Nutritional support in the pharmacological treatment of metabolic syndrome

Community-based lifestyle intervention improves metabolic syndrome and related markers among Kenyan adults

Purpose

Metabolic syndrome (MetS) is a major risk factor for cardiovascular diseases and type-2 diabetes. The study aimed to establish the efficacy of a community-based lifestyle intervention on MetS in Kenyan adults using randomized control trial involving a 15-months follow up.

Methods

A randomized controlled trial involving 352 (18-64 years old) adults with MetS spanning 15-months duration. Participants were recruited from a Nairobi based Mission-led outpatient clinic, randomly assigned equally into intervention and control groups. The intervention group was exposed to a community-based health education on lifestyle modification, while control group was subjected to hospital-led routine care involving treatment and general lifestyle advice. The study was structured into baseline, intervention and evaluation phases with inbuilt data collection in each phase. Physiologic, anthropometric, and clinical parameters as well lifestyle characteristics were measured at baseline, midline and end-line. The parameters were compared across the groups and between the time points during analyses using chi-square test, binary logistic, independent t-test and paired t-test.

Results

Proportion of participants with MetS declined significantly (p < 0.001) with marked (p < 0.05) improvement in markers of MetS (elevated BP, raised sugars, cholesterols, central obesity) in intervention compared to control group. The rates of consumption of fruits, vegetables, legumes, nuts and uptake of physical activity significantly (p < 0.05) improved in the intervention group. However, the intake of processed/fast foods, salt, sugar, and alcohol significantly (p < 0.05) declined in the intervention compared to controls by the end-line.

Conclusion

One in three adults under the community-based lifestyle intervention had improvement in physiologic, anthropometrics and clinical markers relevant to definition of MetS. Additionally, an improved adherence to the recommended dietary intake and increased uptake of physical activity in adults with MetS was observed. These findings underscore the feasibility, effectiveness and proof of concept for community-based lifestyle approach as a viable strategic intervention for addressing premorbid risk factors for cardiovascular CVDs and diabetes before evolving into full blown conditions in low-income settings.

Lack of association between nuts and legumes consumption and metabolic syndrome in young Iranian nurses

BACKGROUND

Most studies have investigated the association between dietary pattern and risk of metabolic syndrome. Limited studies have examined the association between nuts and legumes as a food group and metabolic syndrome. This study explored the association between nuts and legumes and components of metabolic syndrome in Iranian nurses.

METHODS

This cross-sectional study included a representative sample of 420 female nurses of Isfahan who were randomly selected. Nuts and legumes consumption was assessed using a validated dish-based semi quantitative food frequency questionnaire (FFQ). Metabolic syndrome was defined by the National Cholesterol Education Program's Adult Treatment Panel III (ATP III). Linear and logistic regression tests were used to study the association between nuts and legumes consumption and metabolic syndrome and its components.

RESULTS

Mean age of study participants was 35 years. The prevalence of the metabolic syndrome among study participants was 3.6%. Consumption of nuts and legumes was not associated with waist circumference either before (β = -0.01, P = 0.24) or after adjusting for potential confounders (β = -0.18, P = 0.41). The same findings were also observed for diastolic blood pressure (DBP) (β = 0.001, P = 0.42), serum triglyceride (TG) (β = 0.07, P = 0.32), high-density lipoprotein cholesterol (HDL-C) (β = 0.008, P = 0.65) and fasting blood sugar (FBS) (β = -0.001, P = 0.94). We failed to find a significant association between consumption of nuts and legumes and systolic blood pressure (SBP) after adjusting for confounders (β = 0.002, P = 0.38). Individuals in the highest category of nuts and legume consumption did not had elevated odds for metabolic syndrome after adjusting for potential confounders (OR = 0.89, 95% CI = 0.08-9.80, P = 0.93).

CONCLUSIONS

Nuts and legumes consumption was not associated with metabolic syndrome or its components. Prospective studies are needed to investigate further this association.

Metabolically healthy obesity and unhealthy normal weight rural adults in Xinjiang: prevalence and the associated factors

BACKGROUND

This study aimed to describe the prevalence of metabolically healthy obesity (MHO) and metabolically unhealthy normal weight (MUNW) rural adults in Xinjiang and to explore their influencing factors.

METHODS

We selected 13,525 Uyghur, Kazakh and Han participants in Kashi, Yili and Shihezi areas in Xinjiang from 2009 to 2010. Weight status was classified according to body mass index. Metabolic phenotype was further defined based on the National Cholesterol Education Program Adult Treatment Panel III criteria.

