B29.0

Riboflavin Research

42 peer-reviewed studies · Evidence score: 9/10

The Role of Vitamin B Complex in Periodontal Disease: A Systematic Review Examining Supplementation Outcomes, Age Differences in Children and Adults, and Aesthetic Changes

Buzatu R et al. • Nutrients (2025)

Conclusions: Across diverse populations, inadequate vitamin B complex intake-especially folate-was consistently linked to worse periodontal outcomes.

In older adults, each standard deviation increase in serum folate was associated with an approximate 26% reduction in periodontal disease odds ratio (OR = 0.74, 95% confidence interval (CI) 0.58-0.93).
In a large NHANES-based cohort, insufficient thiamine (B1) intake yielded a 33% higher likelihood of severe periodontitis (p < 0.05), while adequate riboflavin was protective (OR = 0.90).
Another dose-response analysis (n = 8959) indicated up to a 30% risk reduction for moderate folate or B1 intake, but no extra benefit with excessive intake.

Systematic Reviewn=8,959

DOI

Preventive Medications in Pediatric Migraine: A Network Meta-Analysis

Kohandel Gargari O et al. • JAMA network open (2024)

In this network meta-analysis of randomized clinical trials, topiramate and pregabalin were associated with reduction in headache frequency and intensity.

Compared with placebo, pregabalin (ratio of means [RoM], 0.38; 95% CI, 0.18-0.79) and topiramate with vitamin D3 (RoM, 0.44; 95% CI, 0.30-0.65) were associated with reduction in migraine frequency.
However, no treatments were associated with significant improvements in quality of life or reduction of the duration of migraine attacks.
Adverse events were higher with amitriptyline (RR, 3.81; 95% CI, 1.41-10.32), topiramate (RR, 4.34; 95% CI, 1.60-11.75), and valproate (RR, 5.93; 95% CI, 1.93-18.23) compared with placebo.

Meta-Analysisn=3,771

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Exploring trajectories in dietary adequacy of the B vitamins folate, riboflavin, vitamins B(6) and B(12), with advancing older age: a systematic review

Gillies N et al. • The British journal of nutrition (2021)

This review was registered with PROSPERO (CRD42018104364).

Riboflavin (seven studies, n 1953) inadequacy progressively increased with age; the prevalence of inadequacy increased from baseline by up to 22·6 and 9·3 % in males and females, respectively.
Dietary folate adequacy (three studies, n 2321) improved in two studies (by up to 22·4 %), but the third showed increasing (8·1 %) inadequacy.
Evidence was similarly limited (two studies, respectively) and inconsistent for vitamins B6 (n 559; −9·9 to 47·9 %) and B12 (n 1410; −4·6 to 7·2 %).

Systematic Reviewn=3,119

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Effect of Vitamin B2 supplementation on migraine prophylaxis: a systematic review and meta-analysis

Chen YS et al. • Nutritional neuroscience (2022)

A pooled analysis of available randomized controlled clinical trials demonstrated that Vitamin B2 400 mg/day for three months supplementation had significant effect on days, duration, frequency, and pain score of migraine attacks.

Vitamin B2 supplementation significantly decreased migraine days (p = .005, I2 = 89%), duration (p = .003, I2 = 0), frequency (p = .001, I2 = 65%), and pain score (p = .015, I2 = 84%).
A pooled analysis of available randomized controlled clinical trials demonstrated that Vitamin B2 400 mg/day for three months supplementation had significant effect on days, duration, frequency, and pain score of migraine attacks.
Further research warranted to confirm findings

Meta-Analysisn=673

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Riboflavin supplements for blood pressure lowering in adults

Bradbury KE et al. • The Cochrane database of systematic reviews (2025)

The evidence for the effect of oral riboflavin supplements on systolic and diastolic blood pressure is very uncertain.

The evidence for the effect of oral riboflavin supplements on systolic and diastolic blood pressure is very uncertain.
The evidence comes from four RCTs, three of which had an overall high risk of bias.
Large, well-conducted trials are needed for high-certainty evidence of the effect of riboflavin for blood pressure lowering.

Meta-Analysisn=320

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Weight Loss and Dietary Interventions for Hidradenitis Suppurativa: A Systematic Review

Sivanand A et al. • Journal of cutaneous medicine and surgery (2020)

Prospective randomized controlled trials should validate these findings.

Hidradenitis suppurativa (HS) is a common inflammatory disorder characterized by recurrent, painful, and malodorous abscesses and nodules predominantly in skin folds.
Patient-controlled weight loss and bariatric surgery were associated with HS regression, though a subset of patients with significant increase in panniculi experienced exacerbations and required excision of excess skin.
Diets demonstrating benefit eliminated dairy and brewer's yeast.

Systematic Reviewn=1,279

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Effects of selected dietary supplements on migraine prophylaxis: A systematic review and dose-response meta-analysis of randomized controlled trials

Talandashti MK et al. • Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology (2025)

The use of certain dietary supplements has resulted in a significant decrease in migraine prophylaxis.

