NederlandBurden of impaired vitality in the general population and potential nutritional solution
The National Health and Wellness Survey (NHWS) database (April–July 2018) was analysed to better understand the profile of healthy Europeans with impaired vitality level and its impact on their QoL [4]. A total of 24,295 adults in good health, aged between 18 and 64 years, were assigned to one of the four vitality groups based on statistical distribution of their vitality score (12-Item Short Form Survey [SF-12] questionnaire): <40: lowest vitality (n = 4,173), 40 to <50 (n = 9,327), 50 to <60 (n = 9,059) and ≥60: highest vitality (n =1,736) [4].
Low vitality level had a high impact on QoL deterioration and was associated with a high economic burden in the general population. The lowest vitality group (<40) was related to an increased odds ratio (OR; 95% confidence interval [CI]) of reporting any problem regarding anxiety/depression (10.3; 8.7–12.3), pain/discomfort (5.6; 4.8–6.5) and usual activities (5.3; 4.2–6.6) evaluated by the EuroQoL 5-Dimension 5-Level (EQ-5D-5L) questionnaire compared to the highest vitality group (>60) (Fig. 1). Also, the low vitality group was related to an increased OR for impairment of presenteeism and activity compared to the highest vitality group (>60).
Fig. 1. Percentage of participants experiencing at least one quality of life issue, according to the EQ-5D-5L (adapted from Tardy et al. 2023 [4])
With an OR of 2.6 (95% CI: 2.3–2.9), patient activation measurement (PAM) level 1 (lack of knowledge and confidence for managing their own health) was the characteristic most associated with vitality impairment. This suggests that for this population, higher engagement in self-care might considerably reduce the daily life burden of low vitality, and opens new roads for innovative health strategies, including accessible solutions, helping to modify people’s behaviour.
Open-label study on Panax ginseng G115®
Interestingly, previous open-label studies have shown the benefits of vitamins, minerals and natural ingredients on mental and physical well-being [5, 6]. The root of Panax ginseng C.A. Meyer (Asian ginseng) has been used for centuries in traditional Asian medicines for a wide variety of ailments, including fatigue. A specific extract, G115®, standardized to 4% of ginsenosides, has notably shown its efficacy in several clinical studies [7–12]. In individuals (n = 103) experiencing fatigue and/or lack of vitality for at least two weeks, a 3-month supplementation with Panax ginseng G115®, vitamins, minerals and natural ingredients improved mental and physical fatigue, starting from two weeks of intake and throughout the study period, as compared to baseline [5]. Comparisons between baseline and 90-day Multidimensional Fatigue Inventory (MFI) were performed using a mixed model for repeated measurements with time points (baseline, D1, D15, D30, D60, D90) as categorical and subject as a random effect. The levels of reduced activity and motivation improved starting from week 2 (reduced activity: –2.29 units; 95% CI: –3.18 to –1.40; p < 0.0001; reduced motivation: –2.82 units; 95% CI: –3.58 to –2.05; p < 0.0001) compared to baseline (mean ± SD, 14.1 ± 4.16; 13.5 ± 3.36, respectively) (Fig. 2).
Fig. 2. Mean difference in Multidimensional Fatigue Inventory (MFI) subscales scores between the baseline and post-baseline visits (adapted from Tardy et al. 2021 [5])
Summary
Literature
- Prins JB, Bleijenberg G, et al. Doctor-patient relationship in primary care of chronic fatigue syndrome. J Chronic Fatigue Syndr. 2000;7(4):3–15. doi.org/10.1300/J092v07n04_02.
- Van Hoof E. The doctor-patient relationship in chronic fatigue syndrome: survey of patient perspectives. Qual Prim Care. 2009;17(4):263–70.
- Pheby DFH, Araja D, et al. A literature review of GP knowledge and understanding of ME/CFS: a report from the socioeconomic working group of the European network on ME/CFS (EUROMENE). Medicina (Kaunas). 2020;57(1):7. doi: 10.3390/medicina57010007.
- Tardy A, Marguet S, et al. Profile and quality of life of the adult population in good health according to the level of vitality: European NHWS cross sectional analysis. Europe PMC. 2023;23(1):1061. doi: 10.21203/rs.3.rs-2040679/v1.
- Tardy AL, Bois De Fer B, et al. Reduced self-perception of fatigue after intake of panax ginseng root extract (G115®) formulated with vitamins and minerals-an open-label study. Int J Environ Res Public Health. 2021;18(12):6257. doi: 10.3390/ijerph18126257.
- Tardy AL, Noah L. Daily intake of Panax ginseng extract (G115®) supplemented with vitamins and minerals reduces self-perception of mental and physical fatigue. EfSM. 2022;2:220115. doi: 10.52778/efsm.22.0115.
- Kennedy DO, Scholey AB, et al. Dose dependent changes in cognitive performance and mood following acute administration of Ginseng to healthy young volunteers. Nutr Neurosci. 2001;4:295–310. doi: 10.1080/1028415x.2001.11747370.
- Scholey AB, Kennedy DO. Acute, dose-dependent cognitive effects of Ginkgo biloba, Panax ginseng and their combination in healthy young volunteers: Differential interactions with cognitive demand. Hum Psychopharmacol. 2002;17:35–44. doi: 10.1002/hup.352.
- Kennedy DO, Haskell CF, et al. Improved cognitive performance in human volunteers following administration of guarana (Paullinia cupana) extract: Comparison and interaction with Panax ginseng. Pharmacol Biochem Behav. 2004;79:401–411. doi: 10.1016/j.pbb.2004.07.014.
- Reay JL, Kennedy DO, et al. Single doses of Panax ginseng (G115) reduce blood glucose levels and improve cognitive performance during sustained mental activity. J Psychopharmacol. 2005;19:357–365. doi: 10.1177/0269881105053286.
- Reay JL, Kennedy DO, et al. Effects of Panax ginseng, consumed with and without glucose, on blood glucose levels and cognitive performance during sustained ‘mentally demanding’ tasks. J Psychopharmacol. 2006;20:771–781. doi: 10.1177/0269881106061516.
- Reay JL, Scholey A, et al. Panax ginseng (G115) improves aspects of working memory performance and subjective ratings of calmness in healthy young adults. Hum Psychopharmacol. 2010;25:462–471. doi: 10.1002/hup.1138.
Acknowledgements: The authors thank Claudia Holm, MD, an employee of Sanofi, for critically reviewing the scientific content of this manuscript and Avinash Bardia, an employee of Sanofi, for providing medical writing and editorial support.
Conflict of interest: A.-L.Tardy, L. Noah, T. Tavares and C. Amand are employees of Sanofi.
Disclosure: This study was funded by Sanofi.
