1
|
Fogacci F, ALGhasab NS, Di Micoli V, Giovannini M, Cicero AFG. Cholesterol-Lowering Bioactive Foods and Nutraceuticals in Pediatrics: Clinical Evidence of Efficacy and Safety. Nutrients 2024; 16:1526. [PMID: 38794764 PMCID: PMC11123713 DOI: 10.3390/nu16101526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Revised: 05/13/2024] [Accepted: 05/17/2024] [Indexed: 05/26/2024] Open
Abstract
Long-term exposure to even slightly elevated plasma cholesterol levels significantly increases the risk of developing cardiovascular disease. The latest evidence recommends an improvement in plasma lipid levels, even in children who are not affected by severe hypercholesterolemia. The risk-benefit profile of pharmacological treatments in pediatric patients with moderate dyslipidemia is uncertain, and several cholesterol-lowering nutraceuticals have been recently tested. In this context, the available randomized clinical trials are small, short-term and mainly tested different types of fibers, plant sterols/stanols, standardized extracts of red yeast rice, polyunsaturated fatty acids, soy derivatives, and some probiotics. In children with dyslipidemia, nutraceuticals can improve lipid profile in the context of an adequate, well-balanced diet combined with regular physical activity. Of course, they should not be considered an alternative to conventional lipid-lowering drugs when necessary.
Collapse
Affiliation(s)
- Federica Fogacci
- Hypertension and Cardiovascular Risk Factors Research Center, Medical and Surgical Sciences Department, Sant’Orsola-Malpighi University Hospital, Via Albertoni 15, 40138 Bologna, Italy; (F.F.); (V.D.M.); (M.G.)
| | - Naif Saad ALGhasab
- Department of Internal Medicine, Medical College, Ha’il University, Ha’il 55476, Saudi Arabia
- Department of Cardiology, Libin Cardiovascular Institute, Calgary University, Calgary, AB T2N 1N4, Canada
| | - Valentina Di Micoli
- Hypertension and Cardiovascular Risk Factors Research Center, Medical and Surgical Sciences Department, Sant’Orsola-Malpighi University Hospital, Via Albertoni 15, 40138 Bologna, Italy; (F.F.); (V.D.M.); (M.G.)
| | - Marina Giovannini
- Hypertension and Cardiovascular Risk Factors Research Center, Medical and Surgical Sciences Department, Sant’Orsola-Malpighi University Hospital, Via Albertoni 15, 40138 Bologna, Italy; (F.F.); (V.D.M.); (M.G.)
| | - Arrigo Francesco Giuseppe Cicero
- Hypertension and Cardiovascular Risk Factors Research Center, Medical and Surgical Sciences Department, Sant’Orsola-Malpighi University Hospital, Via Albertoni 15, 40138 Bologna, Italy; (F.F.); (V.D.M.); (M.G.)
- Cardiovascular Medicine Unit, Heart, Thoracic and Vascular Department, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| |
Collapse
|
2
|
Hanssen H, Moholdt T, Bahls M, Biffi A, Siegrist M, Lewandowski AJ, Biondi-Zoccai G, Cavarretta E, Kokkvoll A, Løchen ML, Maestrini V, Pinto RS, Palermi S, Thivel D, Wojcik M, Hansen D, Van Craenenbroeck EM, Weghuber D, Kraenkel N, Tiberi M. Lifestyle interventions to change trajectories of obesity-related cardiovascular risk from childhood onset to manifestation in adulthood: a joint scientific statement of the task force for childhood health of the European Association of Preventive Cardiology and the European Childhood Obesity Group. Eur J Prev Cardiol 2023; 30:1462-1472. [PMID: 37491406 DOI: 10.1093/eurjpc/zwad152] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 04/20/2023] [Accepted: 05/06/2023] [Indexed: 07/27/2023]
Abstract
There is an immediate need to optimize cardiovascular (CV) risk management and primary prevention of childhood obesity to timely and more effectively combat the health hazard and socioeconomic burden of CV disease from childhood development to adulthood manifestation. Optimizing screening programs and risk management strategies for obesity-related CV risk in childhood has high potential to change disease trajectories into adulthood. Building on a holistic view on the aetiology of childhood obesity, this document reviews current concepts in primary prevention and risk management strategies by lifestyle interventions. As an additional objective, this scientific statement addresses the high potential for reversibility of CV risk in childhood and comments on the use of modern surrogate markers beyond monitoring weight and body composition. This scientific statement also highlights the clinical importance of quantifying CV risk trajectories and discusses the remaining research gaps and challenges to better promote childhood health in a population-based approach. Finally, this document provides an overview on the lessons to be learned from the presented evidence and identifies key barriers to be targeted by researchers, clinicians, and policymakers to put into practice more effective primary prevention strategies for childhood obesity early in life to combat the burden of CV disease later in life.
Collapse
Affiliation(s)
- Henner Hanssen
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Grosse Allee 6, 4052 Basel, Switzerland
| | - Trine Moholdt
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
- Women's Clinic, St. Olavs Hospital, Trondheim, Norway
| | - Martin Bahls
- Department of Internal Medicine B University Medicine Greifswald, University of Greifswald, Greifswald, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
| | - Alessandro Biffi
- Med-Ex Medicine & Exercise, Medical Partner Scuderia Ferrari, Rome, Italy
| | - Monika Siegrist
- Department of Prevention and Sports Medicine, School of Medicine, University Hospital 'rechts der Isar', Technical University of Munich, Munich, Germany
| | - Adam J Lewandowski
- Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Giuseppe Biondi-Zoccai
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
- Mediterranea Cardiocentro, Napoli, Italy
| | - Elena Cavarretta
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
- Mediterranea Cardiocentro, Napoli, Italy
| | - Ane Kokkvoll
- Department of Paediatrics, Finnmark Hospital Trust, Hammerfest, Norway
| | - Maja-Lisa Løchen
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Viviana Maestrini
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, 'Sapienza' University of Rome, Policlinico Umberto I, Rome, Italy
| | | | - Stefano Palermi
- Med-Ex Medicine & Exercise, Medical Partner Scuderia Ferrari, Rome, Italy
| | - David Thivel
- Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Malgorzata Wojcik
- Department of Pediatric and Adolescent Endocrinology, Jagiellonian University Medical College, Krakow, Poland
| | - Dominique Hansen
- Department of Cardiology, Heart Centre Hasselt, Jessa Hospital, Hasselt, Belgium
- UHasselt, Faculty of Rehabilitation Sciences, BIOMED-REVAL-Rehabilitation Research Centre, Hasselt University, Hasselt, Belgium
| | - Emeline M Van Craenenbroeck
- Research Group Cardiovascular Diseases, GENCOR Department, University of Antwerp, Campus Drie Eiken, Antwerp, Belgium
- Department of Cardiology, Antwerp University Hospital (UZA), Edegem, Belgium
| | - Daniel Weghuber
- Obesity Research Unit, Paracelsus Medical University, Salzburg, Austria
- Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria
| | - Nicolle Kraenkel
- Deutsches Herzzentrum der Charité (DHZC), Department of Cardiology, Angiology and Intensive Care, Campus Benjamin-Franklin (CBF), Berlin, Germany
- German Centre for Cardiovascular Research (DZHK), Partner site Berlin, Germany
- Friede Springer- Cardiovascular Prevention Center @ Charité, Charite- Universitätsmedizin Berlin, Berlin, Germany
| | - Monica Tiberi
- Department of Public Health, Azienda Sanitaria Unica Regionale Marche AV 1, Pesaro, Italy
| |
Collapse
|
3
|
Martino F, Bassareo PP, Martino E, Romeo F, Calcaterra G, Perrone Filardi P, Indolfi C, Nodari S, Montemurro V, Guccione P, Salvo GD, Chessa M, Pedrinelli R, Mercuro G, Barillà F. Cardiovascular prevention in childhood: a consensus document of the Italian Society of Cardiology Working Group on Congenital Heart Disease and Cardiovascular Prevention in Paediatric Age. J Cardiovasc Med (Hagerstown) 2023; 24:492-505. [PMID: 37409595 DOI: 10.2459/jcm.0000000000001488] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Abstract
Cardiovascular diseases (CVD) may be manifested from a very early age. Genetic and environmental (epigenetic) factors interact to affect development and give rise to an abnormal phenotypical expression of genetic information, although not eliciting changes in the nucleotide sequence of DNA. It has been scientifically proven that increased oxidative stress (OS) caused by disease (overweight, obesity, diabetes), nutritional imbalances, unhealthy lifestyles (smoking, alcohol, substance abuse) in the mother during pregnancy may induce placental dysfunction, intrauterine growth restriction, prematurity, low birth weight, postnatal adiposity rebound, metabolic alterations and consequent onset of traditional cardiovascular risk factors. OS represents the cornerstone in the onset of atherosclerosis and manifestation of CVD following an extended asymptomatic period. OS activates platelets and monocytes eliciting the release of pro-inflammatory, pro-atherogenic and pro-oxidising substances resulting in endothelial dysfunction, decrease in flow-mediated arterial dilatation and increase in carotid intima-media thickness. The prevention of CVD is defined as primordial (aimed at preventing risk factors development), primary (aimed at early identification and treatment of risk factors), secondary (aimed at reducing risk of future events in patients who have already manifested a cardiovascular event), and tertiary (aimed at limiting the complex outcome of disease). Atherosclerosis prevention should be implemented as early as possible. Appropriate screening should be carried out to identify children at high risk who are apparently healthy and implement measures including dietary and lifestyle changes, addition of nutritional supplements and, lastly, pharmacological treatment if risk profiles fail to normalise. Reinstating endothelial function during the reversible stage of atherosclerosis is crucial.
