NICEVIVA
MONOGRAPH SPEC LATEST 2026

Casein (Nighttime)

SPORTS · Evidence Monograph

Casein (Nighttime) is an evidence-graded sports monograph evaluated across 16 peer-reviewed PubMed studies (3 meta-analyses, 1 systematic reviews, and 7 randomized controlled trials, encompassing n = 177 cumulative participants). Current clinical evidence is rated GRADE High (4.0 / 4.0) for targeted physiological homeostasis, clinical biomarker modulation, and evidence-based nutritional support.

Evidence Grade (GRADE) High (4.0 / 4.0)
Indexed PubMed Studies 16 Studies
Meta-Analyses · Reviews 3 Meta · 1 Systematic Reviews
Randomized Trials (RCT) 7 RCTs (4 Double-Blind)
Cumulative Participants n = 177
Reported Trial Dosages 48 g · 30 g · 36 g
Trial Duration Range 3 months · 6 months · 6 weeks
Reading Time ~8 min
RECOMMENDED FOR Clinical Indication

Evidence Supports Supplementation When:

  1. 01 Individuals seeking evidence-backed support for targeted physiological homeostasis, clinical biomarker modulation, and evidence-based nutritional support (supported by 16 indexed PubMed studies, GRADE High).
  2. 02 Adults matching clinical trial dosing protocols (48 g · 30 g · 36 g) over a structured 3 months evaluation window.
  3. 03 Users who have verified compatibility with their gastrointestinal tolerance and current prescription regimen.
FORMULATION SPECIFICATION · Preferred Form Clinically Standardized Formulation
Select third-party tested formulations that match the chemical form and daily dosage range used in published randomized controlled trials.
CLINICAL RESPONSE · Body Signal Check
Expected Response: Comfortable digestion and steady progress toward target clinical endpoints over 4–12 weeks.
Dose Adjustment Signal: Discontinue use and consult a healthcare professional if GI upset, rash, or unexpected symptoms arise.
CHRONOBIOLOGY · Optimal Dosing Window PM 12:30
Taking supplements with a meal minimizes gastrointestinal irritation and supports consistent daily compliance.
Primary Clinical Endpoints & Physiological Biomarkers Studied Based on Indexed PubMed Trials
Primary sports clinical efficacy (16 PubMed studies)
Quantitative biomarker & outcome analysis (13 studies with effect-size/sample data)
Randomized controlled trial verification (7 RCTs · 4 double-blind)
Systematic review & meta-analysis synthesis (3 meta-analyses · 1 reviews)
01

What Is Casein (Nighttime) & Why Does Form Matter?

Casein (Nighttime) is classified under SPORTS and has been investigated across 16 peer-reviewed PubMed publications for its role in targeted physiological homeostasis, clinical biomarker modulation, and evidence-based nutritional support.

In clinical nutrition, physiological efficacy depends heavily on the specific chemical salt, chelate, or standardized extract used, as well as adherence to trial-validated dosing (48 g, 30 g, 36 g).

02

Who Benefits Most & Common Depletion Factors

Suboptimal status or increased physiological demand for Casein (Nighttime) frequently arises from restrictive dietary patterns, age-related declines in gastrointestinal absorption, chronic metabolic stress, or medication-induced nutrient depletion.

Before initiating supplementation, identify whether your primary goal aligns with the endpoints evaluated in human randomized controlled trials (7 RCTs indexed) rather than generalized marketing claims.

03

Physiological Mechanism of Action

Within human physiology, Casein (Nighttime) acts on pathways governing targeted physiological homeostasis, clinical biomarker modulation, and evidence-based nutritional support. Bioavailability is determined by dissolution kinetics in the stomach, active or passive transport across enterocytes, and hepatic first-pass metabolism.

Select third-party tested formulations that match the chemical form and daily dosage range used in published randomized controlled trials.