RESULTS

The prevalence of normal weight, overweight, and obesity were 51.6, 30.2, and 14.4%, respectively. The mean age of the population was 45.04 years. The prevalence of MHO was 5.5% overall and was 38.5% among obese participants. The prevalence of MUNW was 15.5% overall and was 30.1% among normal weight participants. A metabolically healthy phenotype among obese individuals was positively associated with females and vegetable consumption ≥4 plates per week. However, this was inversely associated with higher age, red meat consumption ≥2 kg per week, and larger waist circumference (WC). Conversely, a metabolically unhealthy phenotype among normal-weight individuals was positively associated with higher age, red meat consumption ≥2 kg per week, and larger WC; this was however inversely associated with vegetable consumption ≥4 plates per week.

CONCLUSIONS

The prevalence of MHO among obese adults in Xinjiang is higher than that of Han adults, while the prevalence of MUNW among normal weight adults is lower than that among Han adults. In obese and normal weight participants, higher age, more red meat consumption, and larger WC increase the risk of metabolic abnormality, and more vegetable consumption reduces the risk of metabolic abnormality.

A Nano-Pharmaceutical Formula of Quercetin Protects from Cardiovascular Complications Associated with Metabolic Syndrome

Metabolic syndrome (MetS) is closely associated with the development of cardiovascular diseases. We recently developed a nano-preparation of the flavonoid quercetin (QU) in a self-nanoemulsifying drug delivery system (SNEDDS). The latter comprised a mixture composed of pumpkin seed oil, D-α-Tocopherol polyethylene glycol 1,000 succinate and polyethylene glycol. The QU SNEDDS preparations exhibited a considerably higher bioavailability compared with the standard quercetin suspension. Here, we investigated whether the quercetin loaded SNEDDS could offer better protection compared with the standard formulation against cardiovascular complications of MetS in rats. MetS was induced by high fructose, high salt and high fat diet for 12 weeks while the nano-preparation or the standard suspension of quercetin was orally administered for the last 6 weeks. Compared to little effect for the standard quercetin suspension (MQ), the treatment of MetS rats with the quercetin loaded SNEDDS (MNQ) virtually abolished the depressant effect of MetS on contractility index (control, 114 ± 4; MetS, 92 ± 3; MQ, 100 ± 2; MNQ, 114 ± 6 1/s) and rate of rise in left ventricular pressure (dP/dtmax) (control, 8,171 ± 274; MetS, 6,664 ± 135; MQ, 6,776 ± 108; MNQ, 7,498 ± 303 mmHg/s). Likewise, the prolongation by MetS of electrocardiographic markers of arrhythmogenesis (QTc, JT, and Tpeak-to-Tend intervals) and concomitant rises in dicrotic notch pressure were preferentially reversed by quercetin nano-preparation. On the other hand, the rises in the isovolumic relaxation constant (Tau, denotes diastolic dysfunction), blood pressure, pulse pressure, and difference between systolic and dicrotic pressure (SDP difference) were equally improved by the two preparations of quercetin. Additionally, no differences were noted in the ability of the two quercetin preparations in abrogating the elevated oxidative (MDA) and inflammatory (TNFα) markers in cardiac tissues of MetS rats. Histopathological, microscopical signs of necrosis, inflammatory cell infiltration, and vascular congestion in MetS hearts were more markedly inhibited by the nano-preparation, compared with the standard preparation of quercetin. In conclusion, the quercetin loaded SNEDDS is evidently more advantageous than the standard preparation of the drug in alleviating functional and histopathological manifestations of cardiac damage incited by MetS.

Endothelium-independent vasorelaxant effect of Asphodelus tenuifolius Cav. via inhibition of myosin light chain kinase activity in the porcine coronary artery

ETHNOPHARMACOLOGICAL RELEVANCE

Asphodelus tenuifolius Cav. (Asphodelaceae), a wild, terrestrial, annual stemless herb, is widely used in traditional medicine for the treatment of hypertension, diabetes, atherosclerosis and circulatory problems. A previous research study from our laboratory revealed that A. tenuifolius has beneficial effects in reducing blood pressure and improves aortic endothelial dysfunction in chronically glucose fed rats. Despite the fact that A. tenuifolius reduces blood pressure and improves endothelial function in vivo, there are no detailed studies about its possible mechanism of action.

AIM OF THE STUDY

This study was designed to provide pharmacological basis and mechanism of action for the traditional use of A. tenuifolius in hypertension and circulatory problems. We explored the vasorelaxant effect of A. tenuifolius and its underlying vasorelaxation mechanism in porcine coronary artery rings.