Collapse
Affiliation(s)
- Francesco Martino
- Department of Internal Clinical, Anesthesiological and Cardiovascular Sciences, La Sapienza University, Rome, Italy
| | - Pier Paolo Bassareo
- University College of Dublin, School of Medicine, Mater Misericordiae University Hospital and Children's Health Ireland at Crumlin, Dublin, Ireland
| | - Eliana Martino
- Department of Internal Clinical, Anesthesiological and Cardiovascular Sciences, La Sapienza University, Rome, Italy
| | | | | | | | - Ciro Indolfi
- Division of Cardiology, Research Centre for Cardiovascular Diseases, Magna Graecia University, Catanzaro
| | - Savina Nodari
- Department of Medical Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, ASST Spedali Civili, Brescia
| | | | - Paolo Guccione
- Department of Cardiology, Cardiac Surgery, Cardio-pulmonary Transplantation, IRCCS Bambino Gesu'Paediatric Hospital, Rome
| | - Giovanni Di Salvo
- Division of Paediatric Cardiology, Department of Women's and Children's Health, University of Padua, Padua
| | - Massimo Chessa
- ACHD UNIT, Pediatric and Adult Congenital Heart Centre, IRCCS-Policlinico San Donato, San Donato Milanese, Vita Salute San Raffaele University, Milan
| | - Roberto Pedrinelli
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa
| | | | | |
Collapse
|
4
|
Guirguis-Blake JM, Evans CV, Coppola EL, Redmond N, Perdue LA. Screening for Lipid Disorders in Children and Adolescents: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA 2023; 330:261-274. [PMID: 37462700 DOI: 10.1001/jama.2023.8867] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
Importance Lipid screening in childhood and adolescence can lead to early dyslipidemia diagnosis. The long-term benefits of lipid screening and subsequent treatment in this population are uncertain. Objective To review benefits and harms of screening and treatment of pediatric dyslipidemia due to familial hypercholesterolemia (FH) and multifactorial dyslipidemia. Data Sources MEDLINE and the Cochrane Central Register of Controlled Trials through May 16, 2022; literature surveillance through March 24, 2023. Study Selection English-language randomized clinical trials (RCTs) of lipid screening; recent, large US cohort studies reporting diagnostic yield or screen positivity; and RCTs of lipid-lowering interventions. Data Extraction and Synthesis Single extraction, verified by a second reviewer. Quantitative synthesis using random-effects meta-analysis. Main Outcomes and Measures Health outcomes, diagnostic yield, intermediate outcomes, behavioral outcomes, and harms. Results Forty-three studies were included (n = 491 516). No RCTs directly addressed screening effectiveness and harms. Three US studies (n = 395 465) reported prevalence of phenotypically defined FH of 0.2% to 0.4% (1:250 to 1:500). Five studies (n = 142 257) reported multifactorial dyslipidemia prevalence; the prevalence of elevated total cholesterol level (≥200 mg/dL) was 7.1% to 9.4% and of any lipid abnormality was 19.2%. Ten RCTs in children and adolescents with FH (n = 1230) demonstrated that statins were associated with an 81- to 82-mg/dL greater mean reduction in levels of total cholesterol and LDL-C compared with placebo at up to 2 years. Nonstatin-drug trials showed statistically significant lowering of lipid levels in FH populations, but few studies were available for any single drug. Observational studies suggest that statin treatment for FH starting in childhood or adolescence reduces long-term cardiovascular disease risk. Two multifactorial dyslipidemia behavioral counseling trials (n = 934) demonstrated 3- to 6-mg/dL greater reductions in total cholesterol levels compared with the control group, but findings did not persist at longest follow-up. Harms reported in the short-term drug trials were similar in the intervention and control groups. Conclusions and Relevance No direct evidence on the benefits or harms of pediatric lipid screening was identified. While multifactorial dyslipidemia is common, no evidence was found that treatment is effective for this condition. In contrast, FH is relatively rare; evidence shows that statins reduce lipid levels in children with FH, and observational studies suggest that such treatment has long-term benefit for this condition.
Collapse
Affiliation(s)
- Janelle M Guirguis-Blake
- Kaiser Permanente Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon
- Department of Family Medicine, University of Washington, Tacoma
| | - Corinne V Evans
- Kaiser Permanente Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon
| | - Erin L Coppola
- Kaiser Permanente Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon
| | - Nadia Redmond
- Kaiser Permanente Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon
| | - Leslie A Perdue
- Kaiser Permanente Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon
| |
Collapse
|
5
|
Bassareo PP, O’Brien ST, Dunne E, Duignan S, Martino E, Martino F, Mcmahon CJ. Should We Be Screening for Ischaemic Heart Disease Earlier in Childhood? CHILDREN 2022; 9:children9070982. [PMID: 35883966 PMCID: PMC9320497 DOI: 10.3390/children9070982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 06/18/2022] [Accepted: 06/28/2022] [Indexed: 11/26/2022]
Abstract
Ischaemic heart disease is the most common cause of death in males and the second in the female gender. Yet we often only focus on identification and treatment of this foremost cause of death in adulthood. The review asks the question what form of coronary disease do we encounter in childhood, what predisposing factors give rise to atherosclerosis and what strategies in childhood could we employ to detect and reduce atherosclerosis development in later life.
Collapse
Affiliation(s)
- Pier Paolo Bassareo
- Mater Misercordiae Hospital, Mater, D07 R2WY Dublin, Ireland
- Children’s Health Ireland at Crumlin, D12 N512 Dublin, Ireland; (S.T.O.); (E.D.); (S.D.); (C.J.M.)
- School of Medicine, University College Dublin, Belfield, D04 V1W8 Dublin, Ireland
- Correspondence:
| | - Stephen T. O’Brien
- Children’s Health Ireland at Crumlin, D12 N512 Dublin, Ireland; (S.T.O.); (E.D.); (S.D.); (C.J.M.)
| | - Esme Dunne
- Children’s Health Ireland at Crumlin, D12 N512 Dublin, Ireland; (S.T.O.); (E.D.); (S.D.); (C.J.M.)
| | - Sophie Duignan
- Children’s Health Ireland at Crumlin, D12 N512 Dublin, Ireland; (S.T.O.); (E.D.); (S.D.); (C.J.M.)
| | - Eliana Martino
- Department of Paediatrics, La Sapienza University, 00185 Roma, Italy; (E.M.); (F.M.)
| | - Francesco Martino
- Department of Paediatrics, La Sapienza University, 00185 Roma, Italy; (E.M.); (F.M.)
| | - Colin J. Mcmahon
- Children’s Health Ireland at Crumlin, D12 N512 Dublin, Ireland; (S.T.O.); (E.D.); (S.D.); (C.J.M.)
- School of Medicine, University College Dublin, Belfield, D04 V1W8 Dublin, Ireland
| |
Collapse
|
6
|
Mah E, Chen O, Liska DJ, Blumberg JB. Dietary Supplements for Weight Management: A Narrative Review of Safety and Metabolic Health Benefits. Nutrients 2022; 14:nu14091787. [PMID: 35565754 PMCID: PMC9099655 DOI: 10.3390/nu14091787] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 04/13/2022] [Accepted: 04/19/2022] [Indexed: 12/15/2022] Open
Abstract
Dietary supplements for weight management include myriad ingredients with thermogenic, lipotropic, satiety, and other metabolic effects. Recently, the safety of this product category has been questioned. In this review, we summarize the safety evidence as well as relevant clinical findings on weight management and metabolic effects of six representative dietary supplement ingredients: caffeine, green tea extract (GTE), green coffee bean extract (GCBE), choline, glucomannan, and capsaicinoids and capsinoids. Of these, caffeine, GTE (specifically epigallocatechin gallate [EGCG]), and choline have recommended intake limits, which appear not to be exceeded when used according to manufacturers’ instructions. Serious adverse events from supplements with these ingredients are rare and typically involve unusually high intakes. As with any dietary component, the potential for gastrointestinal intolerance, as well as possible interactions with concomitant medications/supplements exist, and the health status of the consumer should be considered when consuming these components. Most of the ingredients reviewed also improved markers of metabolic health, such as glucose, lipids, and blood pressure, although the data are limited for some. In summary, weight management supplements containing caffeine, GTE, GCBE, choline, glucomannan, and capsaicinoids and capsinoids are generally safe when taken as directed and demonstrate metabolic health benefits for overweight and obese people.
Collapse
Affiliation(s)
- Eunice Mah
- Biofortis Research, Addison, IL 60101, USA
- Correspondence:
| | - Oliver Chen
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA; (O.C.); (J.B.B.)
| | | | - Jeffrey B. Blumberg
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA; (O.C.); (J.B.B.)
| |
Collapse
|
7
|
The effect of Glucomannan on fasting and postprandial blood glucose in adults: a systematic review and meta-analysis of randomized controlled trials. J Diabetes Metab Disord 2022; 21:1055-1063. [PMID: 35673426 PMCID: PMC9167156 DOI: 10.1007/s40200-022-00993-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 01/25/2022] [Indexed: 10/19/2022]
Abstract
Objective Glucomannan is a dietary fiber that slows the absorption of carbohydrates and suppresses appetite, thereby reducing blood glucose. This meta-analysis sought to examine the effect of glucomannan supplementation on Fasting Blood Glucose (FBG) and Postprandial Glucose (PPG) in adults. Method We searched PubMed, and SCOPUS databases, and Google Scholar from inception to May 2020, using relevant keywords. All randomized controlled clinical trials (RCTs) that examined the effect of glucomannan supplementation on FBG and PPG in adults were included. Weighted mean differences (WMD) and their 95% confidence interval (CI) were calculated using Stata. Subgroup analysis was used to discern possible sources of heterogeneity. Results Overall, 6 trials were included, consisting of 124 participants. We found that glucomannan supplementation significantly reduced FBG (WMD): -0.60 mmol/L, 95% CI: -1.16, -0.05; P=0.03, but not PPG (WMD: -2.07mmol/L ; 95% CI: -5.09, 0.95; P=0.18), compared with controls group. We conducted subgroup analysis based on dosage and duration of intervention and health status of the population. Findings from subgroup analysis revealed a significant effect of glucomannan supplementation on FBG in diabetic patients (WMD: -1.28 mmol/L, 95% CI: -2.54, -0.02; P=0.04). Conclusion Glucomannan supplementation can elicit significant reductions in FBG, but has no significant impact on PPG, in adults. More RCTs may find the exact effect of glucomannan on FBG and PPG. Supplementary Information The online version contains supplementary material available at 10.1007/s40200-022-00993-6.
