Blood pressure decrease with ingestion of a soya product (kinako) or fish oil in women with the metabolic syndrome: role of adiponectin and nitric oxide

Soy Supplementation Does Not Affect Serum Adiponectin Levels in Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Numerous studies have indicated that low levels of serum adiponectin are linked with the development of various chronic diseases. While some recent research has suggested that soy has a positive impact on serum adiponectin levels, the results are inconsistent. Therefore, we aim to conduct a thorough systematic review and meta-analysis of randomized controlled trials (RCTs) that investigate the effects of soy on serum adiponectin levels in adults. The search was conducted until March 2024 on PubMed, Scopus, Web of Science, and Cochrane Library databases to identify RCTs that studied the effects of soy supplementation on serum adiponectin levels. A random-effects model was used to pool the weighted mean differences (WMDs). Ten and nine RCTs were selected for the systematic review and meta-analysis, respectively. After analyzing data from 9 eligible RCTs, it was found that soy supplementation did not significantly impact the concentrations of adiponectin (WMD = -0.24 μg/mL; 95% confidence interval, -1.56 to 1.09; p = 0.72). However, there was significant heterogeneity between the studies (I2 = 89.8%, p < 0.001). Sensitivity analysis showed that overall estimates were not affected by the elimination of any study. We did not observe any evidence regarding publication bias. In conclusion, soy supplementation did not have a significant effect on adiponectin levels in adults. However, further RCTs are needed with longer intervention duration, higher doses, and studies conducted in different countries.

Nutrition Interventions for Lowering Cardiovascular Risk After Hypertensive Disorders of Pregnancy: A Systematic Review

Background

Hypertension is one of the most common medical problems during pregnancy. Hypertensive disorders of pregnancy (HDP) increase the risk of premature cardiovascular disease (CVD) 2- to 4-fold within 10 years after delivery. Early health behaviour modifications may prevent or manage several cardiovascular risk factors. Importantly, compared with women without HDP, fewer women with HDP achieve national dietary guidelines to prevent CVD. This highlights an opportunity for programs tailored for women post-HDP to support their nutritional behaviours as a key component of postpartum CVD preventive care. This systematic review investigated the impacts of nutrition modifications on lowering measures of CVD risk after HDP.

Methods

Four electronic databases (MEDLINE, EMBASE, CINAHL, Cochrane Library) were searched in October 2022 with a search strategy focused on nutrition programs/interventions and women post-HDP. Additional inclusion criteria were original research and reported outcome of CVD risk or cardiovascular risk factors.

Results

Six studies were included: 4 experimental trials and 2 prospective cohort studies. Of the nutrition interventions, 4 were embedded within comprehensive health behaviour intervention programs. Outcome measures varied, but all studies reported blood pressure. A narrative synthesis found that the range of changes in blood pressure varied from no change to clinically meaningful change.

Conclusions

This review found statistically nonsignificant yet clinically important improvements in measures of cardiovascular risk across a range of nutritional interventions in women after HDP. Further high-quality evidence is needed to inform the design and implementation of nutritional preventive cardiovascular care targeting this high CVD-risk population.

Systematic review and meta-analysis of randomized, controlled trials on the effects of soy and soy products supplementation on serum adiponectin levels

BACKGROUND AND AIMS

Our aim in this meta-analysis was to determine the effect of soy and soy product supplementation on serum adiponectin levels.

METHOD

A systematic search was conducted using Medline (PubMed and Web of Science), Scopus, and Cochrane Library for eligible trials up to August 2020. A random-effects model was used to pool calculated effect sizes.

RESULTS

Seven trials were included in the overall analysis. Our analysis showed that soy and soy product supplementation did not significantly affect adiponectin concentrations (WMD = -0.77 μg/ml, 95% CI: -0.61, 2.15, P = 0.27) in comparison with a placebo. The between-study heterogeneity was high (I2: 68.2%, P = 0.004). Subgroup analysis, based on participants' health status and duration of the supplementation, could not detect the potential source of the observed heterogeneity. In addition, subgroup analysis showed that the effect was not statistically significant in all subgroups.

CONCLUSION

Overall, soy and soy product supplementation did not change the circulatory adiponectin levels. In addition, the results were not affected by the participant's health status and duration of supplementation. However, further studies are needed to confirm the present results.