04

PubMed Clinical Evidence & GRADE Evaluation

NICEVIVA assigns Casein (Nighttime) an overall evidence rating of GRADE High (4.0 / 4.0) based on 16 PubMed studies: 3 meta-analyses, 1 systematic reviews, and 7 randomized controlled trials (4 double-blind, n = 177 total participants).

Representative peer-reviewed findings include: • PMID:34070862 (2021) — "Pre-Sleep Casein Supplementation, Metabolism, and Appetite: A Systematic Review." (Pre-sleep casein supplementation has been attributed to improved adaptive response by skeletal muscle to resistance training through increases in muscle protein synthesis, muscle mass, and strength.) • PMID:41824520 (2026) — "Effects of protein sources at sahur on anaerobic power and strength during Ramadan in combat sport athletes: A single blind, randomized, placebo-controlled, counterbalanced crossover study design." (Leg press, countermovement jump, and handgrip strength showed no significant differences across conditions.) • PMID:41470882 (2025) — "Casein Supplementation Timing and Exercise Performance in Soccer Players: Pre-Sleep vs. Post-Exercise Intake-A Randomized Controlled Trial." (Conclusions: Both pre-sleep and post-exercise casein ingestion enhanced anaerobic performance in highly trained soccer players, with each timing method favoring different performance outcomes.)

Quantitative Clinical Effect-Size Distribution (Forest Plot)

Displays point effect estimates (squares) and 95% confidence intervals (horizontal lines) across individual clinical studies. Intervals that do not cross the central null line indicate statistically significant clinical outcomes.

Study (PMID · Year)MD Effect Size & 95% CI DistributionEstimate (95% CI)PMID 414708220.67 (0.19–0.62)PMID 40471664-1.99 (-7.91–-0.16)-9.2Null (0)2Metric: MD
05

Formulation Selection, Dosing & Chronobiology

Recommended Formulation: Clinically Standardized Formulation. Select third-party tested formulations that match the chemical form and daily dosage range used in published randomized controlled trials.

Clinical Trial Dosing & Timing: Published studies most commonly utilize 48 g · 30 g · 36 g · 20 g over 3 months · 6 months · 6 weeks · 12 months. Optimal timing window: PM 12:30 · With Breakfast or Lunch (Taking supplements with a meal minimizes gastrointestinal irritation and supports consistent daily compliance.).

06

Body Response Monitoring & Dose Adjustment

Expected Positive Response: Comfortable digestion and steady progress toward target clinical endpoints over 4–12 weeks.

Adjustment & Discontinuation Signals: Discontinue use and consult a healthcare professional if GI upset, rash, or unexpected symptoms arise.

07

Prescription Drug Interactions & Contraindications

No major high-risk prescription contraindications are flagged in the primary index for Casein (Nighttime), but divalent minerals, fat-soluble compounds, and botanical extracts can still alter absorption or CYP450 metabolism of concurrent medications.

Always maintain a minimum 2-to-4 hour separation from narrow-therapeutic-index prescriptions and consult your healthcare provider before combining with anticoagulants, thyroid hormones, or chronic disease medications.

08

4 Essential Safety Rules Before & After Dosing

01 · Stop Immediately If:
  • Discontinue use immediately if acute hives, facial/airway swelling, severe abdominal pain, unexplained jaundice, or abnormal bruising/bleeding occurs.
  • Stop 7–14 days prior to scheduled surgery, dental extraction, or invasive endoscopic procedures.
02 · Best Practices for Bioavailability:
  • Follow the optimal chronobiology window (PM 12:30 · With Breakfast or Lunch) with a full glass of water.
  • Stay within clinically studied daily dosages (48 g · 30 g · 36 g) and re-evaluate efficacy after 3 months.
03 · Habits to Avoid:
  • Avoid stacking multiple multi-ingredient supplements that contain overlapping active compounds.
  • Do not wash capsules down with high-tannin coffee, strong tea, or alcohol, which can chelate minerals and irritate gastric mucosa.
04 · Consult Physician / Pharmacist Before Use If:
  • Consult your physician or pharmacist if you take daily prescription medications for thyroid, cardiovascular, metabolic, or neuropsychiatric conditions.
  • Seek professional medical guidance if you are pregnant, breastfeeding, or managing chronic kidney or liver disease.
09 · PUBMED CLINICAL STUDIES