In adults, compared with placebo, these supplements did not significantly affect other outcomes, and omega-3 supplementation did not yield a statistically significant reduction in any of these outcomes.
The use of certain dietary supplements has resulted in a significant decrease in migraine prophylaxis.
Further clinical trials of high quality appear to be beneficial.

Meta-Analysis

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Nutritional Status of Children Diagnosed With Autism Spectrum Disorder: A Systematic Review and Meta-Analysis

Alhrbi A et al. • Journal of human nutrition and dietetics : the official journal of the British Dietetic Association (2025)

Journal of Human Nutrition and Dietetics

We used standardized mean difference (SMD) as an effect size for continuous variables and risk ratio (RR) for dichotomous variables with a 95% confidence interval (CI).
Children with ASD were statistically significantly shorter than TDC (SMD: -0.16, 95% CI [-0.28, -0.04], I2 = 7%), but no difference in weight [-0.12, 95% CI (-0.17, 0.92)] and BMI [-0.06, 95% CI (-0.32, 0.20)].
Also, children with ASD had a statistically significantly decreased intake of some water-soluble vitamins like folate, riboflavin, thiamine and niacin.

Meta-Analysis

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An Evaluation of Food and Nutrient Intake among Pregnant Women in The Netherlands: A Systematic Review

Ter Borg S et al. • Nutrients (2023)

High-quality, representative, and recent data are needed to evaluate the nutrient intake of pregnant women in order to make accurate assessments and evaluations, supporting scientific-based advice and national nutritional policies.

For folate and vitamin D, supplements were needed to reach the recommended intake.
The reasons for concern are the low intakes of fruits, vegetables, and (fatty) fish, and the intakes of alcohol, sugary drinks, and salt.
For several foods and nutrients, no or limited intake data were found.

Systematic Reviewn=218

DOI

Dietary interventions for multiple sclerosis-related outcomes

Parks NE et al. • The Cochrane database of systematic reviews (2020)

There are a variety of controlled trials addressing the effects of dietary interventions for MS with substantial variation in active treatment, comparator, and outcomes of interest.

Among four trials comparing PUFAs with MUFAs, there may be little to no difference in global impression of deterioration (RR 0.85, 95% CI 0.71 to 1.03; 4 studies, 542 participants; 40% in the PUFA group versus 47% in the MUFA group; low-certainty evidence).
In two trials comparing different PUFAs (omega-3 versus omega-6), there may be little to no difference in relapses (RR 1.02, 95% CI 0.62 to 1.66; 2 studies, 129 participants; 30% in the omega-3 versus 29% in the omega-6 group; low-certainty evidence).
Among three trials comparing omega-3 with omega-6, there may be little to no difference in change in disability progression, measured as mean change in Expanded Disability Status Scale (EDSS) (mean difference (MD) 0.00, 95% CI -0.30 to 0.30; 3 studies, 166 participants; low-certainty evidence).

Meta-Analysisn=217

DOI

Corneal collagen cross-linking for treating keratoconus

Sykakis E et al. • The Cochrane database of systematic reviews (2015)

The evidence for the use of CXL in the management of keratoconus is limited due the lack of properly conducted RCTs.

The same study reported the number of eyes with an increase of 2 D or more at 36 months in the whole cohort with a RR of 0.03 favouring CXL (95% CI 0.00 to 0.43, 94 eyes).
Another study reported "progression" at 18 months using a different definition; people receiving CXL were less likely to progress, but again the effect was uncertain (RR 0.14, 95% CI 0.01 to 2.61, 44 eyes).
The evidence for the use of CXL in the management of keratoconus is limited due the lack of properly conducted RCTs.

Systematic Reviewn=195

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Pathogen inactivation methods to prevent transfusion-transmissible arboviruses: A systematic review and meta-analysis

Giménez-Richarte Á et al. • Tropical medicine & international health : TM & IH (2023)

Not all PIMs achieve the same LRF, nor is this equivalent between the different arboviruses or blood products.

Not all PIMs achieve the same LRF, nor is this equivalent between the different arboviruses or blood products.
Overall, the LRFs achieved using riboflavin + UV light (Mirasol) are inferior to those achieved with the rest of the PIMs.
Regarding the others, LRFs vary by arbovirus and blood product.

Meta-Analysis

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ESPEN micronutrient guideline

Berger MM et al. • Clinical nutrition (Edinburgh, Scotland) (2022)

This guideline should enable addressing suboptimal and deficient status of a bundle of MNs in at-risk diseases.

The recommendations underwent a consensus process, which resulted in a percentage of agreement (%): strong consensus required of >90% of votes.
This guideline should enable addressing suboptimal and deficient status of a bundle of MNs in at-risk diseases.
In particular, it offers practical advice on MN provision and monitoring during nutritional support.

Meta-Analysis

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Health aspects of vegan diets among children and adolescents: a systematic review and meta-analyses

Koller A et al. • Critical reviews in food science and nutrition (2024)

Overall, the available evidence points to both risks and benefits associated with a vegan diet among children, although more and better designed studies are needed.