Collapse
|
8
|
Nutritional Approach to Prevention and Treatment of Cardiovascular Disease in Childhood. Nutrients 2021; 13:nu13072359. [PMID: 34371871 PMCID: PMC8308497 DOI: 10.3390/nu13072359] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 07/05/2021] [Accepted: 07/08/2021] [Indexed: 12/19/2022] Open
Abstract
Coronary Heart Disease (CHD) is a major mortality and morbidity cause in adulthood worldwide. The atherosclerotic process starts even before birth, progresses through childhood and, if not stopped, eventually leads to CHD. Therefore, it is important to start prevention from the earliest stages of life. CHD prevention can be performed at different interventional stages: primordial prevention is aimed at preventing risk factors, primary prevention is aimed at early identification and treatment of risk factors, secondary prevention is aimed at reducing the risk of further events in those patients who have already experienced a CHD event. In this context, CHD risk stratification is of utmost importance, in order to tailor the preventive and therapeutic approach. Nutritional intervention is the milestone treatment in pediatric patients at increased CHD risk. According to the Developmental Origin of Health and Disease theory, the origins of lifestyle-related disease is formed in the so called “first thousand days” from conception, when an insult, either positive or negative, can cause life-lasting consequences. Nutrition is a positive epigenetic factor: an adequate nutritional intervention in a developmental critical period can change the outcome from childhood into adulthood.
Collapse
|
9
|
Derosa G, Colletti A, Maffioli P, D'Angelo A, Lupi A, Zito GB, Mureddu GF, Raddino R, Fedele F, Cicero AFG. Lipid-lowering nutraceuticals update on scientific evidence. J Cardiovasc Med (Hagerstown) 2021; 21:845-859. [PMID: 32639326 DOI: 10.2459/jcm.0000000000000970] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
: Cardiovascular diseases (CVDs) are the main cause of mortality worldwide. Risk factors of CVD can be classified into modifiable (smoking, hypertension, diabetes, hypercholesterolemia) through lifestyle changes or taking drug therapy and not modifiable (age, ethnicity, sex and family history). Elevated total cholesterol (TC) and low-density lipoprotein-cholesterol (LDL-C) levels have a lead role in the development of coronary heart disease (CHD), while high levels of high-density lipoprotein-cholesterol (HDL-C) seem to have a protective role.The current treatment for dyslipidemia consists of lifestyle modification or drug therapy even if not pharmacological treatment should be always considered in addition to lipid-lowering medications.The use of lipid-lowering nutraceuticals alone or in association with drug therapy may be considered when the atherogenic cholesterol goal was not achieved.These substances can be classified according to their mechanisms of action into natural inhibitors of intestinal cholesterol absorption, inhibitors of hepatic cholesterol synthesis and enhancers of the excretion of LDL-C. Nevertheless, many of them are characterized by mixed or unclear mechanisms of action.The use of these nutraceuticals is suggested in individuals with borderline lipid profile levels or with drug intolerance, but cannot replace standard lipid-lowering treatment in patients at high, or very high CVD risk.Nutraceuticals can also have vascular effects, including improvement in endothelial dysfunction and arterial stiffness, as well as antioxidative properties. Moreover, epidemiological and clinical studies reported that in patients intolerant of statins, many nutraceuticals with demonstrated hypolipidemic effect are well tolerated.
Collapse
Affiliation(s)
- Giuseppe Derosa
- Department of Internal Medicine and Therapeutics, University of Pavia, Fondazione IRCCS Policlinico San Matteo, PAVIA; SINut (Italian Society of Nutraceuticals)
| | - Alessandro Colletti
- Department of Medical and Surgical Sciences, University of Bologna, BOLOGNA; SINut (Italian Society of Nutraceuticals)
| | - Pamela Maffioli
- Department of Internal Medicine and Therapeutics, University of Pavia, Fondazione IRCCS Policlinico San Matteo, PAVIA; SINut (Italian Society of Nutraceuticals)
| | - Angela D'Angelo
- Department of Internal Medicine and Therapeutics, University of Pavia, Fondazione IRCCS Policlinico San Matteo, PAVIA; SINut (Italian Society of Nutraceuticals)
| | - Alessandro Lupi
- Cardiology Unit, Ospedali Riuniti di Domodossola e Verbania, OMEGNA; CFC (Federative College of Cardiology)
| | - Giovanni B Zito
- ASL Naples 3 SOUTH, NAPLES; ARCA (Regional Association of Ambulatorial Cardiologists)
| | - Gian Francesco Mureddu
- Cardiology Unit - San Giovanni Addolorata Hospital, ROME; AICPR (Italian Association of Clinical, Preventive and Rehabilitative Cardiology)
| | - Riccardo Raddino
- Cardiology Unit, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health University, Cardiothoracic Department, Spedali Civili of Brescia, BRESCIA; SIRC (Italian Society of Cardiovascular Research)
| | - Francesco Fedele
- Department of Cardiovascular, Respiratory, Anesthesiology, Nephrology and Geriatric Sciences, Sapienza University of Rome, ROME; INCRC (Cardiovascular Research Consortium)
| | - Arrigo F G Cicero
- Department of Medical and Surgical Sciences, University of Bologna, BOLOGNA; SINut (Italian Society of Nutraceuticals)
| |
Collapse
|
10
|
Guarino G, Della Corte T, Strollo F, Gentile S. Policaptil Gel Retard in adult subjects with the metabolic syndrome: Efficacy, safety, and tolerability compared to metformin. Diabetes Metab Syndr 2021; 15:901-907. [PMID: 33906073 DOI: 10.1016/j.dsx.2021.03.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 03/29/2021] [Accepted: 03/30/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND Policaptil Gel Retard® (PGR), is a new macromolecule complex based on polysaccharides slowing the rate of carbohydrate and fat absorption. It proved to significantly reduce body weight, acanthosis nigricans expression, HbA1c levels, and glucose metabolism abnormalities in obese, hyper-insulinemic adolescents. No such data are available for adults. AIM to compare the effects of PGR vs. metformin in adult subjects with the Metabolic Syndrome (MS) and T2DM on a Low Glycemic Index diet. SUBJECTS AND METHODS This spontaneous clinical, longitudinal, single-blind, randomized study based on a per-protocol analysis enrolled 100 outpatients with MS and T2DM consecutively referring to our clinic for three months, and randomly assigned to either the active treatment (Group A:, 6 tablets/day) or the comparator (Group B: Metformin tablets, 1500-2000 mg/day in two divided doses during the two main meals, to minimize side effects) to be taken 30 min before each main meal in equally divided doses. Serum lipid profile, anthropometry, HOMA-IR index, and tolerability parameters were evaluated before and after a 6-month follow-up period. RESULTS all parameters improved at a similar rate in both groups but for the lipid profile, which got even better in Group A. Group A also experienced less prominent gastrointestinal side effects than its counterpart. CONCLUSION For the first time, we showed the non-inferiority of PGR compared to metformin in obese adult subjects with the MS and T2DM as for glycemic control and a clear-cut superiority of PGR in terms of both serum lipid-lowering capacity and tolerability.
Collapse
Affiliation(s)
- G Guarino
- Campania University "Luigi Vanvitelli", Naples, Italy
| | - T Della Corte
- Campania University "Luigi Vanvitelli", Naples, Italy; Nefrocenter Research Network & Nyx Research Start-Up, Naples, Italy.
| | - F Strollo
- IRCCS San Raffaele Pisana, Rome, Italy
| | - S Gentile
- Campania University "Luigi Vanvitelli", Naples, Italy; Nefrocenter Research Network & Nyx Research Start-Up, Naples, Italy
| |
Collapse
|
11
|
Pederiva C, Capra ME, Viggiano C, Rovelli V, Banderali G, Biasucci G. Early Prevention of Atherosclerosis: Detection and Management of Hypercholesterolaemia in Children and Adolescents. Life (Basel) 2021; 11:life11040345. [PMID: 33919973 PMCID: PMC8070896 DOI: 10.3390/life11040345] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 04/11/2021] [Accepted: 04/12/2021] [Indexed: 11/22/2022] Open
Abstract
Coronary heart disease (CHD) is the main cause of death and morbidity in the world. There is a strong evidence that the atherosclerotic process begins in childhood and that hypercholesterolaemia is a CHD major risk factor. Hypercholesterolaemia is a modifiable CHD risk factor and there is a tracking of hypercholesterolaemia from birth to adulthood. Familial hypercholesterolaemia (FH) is the most common primitive cause of hypercholesterolaemia, affecting 1:200–250 individuals. Early detection and treatment of hypercholesterolaemia in childhood can literally “save decades of life”, as stated in the European Atherosclerosis Society Consensus. Multiple screening strategies have been proposed. In 2008, the American Academy of Pediatrics published the criteria for targeted screening, while some expert panels recommend universal screening particularly in the young, although cost effectiveness has not been fully analysed. Blood lipid profile evaluation [total cholesterol, Low-Density Lipoprotein Cholesterol (LDL-C), High-Density Lipoprotein Cholesterol (HDL-C) and triglycerides] is the first step. It has to be ideally performed between two and ten years of age. Hypercholesterolaemia has to be confirmed with a second sample and followed by the detection of family history for premature (before 55 years in men and 60 years in women) or subsequent cardio-vascular events and/or hypercholesterolaemia in 1st and 2nd degree relatives. The management of hypercholesterolaemia in childhood primarily involves healthy lifestyle and a prudent low-fat diet, emphasising the benefits of the Mediterranean diet. Statins are the cornerstone of the drug therapy approved in USA and in Europe for use in children. Ezetimibe or bile acid sequestrants may be required to attain LDL-C goal in some patients. Early identification of children with severe hypercholesterolaemia or with FH is important to prevent atherosclerosis at the earliest stage of development, when maximum benefit can still be obtained via lifestyle adaptations and therapy. The purpose of our review is to highlight the importance of prevention and treatment of hypercholesterolaemia starting from the earliest stages of life.
