The effect of a cinnamon-, chromium- and magnesium-formulated honey on glycaemic control, weight loss and lipid parameters in type 2 diabetes: an open-label cross-over randomised controlled trial

In vitro testing of honey quality and biological functionality: underestimated elements in the clinical testing of honey

Honey is an attractive functional food that often becomes a subject of clinical studies on the treatment of diverse diseases. However, the clinical efficacy of honey is rather controversial due, at least in part, to its variable composition and botanical origin as well as thermal processing or improper storage conditions. This review addresses the importance of honey quality standards and in vitro testing of the biological properties of honey prior to performing clinical studies, which can have a great impact on clinical outcomes. It focused on recently performed meta-analyses and systematic reviews where honey was used in the management of various disorders including respiratory tract infections, and metabolic and cardiometabolic diseases, with the goal of characterising the honeys used in clinical studies. In addition, it provides recommendations for the use and storage of honey for clinical testing. The vast majority of clinical studies included in meta-analyses do not provide any information about honey quality parameters. In fact, indicators of thermal damage or prolonged storage of honey were analysed only in one clinical study. This observation highlights on the alarming status of honey quality in clinical studies. Furthermore, in vitro biological properties of the analysed honeys were assessed in two clinical studies. Therefore, this review strongly advocates the clinical use of only fully characterised honey samples of known botanical origin with proven in vitro biological functionality and no or minimal thermal processing.

The role of selected nutraceuticals in management of prediabetes and diabetes: An updated review of the literature. Part II

We have already published a review about the results of clinical trials evaluating the effects of selected nutraceuticals on glycemia in humans. In this second part, we describe the role of other nutraceuticals involved in dysglycemia. The available evidence showed promising hypoglycemic effects of the nutraceuticals reviewed both for their efficacy and safety profile. However, contradictory results as regard the efficacy of some supplements such as Allium sativum, Juglans regia, and Lycium barbarum on glucose homeostasis have emerged from some clinical studies. Other nutraceuticals including Aloe vera, Amorphophallus Konjac, Bauhinia forficata, Coccinia, Ganoderma lucidum, Ipomoea batatas, and Lupinus mutabilis require larger and long-term studies rigorously designed to confirm their hypoglycemic effects due to the scarce data available and the poor quality of clinical trials. Further studies are also required for Cinnamomum, Cynara scolymus, Momordica charantia, Olea europaea, and Opuntia streptacantha. Moreover, well-designed large and long-term clinical trials including the use of standardized nutraceutical preparations are necessary for Phaseolus vulgaris and Vaccinium myrtillus.

Geographical Origin Authentication-A Mandatory Step in the Efficient Involvement of Honey in Medical Treatment

Nowadays, in people's perceptions, the return to roots in all aspects of life is an increasing temptation. This tendency has also been observed in the medical field, despite the availability of high-level medical services with many years of research, expertise, and trials. Equilibrium is found in the combination of the two tendencies through the inclusion of the scientific experience with the advantages and benefits provided by nature. It is well accepted that the nutritional and medicinal properties of honey are closely related to the botanical origin of the plants at the base of honey production. Despite this, people perceive honey as a natural and subsequently a simple product from a chemical point of view. In reality, honey is a very complex matrix containing more than 200 compounds having a high degree of compositional variability as function of its origin. Therefore, when discussing the nutritional and medicinal properties of honey, the importance of the geographical origin and its link to the honey's composition, due to potential emerging contaminants such as Rare Earth Elements (REEs), should also be considered. This work offers a critical view on the use of honey as a natural superfood, in a direct relationship with its botanical and geographical origin.

Effects of co-supplementation of chromium and magnesium on metabolic profiles, inflammation, and oxidative stress in impaired glucose tolerance

PURPOSE

To evaluate the effects of chromium (Cr) and magnesium (Mg) ions on metabolic profiles, inflammation, and oxidative stress with impaired glucose tolerance (IGT) and insulin resistance (IR).

METHODS

120 individuals with IGT and IR were randomly divided into four groups treated with (1) chromium, (2) magnesium, (3) chromium and magnesium or (4) placebo. Metabolic and inflammatory indicators were measured at baseline and after 3 months intervention.