MATERIALS AND METHODS

Aqueous methanolic crude extract of A. tenuifolius was prepared by maceration process and then activity guided fractionation was carried out by using different polarity based solvents. Phytochemical studies were carried out using LC-DAD-MS. Segments of porcine distal coronary artery were set up in a wire myograph for isometric force measurements. Extract/fractions of A. tenuifolius seeds were tested for vasodilator activity by measurement of changes in tone after pre-contraction with the thromboxane mimetic U46619 in the presence or absence of inhibitors of intracellular signaling cascades.

RESULTS

Crude extract/fractions of A. tenuifolius produced dose dependent endothelium independent vasorelaxant response in coronary rings, whereas, the butanol fraction of A. tenuifolius (BS-AT) produced the largest relaxation response with 100% relaxation at 1 mg/ml, therefore the mechanism of relaxation of this fraction was determined. The relaxation to BS-AT was unaffected by removal of the endothelium, pre-contraction with KCl, or the presence of the non-selective potassium channel blocker tetraethylammonium, indicating that the relaxation was endothelium-independent, and does not involve activation of potassium channels. BS-AT (1 mg/ml) inhibited the contractile response to calcium,the L-type calcium channel activator BAY K8664,and ionomycin, indicating that it inhibits calcium-induced contractions. The relaxation response to BS-AT was attenuated in the absence of extracellular calcium. However, relaxations to BS-AT were also reduced after deletion of calcium from intracellular stores with cyclopiazonic acid. Incubation with 1 mg/ml BS-AT also inhibited phosphorylation of myosin light chains in homogenates of coronary artery.

CONCLUSION

The butanol extract of Asphodelus tenuifolius produces a large endothelium-independent relaxation of the porcine coronary artery through inhibition of calcium-induced contractions. The effect appears to be downstream of calcium influx, possibly through inhibition of myosin light chain kinase. This study supports previous studies demonstrating that A. tenuifolius reduces blood pressure. Future studies will aim to determine the active compounds underlying this response.

Involvement of Muscarinic Receptors in Hypotensive and Diuretic Effects of Aqueous Soluble Fraction from Asphodelus tenuifolius Cav

Background. Asphodelus tenuifolius Cav. (Asphodelaceae) is widely used in Pakistan traditional medicine as a hypotensive and diuretic agent. Despite the cardioprotective effects described for A. tenuifolius, the mechanisms involved in its probable hypotensive and diuretic effects have never been evaluated. Firstly, different extracts from A. tenuifolius seeds were obtained, and their antioxidant profiles and chemical constituents by LC-DAD-were determined, including molecular networking by the GNPS platform. Then, to evaluate changes in blood pressure, different groups of anesthetized normotensive rats were intravenously treated with the crude extract (AT-Cr, 1-50 mg/kg), aqueous (AS-AT, 1-25 mg/kg), n-butanol (BS-AT, 1-50 mg/kg), and dichloromethane fraction (DS-AT, 1-80 mg/kg). The diuretic effects of AT-Cr, AS-AT, BS-AT, and DS-AT at 100, 200, and 300 mg/kg, p.o. doses, were also evaluated in comparison with hydrochlorothiazide (HCTZ, 10 mg/kg, p.o). The urinary volume, sodium, potassium, and pH were estimated in the sample collected for 6 h from saline-loaded rats. Using pharmacological antagonists or inhibitors, we determine the involvement of acetylcholine, prostaglandins, and nitric oxide in A. tenuifolius-induced hypotensive and diuresis action. In addition, the activities of angiotensin-converting enzyme, erythrocyte carbonic anhydrase, and renal Na+/K+/ATPase were evaluated in vitro. Acute treatment with crude extract and fractions of A. tenuifolius exhibited significant hypotensive and diuretic potential in normotensive rats. However, AS-AT produced the most potent and significant dose-dependent hypotension and diuretic effects in normotensive rats. Previous treatment with atropine significantly reduced the hypotensive and diuretic action of AS-AT, but pretreatment with indomethacin or L-NAME did not affect these effects. Moreover, the 7-day treatment with AS-AT did not reduce activities of serum angiotensin-converting enzyme, erythrocyte carbonic anhydrase, and renal Na+/K+/ATPase. AS-AT showed four major compound node clusters, which included sugars, alkaloids, nucleoside, amino acid, and glycosylated flavonoids. This research supports and extends the traditional use of A. tenuifolius as a hypotensive and diuretic agent. The results showed that AS-AT from A. tenuifolius could present compounds responsible for hypotensive and diuretic activities through the activation of muscarinic receptors.

