Welcome to the March 2025 issue of Research Extracts. “The Extracts” is designed to keep busy practitioners and savvy consumers up to date on the latest research on diet, nutrients, botanicals, the microbiome, the environment, and lifestyle approaches to good health and wellness. Our medical team, including NDs, RDs, MS biology, MS chemistry, an LAc, and a Certified Specialist in Sports Dietetics (CSSD), summarizes the essence of several interesting recent studies. 

In this issue: (1) Movement Moment: dietary creatine and reproductive health, (2) chocolate decreases type 2 diabetes risk, (3) review of rare ginsenosides from ginseng, and (4) dietary choline and Alzheimer’s disease.

Movement Moment: Creatine Supports Women’s Reproductive Health

Creatine is usually thought of as a supplement that aids in building muscle, used by gym goers, bodybuilders, and sprinters, among others. While creatine is a common supplement, it is first and foremost an amino acid found in our muscles and brain. We can acquire this nutrient through foods such as meat, fish, eggs, and dairy, and it is made in small quantities in the kidneys and liver from the amino acids methionine, arginine, and glycine. 

Not only is creatine important for building muscle, but it’s also essential for supporting cellular energy production throughout the lifespan, particularly in organs having high expressions of creatine-specific enzymes, like the ovaries and other female reproductive organs. 

The present study extracted data from the NHANES 2017-2020 Questionnaire for Reproductive Health, including 4,522 female participants aged 12 years and older who provided information about their reproductive health and dietary intake. Daily creatine intake was calculated using Dietary Data Interviews from meat and dairy food sources; creatine supplementation was not included in the daily totals. 

The primary exposure of the study was daily creatine intake, in which the daily recommendation was set at 13 mg/kg of body weight per day. For a woman weighing 170 lbs., this would equate to 1 gram of creatine per day.  

Results showed that average creatine intake was highest in the preteen (12-12.9 years) population, followed by teenagers (13-17.9 years), and then adult (18.0-64.9 years) women. Creatine intake was lowest in women over 65. However, 71% of all study participants were below the recommended daily creatine intake.

A higher intake of creatine correlated with a lower risk of irregular menstrual cycles when adjusted for demographics and dietary factors. Women consuming less than the recommended amount of creatine had an increased risk of pelvic infection and were more likely to deliver higher birth weight babies. They also had a greater need for a hysterectomy or oophorectomy and hormone replacement therapy.

Contributed by Maura Donovan MS, RD, CSSD

Reference

Dark Chocolate Intake May Decrease Type 2 Diabetes Risk

Type 2 diabetes is a widespread chronic disease affecting over 450 million people worldwide. While many factors contribute to the incidence of this disease, lifestyle patterns, particularly dietary choices, have been the subject of ample research as risk factors and treatment methods.

One potentially beneficial dietary ingredient that may surprise you is chocolate. Chocolate is derived from cacao beans, which have exceptionally high levels of dietary flavonoids – compounds that exert antioxidant, anti-inflammatory, and vasodilatory effects that may benefit cardiometabolic conditions including diabetes. Higher amounts of cacao found in dark chocolate compared to milk chocolate may provide greater benefits. 

This current prospective cohort study explored chocolate consumption and the risk of type 2 diabetes. Food frequency questionnaires were used to assess total and types of chocolate consumption. Intake levels of total flavonoids and individual components such as catechin, epicatechin, and gallocatechin were calculated. Throughout the study period, type 2 diabetes diagnosis was self-reported, with confirmation from study doctors based on blood glucose, hemoglobin A1c, symptoms, and treatment. 

The results showed that participants with higher total chocolate intake also had higher total energy, saturated fat, and sugar intakes. Increased dark chocolate consumption was associated with higher Alternate Healthy Eating Index, reflecting better overall diet quality, higher fruit and vegetable intake, and higher total flavonoids and flavan-3-ols in the diet, particularly epicatechin. The inverse was true for those having higher consumption of milk chocolate. 

Participants who consumed at least five or more servings of total chocolate per week had a slightly lower relative risk for type 2 diabetes compared to those rarely or never consuming chocolate. By subtype, consuming five or more servings of dark chocolate but not milk chocolate was associated with a significantly lower rate of type 2 diabetes compared to those who rarely or never consumed dark chocolate. Additionally, similar associations were found for body weight changes; higher milk chocolate and total chocolate intake was associated with higher weight changes, while dark chocolate was not associated with weight gain. 