RESULTS

Comparison among groups showed that fasting plasma glucose (FPG), 2 h post glucose (2hPPG), fasting insulin (FINS) and homeostatic model assessment for insulin resistance (HOMA-IR) in Cr + Mg group were significantly decreased compared with the other three groups (p < .05), and high density lipoprotein (HDL-c) levels were higher. 8-iso prostaglandin F2 alpha (8-iso-PGF2a) decreased in Cr, Mg, and Cr + Mg groups compared with placebo (p < .05), and 8-iso-PGF2a decreased in Cr + Mg groups compared with Cr group and Mg groups (p > .05). Intra-group comparison showed that the levels of FPG, 2hPPG and FINS in Cr + Mg group were significantly decreased after intervention (p < .05), and FINS in Mg group was significantly decreased (p < .01). The levels of HDL-c and triacylglycerol (TG) in Cr + Mg group were significantly improved (p < .05). The level of HDL-c in Mg group was significantly improved compared with baseline (p < .05). Compared with baseline, high-sensitivity C-reactive protein (hsCRP) levels in Cr + Mg group and Mg group were significantly decreased (p < .05).

CONCLUSIONS

The co-supplementation of Cr and Mg improves glycemic and lipid levels and reduces the inflammatory response and oxidative stress profiles of individuals with impaired glucose tolerance and insulin resistance.

Effects of Diet, Lifestyle, Chrononutrition and Alternative Dietary Interventions on Postprandial Glycemia and Insulin Resistance

As years progress, we are found more often in a postprandial than a postabsorptive state. Chrononutrition is an integral part of metabolism, pancreatic function, and hormone secretion. Eating most calories and carbohydrates at lunch time and early afternoon, avoiding late evening dinner, and keeping consistent number of daily meals and relative times of eating occasions seem to play a pivotal role for postprandial glycemia and insulin sensitivity. Sequence of meals and nutrients also play a significant role, as foods of low density such as vegetables, salads, or soups consumed first, followed by protein and then by starchy foods lead to ameliorated glycemic and insulin responses. There are several dietary schemes available, such as intermittent fasting regimes, which may improve glycemic and insulin responses. Weight loss is important for the treatment of insulin resistance, and it can be achieved by many approaches, such as low-fat, low-carbohydrate, Mediterranean-style diets, etc. Lifestyle interventions with small weight loss (7-10%), 150 min of weekly moderate intensity exercise and behavioral therapy approach can be highly effective in preventing and treating type 2 diabetes. Similarly, decreasing carbohydrates in meals also improves significantly glycemic and insulin responses, but the extent of this reduction should be individualized, patient-centered, and monitored. Alternative foods or ingredients, such as vinegar, yogurt, whey protein, peanuts and tree nuts should also be considered in ameliorating postprandial hyperglycemia and insulin resistance. This review aims to describe the available evidence about the effects of diet, chrononutrition, alternative dietary interventions and exercise on postprandial glycemia and insulin resistance.

The Role of Bioactive Compounds from Dietary Spices in the Management of Metabolic Syndrome: An Overview

Metabolic syndrome (MetS) is a combination of physiologically dysregulated parameters that can include elevated fasting blood glucose, high blood pressure, central obesity, increased triglyceride levels, insulin resistance, diabetes, elevated low density lipoprotein levels, and reduced high density lipoprotein levels in the blood. Effective clinical management of MetS is critical as it is strongly associated with long lasting and fatal complications in patients. Alongside standard care of lifestyle changes and medication, dietary supplements derived from herbal resources could be an alternative therapeutic strategy that is safe, efficient, culturally acceptable, and has few side effects. Of the dietary supplements, spicy foods have always been considered a great source of functional bioactive compounds. Herbal therapy is broadly used in many countries as a treatment or as a preventive measure in the management of MetS risk factors, including blood glucose, blood pressure, and blood lipid levels. Herein, an attempt is made to evaluate the recent studies in the management of MetS with herbal alternatives, and to explore the possibility of their use as therapeutic treatments or supplements.

Effect of cinnamon on blood sugar and anthropometric measurement in type two diabetes patients

There is some emerging evidence that suggests certain supplements help lower blood sugar levels. One of these is cinnamon, which exhibits characteristics that mimic insulin, such as the activity of biologically active substances to activate insulin receptor kinase, increasing glucose uptake, autophosphorylation of the insulin receptor, and glycogen synthase activity. To assess the effect of the cinnamon substance on lowering fasting blood sugar, modifying body weight, body mass index (B.M.I.), and waist circumference in type two diabetics. A randomized controlled intervention clinical trial. The study was conducted on 60 patients with type II diabetes mellitus; the study followed both gender patients for four weeks. The contributors were allocated randomly into a group that receives 2 g/d cinnamon substance (intervention group), and a group without cinnamon substance is given (control group). Fasting plasma glucose (F.P.G.) and anthropometrics measurement at the beginning (beforehand cinnamon supplementation and 4week at the end of the study duration). After 4 weeks of cinnamon taken, serum F.P.G. levels significantly improved (P≤0.0001). Anthropometric measurements (weight, height, B.M.I.) were reduced significantly (change mean ≤ P=0.001) for all. The Present study disclosed that supplementation of 2 gm cinnamon improves F.P.G. and has a good role in anthropometric indices (weight, waist circumference, B.M.I.).

