The effect of grape (Vitis vinifera) seed extract supplementation on flow-mediated dilation, blood pressure, and heart rate: A systematic review and meta-analysis of controlled trials with duration- and dose-response analysis

Safety classification of herbal medicine use among hypertensive patients: a systematic review and meta-analysis

Background

The use of herbal medicines (HMs) for the treatment of hypertension (HTN) is increasing globally, but research on the potential adverse effects and safety of HMs in HTN patients is limited. Therefore, this systematic review and meta-analysis aim to determine the global prevalence of HM usage among HTN patients and assess the safety of identified herbs based on current scientific evidence.

Methods

The PubMed/MEDLINE, EMBASE (Ovid), and Cumulated Index to Nursing and Allied Health Literature (CINAHL) databases were searched for cross-sectional studies on the use of HM among HTN patients. Our review includes studies published in English up to the year 2023. After extracting and appraising the data from the studies, a meta-analysis was conducted using the Stata version 16.0 to estimate the pooled prevalence of HM use in patients with HTN (PROSPERO: CRD42023405537). The safety classification of the identified HM was done based on the existing scientific literature.

Results

This study analyzed 37 cross-sectional studies from 21 countries and found that 37.8% of HTN patients used HM to manage their health. The prevalence of HM use varied significantly based on publication year and geographical region. Among the 71 identified herbs, Allium sativum L., Hibiscus sabdariffa L., and Olea europaea L. were the most commonly used. However, four herbs were identified as contraindicated, 50 herbs required caution, and only 11 herbs were considered safe for use.

Conclusion

The study highlights the potential risks of toxicities and adverse effects associated with HM use in the treatment of HTN. Ensuring patient safety involves using safe HMs in appropriate doses and avoiding contraindicated HMs. Future research should focus on identifying commonly used herbs, especially in resource-limited countries with poor HTN management, and additional clinical research is required to assess the toxicity and safety of commonly used HMs.

The effects of grape seed extract supplementation on cardiovascular risk factors, liver enzymes and hepatic steatosis in patients with non-alcoholic fatty liver disease: a randomised, double-blind, placebo-controlled study

BACKGROUND

Despite the high antioxidant potential of grape seed extract (GSE), very limited studies have investigated its effect on non-alcoholic fatty liver disease (NAFLD). Therefore, this study was conducted with the aim of investigating the effect of GSE on metabolic factors, blood pressure and steatosis severity in patients with NAFLD.

METHODS

In this double-blind randomized clinical trial study, 50 NAFLD patients were divided into two groups of 25 participants who were treated with 520 mg/day of GSE or the placebo group for 2 months. The parameters of glycemic, lipid profile, blood pressure and steatohepatitis were measured before and after the intervention.

RESULTS

The GSE group had an average age of 43.52 ± 8.12 years with 15 women and 10 men, while the placebo group had an average age of 44.88 ± 10.14 years with 11 women and 14 men. After 2 months of intervention with GSE, it was observed that insulin, HOMA-IR, TC, TG, LDL-c, ALT, AST, AST/ALT, SBP, DBP and MAP decreased and QUICKi and HDL-c increased significantly (p-value for all < 0.05). Also, before and after adjustment based on baseline, the average changes indicated that the levels of insulin, HOMA-IR, TC, TG, LDL-c, SBP, DBP, MAP in the GSE group decreased more than in the control group (p for all < 0.05). Furthermore, the changes in HDL-c were significantly higher in the GSE group (p < 0.05). The between-groups analysis showed a significant decrease in the HOMA-β and AST before and after adjustment based on baseline levels (p < 0.05). Moreover, the changes in QUICKi after adjustment based on baseline levels were higher in the GSE group than in the control group. Also, between-groups analysis showed that the severity of hepatic steatosis was reduced in the intervention group compared to the placebo group (P = 0.002).

CONCLUSIONS

It seems that GSE can be considered one of the appropriate strategies for controlling insulin resistance, hyperlipidemia, hypertension and hepatic steatosis in NAFLD patients.