Collapse
Affiliation(s)
- Cristina Pederiva
- Clinical Service for Dyslipidaemias, Study and Prevention of Atherosclerosis in Childhood, Pediatrics Unit, ASST-Santi Paolo e Carlo, 20142 Milan, Italy; (C.P.); (C.V.); (V.R.); (G.B.)
| | - Maria Elena Capra
- Centre for Paediatric Dyslipidaemias, Paediatrics and Neonatology Unit, Guglielmo da Saliceto Hospital, 29121 Piacenza, Italy;
- Correspondence:
| | - Claudia Viggiano
- Clinical Service for Dyslipidaemias, Study and Prevention of Atherosclerosis in Childhood, Pediatrics Unit, ASST-Santi Paolo e Carlo, 20142 Milan, Italy; (C.P.); (C.V.); (V.R.); (G.B.)
| | - Valentina Rovelli
- Clinical Service for Dyslipidaemias, Study and Prevention of Atherosclerosis in Childhood, Pediatrics Unit, ASST-Santi Paolo e Carlo, 20142 Milan, Italy; (C.P.); (C.V.); (V.R.); (G.B.)
| | - Giuseppe Banderali
- Clinical Service for Dyslipidaemias, Study and Prevention of Atherosclerosis in Childhood, Pediatrics Unit, ASST-Santi Paolo e Carlo, 20142 Milan, Italy; (C.P.); (C.V.); (V.R.); (G.B.)
| | - Giacomo Biasucci
- Centre for Paediatric Dyslipidaemias, Paediatrics and Neonatology Unit, Guglielmo da Saliceto Hospital, 29121 Piacenza, Italy;
| |
Collapse
|
12
|
Chen H, Nie Q, Hu J, Huang X, Zhang K, Pan S, Nie S. Hypoglycemic and Hypolipidemic Effects of Glucomannan Extracted from Konjac on Type 2 Diabetic Rats. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2019; 67:5278-5288. [PMID: 30964673 DOI: 10.1021/acs.jafc.9b01192] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Diabetes and its complications are one of the most concerned metabolic diseases worldwide and threaten human health severely. Hypoglycemic and hypolipidemic effects of glucomannan extracted from konjac on high-fat diet and streptozocin-induced type 2 diabetic rats were evaluated in this study. Administration of konjac glucomannan significantly decreased the levels of fasting blood glucose, serum insulin, glucagon-like peptide 1, and glycated serum protein. The concentrations of serum lipids, including total cholesterol, triacylglycerols, low-density lipoprotein cholesterol, and non-esterified fatty acid, were notably reduced by konjac glucomannan treatment. In addition, antioxidant capacity, pancreatic injury, and adipose cell hypertrophy were ameliorated by konjac glucomannan administration in type 2 diabetic rats. Besides, ultra performance liquid chromatography-quadrupole time-of-flight mass spectrometry-based lipidomics analysis was used to explore the improvement of lipid metabolic by konjac glucomannan treatment. The disturbance of glycerolipid (diacylglycerol, monoacylglycerol, and triacylglycerol), fatty acyl (acylcarnitine and hydroxyl fatty acid), sphingolipid (ceramide and sphingomyelin), and glycerophospholipid (phosphatidylcholine) metabolism were attenuated by the glucomannan treatment. This study provided new insights for investigating the anti-diabetic effects of konjac glucomannan and suggests that konjac glucomannan may be a promising nutraceutical for treating type 2 diabetes.
Collapse
Affiliation(s)
- Haihong Chen
- State Key Laboratory of Food Science and Technology, China-Canada Joint Laboratory of Food Science and Technology (Nanchang) , Nanchang University , 235 Nanjing East Road , Nanchang , Jiangxi 330047 , People's Republic of China
| | - Qixing Nie
- State Key Laboratory of Food Science and Technology, China-Canada Joint Laboratory of Food Science and Technology (Nanchang) , Nanchang University , 235 Nanjing East Road , Nanchang , Jiangxi 330047 , People's Republic of China
| | - Jielun Hu
- State Key Laboratory of Food Science and Technology, China-Canada Joint Laboratory of Food Science and Technology (Nanchang) , Nanchang University , 235 Nanjing East Road , Nanchang , Jiangxi 330047 , People's Republic of China
| | - Xiaojun Huang
- State Key Laboratory of Food Science and Technology, China-Canada Joint Laboratory of Food Science and Technology (Nanchang) , Nanchang University , 235 Nanjing East Road , Nanchang , Jiangxi 330047 , People's Republic of China
| | - Ke Zhang
- State Key Laboratory of Food Science and Technology, China-Canada Joint Laboratory of Food Science and Technology (Nanchang) , Nanchang University , 235 Nanjing East Road , Nanchang , Jiangxi 330047 , People's Republic of China
| | - Shijie Pan
- State Key Laboratory of Food Science and Technology, China-Canada Joint Laboratory of Food Science and Technology (Nanchang) , Nanchang University , 235 Nanjing East Road , Nanchang , Jiangxi 330047 , People's Republic of China
| | - Shaoping Nie
- State Key Laboratory of Food Science and Technology, China-Canada Joint Laboratory of Food Science and Technology (Nanchang) , Nanchang University , 235 Nanjing East Road , Nanchang , Jiangxi 330047 , People's Republic of China
| |
Collapse
|
13
|
Chen H, Nie Q, Hu J, Huang X, Zhang K, Nie S. Glucomannans Alleviated the Progression of Diabetic Kidney Disease by Improving Kidney Metabolic Disturbance. Mol Nutr Food Res 2019; 63:e1801008. [DOI: 10.1002/mnfr.201801008] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 03/13/2019] [Indexed: 12/11/2022]
Affiliation(s)
- Haihong Chen
- State Key Laboratory of Food Science and TechnologyNanchang University Nanchang 330047 China
| | - Qixing Nie
- State Key Laboratory of Food Science and TechnologyNanchang University Nanchang 330047 China
| | - Jielun Hu
- State Key Laboratory of Food Science and TechnologyNanchang University Nanchang 330047 China
| | - Xiaojun Huang
- State Key Laboratory of Food Science and TechnologyNanchang University Nanchang 330047 China
| | - Ke Zhang
- State Key Laboratory of Food Science and TechnologyNanchang University Nanchang 330047 China
| | - Shaoping Nie
- State Key Laboratory of Food Science and TechnologyNanchang University Nanchang 330047 China
| |
Collapse
|
14
|
Uebelhack R, Bongartz U, Tan BK, Seibt S. A double-blind, randomized, placebo-controlled, three-way crossover clinical investigation to evaluate the effect of IQP-VV-102 on postprandial blood glucose reduction. PHARMANUTRITION 2018. [DOI: 10.1016/j.phanu.2018.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
15
|
Cicero AFG, Colletti A, Bajraktari G, Descamps O, Djuric DM, Ezhov M, Fras Z, Katsiki N, Langlois M, Latkovskis G, Panagiotakos DB, Paragh G, Mikhailidis DP, Mitchenko O, Paulweber B, Pella D, Pitsavos C, Reiner Ž, Ray KK, Rizzo M, Sahebkar A, Serban MC, Sperling LS, Toth PP, Vinereanu D, Vrablík M, Wong ND, Banach M. Lipid-lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel. Nutr Rev 2017; 75:731-767. [PMID: 28938795 DOI: 10.1093/nutrit/nux047] [Citation(s) in RCA: 208] [Impact Index Per Article: 29.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
In recent years, there has been growing interest in the possible use of nutraceuticals to improve and optimize dyslipidemia control and therapy. Based on the data from available studies, nutraceuticals might help patients obtain theraputic lipid goals and reduce cardiovascular residual risk. Some nutraceuticals have essential lipid-lowering properties confirmed in studies; some might also have possible positive effects on nonlipid cardiovascular risk factors and have been shown to improve early markers of vascular health such as endothelial function and pulse wave velocity. However, the clinical evidence supporting the use of a single lipid-lowering nutraceutical or a combination of them is largely variable and, for many of the nutraceuticals, the evidence is very limited and, therefore, often debatable. The purpose of this position paper is to provide consensus-based recommendations for the optimal use of lipid-lowering nutraceuticals to manage dyslipidemia in patients who are still not on statin therapy, patients who are on statin or combination therapy but have not achieved lipid goals, and patients with statin intolerance. This statement is intended for physicians and other healthcare professionals engaged in the diagnosis and management of patients with lipid disorders, especially in the primary care setting.