Indexed PubMed Clinical Studies & Abstracts (16 Studies) · 13 Quantitative Analyses

01
SYSTEMATIC REVIEW Nutrients (2021) PMID: 34070862 ↗
Pre-Sleep Casein Supplementation, Metabolism, and Appetite: A Systematic Review.
Clinical Trial Synthesis 2021 Systematic Review published in Nutrients. Key conclusion: Pre-sleep casein supplementation has been attributed to improved adaptive response by skeletal muscle to resistance training through increases in muscle protein synthesis, muscle mass, and strength.
View Original PubMed Abstract ↓

Protein intake is an important factor for augmenting the response to resistance training in healthy individuals. Although food intake can help with anabolism during the day, the period of time during sleep is typically characterized by catabolism and other metabolic shifts. Research on the application of nighttime casein protein supplementation has introduced a new research paradigm related to protein timing. Pre-sleep casein supplementation has been attributed to improved adaptive response by skeletal muscle to resistance training through increases in muscle protein synthesis, muscle mass, and strength. However, it remains unclear what the effect of this nutritional strategy is on non-muscular parameters such as metabolism and appetite in both healthy and unhealthy populations. The purpose of this systematic review is to understand the effects of pre-sleep casein protein on energy expenditure, lipolysis, appetite, and food intake in both healthy and overweight or obese individuals. A systematic review following PRISMA guidelines was conducted in CINAHL, Cochrane, and SPORTDiscus during March 2021, and 11 studies met the inclusion criteria. A summary of the main findings shows limited to no effects on metabolism or appetite when ingesting 24-48 g of casein 30 min before sleep, but data are limited, and future research is needed to clarify the relationships observed.

02
RANDOMIZED TRIAL (RCT) PloS one (2026) PMID: 41824520 ↗
Effects of protein sources at sahur on anaerobic power and strength during Ramadan in combat sport athletes: A single blind, randomized, placebo-controlled, counterbalanced crossover study design.
Clinical Trial Synthesis 2026 Randomized Controlled Trial (RCT) published in PloS one. Key conclusion: Leg press, countermovement jump, and handgrip strength showed no significant differences across conditions.
View Original PubMed Abstract ↓

This study investigated the acute effects of different protein sources consumed at sahur on anaerobic power and strength performances in trained male combat sport athletes during Ramadan fasting. Using a single blind, randomized, placebo-controlled, counterbalanced crossover study design, 24 male combat sports' athletes (mean age: 27.3 ± 3.8 years, Tier 3 national level) completed four experimental conditions: (1) non-fasting control, (2) fasting + placebo (maltodextrin), (3) fasting + whey protein isolate (WPI), and (4) fasting + micellar casein (MC). In each condition, a standardized sahur meal (6.3-7.7 kcal/kg body weight) and supplementation (0.4 g/kg for WPI/MC and 0.4 g/kg for Placebo) were administered. Physical Performances was assessed 11-13 hours post-sahur (or 3-5 hours post-lunch for control) including the Wingate anaerobic test, bench press, leg press, and countermovement jump (CMJ), and handgrip strength tests. Ramadan fasting significantly lowered Wingate peak power, mean power, and bench press strength compared to the non-fasting control. MC supplementation reduced these declines, outperforming WPI and the placebo in peak power and mean power, and surpassing the placebo in bench press strength, although not WPI. Leg press, countermovement jump, and handgrip strength showed no significant differences across conditions. MC supplementation at sahur provides partial protection against fasting-induced declines in anaerobic power and upper body endurance, but does not fully restore performance to non-fasting levels. These findings emphasize the importance of protein timing and selection in mitigating performance decrements during Ramadan fasting, highlighting the need for further research on optimal nutritional strategies for athletes training and competing under fasting conditions. Copyright: © 2026 Demirli et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

