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Background Military special operators, elite athletes, and others requiring uninterrupted optimal performance currently lack options for sleep and mood support without performance-inhibiting effects. Kavalactones, derived from the root of the kava plant (Piper methysticum Forst), have been shown to elevate mood and wellbeing by producing a feeling of relaxation without addiction or cognitive impairment.Methods In this placebo-controlled, crossover study (NCT05381025), we investigated the effects of 2 weeks of kavalactones use on cortisol (diurnal salivary), sleep (RSQ-W; Restorative Sleep Questionnaire, Weekly), mood (DASS-21; Depression Anxiety Stress Scale-21), and motivation state to expend (Move) or conserve (Rest) energy (CRAVE; Cravings for Rest and Volitional Energy Expenditure, Right Now) in a cohort of 15 healthy, physically fit young males engaged in a rigorous, two-a-day preparation class for special operations forces qualification.Results Cortisol, sleep, and mood were within normal, healthy parameters in this cohort at baseline. This remained unchanged with kavalactones use with no significant findings of clinical interest. However, a statistically similar, positive slope for within-group Move scores was seen in both groups during kavalactones loading (first group Move slope 2.25, second group Move slope 3.29, p = 0.299). This trend was seen regardless of order and with no apparent effects on the Rest metric (all p ≥ 0.05). Moreover, a significant between-group difference appeared after 1 week of kavalactones use in the first phase (p = 0.044) and persisted through the end of the first loading period (p = 0.022). Following the 10-day washout, this between-groups divergence remained significant (p = 0.038) but was reversed by 1 week after the crossover (p = 0.072), with Move scores once again statistically similar between groups and compared to baseline at study end. Furthermore, the group taking kavalactones first never experienced a significant decrease in Move motivation state (lowest mean score 21.0, highest 28.6, all p ≥ 0.05), while the group receiving kavalactones in the last 2 weeks of the study had Move scores that were statistically lower than baseline (lowest mean score 8.6, highest 25.9, all p ≤ 0.05) at all time points but the last (p = 0.063) after 2 weeks of kavalactones exposure.Conclusions We report a novel finding that kavalactones may support performance by maintaining or rescuing the desire to expend energy in the context of significant physical and mental strain in well-conditioned individuals, even in a context of already normal cortisol, sleep, and mood.

Abstract Background Tobacco use is the leading cause of many preventable diseases, resulting in premature death or disease. Given that the majority of adult who smoke want to stop, this health burden could be significantly reduced if the success rate of tobacco cessation can be improved. In addition, most adults planning to quit were interested in trying complementary approaches to facilitating tobacco cessation, which is currently lacking. Therefore, there is an unmet and urgent need for novel interventions to improve the success of tobacco cessation. If such an intervention can reduce tobacco-associated lung carcinogenesis, that will be more desirable. The goal of this project is to develop a safe and effective kava-based intervention to enable tobacco cessation and reduce lung cancer risk, which will improve the health of smokers. Methods A randomized controlled trial will enroll 80 adults who currently smoke at least 10 cigarettes daily and randomize 1:1 into the placebo and AB-free kava arms, being exposed for 4 weeks, with a total of six visits (weeks 0, 1, 2, 4, 8, and 12) to evaluate the compliance and potential issues of AB-free kava use among the participants, explore the potential effect of the AB-free kava intervention on tobacco dependence, tobacco use, and lung carcinogenesis biomarkers. Participants will be enrolled during their primary care clinic visit. Discussion Primary care settings play a critical role in tobacco-related disease screening, counseling, and early intervention, as the majority of adults who smoke visit their physicians annually. Building upon our promising pilot human trial results in conjunction with ample compelling lab animal results, and consistent with evidence of kava’s benefits from epidemiological data, this trial will evaluate the compliance of AB-free kava among adults who currently smoke with no intention to quit. The other exploratory aims include (1) whether AB-free kava intervention can reduce tobacco use and tobacco dependence; (2) whether AB-free kava use suppresses tobacco-induced carcinogenesis; and (3) the potential of the mechanism-based noninvasive biomarkers in precision AB-free kava intervention. The positive results from this study are expected to provide a great opportunity to effectively reduce smoking rates and tobacco-related diseases. Trial registration ClinicalTrials.gov with the identifier: NCT05081882. Registered on October 18, 2021.