TRIAL REGISTRATION

The clinical trial was registered in the Iranian Clinical Trial Registration Center (IRCT20190731044392N1). https://irct.behdasht.gov.ir/trial/61413 . (The registration date: 30/03/2022).

The Effect of Grape Seed Extract on the Alveolar, Jaw, and Skeletal Bone Remodeling: A Scoping Review

Herbal medicine has an important part in promoting and maintaining human health. One of them was grape seed extract (GSE). Various potentials of GSE in human health have been explored, and its potential for maintaining bone health is promising. Some initial research has provided evidence that the GSE was able to affect bone remodeling (bone resorption and bone formation). This scoping review analyzed and discussed all the reports on the effect of GSE on bone healing and bone remodeling in animals in the alveolar bone, jaw bone, and skeletal bone. The further purpose is to give an opportunity to research and development of supplementation of GSE for humans.The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) 2020 guidelines were used to compose this scoping review through database on Scopus, PubMed, Science Direct, Web of Science, Embase, and manual search until December 2022. The inclusion criteria were a study that analyzed the effect of supplementation GSE on all bones.All included study was in vivo study with supplementation of GSE. The supplementation of GSE affects the alveolar bone, jaw bones, and skeletal bone by promoting bone formation and inhibiting bone resorption by suppressing inflammation, apoptosis pathways, and osteoclastogenesis. It not only supports bone remodeling in bone inflammation, osteonecrosis, osteoporosis, and arthritis but also the GSE increases bone health by increasing the density and mineral deposition in trabecula and cortical bone.The supplementation of GSE supports bone remodeling by interfering with the inflammation process and bone formation not only by preventing bone resorption but also by maintaining bone density.

The effect of whole grape products on blood pressure and vascular function: A systematic review and meta-analysis of randomized controlled trials

BACKGROUND AND AIMS

Grape consumption-associated improvements in cardiovascular health have received significant attention over the last few years; however, major gaps have remained in the meta-evidence related to this topic. This systematic review and meta-analysis of randomized controlled trials (RCTs) was performed to explore the effect of whole grapes and its products on blood pressure, endothelial function, heart rate, and pulse rate.

METHODS AND RESULTS

Four database (PubMed, Scopus, Web of Sciences, and the Cochrane Library) were searched until the 14th of January 2022. The pooled effect size of interested outcomes was calculated using the random-effects model. Thirty eligible RCTs were identified. Pooled results indicated that compared to the control group, consumption of grape products significantly decreased systolic blood pressure (SBP) (WMD = -3.17 mmHg; 95% CI: -5.36, -0.99 mmHg; P = 0.004; I2 = 64%; P-heterogeneity<0.001); while, vascular cell adhesion molecule-1 (VCAM-1) increased (WMD = 34.11 ng/ml; 95% CI: 0.98, 67.25 ng/ml; P = 0.04; I2 = 2%; P-heterogeneity = 0.4). Although, the certainty of evidence was low and very low, respectively. No significant effect was observed on diastolic blood pressure, endothelial function, heart rate, pulse rate, and soluble intercellular adhesion molecule-1 (sICAM-1). In a subgroup analysis, consumption of whole grape products (raisin and grape powder) induced a significant decrease in SBP (WMD = -2.69 mmHg; 95% CI: -4.81, -0.57; P = 0.01; I2 = 18.1%; P-heterogeneity < 0.001), while grape juice did not.

CONCLUSION

The low certainty of evidence from RCTs revealed that consumption of grape products, especially in whole forms, resulted in a small reduction of SBP but did not influence other markers of cardiovascular health.

PROSPERO REGISTRATION CODE

CRD42022379231.