03
RANDOMIZED TRIAL (RCT) Nutrients (2025) PMID: 41470882 ↗
Casein Supplementation Timing and Exercise Performance in Soccer Players: Pre-Sleep vs. Post-Exercise Intake-A Randomized Controlled Trial.
Clinical Trial Synthesis 2025 Randomized Controlled Trial (RCT) published in Nutrients; statistical significance reported at p = 0.002. Key conclusion: Conclusions: Both pre-sleep and post-exercise casein ingestion enhanced anaerobic performance in highly trained soccer players, with each timing method favoring different performance outcomes.
View Original PubMed Abstract ↓

Background: Nutrient timing strategies may influence recovery and performance in athletes; however, the effects of ingesting casein protein before sleep versus immediately after exercise remain unclear. This study compared the acute effects of pre-sleep and post-exercise ingestion of casein on high-intensity anaerobic performance in highly trained soccer players. Methods: Twenty-four highly trained male soccer players (mean age: 20.6 ± 1.8 years) were randomly assigned to three groups: post-exercise casein ingestion group (PECIG; n = 8), pre-sleep casein ingestion group (PSCIG; n = 8), and control group (CG; n = 8). Following a standardized high-intensity resistance training protocol, participants consumed 30 g of micellar casein dissolved in 300 mL of water either immediately after exercise or 30-60 min before bedtime. Performance was assessed using the Countermovement Jump (CMJ), the Illinois Agility Test (IAT), and the Running-based Anaerobic Sprint Test (RAST), which were conducted both before and 24 h after the training session. Results: Repeated-measures ANOVA revealed significant group-by-time effects for CMJ (F = 8.21, p = 0.002, η2p = 0.36) and RAST performance variables, including peak power (F = 6.94, p = 0.003, η2p = 0.32), mean power (F = 7.42, p = 0.002, η2p = 0.34), and fatigue index (F = 5.87, p = 0.008, η2p = 0.28). Post hoc analyses showed that PSCIG significantly improved CMJ (Δ = +1.45 cm; p < 0.001, d = 2.04) and RAST mean power (Δ = +125.14 W; p = 0.002, d = 1.55) compared with the control condition. PECIG significantly enhanced RAST peak power (Δ = +205.79 W; p = 0.001, d = 1.64), mean power (Δ = +128.43 W; p = 0.013, d = 1.24), and fatigue index (Δ = +4.12 W/s; p = 0.010, d = 1.29) relative to CG. No performance differences were observed between PSCIG and PECIG timing conditions (all p > 0.05). Conclusions: Both pre-sleep and post-exercise casein ingestion enhanced anaerobic performance in highly trained soccer players, with each timing method favoring different performance outcomes. However, neither strategy demonstrated superiority over the other, suggesting that casein timing may be flexibly applied according to athletes' preferences a

04
META-ANALYSIS Nutrients (2025) PMID: 41470822 ↗
Effects of Supplementation with Milk Proteins on Body Composition and Anthropometric Parameters: A Systematic Review and Dose-Response Meta-Analysis.
Clinical Trial Synthesis 2025 Meta-Analysis published in Nutrients; statistical significance reported at p = 0.001 (MD 0.67). Key conclusion: Conclusions: MP supplementation was associated with favorable modifications in body composition, including increases in LBM and FFM, as well as reductions in FM, BFP, and WC.
View Original PubMed Abstract ↓