Association of dietary patterns and practices on metabolic syndrome in adults with central obesity attending a mission hospital in Kenya: a cross-sectional study

OBJECTIVE

Dietary patterns and practices can predispose or protect against metabolic syndrome (MetS) in humans. Despite the growing problem of MetS in adults, the underpinning dietary behaviour is poorly understood. We determined the dietary patterns and practices relevant to MetS in adults with central obesity attending a mission hospital in Kenya.

STUDY DESIGN

Descriptive, cross-sectional.

SETTING

Outpatient clinic of a mission-based hospital in Nairobi.

PARTICIPANTS

Adults (N=404) aged 18-64 years diagnosed with central obesity as per the International Diabetes Federation definition for MetS.

PRIMARY OUTCOMES

Anthropometric measurements, clinical-biochemical markers and dietary components, quantity and frequency of food intake, as well as time-lapse between consumption of dinner and sleeping.

RESULTS

A high (87.2%) prevalence of MetS was observed for respondents who reported consumption of large amount of carbohydrates (p<0.001), proteins (p<0.001), processed/fast foods (p<0.001) and sugar (p=0.009). Frequent consumption of legumes (p<0.001), nuts (p<0.001), fruits (p<0.001) and vegetables (p=0.021) was linked to reduced MetS. Additionally, longer interval between eating dinner and going to bed was associated with reduced MetS.

CONCLUSION

Regular consumption of fruits, vegetables, legumes and nuts, as well as observing sometime after eating dinner before sleeping, was the dietary pattern significantly associated with a lower risk of MetS. Whereas, consumption of a large quantity of carbohydrates, proteins, processed/fast foods and sugar is likely to predispose to MetS. The findings underscore the need to focus on specific dietary intake patterns including frequency, quantity, quality and variety for MetS prevention and management. The MetS-related interventions could be implemented during individual consultation, group and community health messaging sessions.

Interference with AGEs formation and AGEs-induced vascular injury mediates curcumin vascular protection in metabolic syndrome

Vascular dysfunction predisposes to cardiovascular complications of metabolic syndrome (MetS). The current study investigated the mechanism(s) of curcumin's (CUR) protective effect against vascular reactivity irregularities in MetS. MetS was induced by feeding rats on high fructose high salt diet. Tension studies were undertaken in aortic rings to assess the influence of CUR on vasoconstrictor or vasorelaxant responses. The effect on advanced glycation endproducts (AGEs) was studied by incubating aortic tissues with methylglyoxal, the AGEs precursor, in the absence and presence of CUR. In addition, CUR effects on in-vitro generation of AGEs and diphenyl-2-picrylhydrazyl (DPPH) free radicals were studied. The incubation with CUR for 1 hr produced significant and concentration-dependent alleviation of the exaggerated vasoconstriction observed in aortas isolated from MetS, however failed to improve the concomitant attenuation of vasodilatory responses to ACh in PE-precontracted aortas. By contrast, CUR caused direct concentration-dependent vasodilations of precontracted aortas, effects that were blunted after nitric oxide synthase inhibition by L-NAME. Similar to its effects in MetS aortas, CUR alleviated exaggerated PE vasoconstriction but did not affect impaired ACh vasodilations in AGEs-exposed aortas. In addition, CUR showed significant dose-dependent DPPH free radicals scavenging activity and inhibited both MG and fructose induced AGEs formation at the level of protein oxidation step as evident from the effect on dityrosine and N-formylkyramine. CUR alleviates exaggerated vasoconstriction in MetS through interfering with AGEs formation and AGEs-induced vascular injury. Free radical scavenging and direct vasodilatory activities could also participate in the advantageous vascular actions of CUR.

Dietary Patterns and Metabolic Syndrome among Type 2 Diabetes Patients in Gaza Strip, Palestine

Background

The prevalence of metabolic syndrome is raising worldwide; however, the role of diet in the origin of metabolic syndrome is not understood well. This study identifies major dietary patterns among type 2 diabetes mellitus patients with and without metabolic syndrome; and its association with metabolic syndrome components in Gaza Strip, Palestine.

Methods

This cross sectional study was conducted among 1200 previously diagnosed type 2 diabetes mellitus (both genders, aged 20 – 64 years) patients receiving care in primary healthcare centers in Gaza Strip, Palestine. Metabolic syndrome was defined based on the International Diabetes Federation criteria; dietary patterns were evaluated using a validated semi-quantitative food frequency questionnaire. Statistical analysis was performed using SPSS version 20.