The Effect of Honey on Lipid Profiles: A Systematic Review and Meta-analysis of Controlled Clinical Trials

Honey is known not only as a natural food but also as complementary medicine. According to the controversial evidence about the effects of honey on blood lipids, this meta-analysis was performed to investigate the potential effects of honey on lipid profiles. Relevant studies were identified by searching PubMed, Web of Science (WOS), Scopus, EMBASE, and Cochrane databases. All human controlled clinical trials (either with a parallel or a crossover design) published in English that reported changes in serum lipid markers (Total Cholesterol (TC), Triglyceride (TG), Low Density Lipoprotein Cholesterol (LDL-C), High Density Lipoprotein Cholesterol (HDL-C), and LDL-C/HDL-C ratio) following honey consumption were considered. Standardized Mean Differences (SMDs) and their respective 95% Confidence Intervals (CIs) were calculated to assess the changes in lipid profiles following honey consumption by random effects model. Statistical heterogeneity, sensitivity analysis, publication bias, and quality of the included studies were assessed, as well. The meta-analysis of 23 trials showed that honey had no significant effects on TC, TG, LDL-C, HDL-C, and LDL-C/HDL-C ratio. Significant heterogeneity was seen among the studies for all the studied factors (I2 index > 50%). Subgroup analysis based on the lipid profile status, types of honey, and intervention duration revealed no significant effect on TC, TG, LDL-C, and HDL-C. Quality of the evidences varied form very low to moderate according to various parameters. In conclusion, honey consumption did not affect serum lipid profiles (TC, TG, LDL-C, HDL-C, and LDL-C/HDL-C ratio).

Monofloral Honeys as a Potential Source of Natural Antioxidants, Minerals and Medicine

Background: vegetative diversity is based on different climate and geographical origins. In terms of beekeeping, herbal diversity is strongly correlated to the production of a wide variety of honey. Therefore, based on the existing plant diversity in each country, multiple honey varieties are produced with different health characteristics. While beekeeping potential and consumption preferences are reflected in products’ variety, this leads to an increase in the region’s economy and extensive export. In the last years, monofloral honey has gained interest from consumers and especially in the medicinal field due to the presence of phytochemicals which are directly linked to health benefits, wound healing, antioxidant, anticancer and anti-inflammatory activities. Scope and approach: this review aims to highlight the physicochemical properties, mineral profiles and antioxidant activities of selected monofloral honeys based on their botanical and geographical origin. Moreover, this review focuses on the intercorrelation between monofloral honey’s antioxidant compounds and in vitro and in vivo activities, focusing on the apoptosis and cell proliferation inhibition in various cell lines, with a final usage of honey as a potential therapeutic product in the fight towards reducing tumor growth. Key findings and conclusions: multiple studies have demonstrated that monofloral honeys have different physicochemical structures and bioactive compounds. Useful chemical markers to distinguish between monofloral honeys were evidenced, such as: 2-methoxybenzoic acid and trimethoxybenzoic acid are distinctive to Manuka honey while 4-methoxyphenylacetic acid is characteristic to Kanuka honey. Furthermore, resveratrol, epigallocatechin and pinostrobin are markers distinct to Sage honey, whereas carvacrol and thymol are found in Ziziphus honey. Due to their polyphenolic profile, monofloral honeys have significant antioxidant activity, as well as antidiabetic, antimicrobial and anticancer activities. It was demonstrated that Pine honey decreased the MDA and TBARS levels in liver, kidney, heart and brain tissues, whereas Malicia honey reduced the low-density lipoprotein level. Consumption of Clover, Acacia and Gelam honeys reduced the weight and adiposity, as well as trygliceride levels. Furthermore, the antiproliferative effect of chrysin, a natural flavone in Acacia honey, was demonstrated in human (A375) and murine (B16-F1) melanoma cell lines, whereas caffeic acid, a phenolic compound found in Kelulut honey, proves to be significant candidate in the chemoprevention of colon cancer. Based on these features, the use of hiney in the medicinal field (apitherapy), and the widespread usage of natural product consumption, is gaining interest by each year.