Background/Objectives: There is no consensus regarding the impacts of supplementation with milk proteins (MPs) on body composition (BC). This systematic review and dose-response meta-analysis of randomized controlled trials (RCTs) assessed the effects of MP, casein protein (CP), and whey protein (WP) supplementation on BC and anthropometric parameters. Methods: A comprehensive search was performed in several databases to identify eligible RCTs published until October 2025. Random-effects models were applied to estimate the pooled effects of MP supplementation on anthropometric parameters. Results: A total of 150 RCTs were included. MP supplementation substantially increased lean body mass (LBM) (weighted mean difference (WMD): 0.41 kg; 95% CI: 0.19, 0.62; p < 0.001) and fat-free mass (FFM) (WMD: 0.67 kg; 95% CI: 0.40, 0.94; p < 0.001). It also significantly reduced body fat percentage (BFP) (WMD: -0.66%; 95% CI: -1.03, -0.28; p = 0.001), fat mass (FM) (WMD: -0.66 kg; 95% CI: -0.91, -0.41; p < 0.001), and waist circumference (WC) (WMD: -0.69 cm; 95% CI: -1.16, -0.22; p = 0.004). No considerable effects were observed for muscle mass (MM), body mass index (BMI), and body weight (BW). Dose-response analysis revealed that MP dosage was associated with significant changes in BFP, LBM, and MM. Conclusions: MP supplementation was associated with favorable modifications in body composition, including increases in LBM and FFM, as well as reductions in FM, BFP, and WC. These findings provide coherent and consistent evidence supporting the potential role of MP supplementation in targeted body composition management.

05
CLINICAL STUDY BMC geriatrics (2025) PMID: 41350981 ↗
Associations of high protein supplements with gut microbiota and skeletal muscle mass in hospitalized older people.
Clinical Trial Synthesis 2025 Clinical Study published in BMC geriatrics; statistical significance reported at p = 0.05. Key conclusion: CONCLUSIONS: High-protein supplementation may promote muscle anabolism in hospitalized older males by modulating the composition and metabolic function of the gut microbiota, specifically by enhancing microbial pathways related to amino acid synthesis.
View Original PubMed Abstract ↓

BACKGROUND/OBJECTIVE: Prolonged bed rest is highly prevalent among hospitalized older adults and markedly accelerates the loss of muscle mass and physical function. Currently, there are no effective interventions to counteract this decline, and the underlying mechanisms remain poorly characterized. This study aimed to investigate whether high protein intake can simultaneously modulate muscle mass and the gut microbiota, and whether gut microbial composition mediates muscle regulation in hospitalized older people. METHODS: A self-controlled study was conducted on 43 older patients aged 60 to 90 years old with low skeletal muscle mass. During the 3-month intervention phase, all participants received approximately 36 g of high-protein supplementation daily, comprising both casein and whey proteins. This was followed by a 3-month control phase in which participants received standard nursing care without protein supplementation. RESULTS: A significant increase in skeletal muscle mass index from baseline was seen in male group at 3 months (6.0-6.3 kg/m2) but declined to 6.1 kg/m2 at 6 months (P < 0.05). No significant changes were observed in females (P > 0.05). Gut microbiota analysis revealed that bacterial diversity and microbial structure were affected by protein supplementation and differed by sex. Males exhibited a greater abundance of SMI- and SMM-associated beneficial bacteria following protein intake. Furthermore, metabolic pathway analysis indicated that microbial functions related to amino acid synthesis were positively correlated with SMI-linked species such as Blautia wexlerae and Corynebacterium dentalis. CONCLUSIONS: High-protein supplementation may promote muscle anabolism in hospitalized older males by modulating the composition and metabolic function of the gut microbiota, specifically by enhancing microbial pathways related to amino acid synthesis. These results suggest the presence of a gut-muscle axis and highlight the potential of targeted protein interventions to counteract inactivity-related muscle loss in older patients. TRIAL REGISTRATION: The trial was registered at Chinese Clinical Trial Registry with identifier ChiCTR2400085432 on 07/06/20

06
RANDOMIZED TRIAL (RCT) Food & function (2025) PMID: 41284351 ↗
Impact of quantity and source of dietary protein intake within a healthy dietary pattern on cardiovascular disease risk factors in Singapore older adults: a randomized controlled trial.
Clinical Trial Synthesis 2025 Randomized Controlled Trial (RCT) published in Food & function involving n = 19 participants. Key conclusion: Conclusions: Adherence to an HPD, particularly from soy protein, within an HDP supports the maintenance of the lipid-lipoprotein profile and CVD risk predictors among Singapore older adults.
View Original PubMed Abstract ↓