Note: For an extra cocoa boost, consider one of Thorne’s chocolate protein powders, available as Whey Protein Isolate, MediClear-SGS, or RecoveryPro®.

To read more about the health benefits of chocolate, check out these articles on Take 5 Daily.

Contributed by Carly Duffy, MPH, RD

Reference

Rare Ginsenosides: Their Potential Health Benefits

Several plant species, collectively (and for the purposes of this research summary) referred to as “ginseng,” have long been valued by various cultures because of their many therapeutic benefits. Traditionally used in Eastern medicine for millennia, this adaptogenic root is celebrated for its ability to enhance energy, reduce stress, boost cognitive function, and support overall vitality.* Modern research has further validated its potential in supporting healthy immune function, regulating blood sugar levels, and even promoting healthy aging and a balanced inflammatory response in the body.* With its increasing incorporation into supplements, teas, and skincare products, ginseng continues to be a sought after natural remedy, appealing to those seeking holistic approaches to well-being. 

Ginsenosides are a class of naturally occurring steroidal saponins found primarily in ginseng roots. They are the key bioactive compounds responsible for ginseng's antioxidant and adaptogenic effects. Rare ginsenosides (RGs) are converted from precursor ginsenosides as the plant ages, particularly when the roots are exposed to heat and water (traditionally via steam cooking). RGs often exhibit enhanced bioavailability and potentially stronger health-promoting effects, compared to their parent compounds.

A recent review, summarizing advances in RG research, discusses their structural diversity, traditional uses, clinical applications, biological activities, mechanisms of action, structure-activity relationships, toxicity, stereochemistry, and production strategies.

Some key findings in the review are as follows: 

  • At least 144 RGs were identified with potential bioactivities on different systems, from digestion to hormone activity to blood circulation.* 
  • RGs demonstrated potential for immune regulation, healthy aging, cellular support, and cardiovascular, cerebrovascular, and metabolic benefits.* 
  • Clinical trials suggest their health promoting potential with no significant side effects, although more high-quality data is needed. 
  • The review also discussed different analytical techniques for identification and explored various methods for larger RG scale production. 
  • This review aimed to enhance understanding and future research on RGs in ginseng-derived nutraceuticals and natural products.

Note: Thorne’s Ginseng Plus supplies 420 mg of Korean red ginseng extract per serving, including rare ginsenosides, in synergy with lion’s mane and Greek mountain tea to support healthy cognition, focus, memory, and mood, particularly in times of stress.*

Contributed by: Mario Roxas, ND 

Reference 

  • Fan W, Fan L, Wang Z, et al. Rare ginsenosides: A unique perspective of ginseng research. J Adv Res. 2024;66:303-328 doi: 10.1016/j.jare.2024.01.003.

Dietary Choline Intake and the Incidence of Dementia 

Alzheimer’s disease (AD), the most common form of dementia, is characterized by progressive cognitive decline, memory loss, and impaired functioning. As global prevalence rises, identifying dietary and lifestyle factors that support brain health is increasingly important. Research suggests that choline, an essential nutrient for neurotransmitter synthesis and cell signaling, may play a role in cognitive function and neuroprotection. 

While evidence linking choline intake to a reduced risk of cognitive decline remains limited, a recent large-scale, population-based prospective cohort study investigated the association between dietary choline intake and the incidence of mild cognitive impairment (MCI), AD, and other forms of dementia. The study followed 125,594 participants over several years, tracking their dietary choline and evaluating cognitive health outcomes.

Key findings:

  • Moderate choline intake was linked to improved cognitive performance and a lower risk of AD and other forms of dementia.
  • Individuals consuming between 332.89 mg and 353.93 mg of choline daily had the lowest hazard ratio for developing AD or other forms of dementia.
  • Choline intake was associated with a 17-23% reduced risk of dementia, depending on the choline derivative consumed.
  • Higher choline intake correlated with better visual attention, fluid intelligence, and complex processing speed.

Choline plays a key role in the production of acetylcholine, a neurotransmitter essential for memory and learning. These findings reinforce the potential role of moderate choline intake as a modifiable dietary factor that may contribute to brain health and cognitive longevity. However, while these results are promising, the study authors emphasize that further research is needed to confirm causality and establish optimal intake recommendations.

Note: Choline can be obtained through dietary sources such as eggs, fish, soybeans, dairy, and cruciferous vegetables. Although many foods contain choline, intake levels may vary based on diet, making it important to include a variety of choline-rich foods to support overall health. 

Contributed by Ashley Huber, MS

Reference