Yaqona (kava) is a culturally significant, non-alcoholic drink consumed nightly by many Fijians. Although yaqona is not consumed by primary or secondary school students, cultural protocols related to yaqona preparation and presentation are often taught in their schools, with students then presenting this indigenous drink to acknowledge visitors to the school, open events and support fundraisers. In the early 2000s, some within the Fiji Ministry of Education began questioning whether yaqona use by teachers was negatively impacting their teaching ability, suggesting it should be banned from the school campus. In this study, Fijian teachers were cognitively tested and interviewed following an evening of yaqona consumption with the results suggesting this indigenous substance can disrupt cognition and in turn negatively impact teaching quality the morning after consumption. Although development theory prescribes prohibition and situational bans in cases where indigenous substances negatively impact productivity, the author argues that prohibiting yaqona in Fijian schools would be short-sighted as the findings show that this traditional substance is critical to the facilitation of school function, identity formation and academic achievement, all elements necessary to development.

Photoessay: The author has been documenting the use of kava in different parts of the Pacific for several years, particularly in Tonga and in Auckland where its use is popular among members of communities that consume kava as part of their cultural tradition, and more recently a growing non-traditional user group. In this article, he reflects on his project to document the use of kava through photographs, the evolution of its use in traditional and non-traditional settings and discusses the most recent scientific studies of the drink.

Epidemiological evidence suggests that kava (Piper methysticum Forst) drinks may reduce the risk of cancer in South Pacific Island smokers. However, little is known about the anti-carcinogenic effects of kava on tobacco smoking-related bladder cancer and its underlying mechanisms. Here we show that dietary feeding of kawain (a major active component in kava root extracts) to mice either before or after hydroxy butyl(butyl) nitrosamine (OH-BBN) carcinogen exposure slows down urinary bladder carcinogenesis and prolongs the survival of the OH-BBN-exposed mice. OH-BBN-induced bladder tumors exhibit significantly increased expression of lysine-specific demethylase 1 (LSD1), accompanied by decreased levels of H3K4 mono-methylation compared to normal bladder epithelium, whereas dietary kawain reverses the effects of OH-BBN on H3K4 mono-methylation. Human bladder cancer tumor tissues at different pathological grades also show significantly increased expression of LSD1 and decreased levels of H3K4 mono-methylation compared to normal urothelium. In addition, kava root extracts and the kavalactones kawain and methysticin all increase the levels of H3K4 mono- and di-methylation, leading to inhibitory effects on cell migration. Taken together, our results suggest that modification of histone lysine methylation may represent a new approach to bladder cancer prevention and treatment and that kavalactones may be promising agents for bladder cancer interception in both current and former smokers.

This documentary film is a result of multi-sited ethnographic research between 2015-2019, which explores cultural identity, gender, music, and spirituality through contemporary and common kava practices. Drawing from over 17 years of participation in kava communities, this film is grounded in Tongan experiences, while also including a mobile and expanding Moana/Wansolwara/Oceanic perspective with contributions from Fijians, Sāmoans, Māori, and more. The knowledge holders in this film span across four territories, including Te Ika a Māui in Aotearoa, Utah (US) on Turtle Island, The Kingdom of Tonga, and Kamberra, Australia. They share a complex web of experiences, purpose, and tensions within the contemporary practices of common kava gatherings known in Tongan as faikava. Contemporary kava gatherings are spaces to release the pressures of modern life, nurture ancestral and social relationships, reveal truths, build community, produce and transmit knowledge, negotiate identity, heal, and foster positive well-being through comradery and openness. This film cannot cover all of the complexity of kava culture, yet attempts to be a meaningful introduction to the dynamic practices that are alive and expanding throughout the world.

Abstract Objective: Kava is marketed as a herbal anxiolytic in several countries and is consumed recreationally in high doses in many indigenous Pacific and Australian Aboriginal communities. We reviewed the published literature examining the association (if any) between kava use and motor vehicle crashes (MVCs), MVC‐related injuries or driving performance. Methods: Search of MEDLINE, EMBASE, PsycINFO, CINAHL, Scopus, AMED, Australian Medical Index, Australian Transport Index and trials registries and injury journals up to August 2014. Results: No studies quantifying the effects of kava on MVCs or related injury were located. Four experimental studies using computer‐based driving simulation examined the effects of pharmacological doses of kavalactones on cognitive and visuomotor performance. While no statistically significant adverse changes attributable to kava were found, there was weak evidence of slowed reaction time. One study found the visuo‐motor performance on driving simulation to be significantly impaired when kava was consumed with alcohol. Conclusions: With equivocal evidence limited to experimental studies using simulated driving settings, the contribution of kava to MVCs is unknown. Implications: The gap in knowledge regarding the potential risk of injuries associated with therapeutic and recreational use of kava requires priority attention.