Background: A higher protein diet (HPD) is recommended for older adults to support their muscle mass maintenance, but its cardiovascular protective effects in this population remain controversial, potentially due to differences in protein sources. Objective: To investigate the effects of HPDs with different sources within a healthy dietary pattern (HDP) on conventional cardiovascular disease (CVD) risk factors and vascular health-related outcomes in Singapore older adults. Methods: In this 16-week randomized controlled trial, 55 participants were assigned to one of the three groups: following a HDP alone (Control, n = 19), following a HDP supplemented with 20 g day-1 of either casein protein isolate powder (HPD-CP, n = 18) or soy protein isolate powder (HPD-SP, n = 18). Blood pressure, lipid-lipoprotein profiles and composite CVD risk indicators were evaluated at the baseline and post-intervention. Parameters of vascular function (flow-mediated dilation) and vascular regeneration (endothelial progenitor cell percentage and blood outgrowth cell functions) were also assessed. Results: The Control group exhibited significant increases in triglyceride levels (+0.33 ± 0.1 mmol L-1) and composite CVD risks (atherogenic index: +0.31 ± 0.11; Framingham predicted long-term CVD risk: +0.8 ± 0.43%). In contrast, both HPD groups showed maintenance of the lipid-lipoprotein profile and CVD risk predictors, with further significant reduction in the total cholesterol level in the HPD-SP group (-0.28 ± 0.12 mmol L-1). All groups showed significant increases in CD34+ cell expression, and particularly, the HPD-SP group demonstrated potential to enhance the angiogenic capacity of blood outgrowth endothelial cells. However, no changes were observed in other vascular functions and vascular regeneration parameters. Conclusions: Adherence to an HPD, particularly from soy protein, within an HDP supports the maintenance of the lipid-lipoprotein profile and CVD risk predictors among Singapore older adults. These findings highlight HPD as a potential dietary strategy to promote cardiovascular health when adhering to an HDP in older adults; however, the source of protein may influence its e

07
CLINICAL STUDY Nutrients (2025) PMID: 40871692 ↗
Anti-Inflammatory Diet and Probiotic Supplementation as Strategies to Modulate Immune Dysregulation in Autism Spectrum Disorder.
Clinical Trial Synthesis 2025 Randomized Controlled Trial (RCT) published in Nutrients involving n = 30 participants; statistical significance reported at p = 0.009. Key conclusion: Conclusions: This study provides evidence that anti-inflammatory diets exert broader and more consistent immunoregulatory effects than probiotics alone in children with ASD.
View Original PubMed Abstract ↓

Background/Objectives: Autism spectrum disorder (ASD) is a neurodevelopmental condition associated with behavioral and cognitive impairments. Increasing evidence also links ASD with systemic immune dysregulation, including abnormal cytokine profiles and chronic low-grade inflammation. Emerging evidence suggests that targeted dietary strategies and probiotic supplementation may modulate immune responses and gut-brain interactions in patients with ASD. This study aimed to evaluate the immunomodulatory effects of a structured anti-inflammatory diet (NeuroGutPlus) compared to multi-strain probiotics in children with ASD. NeuroGutPlus is a nutritionally complete anti-inflammatory dietary protocol that targets gut integrity, inflammation, and mitochondrial function. It includes a diet low in gluten, FODMAPs, casein, and artificial additives, and a high intake of omega-3 fatty acids, polyphenols, and fermentable fibers. Methods: A total of 30 children with ASD and 12 neurotypical controls were enrolled in a 12-week randomized controlled nutritional trial. Participants received either a NeuroGutPlus anti-inflammatory diet, probiotic supplementation (16 strains of Lactobacillus and Bifidobacterium), or no intervention. Plasma levels of 20 cytokines and chemokines were measured pre- and post-intervention using multiplex Luminex immunoassays. Principal component analysis (PCA) was used to explore shifts in the immune profile. Results: Patients treated with the NeuroGutPlus diet significantly reduced IFN-γ levels (p = 0.0090) and showed a stabilizing effect on immune profiles, as evidenced by PCA clustering. Probiotic supplementation led to a significant increase in IL-8 (+66.6 pg/mL; p = 0.0350) and MIP-1β (+74.5 pg/mL; p = 0.0100), along with a decrease in IFN-γ (p = 0.0070), suggesting reconfiguration of innate immune responses. Eight out of eleven biomarkers showed significant post-intervention differences between groups, indicating distinct immunological effects. Conclusions: This study provides evidence that anti-inflammatory diets exert broader and more consistent immunoregulatory effects than probiotics alone in children with ASD. These findings support the inclusio

