Combining different plants to make them more effective has been an important part of traditional healing for a very long time. People from old times, like the Egyptians and Greeks, and modern times, like Chinese doctors, have thought about herbal synergy. This piece explores the historical roots and working principles of herbal mixtures. It also includes real-life case studies that show how combining plants can greatly affect health. We reveal the complex web of herbal synergy in healthcare by examining the usefulness and important factors of combining plants.
Historical perspective on herbal synergy
Herbal synergy has been around for hundreds of years. In the past, therapists naturally mixed different plants to make them more effective. From the Egyptians to the Greeks to the Chinese, people have known for a long time that mixing certain herbs can have powerful effects. These old ways of doing things paved the way for modern studies of how complex plant chemicals interact, helping us understand how herbal mixtures work together to make them more powerful. We are now looking into the possibilities of these old practices in fresh ways. For example, you can now buy hemp flower online, which makes these potentially helpful plant products more available to more people.
Herbal synergy has been around for hundreds of years. In the past, therapists naturally mixed different plants to make them more effective. From the Egyptians to the Greeks to the Chinese, people have known for a long time that mixing certain herbs can have powerful effects. These old ways of doing things paved the way for modern studies of how complex plant chemicals interact, helping us understand how herbal mixtures work together to make them more powerful. We are now looking into the possibilities of these old practices in fresh ways. For example, you can now buy hemp flower online, which makes these potentially helpful plant products more available to more people.
Scott Kaplan PhD
Assistant Professor of Economics
United States Naval Academy
Annapolis, MD 21402
MedicalResearch.com: What is the background for this study?
Response: Sugar-sweetened beverages (colloquially known as SSBs), which include sodas, fruit drinks, sports drinks, energy drinks, and sweetened coffee drinks, are the leading source of added sugars in the American diet, according to the CDC. They are associated with serious negative health outcomes, including type 2 diabetes, obesity, heart disease, kidney disease, 
Dr. Lu Qi[/caption]
Lu Qi, MD, PhD, FAHA
Interim Chair, Department of Epidemiolog
HCA Regents Distinguished Chair and Professor
Tulane University School of Public Health and Tropical Medicine
Director, Tulane University Obesity Research Center
Director, Tulane Personalized Health Institute
New Orleans, LA 70112
MedicalResearch.com: What is the background for this study?
Response: Adding salt to foods is a behavior reflecting long-term preference to salty diets. High sodium intake is a major risk factor for chronic kidney disease.
In our previous studies, we have found that adding salt to foods at the table is related to various disorders including cardiovascular diseases, diabetes, and mortality. 
Dr. Kamath[/caption]
Dr. Suneel Kamath MD
Gastrointestinal Oncologist
Cleveland Clinic
Senior Author on this research
MedicalResearch.com: What is the background for this study?
Response: Colorectal cancer rates in young people under age 50 are skyrocketing and have been for the last 3-4 decades. We really don’t understand why because most cases (probably around 70%) are not genetic or hereditary, just random, unfortunate events. We suspect that it is some exposure(s) like excess consumption of red meat, processed foods, sugar-sweetened beverages, excess antibiotic use altering the microbiome, rising incidence of obesity or some other factors. We really don’t know why yet.
Our study used a technology called metabolomics, the study of breakdown products and production building blocks for our bodies, to look for differences in colorectal cancer in young people versus people that are older that developed colorectal cancer. Because metabolomics measures how each individual interacts with the exposures in our environment like diet, air quality, etc., it is a way to bridge the gap between our nature (determined by genetics) and nurture (determined by our exposures).
Dr. Manson[/caption]
JoAnn E. Manson, MD, DrPH, MACP
Dr. Martens[/caption]
Christopher R. Martens PhD
Assistant Professor
Director, Delaware Center for Cognitive Aging Research
Department of Kinesiology & Applied Physiology
University of Delaware
Newark, DE
MedicalResearch.com: What is the background for this study?
Response: One of the main issues with Alzheimer's disease is an impaired ability to make energy in the brain. NAD+ is critically involved in the creation of energy within cells and there is strong evidence that nicotinamide riboside (NR), a precursor to NAD+, can restore brain function in mice that exhibit similar characteristics as people with Alzheimer's disease.