The Study of the Aorta Metallomics in the Context of Atherosclerosis

Atherosclerosis is a multifactorial disease, for which the etiology is so complex that we are currently unable to prevent it and effectively lower the statistics on mortality from cardiovascular diseases. Parallel to modern analyses in molecular biology and biochemistry, we want to carry out analyses at the level of micro- and macroelements in order to discover the interdependencies between elements during atherogenesis. In this work, we used the Inductively Coupled Plasma Optical Emission Spectrometer (ICP-OES) to determine the content of calcium, magnesium, iron, copper, chromium, zinc, manganese, cadmium, lead, and zinc in the aorta sections of people who died a sudden death. We also estimated the content of metalloenzymes MMP-9, NOS-3, and SOD-2 using the immunohistochemical method. It was observed that with the age of the patient, the calcium content of the artery increased, while the content of copper and iron decreased. Very high correlations (correlation coefficient above 0.8) were observed for pairs of parameters in women: Mn–Ca, Fe–Cu, and Ca–Cd, and in men: Mn–Zn. The degree of atherosclerosis negatively correlated with magnesium and with cadmium. Chromium inhibited absorption of essential trace elements such as Cu and Fe due to its content being above the quantification threshold only if Cu and Fe were lower. Moreover, we discussed how to design research for the future in order to learn more about the pathomechanism of atherosclerosis and the effect of taking dietary supplements on the prevalence of cardiovascular diseases.

Crosstalk of Magnesium and Serum Lipids in Dyslipidemia and Associated Disorders: A Systematic Review

Dyslipidemia is a significant threat to public health worldwide and the identification of its pathogenic mechanisms, as well as novel lipid-lowering agents, are warranted. Magnesium (Mg) is a key element to human health and its deficiency has been linked to the development of lipid abnormalities and related disorders, such as the metabolic syndrome, type 2 diabetes mellitus, or cardiovascular disease. In this review, we explored the associations of Mg (dietary intake, Mg concentrations in the body) and the lipid profile, as well as the impact of Mg supplementation on serum lipids. A systematic search was computed in PubMed/MEDLINE and the Cochrane Library and 3649 potentially relevant papers were detected and screened (n = 3364 following the removal of duplicates). After the removal of irrelevant manuscripts based on the screening of their titles and abstracts (n = 3037), we examined the full-texts of 327 original papers. Finally, after we applied the exclusion and inclusion criteria, a number of 124 original articles were included in this review. Overall, the data analyzed in this review point out an association of Mg concentrations in the body with serum lipids in dyslipidemia and related disorders. However, further research is warranted to clarify whether a higher intake of Mg from the diet or via supplements can influence the lipid profile and exert lipid-lowering actions.

A Review on Oxidative Stress, Diabetic Complications, and the Roles of Honey Polyphenols

Despite the availability of various antidiabetic drugs, diabetes mellitus (DM) remains one of the world's most prevalent chronic diseases and is a global burden. Hyperglycaemia, a characteristic of type 2 diabetes mellitus (T2DM), substantially leads to the generation of reactive oxygen species (ROS), triggering oxidative stress as well as numerous cellular and molecular modifications such as mitochondrial dysfunction affecting normal physiological functions in the body. In mitochondrial-mediated processes, oxidative pathways play an important role, although the responsible molecular mechanisms remain unclear. The impaired mitochondrial function is evidenced by insulin insensitivity in various cell types. In addition, the roles of master antioxidant pathway nuclear factor erythroid 2-related factor 2 (Nrf2)/Kelch-like ECH-associated protein 1 (Keap1)/antioxidant response elements (ARE) are being deciphered to explain various molecular pathways involved in diabetes. Dietary factors are known to influence diabetes, and many natural dietary factors have been studied to improve diabetes. Honey is primarily rich in carbohydrates and is also abundant in flavonoids and phenolic acids; thus, it is a promising therapeutic antioxidant for various disorders. Various research has indicated that honey has strong wound-healing properties and has antibacterial, anti-inflammatory, antifungal, and antiviral effects; thus, it is a promising antidiabetic agent. The potential antidiabetic mechanisms of honey were proposed based on its major constituents. This review focuses on the various prospects of using honey as an antidiabetic agent and the potential insights.

Cytotoxicity and insulin resistance reversal ability of biofunctional phytosynthesized MgO nanoparticles

The present study investigates the cytotoxicity of hexagonal MgO nanoparticles synthesized via Amaranthus tricolor leaf extract and spherical MgO nanoparticles synthesized via Amaranthus blitum and Andrographis paniculata leaf extracts. In vitro cytotoxicity analysis showed that the hexagonal MgO nanoparticles synthesized from A. tricolor extract demonstrated the least toxicity to both diabetic and non-diabetic cells at 600 μl/ml dosage. The viability of the diabetic cells (3T3-L1) after incubation with varying dosages of MgO nanoparticles was observed to be 55.3%. The viability of normal VERO cells was 86.6% and this stabilized to about 75% even after exposure to MgO nanoparticles dosage of up to 1000 μl/ml. Colorimetric glucose assay revealed that the A. tricolor extract synthesized MgO nanoparticles resulted in ~ 28% insulin resistance reversal. A reduction in the expression of GLUT4 protein at 54 KDa after MgO nanopaSrticles incubation with diabetic cells was observed via western blot analysis to confirm insulin reversal ability. Fluorescence microscopic analysis with propidium iodide and acridine orange dyes showed the release of reactive oxygen species as a possible mechanism of the cytotoxic effect of MgO nanoparticles. It was inferred that the synergistic effect of the phytochemicals and MgO nanoparticles played a significant role in delivering enhanced insulin resistance reversal capability in adipose cells.