Single study results suggested further differences between vegan and non-vegan children, such as lower bone mineral content or urinary iodine among vegan children.
Risk of Bias was rated as high or very high in 7 out of 18 studies.
The certainty of evidence for the meta-analyses was low (n = 2) or very low (n = 46).

Meta-Analysisn=18

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Dietary Intake and Diabetic Retinopathy: A Systematic Review of the Literature

Shah J et al. • Nutrients (2022)

Therefore, the general recommendation for nutritional counseling to manage diabetes may be beneficial to prevent DR risk, but prospective studies in diverse diabetic populations are needed to confirm our findings and expand clinical guidelines for DR management.

Conversely, high intakes of diet soda, caloric intake, rice, and choline were associated with a higher risk of DR.
No association was seen between vitamin C, riboflavin, vitamin D, and milk and DR.
Only one study in our review assessed dietary intake and DME and found a risk of high sodium intake for DME progression.

Systematic Review

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Association between irritable bowel syndrome and micronutrients: A systematic review

Bek S et al. • Journal of gastroenterology and hepatology (2022)

Irritable bowel syndrome patients are at risk of developing multiple micronutrient deficiencies that may have both localized gastrointestinal as well as systemic effects.

Irritable bowel syndrome patients are at risk of developing multiple micronutrient deficiencies that may have both localized gastrointestinal as well as systemic effects.
Dietary management of IBS patients should include a proper dietitian review to ensure nutritional adequacy where possible.
Further research warranted to confirm findings

Systematic Review

DOI

Bariatric Surgery in Obesity: Effects on Gut Microbiota and Micronutrient Status

Ciobârcă D et al. • Nutrients (2020)

In this review, we discuss the latest evidence concerning the relationship between obesity, GM and micronutrients, the impact of bariatric surgery on GM in relation with micronutrients equilibrium, and the importance of the probiotics' supplementation in obese patients submitted to surgical treatment.

Bariatric surgery, the therapy of choice for severe obesity, produces sustained weight loss and improvements in obesity-related comorbidities.
Also, it significantly alters the gut microbiota (GM) composition and function, which might have an important impact on the micronutrient status as GM is able to synthesize certain vitamins, such as riboflavin, folate, B12, or vitamin K2.
However, recent data have reported that GM is not fully restored after bariatric surgery; therefore, manipulation of GM through probiotics represents a promising therapeutic approach in bariatric patients.

Systematic Review

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Associations of dietary vitamin B1, vitamin B2, vitamin B6, and vitamin B12 with the risk of depression: a systematic review and meta-analysis

Wu Y et al. • Nutrition reviews (2022)

This study suggested that the intake of dietary vitamin B1, B2, B6, and B12 may be inversely associated with the risk of depression; the inverse associations observed between depression and intake of dietary vitamin B2, B6, and B12 were significant in females, but not in males.

The pooled RR (95% CI) of depression for the highest vs the lowest category of dietary vitamin B1, B2, B6, and B12 was 0.69 (0.55-0.87), 0.77 (0.67-0.89), 0.81 (0.71-0.93), and 0.86 (0.75-0.99), respectively.
This study suggested that the intake of dietary vitamin B1, B2, B6, and B12 may be inversely associated with the risk of depression; the inverse associations observed between depression and intake of dietary vitamin B2, B6, and B12 were significant in females, but not in males.
Further studies are needed to confirm these results.

Meta-Analysisn=12

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Association Between One-carbon Metabolism-related Vitamins and Risk of Breast Cancer: A Systematic Review and Meta-analysis of Prospective Studies

Zeng J et al. • Clinical breast cancer (2020)

The corresponding pooled relative risks (RRs) for the highest intake compared with the lowest were 0.93 (95% confidence interval [CI], 0.88-0.99; P = .018), 0.94 (95% CI, 0.89-1.00; P = .037) and 0...

The corresponding pooled relative risks (RRs) for the highest intake compared with the lowest were 0.93 (95% confidence interval [CI], 0.88-0.99; P = .018), 0.94 (95% CI, 0.89-1.00; P = .037) and 0.90 (95% CI, 0.82-0.99; P = .026).
No significant association between vitamin B12 and breast cancer risk was found (RR, 0.99; 95% CI, 0.94-1.04; P = .604).
An increment of folate intake (100 μg/d) corresponded to a 7% deceased risk of ER-/PR- breast cancer (RR, 0.93; 95% CI, 0.89-0.98; P = .007).

Meta-Analysisn=27

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Components of one-carbon metabolism and renal cell carcinoma: a systematic review and meta-analysis

Clasen JL et al. • European journal of nutrition (2020)

There was a lack of precision due largely to the low number of studies.

However, vitamin B6 biomarker status did have a protective (RR = 0.62) but imprecise (95% CrI 0.39-1.14) effect estimate and folate intake had a notable association as well (RR = 0.85, 95% CrI 0.71-1.01).
There was a lack of precision due largely to the low number of studies.
Further investigation is warranted, especially for folate and vitamin B6, which had consistent suggestive evidence of a protective effect for both dietary intake and biomarker status.

Meta-Analysis

DOI

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