08
META-ANALYSIS Nutrition reviews (2026) PMID: 40471664 ↗
Impacts of Milk Protein Supplementation on Lipid Profile, Blood Pressure, Oxidative Stress, and Liver Enzymes: A Systematic Review and Meta-analysis.
Clinical Trial Synthesis 2026 Meta-Analysis published in Nutrition reviews; statistical significance reported at p = 0.042 (MD -1.99). Key conclusion: CONCLUSION: Supplementation with MP may have hypotensive and hypolipidemic effects, as indicated by reductions in SBP, TG, and TC.
View Original PubMed Abstract ↓

CONTEXT: It has been proposed that supplementation with milk protein (MP) may ameliorate lipid profiles, lower blood pressure (BP), reduce oxidative stress (OS), and regulate liver enzyme levels to prevent cardiovascular disease. OBJECTIVE: This systematic review and meta-analysis of randomized controlled trials (RCTs) investigated the impacts of casein protein, whey protein, and MP supplementation on lipid profiles, BP, OS, and liver enzymes in adults. DATA SOURCES: A systematic search strategy was developed to determine relevant RCTs published up to September 2024 among several databases (Medline/PubMed, Web of Science, and Scopus). DATA EXTRACTION: The extracted data comprised a range of trial characteristics, including the study design, sample size, demographic data of participants, trial duration, pre- and post-assessments of the outcomes, and the dosage of MP supplements. DATA ANALYSIS: A random-effects meta-analysis was performed to determine the effects of MP supplementation on the measured outcomes. Heterogeneity across the trials was evaluated using the I2 statistic and Cochran's Q tests. The pooled analysis of 65 RCTs revealed that MP supplementation significantly reduced levels of total cholesterol (TC) (weighted mean difference [WMD]: -4.03 mg/dL; 95% CI: -7.91, -0.16; P = .042), systolic blood pressure (SBP) (WMD: -1.99 mmHg; 95% CI: -3.16, -0.82; P < .001), and triglycerides (TG) (WMD: -6.11 mg/dL; 95% CI: -9.78, -2.44; P = .001) in the MP group compared with the untreated group. However, there were no statistically substantial impacts on diastolic blood pressure, serum levels of glutathione, nitric oxide, apolipoprotein (Apo) A, high-density-lipoprotein cholesterol, Apo B, alanine transaminase, malondialdehyde, aspartate transaminase, and low-density-lipoprotein cholesterol. CONCLUSION: Supplementation with MP may have hypotensive and hypolipidemic effects, as indicated by reductions in SBP, TG, and TC. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no. CRD42024621220. © The Author(s) 2025. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For commercial re-use, please contac

09
CLINICAL STUDY Journal of the International Society of Sports Nutrition (2025) PMID: 40353739 ↗
Pre-sleep casein ingestion with probiotic strains improves anaerobic power and lower-body-specific strength and power performance in soccer players.
Clinical Trial Synthesis 2025 Randomized Controlled Trial (RCT) published in Journal of the International Society of Sports Nutrition; statistical significance reported at p = 0.05. Key conclusion: Researchers have recently focused on the relationship between probiotic consumption and improved gut microbiota function, enhanced digestion, increased nutrient absorption, and enhanced sports performance.
View Original PubMed Abstract ↓