Current Evidence to Propose Different Food Supplements for Weight Loss: A Comprehensive Review

The use of food supplements for weight loss purposes has rapidly gained popularity as the prevalence of obesity increases. Navigating through the vast, often low quality, literature available is challenging, as is providing informed advice to those asking for it. Herein, we provide a comprehensive literature revision focusing on most currently marketed dietary supplements claimed to favor weight loss, classifying them by their purported mechanism of action. We conclude by proposing a combination of supplements most supported by current evidence, that leverages all mechanisms of action possibly leading to a synergistic effect and greater weight loss in the foreseen absence of adverse events. Further studies will be needed to confirm the weight loss and metabolic improvement that may be obtained through the use of the proposed combination.

Honey and obesity-related dysfunctions: a summary on health benefits

Honey is a natural product, containing flavonoids and phenolic acids, appreciated for its therapeutic abilities since ancient times. Although the bioactive potential is linked to the composition, that is variable depending on mainly the botanical origin, honey has antioxidant and anti-inflammatory properties. Therefore, honey, administered alone or in combination with conventional therapy, might result useful in the management of chronic diseases that are commonly associated with oxidative stress and inflammation state. Obesity is a metabolic disorder characterized by visceral adiposity. The adipose tissue becomes hypertrophic and undergoes hyperplasia, resulting in a hypoxic environment, oxidative stress and production of pro-inflammatory mediators that can be responsible for other disorders, such as metabolic syndrome and neurodegeneration. Experimental evidence from animals have shown that honey improves glycemic control and lipid profile with consequent protection from endothelial dysfunction and neurodegeneration. The purpose of the present review is to summarize the current literature concerning the beneficial effects of honey in the management of the obesity-related dysfunctions, including neurodegeneration. Based on the key constituents of honey, the paper also highlights polyphenols to be potentially responsible for the health benefits of honey. Further well-designed and controlled studies are necessary to validate these benefits in humans.

Chromium Supplementation; Negotiation with Diabetes Mellitus, Hyperlipidemia and Depression

Chromium (Cr) is an essential trace element which found naturally in a daily diet and available in the form of supplementary tablets to boost disorders like diabetes mellitus (DM) and functions like lipid metabolism and beneficial on depression too. Diabetes is one of the most prevalent endocrine diseases or in other words, the most severe metabolic syndrome (MS), which associated with high production of free-radicals which is out of bodies detoxifying machine capacity or high oxidative stress (HOS), vasculitis and elevated lipid profile. many research papers and clinical trials published about the significance of chromium on biological activities, pre and post clinical. For this review research articles, clinical trials, from 1^st Jan'10 to 31^st Dec'18 and refer literature for the biochemical, pharmacological and biological activity of Chromium. Primarily articles gathered from the above search engines. Then precisely according to our aim and goal and regarding designed objectives dismisses similar articles and finally came to 84 articles for the above said period. This review trying to cover the entire picture from what chromium is to the recent updates on their greater role in increasing insulin sensitivity of cells and enhancing lipid metabolism and even recent findings suggest its positive effects including prevention and ameliorating properties on depression. The biological activities, pharmacological features, clinical implications including efficacy and role of chromium compounds on the glycaemic index will be discussed. The outcome of this review is to bring the pros and cons of chromium supplementation along with is safety and toxicity concern beside molecular pathways, biochemistry and clinical trials, all in one comprehensive review.