A minor metabolite from Curcuma longa effective against metabolic syndrome: results from a randomized, double-blind, placebo-controlled clinical study

Metabolic syndrome (MetS) is characterized by the presence of at least three interrelated risk factors, including central obesity, hypertension, elevated serum triglycerides, low serum high-density lipoproteins, and insulin resistance. Abdominal obesity is considered a predominant risk factor. Lifestyle changes with medications to lower cholesterol, blood sugar, and hypertension are the general treatment approaches. Functional foods and bioactive food ingredients represent versatile tools for addressing different aspects of MetS. In a randomized placebo-controlled clinical study, we evaluated the effect of Calebin A, a minor bioactive phytochemical from Curcuma longa, on metabolic syndrome in obese adults (N = 100), and 94 individuals completed the study (N = 47 in both groups). They were subjected to Calebin A supplementation for 90 days, which resulted in a statistically significant reduction in their body weight, waist circumference, body mass index, low-density lipoprotein-cholesterol, and triglyceride levels compared to those with the placebo. A small but significant increase in high-density lipoprotein-cholesterol levels was also observed in these individuals. Furthermore, Calebin A showed a positive effect on adipokines by reducing circulating leptin levels. Finally, C-reactive protein levels were significantly reduced in Calebin A-supplemented individuals, suggesting a beneficial impact on managing MetS-induced inflammation. Blood glucose levels, insulin resistance, and blood pressure levels were not affected by Calebin A. In conclusion, Calebin A may be an effective supplement for managing abdominal obesity, dyslipidemia, and systemic inflammation in individuals with metabolic syndrome. This study was prospectively registered on the Clinical Trial Registry of India (CTRI) with the registration number CTRI/2021/09/036495. https://ctri.nic.in/Clinicaltrials/advancesearchmain.php.

The current status of old traditional medicine introduced from Persia to China

Traditional Chinese medicine (TCM) includes over ten thousand herbal medicines, some of which were introduced from outside countries and territories. The Silk Road enabled the exchange of merchandise such as teas, silks, carpets, and medicines between the East and West of the Eurasia continent. During this time, the ‘Compendium of Materia Medica’ (CMM) was composed by a traditional medicine practitioner, Shizhen Li (1,518–1,593) of the Ming Dynasty. This epoch-making masterpiece collected knowledge of traditional medical materials and treatments in China from the 16th century and before in utmost detail, including the origin where a material was obtained. Of 1892 medical materials from the CMM, 46 came from Persia (now Iran). In this study, the basic information of these 46 materials, including the time of introduction, the medicinal value in TCM theory, together with the current status of these medicines in China and Iran, are summarized. It is found that 20 herbs and four stones out of the 46 materials are registered as medicinal materials in the latest China Pharmacopoeia. Now most of these herbs and stones are distributed in China or replacements are available but saffron, ferula, myrrh, and olibanum are still highly dependent on imports. This study may contribute to the further development, exchange, and internationalization of traditional medicine of various backgrounds in the world, given the barriers of transportation and language are largely eased in nowadays.

Bioactive Compounds, Health Benefits and Food Applications of Grape

Grape (Vitis vinifera L.) is one of the most popular fruits worldwide. It contains various bioactive compounds, such as proanthocyanidins, anthocyanins, flavonols, phenolic acids and stilbenes, the contents of which could vary considerably in grape skin, pulp and seed. Many studies have revealed that grape possesses a variety of health benefits, such as antioxidant, anti-inflammatory, gut-microbiota-modulating, anticancer and cardioprotective effects. Grape is eaten as fresh fruit and is also used as raw material to produce various products, such as wine, grape juice and raisins. Moreover, the byproducts of grape, such as grape pomace and grape seed, have many applications in the food industry. In this paper, the bioactive compounds in grape are briefly summarized based on literature published in recent years. In addition, the health benefits of grape and its bioactive components are discussed, with special attention paid to the underlying mechanisms. Furthermore, the applications of grape in the food industry are elucidated, especially the applications of grape pomace and grape seed. This paper can contribute to understanding the health benefits and mechanisms of grape and its bioactive compounds, as well as the promotion of the use of grape in the food industry.