-9
5. Mahady, G. B., Pendland, S. L., Yun, G., & Lu, Z. Z. (2002). Turmeric (Curcuma longa) and curcumin inhibit the growth of Helicobacter pylori, a group 1 carcinogen. Anticancer research, 22(6C), 4179–4181.
6. Reddy, R. C., Vatsala, P. G., Keshamouni, V. G., Padmanaban, G., & Rangarajan, P. N. (2005). Curcumin for malaria therapy. Biochemical and biophysical research communications, 326(2), 472–474. https://doi.org/10.1016/j.bbrc.2004.11.051
7. Aggarwal, B. B., & Harikumar, K. B. (2009). Potential therapeutic effects of curcumin, the anti-inflammatory agent, against neurodegenerative, cardiovascular, pulmonary, metabolic, autoimmune and neoplastic diseases. The international journal of biochemistry & cell biology, 41(1), 40–59. https://doi.org/10.1016/j.biocel.2008.06.010
8. Panahi, Y., Hosseini, M. S., Khalili, N., Naimi, E., Simental-Mendía, L. E., Majeed, M., & Sahebkar, A. (2016). Effects of curcumin on serum cytokine concentrations in subjects with metabolic syndrome: A post-hoc analysis of a randomized controlled trial. Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie, 82, 578–582. https://doi.org/10.1016/j.biopha.2016.05.037
9. Kuptniratsaikul, V., Dajpratham, P., Taechaarpornkul, W., Buntragulpoontawee, M., Lukkanapichonchut, P., Chootip, C., Saengsuwan, J., Tantayakom, K., & Laongpech, S. (2014). Efficacy and safety of Curcuma domestica extracts compared with ibuprofen in patients with knee osteoarthritis: a multicenter study. Clinical interventions in aging, 9, 451–458. https://doi.org/10.2147/CIA.S58535
10. Mazzolani, F., & Togni, S. (2013). Oral administration of a curcumin-phospholipid delivery system for the treatment of central serous chorioretinopathy: a 12-month follow-up study. Clinical ophthalmology (Auckland, N.Z.), 7, 939–945. https://doi.org/10.2147/OPTH.S45820
11. Allegri, P., Mastromarino, A., & Neri, P. (2010). Management of chronic anterior uveitis relapses: efficacy of oral phospholipidic curcumin treatment. Long-term follow-up. Clinical ophthalmology (Auckland, N.Z.), 4, 1201–1206. https://doi.org/10.2147/OPTH.S13271
12. Trujillo, J., Chirino, Y. I., Molina-Jijón, E., Andérica-Romero, A. C., Tapia, E., & Pedraza-Chaverrí, J. (2013). Renoprotective effect of the antioxidant curcumin: Recent findings. Redox biology, 1(1), 448–456. https://doi.org/10.1016/j.redox.2013.09.003
13. Anand, P., Kunnumakkara, A. B., Newman, R. A., & Aggarwal, B. B. (2007). Bioavailability of curcumin: problems and promises. Molecular pharmaceutics, 4(6), 807–818. https://doi.org/10.1021/mp700113r
14. Han H. K. (2011). The effects of black pepper on the intestinal absorption and hepatic metabolism of drugs. Expert opinion on drug metabolism & toxicology, 7(6), 721–729. https://doi.org/10.1517/17425255.2011.570332
15. Shoba, G., Joy, D., Joseph, T., Majeed, M., Rajendran, R., & Srinivas, P. S. (1998). Influence of piperine on the pharmacokinetics of curcumin in animals and human volunteers. Planta medica, 64(4), 353–356. https://doi.org/10.1055/s-2006-957450
16. Basnet, P., & Skalko-Basnet, N. (2011). Curcumin: an anti-inflammatory molecule from a curry spice on the path to cancer treatment. Molecules (Basel, Switzerland), 16(6), 4567–4598. https://doi.org/10.3390/molecules16064567
17. Lao, C. D., Ruffin, M. T., 4th, Normolle, D., Heath, D. D., Murray, S. I., Bailey, J. M., Boggs, M. E., Crowell, J., Rock, C. L., & Brenner, D. E. (2006). Dose escalation of a curcuminoid formulation. BMC complementary and alternative medicine, 6, 10. https://doi.org/10.1186/1472-6882-6-10
18. Lin, Y. G., Kunnumakkara, A. B., Nair, A., Merritt, W. M., Han, L. Y., Armaiz-Pena, G. N., Kamat, A. A., Spannuth, W. A., Gershenson, D. M., Lutgendorf, S. K., Aggarwal, B. B., & Sood, A. K. (2007). Curcumin inhibits tumor growth and angiogenesis in ovarian carcinoma by targeting the nuclear factor-kappaB pathway. Clinical cancer research : an official journal of the American Association for Cancer Research, 13(11), 3423–3430. https://doi.org/10.1158/1078-0432.CCR-06-3072
19. Marchiani, A., Rozzo, C., Fadda, A., Delogu, G., & Ruzza, P. (2014). Curcumin and curcumin-like molecules: from spice to drugs. Current medicinal chemistry, 21(2), 204–222. https://doi.org/10.2174/092986732102131206115810
20. Sahebkar, A., Serban, M. C., Ursoniu, S., & Banach, M. (2015). Effect of curcuminoids on oxidative stress: A systematic review and meta-analysis of randomized controlled trials. Journal of functional foods, 18, 898-909.