Public Knowledge, Attitude, and Practice on Herbal Remedies Used During Pregnancy and Lactation in West Bank Palestine

The use of herbal products by pregnant and lactating mothers without awareness of their harmful effects may expose both mother and fetus or infant to great dangers, such as abortion, premature delivery, uterine bleeding, and physical and mental retardation of the fetus. Thus, the aim of this study was to investigate the extent to which herbal product treatment is used and the reason for which such products are used and to ensure that these reasons are correct. An ethnopharmacological survey (cross-sectional observational design study) using a pre-piloted questionnaire was undertaken on herbal products used by pregnant and lactating women in the West Bank area of Palestine. A questionnaire was distributed to 350 pregnant and lactating women. The informed consent forms, ethics, and aims of the present study were reviewed and approved by the Institutional Review Board (IRB) at An-Najah National University. To identify the most important species used, the use value (UV) index was employed, while the SPSS program was used to analyze the data. Collected data revealed that 13 medicinal plants are utilized, while 12 plants are not used during pregnancy. Moreover, 15 plants are utilized and 9 plants are not used during lactation for treating and dealing with various problems. The most commonly used plants belonged to 14 families, including Lamiaceae, Apiaceae, Leguminosae, and Rubiaceae. The plants most used during pregnancy were sage (Salvia fruticosa), anise (Pimpinella anisum), and peppermint (Mentha × piperita). Castor (Ricinus communis) oil, ginger (Zingiber officinale), saffron (Crocus sativus), and senna (Senna alexandrina) mostly were not used by pregnant women. Moreover, cinnamon (Cinnamomum verum), anise (P. anisum), peppermint (M. piperita), and sage (S. fruticosa) were mostly used during lactation. Castor (R. communis) oil, ginger (Z. officinale), garlic (Allium sativum), and aloe (Aloe vera) mostly were not used during lactation. This study is of great importance in order to decrease the possibility of endangering the lives of fetuses and infants. A combined effort among researchers, scientists, lactating women, and pregnant women may help in changing wrong uses and thoughts about medicinal plants and help to improve the overall health of both mother and fetus.

A meta-analysis of the effect of chromium supplementation on anthropometric indices of subjects with overweight or obesity

The role of chromium as a weight loss agent remains questionable, and although previous meta-analyses findings have reported small reductions in body weight in individuals with overweight/obesity following chromium supplementation, there have been significant limitations with these findings. The objective of this meta-analysis was to evaluate the current evidence for the efficacy of oral chromium supplementation in individuals with overweight/obesity from randomized controlled trials. Studies were identified by a search of electronic databases from inception to November 2018 and combined and stratified analyses were used. Twenty-one trials from 19 studies were identified which met all inclusion criteria which were suitable for statistical pooling, and data from 1316 participants were included. Pooled analysis showed significant reductions in anthropometric indices associated with body composition; for weight loss (weighted mean difference [WMD]: -0.75 kg, 95% confidence interval [CI], -1.04, -0.45, P < 0.001), body mass index (WMD: -0.40, 95% CI, -0.66, -0.13, P = 0.003 and body fat percentage (WMD: -0.68%, 95% CI, -1.32, -0.03, P = 0.04) in individuals with overweight/obesity. No changes were detected in controls. Subgroup analysis showed significant improvements in weight loss and body fat percentage, particularly for study durations ≤12 weeks and doses ≤400 μg/d. Chromium supplementation was associated with some improvements in body composition in subjects with obesity/overweight. The effect size was medium and the clinical relevance of chromium as a weight loss aid remains uncertain. Further investigation from larger and well-designed randomized controlled studies, especially in patients with diabetes, is warranted.

Assessment of Human Health Risk of Toxic Elements Due to Cinnamon Ingestion in the Diet

Recent studies highlighted the beneficial action of cinnamon on postprandial glycemia and LDL-cholesterol concentrations, both in healthy subjects and type 2 diabetic patients. Inclusion of 3 to 6 g of cinnamon in diet revealed a beneficial effect on glucose metabolism control in non-diabetic adults during postprandial period. Given the levels of toxic elements present in cinnamon species from different countries, such large daily intakes of cinnamon can easily exceed their maximum permissible limits and, consequently, induce adverse health effects. This study aimed to investigate the elemental concentration profile in cinnamon powder products available in the Portuguese market and to assess the cumulative non-carcinogenic risk to human health due to the exposure to mixtures of such elements through the inclusion of 6 g of cinnamon in diet. Concentrations of Cu, Zn, Fe, Al, Cl, Mn, and Sr were determined by wavelength dispersive X-ray fluorescence spectroscopy in different lots of eight branded and one bulk cinnamon powder products. Linear mixed models have revealed significant differences in concentrations of Zn, Fe, Al, and Cl between brands. In particular, bulk cinnamon samples presented the highest contents of Fe (475.0-490.0 mg kg^-1) and Al (1139.0-1336.0 mg kg^-1). The non-carcinogenic risk was assessed following EPA's guidelines through the hazard quotient (HQ). Estimated HQ values were lower than the USEPA guideline of 1. Additionally, the hazard index (HI), representing the combined non-carcinogenic effects of all toxic elements, revealed no potential human health risk for heavy consumers of cinnamon (HI = 0.660). AbstractGraphical ᅟ.