We had previously studied the effects of NR in healthy older adults and wanted to see whether it is even capable of getting into brain tissue. We used remaining blood samples from our original study and measured the amount of NAD+ within tiny "vesicles" in the blood that we are quite confident originated from the brain and other neural tissue
Dr. Mahdavi[/caption]
Dr. Sara Mahdavi, PhD
Clinical Scientist and Clinical Instructor
Research Appointment in the Faculty of Medicine
University of Toronto
Toronto, ON
MedicalResearch.com: What is the background for this study?
Response: This was a long-term study spanning 16 years and began with a population of young adults who were medically assessed on a regular basis. It was remarkable to see just how striking the effects of coffee were in the group that had the susceptible genetic variant, what we termed “slow caffeine metabolizers” yet no effect whatsoever in those who did not were termed “fast metabolizers”.
Dr. Simin Liu[/caption]
Simin Liu MD MPH ScD
Professor of Epidemiology at the School of Public Health,
Professor of Medicine (Endocrinology) and
Professor of Surgery at the Alpert School of Medicine
Brown University
MedicalResearch.com: What is the background for this study?
Response: Our research team has been researching the roles of environmental and genetic determinants of chronic diseases for nearly three decades, with special emphasis on evaluating micronutrients, minerals, and trace elements in relation to cardiometabolic outcomes, and findings of which have contributed to the design of several large, randomized trials of dietary supplements in the US (Liu JAMA 1999; 2011; Diabetes Care 2005a,b; Diabetes 2006). Several large intervention trials have consistently shown beneficial effects on clinical cardiometabolic outcomes of a diet pattern rich in micronutrients, although research on micronutrient supplementation has mainly focused on the health effects of a single or a few vitamins and minerals.
We decided to take a comprehensive and systematic approach to evaluate all the publicly available/accessible studies reporting all micronutrients including phytochemicals and antioxidant supplements and their effects on cardiovascular risk factors as well as multiple CVDs.
Dr. Holland[/caption]
Thomas M Holland, MD, MS
Assistant Professor
Rush Institute for Health Aging
Rush College of Medicine & Rush College of Health Sciences
Response: We started many years ago by studying some natural and synthetic molecules that were able to counteract the early stages of this disease. With a view to early prevention, we wondered if these molecules could be routinely taken with the diet or dietary supplements. So our studies focused on the search for bioactive molecules present in food and edible plants.
Hops are very rich in polyphenolic compounds, and for this reason it is historically used for the production of beer, but also for the preparation of herbal teas and infusions, and its uses in traditional medicine are known. In recent years we have also collected interesting results on Coffee, Sage, Radix Imperatoriae, Cocoa and Cinnamon extracts.
Dr. Shan[/caption]
Zhilei Shan, MD, PhD
Postdoctoral fellow on Nutritional Epidemiology
Harvard T.H. Chan School of Public Health
MedicalResearch.com: What is the background for this study?
Response: Unhealthy sleep behaviors and sleep disturbances are associated with higher risk of multiple diseases and mortality. The current profiles of sleep habits and disturbances, particularly the differences between workdays and free days, are unknown in the contemporary US.
MedicalResearch.com: What are the main findings?
Response: In this nationally representative cross-sectional analysis with 9004 adults aged 20 years or older, differences in sleep patterns between workdays and free days were observed. The mean sleep duration was 7.59 hours on workdays and 8.24 hours on free days (difference, 0.65 hour). The mean sleep and wake times were at 11:02 PM and 6:41 AM, respectively, on workdays and 11:25 PM and 7:41 AM, respectively, on free days (differences, 0.23 hour for sleep time and 1.00 hour for wake time). With regard to sleep disturbances, 30.5% of adults experienced 1 hour or more of sleep debt,46.5% experienced 1 hour or more of social jet lag, 29.8% had trouble sleeping, and 27.2% experienced daytime sleepiness.
Dr. Orkaby[/caption]
Ariela Orkaby, MD, MPH
Geriatrics & Preventive Cardiology
Associate Epidemiologist
Division of Aging, Brigham and Women's Hospital
Assistant Professor of Medicine, Harvard Medical School
MedicalResearch.com: What is the background for this study?
Response: As the population is living longer, there is increased risk of frailty and vulnerability. Frailty is defined as reduced physiological reserve and decreased ability to cope with even an acute stress. Up to half of adults over the age of 85 are living with frailty and preventative measures are greatly needed. We tested the effect of vitamin D and marine omega-3 fatty acid supplementation on the risk of developing frailty in healthy older adults in the US enrolled in the VITamin D and OmegA-3 TriaL (VITAL) trial.