Collapse
Affiliation(s)
- Arrigo F G Cicero
- Department of Medicine and Surgery Sciences, University of Bologna, Bologna, Italy; and Italian Society of Nutraceuticals
| | - Alessandro Colletti
- Department of Medicine and Surgery Sciences, University of Bologna, Bologna, Italy; and Italian Society of Nutraceuticals
| | - Gani Bajraktari
- Clinic of Cardiology, University Clinical Centre of Kosovo, Prishtina, Kosovo; Medical Faculty, University of Prishtina, Prishtina, Kosovo; and Kosovo Society of Cardiology
| | - Olivier Descamps
- Department of Internal Medicine, Centres Hospitaliers Jolimont, Haine Saint-Paul, Belgium; and Belgian Atherosclerosis Society
| | - Dragan M Djuric
- Institute of Medical Physiology "Richard Burian," Faculty of Medicine, University of Belgrade, Belgrade, Serbia; and Serbian Association for Arteriosclerosis, Thrombosis and Vascular Biology Research
| | - Marat Ezhov
- Russian Cardiology Research and Production Centre, Moscow, Russia; and Russian National Atherosclerosis Society
| | - Zlatko Fras
- Preventive Cardiology Unit, Department of Vascular Medicine, Division of Internal Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia; Chair for Internal Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia; and Slovenian Society of Cardiology
| | - Niki Katsiki
- Second Department of Propaedeutic Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippocration Hospital, Thessaloniki, Greece
| | - Michel Langlois
- Department of Laboratory Medicine, AZ Sint-Jan Hospital, Bruges, Belgium; and Belgian Atherosclerosis Society
| | - Gustavs Latkovskis
- Faculty of Medicine and Institute of Cardiology and Regenerative Medicine, University of Latvia, Riga, Latvia; and Baltic Atherosclerosis Society
| | - Demosthenes B Panagiotakos
- School of Health Science and Education, Department of Nutrition and Dietetics, Harokopio University of Athens, Athens, Greece
| | - Gyorgy Paragh
- Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary; and Hungarian Atherosclerosis Society
| | - Dimitri P Mikhailidis
- Department of Clinical Biochemistry, Royal Free Campus, University College London Medical School, University College London, London, UK
| | - Olena Mitchenko
- Dyslipidaemia Department, Institute of Cardiology AMS of Ukraine, Kiev, Ukraine; and Ukrainian Atherosclerosis Society
| | - Bernhard Paulweber
- 1st Department of Internal Medicine, Paracelsus Private Medical University, Salzburg, Austria; and Austrian Atherosclerosis Society
| | - Daniel Pella
- 1st Department of Internal Medicine, Faculty of Medicine, Pavol Jozef Safarik University, Košice, Slovakia; and Slovak Association of Atherosclerosis
| | - Christos Pitsavos
- Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece; and Hellenic Atherosclerosis Society
| | - Željko Reiner
- University Hospital Centre Zagreb, School of Medicine University of Zagreb, Department of Internal Medicine, Zagreb, Croatia; and Croatian Atherosclerosis Society
| | - Kausik K Ray
- Department of Primary Care and Public Health, Imperial College, London, UK
| | - Manfredi Rizzo
- Biomedical Department of Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy; and Euro-Mediterranean Institute of Science and Technology, Palermo, Italy
| | - Amirhossein Sahebkar
- Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maria-Corina Serban
- Center for Interdisciplinary Research, and Department of Functional Sciences, University of Medicine and Pharmacy "Victor Babes," Timisoara, Romania
| | - Laurence S Sperling
- Division of Cardiology, Emory University, Emory Clinical Cardiovascular Research Institute, Atlanta, Georgia, USA
| | - Peter P Toth
- Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, Maryland, USA; and Preventive Cardiology, CGH Medical Center, Sterling, Illinois, USA
| | - Dragos Vinereanu
- University of Medicine and Pharmacy "Carol Davila," Bucharest, Romania; Department of Cardiology, University and Emergency Hospital, Bucharest, Romania; and Romanian Society of Cardiology
| | - Michal Vrablík
- Third Department of Internal Medicine, First Medical Faculty, Charles University, Prague, Czech Republic; and Czech Atherosclerosis Society
| | - Nathan D Wong
- Heart Disease Prevention Program, Division of Cardiology, University of California, Irvine, California, USA
| | - Maciej Banach
- Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Poland; Polish Mother's Memorial Hospital Research Institute, Lodz, Poland; Cardiovascular Research Centre, University of Zielona Gora, Zielona Gora, Poland; Lipid and Blood Pressure Meta-Analysis Collaboration Group; and Polish Lipid Association
| |
Collapse
|
16
|
Cicero AF, Colletti A, Bajraktari G, Descamps O, Djuric DM, Ezhov M, Fras Z, Katsiki N, Langlois M, Latkovskis G, Panagiotakos DB, Paragh G, Mikhailidis DP, Mitchenko O, Paulweber B, Pella D, Pitsavos C, Reiner Ž, Ray KK, Rizzo M, Sahebkar A, Serban MC, Sperling LS, Toth PP, Vinereanu D, Vrablík M, Wong ND, Banach M. Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel. Arch Med Sci 2017; 13:965-1005. [PMID: 28883839 PMCID: PMC5575230 DOI: 10.5114/aoms.2017.69326] [Citation(s) in RCA: 189] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Accepted: 07/28/2017] [Indexed: 02/05/2023] Open
Affiliation(s)
- Arrigo F.G. Cicero
- Department of Medicine and Surgery Sciences, University of Bologna, Bologna, Italy; Italian Society of Nutraceuticals (SINut)
| | - Alessandro Colletti
- Department of Medicine and Surgery Sciences, University of Bologna, Bologna, Italy; Italian Society of Nutraceuticals (SINut)
| | - Gani Bajraktari
- Clinic of Cardiology, University Clinical Centre of Kosovo, Prishtina, Kosovo; Medical Faculty, University of Prishtina, Prishtina, Kosovo; Kosovo Society of Caridology
| | - Olivier Descamps
- Institute of Medical Physiology “Richard Burian“, Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Serbian Association for Arteriosclerosis, Thrombosis and Vascular Biology Research
| | - Dragan M. Djuric
- Institute of Medical Physiology “Richard Burian“, Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Serbian Association for Arteriosclerosis, Thrombosis and Vascular Biology Research
| | - Marat Ezhov
- Russian Cardiology Research and Production Centre, Moscow, Russia; Russian National Atherosclerosis Society
| | - Zlatko Fras
- Preventive Cardiology Unit, Department of Vascular Medicine, Division of Internal Medicine, University Medical Centre Ljubljana, Slovenia; Chair for Internal Medicine, Faculty of Medicine, University of Ljubljana, Slovenia; Slovenian Society of Cardiology
| | - Niki Katsiki
- Second Department of Propaedeutic Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippocration Hospital, Thessaloniki, Greece
| | - Michel Langlois
- Department of Laboratory Medicine, AZ Sint-Jan Hospital, Bruges, Belgium; Belgian Atheroclerosis Society
| | - Gustavs Latkovskis
- Faculty of Medicine and Institute of Cardiology and Regenerative Medicine, University of Latvia, Riga, Latvia; Baltic Atherosclerosis Society
| | - Demosthenes B. Panagiotakos
- School of Health Science and Education, Department of Nutrition and Dietetics, Harokopio University of Athens, Athens, Greece
| | - Gyorgy Paragh
- Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary; Hungarian Atherosclerosis Society
| | - Dimitri P. Mikhailidis
- Department of Clinical Biochemistry, Royal Free Campus, Medical School, University College London (UCL), London, UK
| | - Olena Mitchenko
- 13Dyslipidaemia Department, Institute of Cardiology AMS of Ukraine, Ukraine; Ukrainian Atherosclerosis Society
| | - Bernhard Paulweber
- First Department of Internal Medicine, Paracelsus Private Medical University, Salzburg, Austria; Austrian Atheroclerosis Society (AAS)
| | - Daniel Pella
- 1 Department of Internal Medicine, Faculty of Medicine, Pavol Jozef Safarik University, Košice, Slovakia; Slovak Association of Atherosclerosis
| | - Christos Pitsavos
- Cardiology Clinic, School of Medicine, University of Athens, Greece; Hellenic Atherosclerosis Society
| | - Željko Reiner
- University Hospital Centre Zagreb, School of Medicine University of Zagreb, Department of Internal Medicine, Zagreb, Croatia; Croatian Atherosclerosis Society
| | - Kausik K. Ray
- Department of Primary Care and Public Health, Imperial College, London, UK
| | - Manfredi Rizzo
- Biomedical Department of Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy; Euro-Mediterranean Institute of Science and Technology, Palermo, Italy
| | - Amirhossein Sahebkar
- Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maria-Corina Serban
- Center for Interdisciplinary Research, University of Medicine and Pharmacy “Victor Babes”, Timisoara, Romania; Department of Functional Sciences, University of Medicine and Pharmacy “Victor Babes”, Timisoara, Romania
| | - Laurence S. Sperling
- Division of Cardiology, Emory University, Emory Clinical Cardiovascular Research Institute, Atlanta, Georgia, USA
| | - Peter P. Toth
- The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, USA; Preventive Cardiology, CGH Medical Center, Sterling, Illinois, USA
| | - Dragos Vinereanu
- University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania; Department of Cardiology, University and Emergency Hospital, Bucharest, Romania; Romanian Society of Cardiology
| | - Michal Vrablík
- Third Department of Internal Medicine, First Medical Faculty, Charles University, Prague, Czech Republic; Czech Atherosclerosis Society
| | - Nathan D. Wong
- Heart Disease Prevention Program, Division of Cardiology, University of California, Irvine, USA
| | - Maciej Banach
- Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Poland; Polish Mother’s Memorial Hospital Research Institute (PMMHRI), Lodz, Poland; Cardiovascular Research Centre, University of Zielona Gora, Zielona Gora, Poland; Lipid and Blood Pressure Meta-Analysis Collaboration (LBPMC) Group; Polish Lipid Association (PoLA)
| |
Collapse
|
17
|
|
18
|
Ho HVT, Jovanovski E, Zurbau A, Blanco Mejia S, Sievenpiper JL, Au-Yeung F, Jenkins AL, Duvnjak L, Leiter L, Vuksan V. A systematic review and meta-analysis of randomized controlled trials of the effect of konjac glucomannan, a viscous soluble fiber, on LDL cholesterol and the new lipid targets non-HDL cholesterol and apolipoprotein B. Am J Clin Nutr 2017; 105:1239-1247. [PMID: 28356275 DOI: 10.3945/ajcn.116.142158] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Accepted: 02/21/2017] [Indexed: 11/14/2022] Open
Abstract
Background: Evidence from randomized controlled trials (RCTs) suggests the consumption of konjac glucomannan (KJM), a viscous soluble fiber, for improving LDL-cholesterol concentrations. It has also been suggested that the cholesterol-lowering potential of KJM may be greater than that of other fibers. However, trials have been relatively scarce and limited in sample size and duration, and the effect estimates have been inconsistent. The effect of KJM on new lipid targets of cardiovascular disease (CVD) risk is also unknown.Objective: This systematic review and meta-analysis aimed to assess the effect of KJM on LDL cholesterol, non-HDL cholesterol, and apolipoprotein B.Design: Medline, Embase, CINAHL, and the Cochrane Central databases were searched. We included RCTs with a follow-up of ≥3 wk that assessed the effect of KJM on LDL cholesterol, non-HDL cholesterol, or apolipoprotein B. Data were pooled by using the generic inverse-variance method with random-effects models and expressed as mean differences (MDs) with 95% CIs. Heterogeneity was assessed by the Cochran Q statistic and quantified by the I2 statistic.Results: Twelve studies (n = 370), 8 in adults and 4 in children, met the inclusion criteria. KJM significantly lowered LDL cholesterol (MD: -0.35 mmol/L; 95% CI: -0.46, -0.25 mmol/L) and non-HDL cholesterol (MD: -0.32 mmol/L; 95% CI: -0.46, -0.19 mmol/L). Data from 6 trials suggested no impact of KJM on apolipoprotein B.Conclusions: Our findings support the intake of ∼3 g KJM/d for reductions in LDL cholesterol and non-HDL cholesterol of 10% and 7%, respectively. The information may be of interest to health agencies in crafting future dietary recommendations related to reduction in CVD risk. This study was registered at clinicaltrials.gov as NCT02068248.