Effect of Q10 supplementation on body weight and body mass index: A systematic review and meta-analysis of randomized controlled clinical trials

AIMS

This meta-analysis study was carried out to assess the effects of coenzyme Q10 supplementation on body weight and body mass index of patients in randomized controlled clinical trial studies.

MATERIALS AND METHODS

A comprehensive systematic search of literature was performed through ISI web of sciences, PubMed, Scopus and Cochrane library databases up to February 2018 which was supplemented by manual search of the references list of included studies. From a total of 1579 identified articles, only 17 trials with 14 and 14 effect-sizes were included for pooling the effects of co-enzyme Q10 supplementation on body weight and body mass index, respectively.

RESULTS

Results of random-effect size meta-analysis showed that supplementation with coenzyme Q10 had no significant decreasing effects on body weight (WMD: 0.28 kg; 95% CI = -0.91, 1.47; P = 0.64) and BMI (WMD: -0.03; 95% CI = -0.4, 0.34; P = 0.86) of study participants. Subgroup analysis revealed that dosage of Q10 and trial duration could not differ the results of Q10 supplementation.

CONCLUSION

Results of this meta-analysis study failed to show any beneficial effect of coenzyme Q10 supplementation on body weight and BMI of patients in clinical trial studies.

Honey and Its Role in Relieving Multiple Facets of Atherosclerosis

Honey, a natural sweetener has been used universally as a complete food and in complementary medicine since early antiquity. Honey contains over 180 substances, including sugars mainly fructose and glucose, water and a plethora of minor constituents such as vitamins, minerals and phytochemicals. The chemical composition of honey varies depending on floral origin, environment and geographical conditions. The sugar components dominate honey composition and they are accountable for sensory and physicochemical properties in food industry. Although present in small quantities, non-sugar components are the major contributors to the health benefits of honey. Our review summarizes and discusses composition of honey, its protective effects and possible action modes on risk factors of atherosclerosis.

Long-term effects of honey on cardiovascular parameters and anthropometric measurements of postmenopausal women

OBJECTIVE

To investigate the long-term effects of Tualang Honey versus Honey Cocktail (mixture of honey, bee bread, and royal jelly) on cardiovascular markers and anthropometric measurements of postmenopausal women.

METHODS

We conducted a randomised, double blinded, two-armed parallel study comparing 20 g/day of Tualang Honey versus 20 g/day Honey Cocktail among postmenopausal women aged 45-65 years. The cardiovascular parameters and anthropometrics measurements were assessed at baseline, 6 months, and 12 months of the intervention.

RESULTS

100 subjects were successfully randomised into the groups. There was a significant decrease in the diastolic blood pressure from 77.92 mmHg at baseline to 73.45 mmHg at 12 months (F-statistic = 2.55, p-value = 0.047) in the Tualang Honey group compared to Honey Cocktail. There was also a significant decrease in the fasting blood sugar from 6.11 mmol/L at baseline to 5.71 mmol/L at 12 months (F-statistic = 4.03, p-value = 0.021) in the Tualang Honey group compared to the Honey Cocktail group. The body mass index remained unchanged at 27 kg/m2 (F-statistic = 1.60, p-value = 0.010) throughout 12 months of the intervention in the Honey Cocktail group.

CONCLUSION

Subjects who received Honey Cocktail showed remarkable effects on body mass index. However, Tualang Honey supplementation showed superior effect in lowering diastolic blood pressure and fasting blood sugar compared to Honey Cocktail. Further studies are required to ascertain the underlying mechanism(s) of Tualang Honey and Honey Cocktail on each observed parameter.

Molecular mechanisms of the anti-obesity effect of bioactive ingredients in common spices: a review

The mechanisms of the anti-obesity effects of bioactive compounds in common spices in adipocytes, animal models and human participants have been reviewed.

The effect of maternal chromium status on lipid metabolism in female elderly mice offspring and involved molecular mechanism

Maternal malnutrition leads to the incidence of metabolic diseases in offspring. The purpose of this project was to examine whether maternal low chromium could disturb normal lipid metabolism in offspring, altering adipose cell differentiation and leading to the incidence of lipid metabolism diseases, including metabolic syndrome and obesity. Female C57BL mice were given a control diet (CD) or a low chromium diet (LCD) during the gestational and lactation periods. After weaning, offspring was fed with CD or LCD. The female offspring were assessed at 32 weeks of age. Fresh adipose samples from CD–CD group and LCD–CD group were collected. Genome mRNA were analysed using Affymetrix GeneChip Mouse Gene 2.0 ST Whole Transcript-based array. Differentially expressed genes (DEGs) were analysed based on gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis database. Maternal low chromium irreversibly increased offspring body weight, fat-pad weight, serum triglyceride (TG) and TNF-α. Eighty five genes increased and 109 genes reduced in the offspring adipose of the maternal low chromium group. According to KEGG pathway and String analyses, the PPAR signalling pathway may be the key controlled pathway related to the effect of maternal low chromium on female offspring. Maternal chromium status have long-term effects of lipid metabolism in female mice offspring. Normalizing offspring diet can not reverse these effects. The potential underlying mechanisms are the disturbance of the PPAR signalling pathway in adipose tissue.