The outer island of Kadavu is representative of the Fijian periphery. This paper deals with its physical characteristics, infrastructural conditions, and village economic activities with the aim of understanding the changes it has gone through in recent years. A combination of micro-geographic studies in two villages and a meso-geographical analysis show that the pattern of development found in Kadavu in the early 1980s has not changed much. The current pattern of cash crop production and trade is almost entirely dependent on the kava beverage crop, infrastructure is underdeveloped, the island suffers from the peripheral penalty phenomenon, and government initiatives aimed at changing the trend are very limited. However, the current form of non-capitalist production and its derived benefit has forced villagers into a strategy of adaptation which might actually be preferable for them under the current conditions of peripheralization.

The long term use of antiepileptic drugs possesses many unwanted effects; thus, new safe combinations are urgently mandated. Hence, the present study aimed to investigate the anticonvulsant effect of kava alone or in combination with a synthetic anticonvulsant drug, diazepam (DZ). To this end, female Wistar rats were divided into two subsets, each comprising 6 groups as follows: group (i) received 1% Tween 80 p.o. and served as control, while groups (ii) and (iii) received kava at two dose levels (100 and 200 mg/kg, p.o.). The remaining three groups received (iv) DZ alone (10 mg/kg p.o.) or kava in combination with DZ (v) (5 mg/kg, p.o.) or (vi) (10 mg/kg, p.o.). Results of the present study revealed that kava increased the maximal electroshock seizure threshold (MEST) and enhanced the anticonvulsant effect of diazepam following both acute and chronic treatment. Moreover, neither kava nor its combination with DZ impaired motor co-ordination either acutely or chronically. Furthermore, kava ameliorated both the reduction in locomotor activity as well as changes in liver function tests induced by chronic administration of DZ. Moreover, no elevation was shown in the creatinine concentration vs. control group following chronic administration of kava or DZ either alone or in combination with kava. In conclusion, the present study suggests the possibility of combining a low dose DZ with kava to reduce harmful effects and might be recommended for clinical use in patients chronically treated with this synthetic anticonvulsant drug.

Flavokawain A (FKA), a major chalcone in the Kava plant, has recently demonstrated promising anti-cancer activities. A systematic evaluation of FKA's safety profile has not been reported before. In this study, male FVB/N mice were fed with an AIN-76A diet or AIN-76A diet supplemented with 0.6% (6 g/kg food) FKA or 0.6% commercial kava root extract (KRE) for three weeks. Dietary feeding of FKA did not affect food consumption and body weight. Histopathological examination of liver, kidney, colon, lung, heart, spleen, and thymus revealed no signs of FKA-induced toxicity. Biochemical serum analysis and histological examination confirmed normal organ function in FKA-treated mice. The cytotoxicity profile showed FKA had minimal side effects on bone marrow and small intestinal epithelial cells compared with Adriamycin. In addition, oral feeding of FKA increased activities of both glutathione S-transferase and quinone reductase in the liver, lung, prostate and bladder tissues of mice. In comparison, dietary feeding of 0.6% KRE increased liver/body weight ratio and decreased spleen, thymus, and testis/body weight ratios, as well as induced nodular proliferation in liver tissues. Therefore, dietary feeding FKA showed no adverse effects on major organ function and homeostasis in mice, suggesting the potential of FKA for chemoprevention study of human cancers.

Herbal hepatotoxicity is a rare but highly disputed disease because numerous confounding variables may complicate accurate causality assessment. Case evaluation is even more difficult when the WHO global introspection method (WHO method) is applied as diagnostic algorithm. This method lacks liver specificity, hepatotoxicity validation, and quantitative items, basic qualifications required for a sound evaluation of hepatotoxicity cases. Consequently, there are no data available for reliability, sensitivity, specificity, positive and negative predictive value. Its scope is also limited by the fact that it cannot discriminate between a positive and a negative causality attribution, thereby stimulating case overdiagnosing and overreporting. The WHO method ignores uncertainties regarding daily dose, temporal association, start, duration, and end of herbal use, time to onset of the adverse reaction, and course of liver values after herb discontinuation. Insufficiently considered or ignored are comedications, preexisting liver diseases, alternative explanations upon clinical assessment, and exclusion of infections by hepatitis A-C, cytomegalovirus (CMV), Epstein-Barr virus (EBV), herpes simplex virus (HSV), and varicella zoster virus (VZV). We clearly prefer as alternative the scale of CIOMS (Council for International Organizations of Medical Sciences) which is structured, quantitative, liver specific, and validated for hepatotoxicity. In conclusion, causality of herbal hepatotoxicity is best assessed by the liver specific CIOMS scale validated for hepatotoxicity rather than the obsolete WHO method that is liver unspecific and not validated for hepatotoxicity. CIOMS based assessments will ensure the correct diagnosis and exclude alternative diagnosis that may require other specific therapies.