Results

Two major dietary patterns were identified by factor analysis: Asian-like pattern and sweet-soft drinks-snacks pattern. After adjustment for confounding variables, patients in the highest tertile of the Asian-like pattern characterized by a high intake of whole grains, potatoes, beans, legumes, vegetables, tomatoes and fruithad a lower odds for (Metabolic syndrome, central obesity, high triglycerides, low HDL cholesterol and high blood pressure), (OR 0.766 CI 95% (.642–.914)), (OR 0.797 CI 95% (.652–.974)), (OR 0.791 CI 95% (.687–.911)), (OR 0.853 CI 95% (.743–.978)) and (OR 0.815 CI 95% (.682–.973)) respectively, (P value < 0.05 for all). No significant association was found between the sweet-soft drinks-snacks pattern with metabolic syndrome and its components.

Conclusion

The Asian-like pattern may be associated with a lower prevalence of metabolic syndrome and its components among type 2 diabetes patients.

Risperidone-induced metabolic dysfunction is attenuated by Curcuma longa extract administration in mice

Antipsychotics, such as risperidone, increase food intake and induce alteration in glucose and lipid metabolism concomitantly with overweight and body fat increase, these biological abnormalities belong to the metabolic syndrome definition (high visceral adiposity, hypertriglyceridemia, hyperglycemia, low HDL-cholesterol and high blood pressure). Curcumin is a major component of traditional turmeric (Curcuma longa) which has been reported to improve lipid and glucose metabolism and to decrease weight in obese mice. We questioned the potential capacity of curcumin, contained in Curcuma longa extract (Biocurcuma™), to attenuate the risperidone-induced metabolic dysfunction. Two groups of mice were treated once a week, for 22 weeks, with intraperitoneal injection of risperidone (Risperdal) at a dose 12.5 mpk. Two other groups received intraperitoneal injection of the vehicle of Risperdal following the same schedule. Mice of one risperidone-treated groups and of one of vehicle-treated groups were fed a diet with 0.05% Biocurcuma™ (curcumin), while mice of the two other groups received the standard diet. Curcumin limited the capacity of risperidone to reduce spontaneous motricity, but failed to impede risperidone-induced increase in food intake. Curcumin did not reduce the capacity of risperidone to induce weight gain, but decreased visceral adiposity and decreased the risperidone-induced hepatomegaly, but not steatosis. Furthermore, curcumin repressed the capacity of risperidone to induce the hepatic over expression of enzymes involved in lipid metabolism (LXRα, FAS, ACC1, LPL, PPARγ, ACO, SREBP2) and decreased risperidone-induced glucose intolerance and hypertriglyceridemia. Curcumin decreased risperidone-induced increases in serum markers of hepatotoxicity (ALAT, ASAT), as well as of one major hepatic pro-inflammatory transcription factor (NFκB: p105 mRNA and p65 protein). These findings support that nutritional doses of curcumin contained in Curcuma longa extract are able to partially counteract the risperidone-induced metabolic dysfunction in mice, suggesting that curcumin ought to be tested to reduce the capacity of risperidone to induce the metabolic syndrome in human.

Effects of Polyphenol Intake on Metabolic Syndrome: Current Evidences from Human Trials

Metabolic syndrome (MetS) is a cluster of cardiovascular risk factors which severely increases the risk of type II diabetes and cardiovascular disease. Several epidemiological studies have observed a negative association between polyphenol intake and MetS rates. Nevertheless, there are relatively small numbers of interventional studies evidencing this association. This review is focused on human interventional trials with polyphenols as polyphenol-rich foods and dietary patterns rich in polyphenols in patients with MetS. Current evidence suggests that polyphenol intake has the potential to alleviate MetS components by decreasing body weight, blood pressure, and blood glucose and by improving lipid metabolism. Therefore, high intake of polyphenol-rich foods such as nuts, fruits, vegetables, seasoning with aromatic plants, spices, and virgin olive oil may be the cornerstone of a healthy diet preventing the development and progression of MetS, although there is no polyphenol or polyphenol-rich food able to influence all MetS features. However, inconsistent results have been found in different trials, and more long-term randomized trials are warranted to develop public health strategies to decrease MetS rates.