21. Banach, M., Serban, C., Aronow, W. S., Rysz, J., Dragan, S., Lerma, E. V., Apetrii, M., & Covic, A. (2014). Lipid, blood pressure and kidney update 2013. International urology and nephrology, 46(5), 947–961. https://doi.org/10.1007/s11255-014-0657-6
22. Menon, V. P., & Sudheer, A. R. (2007). Antioxidant and anti-inflammatory properties of curcumin. Advances in experimental medicine and biology, 595, 105–125. https://doi.org/10.1007/978-0-387-46401-5_3
23. Panahi, Y., Alishiri, G. H., Parvin, S., & Sahebkar, A. (2016). Mitigation of Systemic Oxidative Stress by Curcuminoids in Osteoarthritis: Results of a Randomized Controlled Trial. Journal of dietary supplements, 13(2), 209–220. https://doi.org/10.3109/19390211.2015.1008611
24. Priyadarsini, K. I., Maity, D. K., Naik, G. H., Kumar, M. S., Unnikrishnan, M. K., Satav, J. G., & Mohan, H. (2003). Role of phenolic O-H and methylene hydrogen on the free radical reactions and antioxidant activity of curcumin. Free radical biology & medicine, 35(5), 475–484. https://doi.org/10.1016/s0891-5849(03)00325-3
25. Biswas S. K. (2016). Does the Interdependence between Oxidative Stress and Inflammation Explain the Antioxidant Paradox?. Oxidative medicine and cellular longevity, 2016, 5698931. https://doi.org/10.1155/2016/5698931
26. Jurenka J. S. (2009). Anti-inflammatory properties of curcumin, a major constituent of Curcuma longa: a review of preclinical and clinical research. Alternative medicine review : a journal of clinical therapeutic, 14(2), 141–153.
27. Recio, M. C., Andujar, I., & Rios, J. L. (2012). Anti-inflammatory agents from plants: progress and potential. Current medicinal chemistry, 19(14), 2088–2103. https://doi.org/10.2174/092986712800229069
28. Hunter, D. J., Schofield, D., & Callander, E. (2014). The individual and socioeconomic impact of osteoarthritis. Nature reviews. Rheumatology, 10(7), 437–441. https://doi.org/10.1038/nrrheum.2014.44
29. Global Burden of Disease Study 2013 Collaborators (2015). Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet (London, England), 386(9995), 743–800. https://doi.org/10.1016/S0140-6736(15)60692-4
30. Goldring M. B. (2000). Osteoarthritis and cartilage: the role of cytokines. Current rheumatology reports, 2(6), 459–465. https://doi.org/10.1007/s11926-000-0021-y
31. Rahimnia, A. R., Panahi, Y., Alishiri, G., Sharafi, M., & Sahebkar, A. (2015). Impact of Supplementation with Curcuminoids on Systemic Inflammation in Patients with Knee Osteoarthritis: Findings from a Randomized Double-Blind Placebo-Controlled Trial. Drug research, 65(10), 521–525. https://doi.org/10.1055/s-0034-1384536
32. Sahebkar A. (2010). Molecular mechanisms for curcumin benefits against ischemic injury. Fertility and sterility, 94(5), e75–e77. https://doi.org/10.1016/j.fertnstert.2010.07.1071
33. Henrotin, Y., Priem, F., & Mobasheri, A. (2013). Curcumin: a new paradigm and therapeutic opportunity for the treatment of osteoarthritis: curcumin for osteoarthritis management. SpringerPlus, 2(1), 56. https://doi.org/10.1186/2193-1801-2-56
34. Belcaro, G., Cesarone, M. R., Dugall, M., Pellegrini, L., Ledda, A., Grossi, M. G., Togni, S., & Appendino, G. (2010). Product-evaluation registry of Meriva®, a curcumin-phosphatidylcholine complex, for the complementary management of osteoarthritis. Panminerva medica, 52(2 Suppl 1), 55–62.