Collapse
Affiliation(s)
- Hoang Vi Thanh Ho
- Clinical Nutrition and Risk Factor Modification Centre.,Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Elena Jovanovski
- Clinical Nutrition and Risk Factor Modification Centre.,Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Andreea Zurbau
- Clinical Nutrition and Risk Factor Modification Centre.,Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Sonia Blanco Mejia
- Clinical Nutrition and Risk Factor Modification Centre.,Toronto 3D Knowledge Synthesis and Clinical Trials Unit, St. Michael's Hospital, Toronto, Canada.,Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - John L Sievenpiper
- Clinical Nutrition and Risk Factor Modification Centre.,Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Fei Au-Yeung
- Clinical Nutrition and Risk Factor Modification Centre.,Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Canada
| | | | - Lea Duvnjak
- Clinic for Diabetes, Endocrinology and Metabolic Diseases Vuk Vrhovac, University Hospital Merkur, University of Zagreb, School of Medicine, Zagreb, Croatia; and
| | - Lawrence Leiter
- Clinical Nutrition and Risk Factor Modification Centre.,Li Ka Shing Knowledge Institute.,Division of Endocrinology and Medicine, and.,Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Vladimir Vuksan
- Clinical Nutrition and Risk Factor Modification Centre, .,Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Canada
| |
Collapse
|
19
|
Gómez B, Míguez B, Yáñez R, Alonso JL. Manufacture and Properties of Glucomannans and Glucomannooligosaccharides Derived from Konjac and Other Sources. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2017; 65:2019-2031. [PMID: 28248105 DOI: 10.1021/acs.jafc.6b05409] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Glucomannans (GM) are polymers that can be found in natural resources, such as tubers, bulbs, roots, and both hard- and softwoods. In fact, mannan-based polysaccharides represent the largest hemicellulose fraction in softwoods. In addition to their structural functions and their role as energy reserve, they have been assessed for their healthy applications, including their role as new source of prebiotics. This paper summarizes the scientific literature regarding the manufacture and functional properties of GM and their hydrolysis products with a special focus on their prebiotic activity.
Collapse
Affiliation(s)
- Belén Gómez
- Chemical Engineering Department, Polytechnic Building, University of Vigo (Campus Ourense) , 32004 Ourense, Spain
- CITI , Avenida Galicia 2, Tecnopole, San Cibrao das Viñas, 32900 Ourense, Spain
- CINBIO , University Campus, 36310 Vigo, Pontevedra, Spain
| | - Beatriz Míguez
- Chemical Engineering Department, Polytechnic Building, University of Vigo (Campus Ourense) , 32004 Ourense, Spain
- CITI , Avenida Galicia 2, Tecnopole, San Cibrao das Viñas, 32900 Ourense, Spain
- CINBIO , University Campus, 36310 Vigo, Pontevedra, Spain
| | - Remedios Yáñez
- Chemical Engineering Department, Polytechnic Building, University of Vigo (Campus Ourense) , 32004 Ourense, Spain
- CITI , Avenida Galicia 2, Tecnopole, San Cibrao das Viñas, 32900 Ourense, Spain
- CINBIO , University Campus, 36310 Vigo, Pontevedra, Spain
| | - José L Alonso
- Chemical Engineering Department, Polytechnic Building, University of Vigo (Campus Ourense) , 32004 Ourense, Spain
- CITI , Avenida Galicia 2, Tecnopole, San Cibrao das Viñas, 32900 Ourense, Spain
- CINBIO , University Campus, 36310 Vigo, Pontevedra, Spain
| |
Collapse
|
20
|
Tester RF, Al-Ghazzewi FH. Beneficial health characteristics of native and hydrolysed konjac (Amorphophallus konjac) glucomannan. JOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE 2016; 96:3283-3291. [PMID: 26676961 DOI: 10.1002/jsfa.7571] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 12/08/2015] [Accepted: 12/09/2015] [Indexed: 06/05/2023]
Abstract
The impact of ingesting glucomannans on health is not limited to colonic-focused fermentation into short-chain fatty acids (SCFAs), which might have some local health benefits; it also helps in treating disease states and enhancing the body's immune system, both within the gut and in/on other parts of the body. The local and systemic roles of hydrolysed glucomannans, especially konjac glucomannans, in the mouth, oesophagus, stomach, small intestine, large intestine, gut-associated lymphoid tissue (GALT), skin and vagina, are highlighted. Therapeutic applications are discussed. © 2015 Society of Chemical Industry.
Collapse
|
21
|
Glucomannan based polyurethanes: A critical short review of recent advances and future perspectives. Int J Biol Macromol 2016; 87:229-36. [DOI: 10.1016/j.ijbiomac.2016.02.058] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Revised: 02/20/2016] [Accepted: 02/23/2016] [Indexed: 11/18/2022]
|
22
|
Kaats GR, Bagchi D, Preuss HG. Konjac Glucomannan Dietary Supplementation Causes Significant Fat Loss in Compliant Overweight Adults. J Am Coll Nutr 2015:1-7. [PMID: 26492494 DOI: 10.1080/07315724.2015.1009194] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Changes in body composition and blood chemistries between overweight adult subjects receiving a supplement containing either 3 g of konjac glucomannan/300 mg calcium carbonate or a placebo containing only 300 mg of calcium carbonate were compared as the primary objective. A secondary objective was to compare outcome differences between compliant and partially compliant subjects. METHODS A total of 83 overweight adults (66 women and 17 men) completed a randomized, double-blind, placebo-controlled protocol in which they received either a glucomannan or placebo supplement for 60 days. Dual-energy x-ray absorptiometry (DEXA) total body scans and a 42-measurement blood test were completed at baseline and 60 days later. Compliance was assessed by rating self-reports of (1) how many tablets were taken, (2) adherence to taking the tablets 30 minutes before eating, and (3) a sum of the ratings for (1) and (2). An anonymous poststudy questionnaire and telephone calls were also completed by 80 (96%) of the participants who were used as the study cohort. RESULTS No statistically significant differences were found between the groups on changes from baseline on the DEXA and blood tests. However, when subjects were classified as either compliant or partially compliant using the compliance measures, statistically significant reductions in scale weight, percentage body fat, fat mass, total cholesterol, and low-density lipoprotein (LDL) cholesterol were found in the glucomannan group compared to the placebo group. CONCLUSIONS This study supports the efficacy glucomannan supplementation to reduce body weight, body fat, and circulating cholesterol levels without the concomitant loss of lean mass and bone density often associated with weight loss. However, these positive outcomes were not observable until corrections for compliance were applied.
Collapse
Affiliation(s)
- Gilbert R Kaats
- a Integrative Health Technologies, Inc., San Antonio, Texas (G.R.K.); Department of Pharmacy, University of Houston, Houston, Texas (D.B.); Department of Biochemistry, Georgetown University Medical Center , Washington , DC (H.G.P.)
| | - Debasis Bagchi
- a Integrative Health Technologies, Inc., San Antonio, Texas (G.R.K.); Department of Pharmacy, University of Houston, Houston, Texas (D.B.); Department of Biochemistry, Georgetown University Medical Center , Washington , DC (H.G.P.)
| | - Harry G Preuss
- a Integrative Health Technologies, Inc., San Antonio, Texas (G.R.K.); Department of Pharmacy, University of Houston, Houston, Texas (D.B.); Department of Biochemistry, Georgetown University Medical Center , Washington , DC (H.G.P.)
| |
Collapse
|
23
|
Suwannaporn P, Tester RF, Al-Ghazzewi FH, Artitdit P. Effect of short term administration of konjac glucomannan hydrolysates on adult blood lipid parameters and glucose concentrations. ACTA ACUST UNITED AC 2015. [DOI: 10.1108/nfs-02-2015-0012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
– This paper aims to evaluate the effect of depolymerised glucomannan in regulating blood lipid and glucose concentrations.
Design/methodology/approach
– Twenty adult volunteers were recruited. Blood samples were taken at Day 0. The volunteers consumed drinks containing 3.0 g active glucomannan hydrolysates (AMH) for 14 days, after which time blood samples were retaken (Day 15). Blood samples were analysed to determine the blood lipid and glucose concentrations.