Dr. Maki Inoue-Choi,[/caption]
Maki Inoue-Choi, Ph.D., M.S., R.D.
Staff Scientist
Metabolic Epidemiology Branch
National Institutes of Health
MedicalResearch.com: What is the background for this study?
Response: Tea is rich in bioactive compounds that can possibly protect against health conditions such as cancer and heart disease. A lower risk of death was seen among tea drinkers than non-drinkers in previous studies, but these were largely in populations where green tea drinking is common. In contrast, the studies in populations where black tea drinking is more common have been limited and the findings from these studies have been inconsistent.
Dr. Barry[/caption]
Michael J. Barry, M.D
Director of the Informed Medical Decisions Program
Health Decision Sciences Center
Massachusetts General Hospital.
Professor of medicine at Harvard Medical School
Dr. Barry was appointed as Vice Chair of USPSTF in March 2021.
He previously served as a member from January 2017 through December 2020.
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The Task Force looked at the use of vitamin and mineral supplementation specifically for the prevention of heart disease, stroke, and cancer. We found that there is not enough evidence to recommend for or against taking multivitamin supplements, nor the use of single or paired nutrient supplements, to prevent these conditions.
However, we do know that you should not take vitamin E or beta-carotene for this purpose.
Dr. Klimis-Zacas[/caption]
Dorothy Klimis-Zacas, MS, PhD, FACN
Professor of Clinical Nutrition
School of Food and Agriculture
Graduate Faculty
School of Biomedical Sciences
Associate Faculty, Institute of Medicine
Fulbright Fellow
University of Maine Orono, Maine 04469
MedicalResearch.com: What is the background for this study?
Response: Bioactive compounds such as polyphenols have been documented to have wound healing properties . In the Klimis-Zacas laboratory, phenolic extracts (PE) from wild blueberries (WB) were reported to promote angiogenesis in HUVEC cells via cell migration, angiogenesis, through VEGF/P13K/AKT pathway documented that the PE, primarily composed of chlorogenic acid significantly promoted cell migration and closure speed of wound by 38% above the control as well as angiogenesis and gene expression for proteins critical for cell movement while the anthocyanin fraction inhibited the above processes (5,6). 
Dr. Sesso[/caption]
Howard D. Sesso, ScD, MPH
Associate Professor of Medicine
Division of Preventive Medicine
Brigham and Women's Hospital
MedicalResearch.com: What is the background for this study? How does the amount of flavanols in the study arm compare to what might be obtained in a typical diet?
Response: The COcoa Supplement and Multivitamin Outcomes Study (COSMOS) is a randomized, double-blind, placebo-controlled clinical trial that tested the effects of two promising dietary supplements on cardiovascular disease (CVD) and cancer in 21,442 older adults. Cocoa flavanols have been shown to have favorable vascular effects in small and short-term clinical trials. The 500 mg/day flavanols tested in COSMOS exceeds that readily obtained in the diet typically from cocoa, tea, grapes, and berries. Of note, flavanol content in not typically listed on food labels.
COSMOS also tested a multivitamin, the most common dietary supplement taken by US adults and previously linked with a potential modest reduction in cancer in a previous long-term trial of men conducted by our research group at the Division of Preventive Medicine at Brigham and Women’s Hospital.
Dr. Dalton[/caption]
Kristine Dalton PhD FAAO, FBCLA
School of Optometry & Vision Science
University of Waterloo
Waterloo, Canada
MedicalResearch.com: What is the background for this study?
Response: Dynamic visual acuity refers to the ability to detect and perceive small details in objects that are moving relative to an observer. Dynamic visual acuity is a complex visual function, that involves a number of different aspects of vision, including detecting the target, moving the eyes appropriately to observe the target, and processing the visual information from the target in the brain to interpret what we are seeing. What makes dynamic visual acuity so interesting to study, is that as a visual function, it appears to play an important role in a number of real-world situations, including playing sports, driving, and piloting, and it may provide us more information about how the visual system is functioning compared to the more traditional, static vision tests alone.
Previous research has demonstrated that consumption of caffeine has been shown to benefit physiological, psychomotor, and cognitive performance. More recently there has been an increased interest in studying the impacts of caffeine on the vision system, however the impact of caffeine on dynamic visual acuity has not been studied. This study was designed to address this limitation in the literature, particularly because dynamic visual acuity appears to be such an important visual function for real-world activities. 