In order to compare the genetic relationships among Kava, Pepper and it’s wild relatives and to distinguish Kava from Pepper and it’s wild relatives, we conducted research on Kava by using RAPD and SCAR molecular markers. 20 random primers selected from 80 random primers were used for RAPD amplification to identify the genetic relationships among Kava, Pepper and it’s wild relatives. Total 170 bands were amplified by 20 random primers, in which 20 bands were polymorphic (12%). Cluster analysis grouped the 28 accessions into six groups at similarity coefficient of 0.36, where 6 materials of Kava formed a group, indicating that Kava was distantly relation to Pepper and its wild relatives. Kava had 562 bp and 355 bp specific fragments amplified by primers OPQ- 02 and OPQ-03, respectively, were recycled for cloning and sequencing analysis, and then converted to SCAR markers. Two pairs of specific SCAR primers for Kava, P4.1 and P4.2, P8.1 and P8.2 were designed. PCR amplification of 28 test materials were performed using the two pairs of the specific primers respectively, the specific bands of 562 bp and 355 bp with expected sizes were amplified in 6 Kava materials but not in other materials. The results showed that primers P4.1 and P4.2, P8.1 and P8.2 might be used as specific SCAR primers for Kava germplasm resources identification. This research provided the basis for selecting rootstocks, molecular identification and the fingerprint construction of Kava.

Aim: To evaluate in vivo the association of hypericum (Hypericum perforatum), valerian (Valeriana officinalis) and kava (Piper methysticum) with analgesia by assessing their effects in reducing orofacial pain as well as the possible hepatic, hematologic and biochemical alterations induced by regular administration of these extracts. Methods: Orofacial pain was induced in mice with the administration of 2.5% formalin in the upper lip. After 60 min, the animals were treated with saline, carbamazepine and hydroalcoholic plant extracts. The nociceptive intensity was determined by the timing at which the animal remained rubbing the injected area. To assess the hepatotoxic effect, mice were chronically treated for 25 days with saline, carbamazepine and hydroalcoholic extract. The animals were euthanized and the liver weighed, followed by a differential count of leukocytes and measurement of alanine transaminase and alkaline phosphatase. Results: The evaluation of analgesic activity in phase 1 reduced the time of rubbing compared to the control by 86% (0.05 mL/10 g) and 76% (0.10 mL/10 g). In phase 2, the extracts reduced rubbing time by 94% and 85%, respectively. In the evaluation of alkaline phosphatase, the groups treated with extracts at doses of 0.05 mL/10 g and 0.1 mL/10 g increased by 16.1% and 9.5% compared to the control group and a reduction of 8.5% and 9.1% in the evaluation of alanine transaminase respectively. It was demonstrated that in the differential counts showed an increase in eosinophils in the treated group with 0.05 mL/10 g. Conclusions: The use of hydroalcoholic extract of the associated plants reduced the orofacial formalin-induced pain with better results than carbamazepine, at both the neural conductor level of pain (phase 1) and in inflammatory or later pain (phase 2) without presenting hepatotoxicity. The observed eosinophilia is suggestive of a phenomenon called hormesis.

Background. »Lost illusions« about conventionalmedicine, together with the orientation towards the »natural«way of life, lead into ever increasing use of alternative or complementaryways of treatment. Herbal medicines are enteringinto psychiatric practice with the intention of treatment (mostlyself-treatment) psychiatric symptoms. Side effects may includechanges of mood, thinking processes or behaviour, and interactionswith psychiatric medications.Conclusions. With this article we would like to draw attentionto common self-treatment or self-medication in persons withpsychiatric symptoms, and to the equally common fact that thephysicians are – more often than not – unacquainted withthis practice. Some of the most frequently used herbal medicinesare presented in the article (registered in Slovenia as classC medicinal products). Regardless of their extensive use andimplementation of regulatory procedures, in most cases qualitativeand quantitative data are insufficient for final conclusionsabout their efficacy and safety to be reliable. Partial exceptionto this represents the use of St. John’s worth in the treatmentof depression and ginkgo in the treatment of memoryimpairments in dementia. Self-treatment in general populationshould not be neglected, however, full professional scepticismshould be maintained.