Prevalence and Determinants of Metabolic Health in Subjects with Obesity in Chinese Population

Background: The study was to investigate the prevalence of metabolic health in subjects with obesity in the Chinese population and to identify the determinants related to metabolic abnormality in obese individuals. Methods: 5013 subjects were recruited from seven provincial capitals in China. The obesity and metabolic status were classified based on body mass index (BMI) and the number of abnormalities in common components of metabolic syndrome. Results: 27.9% of individuals with obesity were metabolically healthy. The prevalence of the metabolically healthy obese (MHO) phenotype was significantly decreased with age in women (p_trend < 0.001), but not significantly in men (p_trend = 0.349). Central obesity (odds ratio [OR] = 4.07, 95% confidence interval [CI] = 1.93–8.59), longer sedentary time (OR = 1.97, 95%CI = 1.27–3.06), and with a family history of obesity related diseases (hypertension, diabetes, dyslipidemia) (OR = 1.85, 95%CI = 1.26–2.71) were significantly associated with having metabolic abnormality in obese individuals. Higher levels of physical activity and more fruit/vegetable intake had decreased ORs of 0.67 (95%CI = 0.45–0.98) and 0.44 (95%CI = 0.28–0.70), respectively. Conclusion: 27.9% of obese participants are in metabolic health. Central obesity, physical activity, sedentary time, fruits/vegetables intake and family history of diseases are the determinants associated with metabolic status in obesity.

Nanoscale Nutrient Delivery Systems for Food Applications: Improving Bioactive Dispersibility, Stability, and Bioavailability

There has been a surge of interest in the development of nanoscale systems for the encapsulation, protection, and delivery of lipophilic nutrients, vitamins, and nutraceuticals. This review article highlights the challenges associated with incorporating these lipophilic bioactive components into foods, and then discusses potential nanoscale delivery systems that can be used to overcome these challenges. In particular, the desirable characteristics required for any nanoscale delivery system are presented, as well as methods of fabricating them and of characterizing them. An overview of different delivery systems is given, such as microemulsions, nanoemulsions, emulsions, microgels, and biopolymer nanoparticles, and their potential applications are discussed. Nanoscale delivery systems have considerable potential within the food industry, but they must be carefully formulated to ensure that they are safe, economically viable, and effective.

PRACTICAL APPLICATION

Nanoscale delivery systems have numerous potential applications in the food industry for encapsulating, protecting, and releasing bioactive agents, such as nutraceuticals and vitamins. This review article highlights methods for designing, fabricating, characterizing, and utilizing edible nanoparticles from a variety of different food-grade ingredients.

Argan oil reduces, in rats, the high fat diet-induced metabolic effects of obesity

BACKGROUND AND AIM

Obesity is a multi-factorial disorder which is of worldwide concern. In addition to calorie control, some specific dietary components might help resolving some of the complication of obesity, by providing antioxidant and anti-inflammatory activities. We investigated the effect of argan oil supplementation on plasma lipid profile and oxidant-antioxidant status of rats with high-fat diet (HFD)-induced obesity compared with rats fed a normal diet (ND).

METHODS AND RESULTS

We used an animal model of high fat diet-induced obesity to study the metabolic effects of argan oil and we measured several markers lipid and redox statuses. Consumption of a high-fat diet led to an increase in serum total cholesterol (TC), LDL-cholesterol (LDL-C), and triacylglycerols (TAG) concentrations; however, argan oil blunted the increases of TC, LDL-C and TG, glucose, and insulin. Plasma total antioxidant capacity, erythrocyte catalase and superoxide dismutase activities were lower, whereas plasma hydroperoxide, thiobarbituric acid-reacting substances, and susceptibility of LDL to copper-induced oxidation were higher in obese rats compared with normal rats. Administration of argan oil ameliorated all these indices of redox status.

CONCLUSIONS

Proper diet and lifestyle should be foremost implemented to reduce the lipoprotein metabolism and oxidant/antioxidant status alterations brought about by obesity. In addition, argan oil reduces the metabolic effects of obesity and its use might be promoted within the context of a balanced diet.

