Effect of sumac powder on clinical symptoms, hyperandrogenism, inflammation, blood glucose, lipid profiles in women with polycystic ovary syndrome: A double-blind randomized clinical trial

The effect of sumac on cardiovascular risk factors in adults: A systematic review and meta-analysis of randomized controlled trials

Clinical evidence suggests the beneficial effects of sumac on cardiovascular risk factors. However, these results are controversial. This systematic review and meta-analysis of randomized controlled trials (RCTs) was performed to determine the effect of sumac supplementation on cardiovascular risk factors in adults. The PubMed, Embase, Web of Science, and Cochrane databases were searched from inception to 30 December 2023 to identify RCTs that were published in English. Data were presented as weighted mean difference (WMD) and associated 95 % confidence interval (CI). The quality of the included trials was measured using the Cochrane Collaboration's modified risk of bias tool. A pooled analysis of 16 trials showed that sumac consumption led to a significant reduction in fasting blood glucose (WMD: -6.03 mg/dl; 95 % CI: -9.67 to -2.39), hemoglobin A1c (WMD: -0.45 %; 95 % CI: -0.59 to -0.31), triglycerides (WMD: -9.07 mg/dL; 95 % CI: -16.19 to -1.94), low-density lipoprotein cholesterol (WMD: -5.58 mg/dL; 95 % CI: -11.27 to -0.12), BMI (WMD: -0.22 kg/m2; 95 % CI: -0.38 to -0.05), weight (WMD: -0.85 kg; 95 % CI: -1.44 to -0.27), waist circumference (WMD: -0.54 cm; 95 % CI: -0.92 to -0.15), and diastolic blood pressure (WMD: -2.72 mmHg; 95 % CI: -4.16 to -1.29). High-density lipoprotein-cholesterol level also increased significantly (WMD: 3.69 mg/dL; 95 % CI: 1.81-5.57). The overall results support possible protective and therapeutic effects of sumac on cardiovascular risk factors in adults. Additional prospective studies are suggested using longer intervention periods and higher supplementation doses to confirm these results.

ٍEffects of Sumac Consumption on Blood Pressure, Glycemic Indices, and Body Composition in Adults: A GRADE-assessed Systematic Review and Dose-response Meta-analysis

BACKGROUND

Owing to the rich phytochemical content of Rhus coriaria L. (Anacardiaceae), known as Sumac, it may affect blood pressure, glycemic, and anthropometric indices. We, therefore, aimed to examine evidence on effect of Sumac on these factors by conducting a meta-analysis of RCTs.

METHODS

A systematic literature search up to January 2024 was completed in PubMed/Medline, Scopus, and Web of Science. Heterogeneity tests of the selected trials were performed using the I2 statistic. Random effects models were assessed based on the heterogeneity tests, and pooled data were determined as weighted mean differences (WMD) with a 95 % confidence interval (CI).

RESULTS

Fifteen RCTs were included in this meta-analysis. Our findings showed that Sumac consumption significantly reduced diastolic blood pressure (DBP) (WMD = -2.88 mmHg; 95 %CI, -4.22 to -1.54; P = 0.001), fasting blood glucose (FBG) (WMD = -5.15 mg/dL; 95 %CI, -8.73 to -1.57; P = 0.005), insulin (WMD = -1.95 uIU/ml; 95 %CI, 3.11 to -0.79; P = 0.001), Hemoglobin A1c (WMD = -0.48 %; 95 %CI -0.84 to -0.12; P = 0.001), Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) (WMD = -0.71; 95 %CI, -1.14 to -0.27; P = 0.001), and waist to hip ratio (WHR) (WMD = -0.01; 95 %CI, -0.02 to -0.00; P = 0.017). Sumac consumption had no significant effects on weight, body mass index, and waist circumference.

CONCLUSION

We found that Sumac consumption could improve DBP, glycemic indices, and WHR. Also, supplementation of this herb in higher doses or longer durations had more promising effects on FBG, HOMA-IR, and WHR.

Effects of vitamin D supplementation on metabolic parameters in women with polycystic ovary syndrome: a randomized controlled trial

OBJECTIVE

The aim of this study was to explore the effects of vitamin D supplementation on metabolic parameters in women with polycystic ovary syndrome (PCOS).

METHODS

A total of 60 PCOS women with vitamin D deficiency or insufficiency were enrolled in this randomized controlled trial. Participants were randomized to vitamin D group (2000 IU/day) or control group. The observational parameters were measured at baseline and after treatment, including body mass index (BMI), waist to hip ratio (WHR), oral glucose tolerance test (OGTT) and insulin release test, and lipid metabolism parameters.

RESULTS

The serum 25(OH)D concentrations at different time points after vitamin D supplementation were significantly higher than that in control group (P < 0.05). The BMI, WHR, insulin concentrations, homeostasis model assessment of insulin resistance (HOMA-IR), triglycerides (TG), total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) concentrations in women of Vitamin D group after 12 weeks of treatment were significantly lower than that in women of control group (P < 0.05). The serum insulin concentrations and HOMA-IR at different time points of OGTT, serum TG, TC and LDL-C concentrations in women of vitamin D group (obesity) were significantly lower compared with control group (obesity) (P < 0.05). The BMI, WHR, TG, TC and LDL-C concentration in women of vitamin D group (IR) were significantly lower compared with control group (IR) (P < 0.05). No significant difference was observed in metabolic parameters between vitamin D group (non-obesity) and control group (non-obesity) (P > 0.05), and these differences of metabolic parameters were also not observed between vitamin D group (non-IR) and control group (non-IR) (P > 0.05).