35. Belcaro, G., Hosoi, M., Pellegrini, L., Appendino, G., Ippolito, E., Ricci, A., Ledda, A., Dugall, M., Cesarone, M. R., Maione, C., Ciammaichella, G., Genovesi, D., & Togni, S. (2014). A controlled study of a lecithinized delivery system of curcumin (Meriva®) to alleviate the adverse effects of cancer treatment. Phytotherapy research : PTR, 28(3), 444–450. https://doi.org/10.1002/ptr.5014
36. Chandran, B., & Goel, A. (2012). A randomized, pilot study to assess the efficacy and safety of curcumin in patients with active rheumatoid arthritis. Phytotherapy research : PTR, 26(11), 1719–1725. https://doi.org/10.1002/ptr.4639
37. Daily, J. W., Yang, M., & Park, S. (2016). Efficacy of Turmeric Extracts and Curcumin for Alleviating the Symptoms of Joint Arthritis: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. Journal of medicinal food, 19(8), 717–729. https://doi.org/10.1089/jmf.2016.3705
38. Na, L. X., Li, Y., Pan, H. Z., Zhou, X. L., Sun, D. J., Meng, M., Li, X. X., & Sun, C. H. (2013). Curcuminoids exert glucose-lowering effect in type 2 diabetes by decreasing serum free fatty acids: a double-blind, placebo-controlled trial. Molecular nutrition & food research, 57(9), 1569–1577. https://doi.org/10.1002/mnfr.201200131
39. Chuengsamarn, S., Rattanamongkolgul, S., Luechapudiporn, R., Phisalaphong, C., & Jirawatnotai, S. (2012). Curcumin extract for prevention of type 2 diabetes. Diabetes care, 35(11), 2121–2127. https://doi.org/10.2337/dc12-0116
40. Bradford P. G. (2013). Curcumin and obesity. BioFactors (Oxford, England), 39(1), 78–87. https://doi.org/10.1002/biof.1074
41. Hlavačková, L., Janegová, A., Uličná, O., Janega, P., Cerná, A., & Babál, P. (2011). Spice up the hypertension diet – curcumin and piperine prevent remodeling of aorta in experimental L-NAME induced hypertension. Nutrition & metabolism, 8, 72. https://doi.org/10.1186/1743-7075-8-72
42. Sahebkar A. (2014). Are curcuminoids effective C-reactive protein-lowering agents in clinical practice? Evidence from a meta-analysis. Phytotherapy research : PTR, 28(5), 633–642. https://doi.org/10.1002/ptr.5045
43. Ak, T., & Gülçin, I. (2008). Antioxidant and radical scavenging properties of curcumin. Chemico-biological interactions, 174(1), 27–37. https://doi.org/10.1016/j.cbi.2008.05.003
44. Sahebkar, A., Mohammadi, A., Atabati, A., Rahiman, S., Tavallaie, S., Iranshahi, M., Akhlaghi, S., Ferns, G. A., & Ghayour-Mobarhan, M. (2013). Curcuminoids modulate pro-oxidant-antioxidant balance but not the immune response to heat shock protein 27 and oxidized LDL in obese individuals. Phytotherapy research : PTR, 27(12), 1883–1888. https://doi.org/10.1002/ptr.4952
45. Mohammadi, A., Sahebkar, A., Iranshahi, M., Amini, M., Khojasteh, R., Ghayour-Mobarhan, M., & Ferns, G. A. (2013). Effects of supplementation with curcuminoids on dyslipidemia in obese patients: a randomized crossover trial. Phytotherapy research : PTR, 27(3), 374–379. https://doi.org/10.1002/ptr.4715
46. DiSilvestro, R. A., Joseph, E., Zhao, S., & Bomser, J. (2012). Diverse effects of a low dose supplement of lipidated curcumin in healthy middle aged people. Nutrition journal, 11, 79. https://doi.org/10.1186/1475-2891-11-79
47. Sahebkar A. (2014). Curcuminoids for the management of hypertriglyceridaemia. Nature reviews. Cardiology, 11(2), 123. https://doi.org/10.1038/nrcardio.2013.140-c1
48. Soni, K. B., & Kuttan, R. (1992). Effect of oral curcumin administration on serum peroxides and cholesterol levels in human volunteers. Indian journal of physiology and pharmacology, 36(4), 273–275.