One-week administration of hydroxytyrosol to humans does not activate Phase II enzymes

The notion that (poly)phenols act as direct free radical scavengers is being challenged by mere chemical and biochemical considerations such as bioavailability and intracellular concentrations. An alternative hypothesis that is gaining considerable traction is that (poly)phenols are processed by the body as xenobiotics via the Keap1/Nrf2/ARE signaling axis, leading to the induction of Phase II enzymes. However, there are no solid human data to confirm this interesting supposition. In this study, we tested the activities of hydroxytyrosol (HT) on Phase II enzymes' expression in a double-blind, randomized, placebo-controlled study. We tested two HT doses, i.e. 5 and 25mg/d, vs. placebo following a Latin square design. We report that HT is well tolerated but does not significantly modify Phase II enzyme expression in peripheral blood mononuclear cells. Moreover, we were unable to record significant effects on a variety of surrogate markers of cardiovascular disease such as lipid profile and inflammation and oxidation markers. Available evidence indicates that the "hormesis hypothesis" that (poly)phenols activate Phase II enzymes requires solid human confirmation that might be provided by future trials. This study is registered at ClinicalTrials.gov (identifier: NCT02273622).

Soy isoflavones in nutritionally relevant amounts have varied nutrigenomic effects on adipose tissue

Soy consumption has been suggested to afford protection from cardiovascular disease (CVD). Indeed, accumulated albeit controversial evidence suggests that daily consumption of ≥25 g of soy protein with its associated phytochemicals intact can improve lipid profiles in hypercholesterolemic humans. However, the belief that soy foods and supplements positively impact human health has become increasingly controversial among the general public because of the reported estrogenic activities of soy isoflavones. In this study, we investigated the nutrigenomic actions of soy isoflavones (in nutritionally-relevant amounts) with a specific focus on the adipose tissue, due to its pivotal role in cardiometabolism. Young C57BL/6 mice were maintained for eight weeks under two different diet regimes: (1) purified control diet; or (2) purified control diet supplemented with 0.45 g% soybean dry purified extract (a genistein/daidzein mix). Soy isoflavones increased plasma total cholesterol concentrations and decreased triglyceride ones. Circulating leptin levels was also increased by soy consumption. Differentially expressed genes in adipose tissue were classified according to their role(s) in cellular or metabolic pathways. Our data show that soy isoflavones, administered in nutritionally-relevant amounts, have diverse nutrigenomic effects on adipose tissue. Taking into account the moderate average exposure to such molecules, their impact on cardiovascular health needs to be further investigated to resolve the issue of whether soy consumption does indeed increase or decrease cardiovascular risk.

Improvement of Blood Pressure, Glucose Metabolism, and Lipid Profile by the Intake of Powdered Asparagus ( Lú Sŭn) Bottom-stems and Cladophylls

Asparagus (蘆筍 Lú Sǔn; Asparagus officinalis L.) is a common vegetable, long used as an herbal medicine. The cladophylls and bottom-stems of asparagus have various pharmacological effects, but they are generally discarded at harvesting. The present open clinical trial was performed to examine the effects of the intake of cladophylls and bottom-stems on the improvement of metabolic syndrome characterized by hypertension, hyperglycemia, and dyslipidemia. Twenty-eight healthy volunteers ingested either cladophyll or bottom-stem powder (6 g/day) daily for 10 weeks. The cladophyll intake resulted in significant reduction in the subjects’ diastolic blood pressure and fasting plasma glucose (FPG), and decreased both the left cardio-ankle vascular index score and the total cholesterol level (T-CHO). The bottom-stem intake significantly reduced the subjects’ systolic and diastolic blood pressure and FPG as well as T-CHO. These results suggest the possibility that asparagus cladophylls and bottom-stems differentially improve hypertension, hyperglycemia, and dyslipidemia.

Milk, dairy products, and their functional effects in humans: a narrative review of recent evidence

Milk is a widely consumed beverage that is essential to the diet of several millions of people worldwide because it provides important macro- and micronutrients. Milk is recognized as being useful during childhood and adolescence because of its composition; however, its relatively high saturated fat proportion raises issues of potential detrimental effects, namely on the cardiovascular system. This review evaluates the most recent literature on dairy and human health, framed within epidemiologic, experimental, and biochemical evidence. As an example, the effects of milk (notably skimmed milk) on body weight appear to be well documented, and the conclusions of the vast majority of published studies indicate that dairy consumption does not increase cardiovascular risk or the incidence of some cancers. Even though the available evidence is not conclusive, some studies suggest that milk and its derivatives might actually be beneficial to some population segments. Although future studies will help elucidate the role of milk and dairy products in human health, their use within a balanced diet should be considered in the absence of clear contraindications.