CONCLUSION

Vitamin D supplementation had beneficial effects on metabolic parameters in PCOS women, especially in women with obesity or insulin resistance.

The effect of Sumac on cardiometabolic parameters in adults: a systematic review and meta-analysis of randomized controlled trials

Background

The current evidence on the effect of Sumac consumption on cardiovascular parameters has produced controversial findings.

Methods

We systematically searched several databases, including PubMed-Medline, SCOPUS, and ISI Web of Science, to find eligible studies until January 2023. Meta-analysis to calculated the weighted mean difference (WMD) and 95 %CI, Sub-group meta-analysis and meta-regression analysis were conducted throughout the study.

Results

16 randomized controlled trials comprising a total number of 1,225 participants were included. The results of meta-analysis revealed that Sumac significantly affected low-density lipoprotein (WMD: -8.66 mg/dL; 95% CI: -14.2, -3.12), high-density lipoprotein (WMD: 3.15 mg/dL; 1.99,4.31), triglycerides (WMD: -11.96 mg/dL; -19.44, -4.48), fasting blood glucose (WMD: -4.15 mg/dL; -7.31, -0.98), insulin (WMD: -1.72; -3.18, -0.25), homeostasis model assessment of insulin resistance (HOMA-IR; WMD: -0.61; -1.22, -0.01), and anthropometric indices (p < 0.05). Moreover, the results significantly reduced total cholesterol when the intervention duration was ≥12 weeks (WMD: -8.58 mg/dL; -16.8, -0.37).

Conclusion

These findings suggest that Sumac is potentially an effective complementary intervention to improve cardiometabolic parameters. Thus, patients could utilize Sumac as part of their diet to improve their overall cardiometabolic status.

The Effects of Sumac Consumption on Inflammatory and Oxidative Stress Factors: A Systematic Review of Randomized Clinical Trials

BACKGROUND

Rhus coriaria L., commonly known as Sumac, is a plant from the Anacardiaceae family that is known for its high phytochemical content. These phytochemicals have the potential to effectively manage inflammation and oxidative stress. To explore the existing evidence on the impact of Sumac consumption on inflammation and oxidative stress, we conducted a systematic review of randomized controlled trials.

METHODS

We conducted a comprehensive search of Medline/PubMed, Scopus, and Web of Science from inception to August 2023 to identify relevant studies examining the effects of Sumac on biomarkers of inflammation and oxidative stress. The selected studies were assessed for risk of bias using the Cochrane tool.

RESULTS

A total of seven trials were included in this review. Among these trials, three focused on diabetes patients, while the remaining four involved individuals with fatty liver, overweight individuals with depression, and those with polycystic ovary or metabolic syndrome. Five studies reported the effects of Sumac on oxidative stress, with four of them demonstrating a significant reduction in malondialdehyde (MDA) levels and an increase in total antioxidant capacity (TAC) and paraoxonase 1 (PON1). Regarding inflammation, one study reported no significant difference in tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) levels between the intervention and control groups. The results for high-sensitivity C-reactive protein levels, reported in five trials, were inconsistent.

CONCLUSION

Sumac consumption over time may positively affect oxidative stress, although short-term use shows minimal impact. While one study found no significant effect on IL-6 and TNF-α, hs-CRP levels could decrease or remain unchanged. Further meta-analyses are needed to fully understand Sumac's potential benefits in managing metabolic diseases.

Effects of sumac supplementation on lipid profile: A systematic review and meta-analysis of randomized controlled trials

This systematic review aimed to gather data on the effects of sumac supplementation on lipid profile. A systematic literature search was carried out using electronic databases (PubMed, Scopus, and Web of Science) up to March 2023 to identify eligible randomized controlled trials (RCTs) assessing the effects of sumac intake on lipid profile as an outcome. All participants enrolled in our study were adult individuals who consumed sumac, in various forms, as an intervention. The included articles were assessed using the Cochrane risk of bias assessment tool. Heterogeneity tests of the selected trials were performed using the I2 statistic. Random effects models were assessed based on the heterogeneity tests, and pooled data were determined as the weighted mean difference with a 95% confidence interval. In total, seven RCTs with a total sample size of 570 subjects were included. This study found a significant decrease in total cholesterol (TC) (weighted mean difference [WMD]: -10.01 mg/dL; 95% CI: -18.67, -1.34), triglyceride (TG) (WMD: -8.52 mg/dL; 95% CI: -14.79, -2.25), and low-density lipoprotein (LDL)-C levels (WMD: -9.25 mg/dL; 95% CI: -14.56, -3.93); Moreover, a significant increase was observed in high-density lipoprotein (HDL)-C concentration (WMD: 2.97 mg/dL; 95% CI: 0.75, 5.19). The reduction in TG and TC was greater in studies with a duration of ≥12 compared to <12 weeks. The increase in HDL-C was greater in participants with an intervention duration of ≥12 compared to <12 weeks. Moreover, subgroup analysis based on the dose of sumac suggested a significant reduction in TC and LDL, specifically for doses below 3 g. Consumption of sumac significantly decreased serum TC, LDL-C, and TG concentrations. This study suggested significantly positive effects on HDL-C by intake of sumac. Longer interventions (>12 weeks) have a more favorable impact on TC, LDL-C, and HDL-C, while sumac doses below 3 g/day show greater effects on TC and LDL-C. These findings underscore the potential of sumac supplementation as a valuable approach to lipid profile management.