49. Ganjali, S., Sahebkar, A., Mahdipour, E., Jamialahmadi, K., Torabi, S., Akhlaghi, S., Ferns, G., Parizadeh, S. M., & Ghayour-Mobarhan, M. (2014). Investigation of the effects of curcumin on serum cytokines in obese individuals: a randomized controlled trial. TheScientificWorldJournal, 2014, 898361. https://doi.org/10.1155/2014/898361
50. Cox, K. H., Pipingas, A., & Scholey, A. B. (2015). Investigation of the effects of solid lipid curcumin on cognition and mood in a healthy older population. Journal of psychopharmacology (Oxford, England), 29(5), 642–651. https://doi.org/10.1177/0269881114552744
51. Agharazi, M., Gazerani, S., & Huntington, M. K. (2022). Topical Turmeric Ointment in the Treatment of Diabetic Foot Ulcers: A Randomized, Placebo-Controlled Study. The international journal of lower extremity wounds, 15347346221143222. Advance online publication. https://doi.org/10.1177/15347346221143222
52. McFarlin, B. K., Venable, A. S., Henning, A. L., Sampson, J. N., Pennel, K., Vingren, J. L., & Hill, D. W. (2016). Reduced inflammatory and muscle damage biomarkers following oral supplementation with bioavailable curcumin. BBA clinical, 5, 72–78. https://doi.org/10.1016/j.bbacli.2016.02.003
53. Jarhahzadeh, M., Alavinejad, P., Farsi, F., Husain, D., & Rezazadeh, A. (2021). The effect of turmeric on lipid profile, malondialdehyde, liver echogenicity and enzymes among patients with nonalcoholic fatty liver disease: a randomized double blind clinical trial. Diabetology & metabolic syndrome, 13(1), 112. https://doi.org/10.1186/s13098-021-00731-7
54. Dehzad, M. J., Ghalandari, H., Nouri, M., & Askarpour, M. (2023). Effects of curcumin/turmeric supplementation on glycemic indices in adults: A grade-assessed systematic review and dose-response meta-analysis of randomized controlled trials. Diabetes & metabolic syndrome, 17(10), 102855. https://doi.org/10.1016/j.dsx.2023.102855
55. Esmaily, H., Sahebkar, A., Iranshahi, M., Ganjali, S., Mohammadi, A., Ferns, G., & Ghayour-Mobarhan, M. (2015). An investigation of the effects of curcumin on anxiety and depression in obese individuals: A randomized controlled trial. Chinese journal of integrative medicine, 21(5), 332–338. https://doi.org/10.1007/s11655-015-2160-z
56. Kocaadam, B., & Şanlier, N. (2017). Curcumin, an active component of turmeric (Curcuma longa), and its effects on health. Critical reviews in food science and nutrition, 57(13), 2889–2895. https://doi.org/10.1080/10408398.2015.1077195
57. Sharma, R. A., Euden, S. A., Platton, S. L., Cooke, D. N., Shafayat, A., Hewitt, H. R., Marczylo, T. H., Morgan, B., Hemingway, D., Plummer, S. M., Pirmohamed, M., Gescher, A. J., & Steward, W. P. (2004). Phase I clinical trial of oral curcumin: biomarkers of systemic activity and compliance. Clinical cancer research : an official journal of the American Association for Cancer Research, 10(20), 6847–6854. https://doi.org/10.1158/1078-0432.CCR-04-0744