Mediterranean diet and metabolic syndrome: an updated systematic review

The metabolic syndrome is a health condition characterized by abdominal obesity, dyslipidemia, elevated blood pressure and impaired glucose tolerance, with increasing prevalence. Adherence to the Mediterranean diet seems to exert beneficial effects regarding the metabolic syndrome prevalence and progression. Thus, we performed an updated systematic review of studies which have evaluated the effect of the Mediterranean dietary pattern on the metabolic syndrome. This was a systematic review of epidemiological observational studies and clinical trials. English language publications in the databases PubMed, Embase, Scopus, until May 31, 2013, were included in this review. New evidence from prospective cohort studies, cross-sectional studies and clinical trials supports the beneficial role of adherence to the Mediterranean dietary pattern regarding metabolic syndrome presence and progression. Considering the magnitude of metabolic syndrome, efforts should be made to encourage adoption of this pattern in Mediterranean countries and similar dietary pattern in countries where metabolic syndrome is prevalent.

Moderate alcohol use and health: a consensus document

AIMS

The aim of this consensus paper is to review the available evidence on the association between moderate alcohol use, health and disease and to provide a working document to the scientific and health professional communities.

DATA SYNTHESIS

In healthy adults and in the elderly, spontaneous consumption of alcoholic beverages within 30 g ethanol/d for men and 15 g/d for women is to be considered acceptable and do not deserve intervention by the primary care physician or the health professional in charge. Patients with increased risk for specific diseases, for example, women with familiar history of breast cancer, or subjects with familiar history of early cardiovascular disease, or cardiovascular patients should discuss with their physician their drinking habits. No abstainer should be advised to drink for health reasons. Alcohol use must be discouraged in specific physiological or personal situations or in selected age classes (children and adolescents, pregnant and lactating women and recovering alcoholics). Moreover, the possible interactions between alcohol and acute or chronic drug use must be discussed with the primary care physician.

CONCLUSIONS

The choice to consume alcohol should be based on individual considerations, taking into account the influence on health and diet, the risk of alcoholism and abuse, the effect on behaviour and other factors that may vary with age and lifestyle. Moderation in drinking and development of an associated lifestyle culture should be fostered.

Why it is necessary to translate curcumin into clinical practice for the prevention and treatment of metabolic syndrome?

Curcumin (diferuloylmethane) is the yellow-orange pigment of dried Curcuma longa L. rhizomes (turmeric). During the past two decades, there has been a large volume of published studies describing the biological and pharmacological properties of this phytochemical including anticancer, anti-inflammatory, antioxidant, antithrombotic, antiatherosclerotic, cardioprotective, neuroprotective, memory enhancing, antiparkinsonism, antirheumatic, anti-infectious, antiaging, antipsoriatic, and anticonvulsant activities. In addition, curcumin has been shown to be extremely safe and interact with multiple molecular targets that are involved in the pathogenesis of metabolic syndrome. Curcumin could favorably affect all leading components of metabolic syndrome including insulin resistance, obesity, hypertriglyceridemia, decreased HDL-C and hypertension, and prevent the deleterious complications of MetS including diabetes and cardiovascular disease. Owing to its antioxidant and anti-inflammatory properties, curcumin can also exert several pleiotropic effects and improve endothelial dysfunction, adipokine imbalances, and hyperuricemia which usually accompany MetS. Despite the potential tremendous benefit of this multifaceted phytopharmaceutical, no trial result has yet been publicized on this issue. This review seeks to briefly summarize the ample scientific evidence that supports the therapeutic efficacy of curcumin, at least as an adjunctive treatment, in patients with MetS.

Metabolic syndrome and inflammation: a critical review of in vitro and clinical approaches for benefit assessment of plant food supplements

Metabolic syndrome is defined as the clustering in an individual of several metabolic abnormalities associated with insulin resistance, type 2 diabetes, and obesity, in which low-grade chronic inflammatory activity is commonly observed. Part of the European Project PlantLIBRA is concerned with methods to assess the benefits of plant food supplements (PFSs) in countering inflammatory activity and metabolic syndrome. This paper summarizes the current methods used for benefit assessment of PFS, taking into consideration only in vitro, in silico, and clinical methodologies used to investigate the anti-inflammatory properties of plants. No in silico studies (using computer simulation) related to metabolic syndrome were found; these methods appear to be used exclusively for identifying or testing potentially effective compounds in drug development. Most in vitro methods for the assessment of beneficial effects of botanicals or plant food supplements in diabetes were based on a quantitative polymerase chain reaction (PCR), whereas the preferred kind of clinical study was the double-blind randomized controlled clinical trial. Only two parameters were observed to change after treatment with botanicals in both in vitro and in vivo studies: interleukin-6 and tumour necrosis factor-α, and these biomarkers should be carefully considered in future studies for PFS benefit assessment.