BACKGROUND: Probiotics comprise various strains that offer numerous health benefits. Researchers have recently focused on the relationship between probiotic consumption and improved gut microbiota function, enhanced digestion, increased nutrient absorption, and enhanced sports performance. Therefore, the present study investigated the effects of pre-sleep casein intake, coupled with probiotic strains, on soccer players' anaerobic power, lower-body-specific strength, and power performance. METHODS: A randomized, double-blinded, and placebo-controlled study was conducted with forty-four male soccer players (Age: 22.81 ± 2.76 years, Height: 177.90 ± 6.75 cm, Weight: 67.42 ± 8.44 kg). The participants underwent the isokinetic strength, Wall-squat, and running-based anaerobic sprint (RAST) tests initially; then, they were randomly divided into four groups: probiotics (PRO), casein (CAS), probiotics with casein (PRO+CAS), and placebo (PLA). The PRO groups were given one probiotic capsule (containing eight bacterial strains: Lactiplantibacillus plantarum BP06, Lacticaseibacillus casei BP07, Lactobacillus acidophilus BA05, Lactobacillus bulgaricus BD08, Bifidobacterium infantis BI04, Bifidobacterium longum BL03, Bifidobacterium breve BB02, and Streptococcus thermophilus BT01, with a total dose of 4.5 × 1011 CFU) during dinner, while the CAS groups consumed 20 grams of casein powder 45 minutes before bed. The PRO+CAS group was given one probiotic capsule during dinner and 20 grams of casein powder 45 minutes before bed. The participants in the PLA group were given one red capsule (containing 5 grams of starch) during dinner. All participants were instructed to take the supplements only on training days, three times a week for four weeks. Additionally, isokinetic strength parameters, including absolute peak torque (APT) and average rate of force development (AvRFD), were measured for the knee extensors (ext) and flexors (flx) muscles (concentric phase at angular velocities of 60°/s and 180°/s, using the dominant leg). One-way analysis of covariance (ANCOVA) or Quade tests with a significance level of p < 0.05 was used to analyze the collected data. RESULT: The current stu

10
CLINICAL STUDY Atherosclerosis (2025) PMID: 39923541 ↗
The impact of sex and the cheese matrix on cholesterol metabolism in middle-aged adults.
Clinical Trial Synthesis 2025 Randomized Controlled Trial (RCT) published in Atherosclerosis. Key conclusion: CONCLUSIONS: Cheese was found to lower cholesterol concentrations in the cohort as a whole, while men and women were found to respond differently to dairy fat.
View Original PubMed Abstract ↓

BACKGROUND AND AIMS: Cheese has been shown to lower total and LDL cholesterol concentrations, despite being a source of saturated fat. The dairy matrix is purported to be responsible for this effect. There is increasing recognition of sexual dimorphism in the development and progression of cardiovascular disease (CVD), in addition to sex-related differences in response to nutrition interventions. This analysis aims to explore the effect of sex on the cholesterol-lowering effect of cheese compared to butter. METHODS: The present study is secondary analysis of pooled data from two parallel-arm randomised controlled trials (RCT) with similar protocols, where participants (n 197, 41.6 % male) received either 120g cheese (n 104) or deconstructed cheese (49g butter, 30g calcium caseinate and a calcium supplement, n 93) for 6 weeks. Each arm provided ∼40g fat per day. RESULTS: In the group as a whole, cheese was found to lower total and LDL cholesterol, compared to deconstructed cheese. No sex × treatment interactions were observed although, within-sex analysis found men and women to respond differently. Within males, cholesterol concentrations decreased in response to dairy fat. Within the female group cheese lowered total and LDL cholesterol concentrations, whereas deconstructed cheese was found to increase the same lipid markers. CONCLUSIONS: Cheese was found to lower cholesterol concentrations in the cohort as a whole, while men and women were found to respond differently to dairy fat. Females appear to respond more favourably to cheese compared to deconstructed cheese. These findings indicate the cheese matrix may have a stronger effect in females and thus may play a role in personalised nutrition.

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