Honey and diabetes mellitus: Obstacles and challenges - Road to be repaired

Background and objective

Since ancient times, honey has been used due to its nutritional and therapeutic value. The role of honey has been acknowledged in the scientific literature however, its use has been controversially discussed and has not been well accepted in modern medicine especially for diabetic patients. This study aimed to investigate the role of honey in diabetic patients.

Methods

In this study, we identified 107 research articles from data based search engines including “PubMed”, “ISI-Web of Science”, “Embase” and “Google Scholar”. The research papers were selected by using the primary key-terms including “Honey”, “Honey bee” and “Diabetes Mellitus”. The research documents in which “Honey” and “Diabetes Mellitus” were debated are included. After screening, we reviewed 66 papers and finally we selected 35 studies which met the inclusion criteria and the remaining documents were excluded.

Results

This study investigated the preclinical, clinical, human and animal model studies on honey and diabetes mellitus and found that honey decreases the fasting serum glucose, increases the sting C-peptide and 2-h postprandial C-peptide. Although, there is a dearth of data and literature also contrary discussed the use of honey in diabetic patients.

Conclusion

Honey decreases the fasting serum glucose, increases fasting C-peptide and 2-h postprandial C-peptide. Honey had low glycemic index and peak incremental index in diabetic patients. The use of honey in diabetic patients still has obstacles and challenges and needs more large sample sized, multi-center clinical controlled studies to reach better conclusions.

Controlling type-2 diabetes by inclusion of Cr-enriched yeast bread in the daily dietary pattern: a randomized clinical trial

PURPOSE

Chromium (Cr)-enriched yeast supplementation to whole wheat bread (WWCrB) has been shown to ameliorate postprandial glycemic response in healthy subjects. The present study investigates the long-term benefit of WWCrB consumption for patients with type-2 diabetes mellitus (T2DM).

METHODS

Thirty patients with T2DM were randomly assigned to a group receiving WWCrB or the plain whole wheat bread (WWB) group. Plasma glucose, insulin, glycosylated hemoglobin (HbA_1c) and insulin resistance were determined, and oral glucose tolerance test (OGTT) was performed at the beginning and the end of the dietary intervention, which lasted for 12 weeks. Biochemical parameters related to the disease, markers of inflammation as well as body weight and energy balance were examined.

RESULTS

At the end of the study, subjects of WWCrB group exerted lower levels of glucose, insulin and HbA_1c and improved insulin resistance (P < 0.05 against before treatment). Area under the glucose curve attained during OGTT decreased after the intervention (28,117.5 ± 1266.4 vs. 31,588.5 ± 1187.5 mg min/dL before treatment, P < 0.05) with significantly lower values of glucose concentration at 0 and 60 min. A significant reduction in body weight and systolic blood pressure (SBP) was observed (P < 0.05 against before treatment). Markers of inflammation and lipid profiles were not affected by WWCrB consumption.

CONCLUSIONS

Inclusion of WWCrB in the daily dietary pattern of diabetic patients resulted in improvement of glucose tolerance and insulin resistance, significant reduction in HbA_1c, weight loss and lower SBP. Patients with inadequate glycemic control may benefit from the consumption of WWCrB.

Natural Products to Counteract the Epidemic of Cardiovascular and Metabolic Disorders

Natural products have always been exploited to promote health and served as a valuable source for the discovery of new drugs. In this review, the great potential of natural compounds and medicinal plants for the treatment or prevention of cardiovascular and metabolic disorders, global health problems with rising prevalence, is addressed. Special emphasis is laid on natural products for which efficacy and safety have already been proven and which are in clinical trials, as well as on plants used in traditional medicine. Potential benefits from certain dietary habits and dietary constituents, as well as common molecular targets of natural products, are also briefly discussed. A glimpse at the history of statins and biguanides, two prominent representatives of natural products (or their derivatives) in the fight against metabolic disease, is also included. The present review aims to serve as an "opening" of this special issue of Molecules, presenting key historical developments, recent advances, and future perspectives outlining the potential of natural products for prevention or therapy of cardiovascular and metabolic disease.