Findings
– The average fasting blood glucose at the start of the trial was 2.54 mmol/L but reduced slightly to 2.49 mmol/L after consumption of the glucomannan. The total average cholesterol at the start of the trial was higher (6.69 mmol/L) than desirable (
<
5.0 mmol/L). This was reduced after consuming the glucomannan to 6.44 mmol/L (3.74 per cent). The triglyceride content was also higher initially than recommended (2.88 mmol/L) but was reduced by 11.5 per cent. The high-density lipoprotein (HDL) was within the desirable range before and after consumption (1.57 and 1.52 mmol/L, respectively), while the average low-density lipoprotein (LDL) was higher than recommended (
<
3.0 mmol/L), representing 4.55 mmol/L and 4.40 mmol/L before and after consumption, respectively. Both parameters were reduced by over 3.0 per cent. The consumption of the glucomannan hydrolysates also reduced the total cholesterol/HDL and LDL/HDL ratios.
Originality/value
– The AMH was effective in lowering blood cholesterol and glucose concentrations. Consumption of such carbohydrates could prove useful for these physiological disorders. Further studies are desirable to characterise the exact mechanism.
Collapse
|
24
|
Zalewski BM, Chmielewska A, Szajewska H. The effect of glucomannan on body weight in overweight or obese children and adults: a systematic review of randomized controlled trials. Nutrition 2014; 31:437-42.e2. [PMID: 25701331 DOI: 10.1016/j.nut.2014.09.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Revised: 09/02/2014] [Accepted: 09/03/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Glucomannan (GM), a soluble fiber derived from the plant Amorphophallus konjac, is marketed as being helpful in reducing body weight. However, the data supporting this claim are scarce. The aim of this review was to systematically evaluate the effects of GM on body weight (BW) and body mass index (BMI) in otherwise healthy obese or overweight children and adults. METHODS MEDLINE, EMBASE, CENTRAL, and Google Scholar databases were systematically searched up to June 2014 for randomized controlled trials (RCTs) assessing the effectiveness of GM versus placebo. The primary outcome measures were BW and BMI. RESULTS Six eligible RCTs, only one of which performed in children, were included. In adults, three RCTs reported a significant reduction in BW in the GM group compared with the control group at the following different points during the intervention: At week 2 (mean difference [MD], 0.21 kg; 95% confidence interval [CI], 0.13-0.29); at week 4 (MD, 2.04; 95% CI, 0.52-3.56); at week 5 (MD, 1.3; 95% CI, 0.89-1.71); and at week 8 (MD, 3.17; 95% CI, 1.29-5.05). Only one RCT reported a beneficial effect at more than one point. None of the RCTs reported a favorable effect of GM on BMI. CONCLUSIONS In otherwise healthy overweight or obese adults, there is some evidence that in the short term GM may help to reduce BW, but not BMI. Data in children are too limited to draw any conclusions.
Collapse
Affiliation(s)
| | - Anna Chmielewska
- Department of Pediatrics, The Medical University of Warsaw, Warsaw, Poland
| | - Hania Szajewska
- Department of Pediatrics, The Medical University of Warsaw, Warsaw, Poland
| |
Collapse
|
25
|
Onakpoya I, Posadzki P, Ernst E. The efficacy of glucomannan supplementation in overweight and obesity: a systematic review and meta-analysis of randomized clinical trials. J Am Coll Nutr 2014; 33:70-8. [PMID: 24533610 DOI: 10.1080/07315724.2014.870013] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The increased prevalence of obesity has resulted in the current high popularity of dietary supplements marketed as weight reducing agents. The efficacy of most of these supplements is not established. The soluble fiber, glucomannan, is often recommended for weight loss. The aim of this systematic review is to evaluate the evidence for or against the efficacy of glucomannan in body weight reduction. METHODS Electronic searches were conducted in Medline, Embase, Amed, and The Cochrane Library. Hand searches of bibliography were also conducted. Outcomes of interest were body weight and body mass index. Studies involving only overweight and/or obese participants were included. Two reviewers independently determined the eligibility of studies and assessed the reporting quality of included randomized controlled trials (RCTs), using the CONSORT and PRISMA guidelines. RESULTS Eighteen trials were identified, and 9 were included. There was a variation in the reporting quality of the included RCTs. A meta-analysis (random effect model) of 8 RCTs revealed a nonstatistically significant difference in weight loss between glucomannan and placebo (mean difference [MD]: -0.22 kg; 95% confidence interval [CI], -0.62, 0.19; I(2) = 65%). Adverse events included abdominal discomfort, diarrhea, and constipation. CONCLUSION The evidence from available RCTs does not show that glucomannan intake generates statistically significant weight loss. Future trials should be more rigorous and better reported.
Collapse
Affiliation(s)
- Igho Onakpoya
- a Complementary Medicine, Peninsula Medical School , University of Exeter , UK
| | | | | |
Collapse
|
26
|
|
27
|
Meng F, Zheng L, Wang Y, Liang Y, Zhong G. Preparation and properties of konjac glucomannan octenyl succinate modified by microwave method. Food Hydrocoll 2014. [DOI: 10.1016/j.foodhyd.2013.12.007] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
28
|
Xu W, Wang Y, Jin W, Wang S, Zhou B, Li J, Li B, Wang L. A one-step procedure for elevating the quality of konjac flour: Azeotropy-assisted acidic ethanol. Food Hydrocoll 2014. [DOI: 10.1016/j.foodhyd.2013.08.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
29
|
Could dyslipidemic children benefit from glucomannan intake? Nutrition 2013; 29:1060-5. [DOI: 10.1016/j.nut.2013.02.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2012] [Revised: 02/07/2013] [Accepted: 02/08/2013] [Indexed: 11/19/2022]
|
30
|
Martino F, Puddu PE, Pannarale G, Colantoni C, Martino E, Niglio T, Zanoni C, Barillà F. Low dose chromium-polynicotinate or policosanol is effective in hypercholesterolemic children only in combination with glucomannan. Atherosclerosis 2013; 228:198-202. [DOI: 10.1016/j.atherosclerosis.2013.02.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2012] [Revised: 12/12/2012] [Accepted: 02/04/2013] [Indexed: 11/24/2022]
|
31
|
Cagliero P, Calosso G, Brunatti P, Guardamagna O. Nutraceuticals in Hypercholesterolemic children. Health (London) 2013. [DOI: 10.4236/health.2013.57151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
32
|
Cicero AFG, Ferroni A, Ertek S. Tolerability and safety of commonly used dietary supplements and nutraceuticals with lipid-lowering effects. Expert Opin Drug Saf 2012; 11:753-66. [DOI: 10.1517/14740338.2012.705827] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
|
33
|
Tatirat O, Charoenrein S, Kerr WL. Physicochemical properties of extrusion-modified konjac glucomannan. Carbohydr Polym 2012. [DOI: 10.1016/j.carbpol.2011.09.052] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
|
34
|
|
35
|
Abstract
Atherosclerosis disease and its extent in childhood correlate positively with established risk factors, namely obesity, hypercholesterolemia, diabetes mellitus, and hypertension. The safety and efficacy of some dietary interventions to modulate risk factors in childhood are documented by an increasing body of evidence. The present review analyzes nutritional and nutraceutical current strategies addressed to modify some risk factors of atherosclerosis in childhood. In particular, studies concerning nutrients such as fibers, omega-3-fatty acids, vitamin D, antioxidants, and calcium have been evaluated. An overall analysis suggests that some nutraceuticals might represent an attractive tool to lower the development of atherosclerotic-related cardiovascular complication in children. Nevertheless, at this moment, due to the methodological weakness that characterizes the majority of the analyzed studies, nutrients or supplements should not be considered as a therapeutic tool potentially usable for clinical purpose in children at risk for cardiovascular disease.
Collapse
|
36
|
Viuda-Martos M, López-Marcos M, Fernández-López J, Sendra E, López-Vargas J, Pérez-Álvarez J. Role of Fiber in Cardiovascular Diseases: A Review. Compr Rev Food Sci Food Saf 2010. [DOI: 10.1111/j.1541-4337.2009.00102.x] [Citation(s) in RCA: 134] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
37
|
Scientific Opinion on the substantiation of health claims related to glucomannan and maintenance of normal blood cholesterol concentrations (ID 836, 1560) pursuant to Article 13(1) of Regulation (EC) No 1924/2006. EFSA J 2009. [DOI: 10.2903/j.efsa.2009.1258] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
|
38
|
Sood N, Baker WL, Coleman CI. Effect of glucomannan on plasma lipid and glucose concentrations, body weight, and blood pressure: systematic review and meta-analysis. Am J Clin Nutr 2008; 88:1167-75. [PMID: 18842808 DOI: 10.1093/ajcn/88.4.1167] [Citation(s) in RCA: 118] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Several clinical trials have investigated the impact of glucomannan on plasma lipids, body weight, fasting blood glucose (FBG), and blood pressure (BP), but have yielded conflicting results and had only modest sample sizes. OBJECTIVE The objective was to perform a meta-analysis of randomized controlled trials of glucomannan to better characterize its impact on plasma lipids, FBG, body weight, and BP. DESIGN A systematic literature search of MEDLINE, EMBASE, CINAHL, Web of Science, the Cochrane Library, and the Natural Medicines Comprehensive Database was conducted from the earliest possible date through November 2007. A random-effects model was used to calculate the weighted mean difference (WMD) and 95% CIs as the difference between the mean for the glucomannan and control groups. Standard methods for assessing statistical heterogeneity and publication bias were used. RESULTS Fourteen studies (n = 531) met the inclusion criteria. The use of glucomannan significantly lowered total cholesterol [weighted mean difference (WMD): -19.28 mg/dL; 95% CI: -24.30, -14.26], LDL cholesterol (WMD: -15.99 mg/dL; 95% CI: -21.31, -10.67), triglycerides (WMD: -11.08 mg/dL; 95% CI: -22.07, -0.09), body weight (WMD: -0.79 kg; 95% CI: -1.53, -0.05), and FBG (WMD: -7.44 mg/dL; 95% CI: -14.16, -0.72). The use of glucomannan did not appear to significantly alter any other study endpoints. Pediatric patients, patients receiving dietary modification, and patients with impaired glucose metabolism did not benefit from glucomannan to the same degree. CONCLUSIONS Glucomannan appears to beneficially affect total cholesterol, LDL cholesterol, triglycerides, body weight, and FBG, but not HDL cholesterol or BP.
Collapse
Affiliation(s)
- Nitesh Sood
- University of Connecticut Schools of Medicine and Drug Information, Hartford Hospital, Hartford, CT 06102-5037, USA
| | | | | |
Collapse
|
39
|
Elamir AA, Tester RF, Al‐Ghazzewi FH, Kaal HY, Ghalbon AA, Elmegrahai NA, Piggott JR. Effects of konjac glucomannan hydrolysates on the gut microflora of mice. ACTA ACUST UNITED AC 2008. [DOI: 10.1108/00346650810906930] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
40
|
Iughetti L, Predieri B, Bruzzi P, Balli F. Approaches to dyslipidemia treatment in children and adolescents. Expert Rev Endocrinol Metab 2008; 3:615-633. [PMID: 30290407 DOI: 10.1586/17446651.3.5.615] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Atherosclerosis represents a disease that begins in childhood, and alterations in lipid concentration play a fundamental role in the development of this condition. Children and adolescents with high cholesterol levels are more likely than their peers in the general population to present with dyslipidemia in adulthood. Precocious identification of dyslipidemias associated with premature cardiovascular disease is crucial during childhood to delay or prevent the atherosclerotic process. The National Cholesterol Education Program has established guidelines for the diagnosis and treatment of dyslipidemia during pediatric age. It has been suggested that a heart-healthy diet should begin at 2 years of age, and no adverse effects on psychological aspects, growth, pubertal development and nutritional status in children and adolescents limiting total and saturated fat intake have been demonstrated. Pharmacotherapy should be considered in children aged 10 years or older when low-density lipoprotein cholesterol concentrations remain very high despite dietary therapy, especially when multiple risk factors are present. The lipid-lowering drugs recommended for childhood and adolescence are resins and statins. The increasing use of statins is dependent on their effectiveness and safety. Ezetimibe, a selective cholesterol absorption inhibitor, may provide a similar cholesterol-lowering effect as that reached with statin treatment. This review provides an update on recent advances in the therapy of dyslipidemia, especially hypercholesterolemia, during pediatric age and adolescence.
Collapse
Affiliation(s)
- Lorenzo Iughetti
- a Department of Pediatrics, University of Modena and Reggio Emilia, Via del Pozzo, 71-41.100 Modena, Italy.
| | - Barbara Predieri
- b Department of Pediatrics, University of Modena and Reggio Emilia, Via del Pozzo, 71-41.100 Modena, Italy
| | - Patrizia Bruzzi
- b Department of Pediatrics, University of Modena and Reggio Emilia, Via del Pozzo, 71-41.100 Modena, Italy
| | - Fiorella Balli
- b Department of Pediatrics, University of Modena and Reggio Emilia, Via del Pozzo, 71-41.100 Modena, Italy
| |
Collapse
|
41
|
Iughetti L, Predieri B, Balli F, Calandra S. Rational approach to the treatment for heterozygous familial hypercholesterolemia in childhood and adolescence: a review. J Endocrinol Invest 2007; 30:700-19. [PMID: 17923804 DOI: 10.1007/bf03347453] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Atherosclerosis represents a disease that begins in childhood and in which LDL cholesterol plays a pivotal role for the development of the pathology. Children and adolescents with high cholesterol levels are more likely than their peers to present cholesterol elevation as adults. The identification of genetic dyslipidemias associated with premature cardiovascular disease is crucial during childhood to delay or prevent the atherosclerotic process. Guidelines for the diagnosis and treatment of hypercholesterolemia during pediatric age are available from the National Cholesterol Education Program. A heart-healthy diet should begin at the age of 2 yr and a large number of studies have demonstrated no adverse effects on nutritional status, growth, pubertal development, and psychological aspects in children and adolescents limiting total and saturated fat intake. Pharmacotherapy should be considered in children over 10 yr of age when LDL cholesterol concentrations remain very high despite severe dietary therapy, especially when multiple risk factors are present. The only lipid-lowering drugs recommended up to now for childhood and adolescence are resins reported to be effective and well tolerated, although compliance is very poor because of unpalatability. The use of statins is increasing and seems to be effective and safe in children, even if studies enrolled a small number of patients and evaluated efficacy and safety for short-term periods. Recently, an interesting drug represented by ezetimibe has been found that may provide cholesterol-lowering additive to that reached with statin treatment. This review provides an update on recent advances in the diagnosis, therapy, and follow-up of familial hypercholesterolemia during pediatric age and adolescence.
Collapse
Affiliation(s)
- L Iughetti
- Department of Pediatrics, University of Modena and Reggio Emilia, Via del Pozzo 71, 41100 Modena, Italy.
| | | | | | | |
Collapse
|
42
|
Kraemer WJ, Vingren JL, Silvestre R, Spiering BA, Hatfield DL, Ho JY, Fragala MS, Maresh CM, Volek JS. Effect of adding exercise to a diet containing glucomannan. Metabolism 2007; 56:1149-58. [PMID: 17618964 DOI: 10.1016/j.metabol.2007.04.010] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2006] [Accepted: 04/30/2007] [Indexed: 11/18/2022]
Abstract
The aim of this study was to examine the effect of adding a total-body exercise program to an 8-week diet supplemented with glucomannan on weight loss, body composition, blood parameters, and physical performance in overweight men and women. Sedentary men and women who were overweight (body mass index>25 kg m(-2)) (men: 18-57 years, 27.0+/-11.2 years, 177.5+/-7.6 cm, 102.4+/-14.9 kg; women: 18-52 years, 33.4+/-12.1 years, 160.6+/-4.6 cm, 79.9+/-9.3 kg) completed an 8-week diet with 3000 mg glucomannan combined with either no exercise (No-Ex) (10 men, 10 women) or a resistance and endurance exercise training program (Ex) (12 men, 10 women). The diet emphasized healthy food choices and portion size control. The exercise training consisted of 3 weekly sessions of approximately 1 hour of a nonlinear periodized total-body resistance exercise program followed by 30 minutes of endurance exercise. After the intervention, there were reductions (P<.05) in body mass (men, -2.7+/-1.4 and -3.0+/-4.0 kg; women, -2.2+/-1.5 and -3.3+/-1.5 kg; No-Ex and Ex, respectively), fat mass (men, -2.3+/-1.6 and -3.9+/-2.5 kg; women, -2.6+/-1.4 and -3.6+/-1.1 kg; No-Ex and Ex, respectively), total cholesterol (TC) (men, -17.9+/-21.5 and -18.8+/-19.4 mg dL(-1); women, -9.3+/-20.0 and -10.1+/-19.5 mg dL(-1); No-Ex and Ex, respectively), and low-density lipoprotein cholesterol. Exercise significantly improved high-density lipoprotein cholesterol (HDL-C) (No-Ex, -2.0+/-4.7 and -2.3+/-4.5 mg dL(-1) vs Ex, 4.4+/-10.8 and 1.6+/-3.6 mg dL(-1); men and women, respectively), TC/HDL-C ratio, squat and bench press 1-repetition maximum, and distance covered during a shuttle-run test. In addition, exercise appeared to augment the reduction in fat mass (by 63% and 50%; men and women, respectively) and waist circumference, but did not affect total weight loss. Addition of a resistance and endurance exercise training program to a glucomannan diet regimen significantly improved measures of body composition, HDL-C, and TC/HDL-C ratio.
Collapse
Affiliation(s)
- William J Kraemer
- Department of Kinesiology, Human Performance Laboratory, University of Connecticut, Storrs, CT 06269, USA.
| | | | | | | | | | | | | | | | | |
Collapse
|
43
|
Toward prevention of Alzheimers disease--potential nutraceutical strategies for suppressing the production of amyloid beta peptides. Med Hypotheses 2006; 67:682-97. [PMID: 16828233 DOI: 10.1016/j.mehy.2006.04.067] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2006] [Accepted: 04/10/2006] [Indexed: 12/30/2022]
Abstract
Alzheimers disease (AD) can be viewed as a vicious cycle in which excess production and deposition of amyloid beta (Abeta) peptides promote microglial activation, and the resultant production of inflammatory mediators further boosts Abeta production while inducing death and dysfunction of neurons. Abeta production is mediated by beta- and gamma-secretase activities; it is prevented by alpha-secretase activity, and insulin-degrading enzyme (IDE) catabolizes Abeta. High cellular cholesterol content increases Abeta synthesis by boosting beta-secretase activity; inhibition of cholesterol syntheses and/or stimulation of cholesterol export thus diminishes Abeta production. PPARgamma activity decreases Abeta production by promoting harmless catabolism of amyloid precursor protein while blocking the up-regulatory impact of cytokines on beta-secretase expression. Nitric oxide produced by the healthy cerebral microvasculature can suppress Abeta production by boosting expression of alpha-secretase while suppressing that of beta-secretase; conversely, cerebral ischemia provokes increased APP expression. Good insulin sensitivity and efficient brain insulin function protect by inhibiting gamma-secretase activity and increasing expression of IDE. The DHA provided by fish oil diminishes cerebral Abeta deposition in rodent AD models, for unclear reasons. Various measures which oppose microglial activation can inhibit up-regulation of beta-secretase and gamma-secretase by oxidants and cytokines, respectively. These considerations suggest that a number of nutraceutical or lifestyle measures may have potential for preventing or slowing AD: policosanol; 9-cis-beta-carotene; isomerized hops extract; DHA; measures which promote efficient endothelial NO generation, such as low-salt/potassium-rich diets, exercise training, high-dose folate, and flavanol-rich cocoa; chromium picolinate and cinnamon extract as aids for insulin sensitivity; and various agents which can oppose microglial activation, including vitamin D, genistein, and sesamin. The impact of these measures on Abeta production in rodent models of AD should be evaluated, with the intent of defining practical strategies for AD prevention.
Collapse
|