The Effect of Herbal Medicine and Natural Bioactive Compounds on Plasma Adiponectin: A Clinical Review

Noncommunicable diseases (NCDs) are one of the major public health concerns globally. Most of the NCDs including insulin resistance, metabolic syndrome, type 2 diabetes mellitus, fatty liver disease, and coronary heart disease are related to obesity and are called obesity-related NCDs (OR-NCDs). However, adipocytes can reduce OR-NCDs by secreting adiponectin. Adiponectin has an inverse relationship with body fat. Obese people have impairment in differentiating pre-adipocytes to adipocytes, the process facilitated by adiponectin. Adiponectin directly increases insulin sensitivity and reduces obesity-related insulin resistance by down-regulating hepatic glucose production and increasing fatty acid (FA) oxidation in skeletal muscle. Considering the various beneficial effects of adiponectin on health, increasing adiponectin might be a promising approach to prevent and treat OR-NCDs. Recent studies have shown that nutraceuticals and medicinal compounds isolated from plants could prevent and treat various diseases, particularly cardiovascular diseases (CVDs), diabetes mellitus, obesity, and non-alcoholic fatty liver disease. However, to our knowledge, the effect of these natural products, including herbal supplements and functional foods on adiponectin, has not yet been fully reviewed. The main aim of this review is to summarize the effects of nutraceuticals and herbal bioactive compounds on plasma adiponectin concentrations based on clinical studies. It can be concluded that medicinal plants, and herbal bioactive compounds, particularly curcumin, anthocyanins, resveratrol, soy, walnut, and dihydromyricetin can be used as adjunct or complementary therapeutic agents to increase plasma adiponectin, which could potentially prevent and treat NCDs.

N-3 Polyunsaturated Fatty Acids and Their Lipid Mediators as A Potential Immune-Nutritional Intervention: A Molecular and Clinical View in Hepatic Disease and Other Non-Communicable Illnesses

In recent years, the beneficial effect of n-3 polyunsaturated fatty acids (n-3 PUFAs) intake on human health has been widely accepted in the field of immunonutrition. Today, we find a diversity of supplements based on n-3 PUFAs and/or minerals, vitamins and other substances. The main objective of this review is to discuss the importance of n-3 PUFAs and their derivatives on immunity and inflammatory status related to liver disease and other non-communicable illnesses. Based on the burden of liver diseases in 2019, more than two million people die from liver pathologies per year worldwide, because it is the organ most exposed to agents such as viruses, toxins and medications. Consequently, research conducted on n-3 PUFAs for liver disease has been gaining prominence with encouraging results, given that these fatty acids have anti-inflammatory and cytoprotective effects. In addition, it has been described that n-3 PUFAs are converted into a novel species of lipid intermediaries, specialized pro-resolving mediators (SPMs). At specific levels, SPMs improve the termination of inflammation as well as the repairing and regeneration of tissues, but they are deregulated in liver disease. Since evidence is still insufficient to carry out pharmacological trials to benefit the resolution of acute inflammation in non-communicable diseases, there remains a call for continuing preclinical and clinical research to better understand SPM actions and outcomes.

The effect of soy products on circulating adiponectin and leptin concentration in adults: A systematic review and meta-analysis of randomised controlled trials

BACKGROUND

Human clinical trials that have investigated the effect of soy product consumption on adipokines have reported inconsistent results. Our objective was to elucidate the role of soy product consumption on adiponectin and leptin in adults through a systematic review and meta-analysis of available randomised placebo-controlled trials (RCTs).

METHODS

The systematic search included PubMed, Scopus, Web of Science, EmBase, Google Scholar and Cochrane database from inception to July 2020. Human clinical trials that reported the effect of soy product consumption on leptin and adiponectin were included. The pooled weighted mean difference (WMD) was calculated by the random-effects model. Heterogeneity, sensitivity analysis, and publication bias were reported using standard methods. Quality assessment was performed using Cochrane risk of bias assessment tool.

RESULTS

Overall, 13 RCTs with 824 participants were included in this meta-analysis. Our analysis showed that soy product consumption did not significantly affect leptin (WMD: 0.01 ng/mL; 95% CI, -0.16, 0.18; P = .88) and adiponectin (WMD: -0.09 ng/mL; 95% CI, -0.29, 0.12; P = .39) concentration in comparison with control. Furthermore, subgroup analysis indicated that the effect remained non-significant when analysed by study design, participant demographics and intervention characteristics. Based on the Cochrane Collaboration Risk of Bias tool, seven studies were considered good quality and six studies were fair.

CONCLUSION

The present systematic review and meta-analysis suggest that soy product consumption had no significant effect on leptin and adiponectin levels in adults. However, future larger and well-designed trials are still needed to further explore this research area and to address the heterogeneous study design used in the existing literature.

Secondary data analysis investigating effects of marine omega-3 fatty acids on circulating levels of leptin and adiponectin in older adults

BACKGROUND

Higher leptin and lower adiponectin levels have been linked to progressing systemic inflammation and diseases of aging. Among older adults with obesity and an inflammatory conditions, we quantified effects of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) supplementation on leptin, adiponectin, and the leptin-to-adiponectin ratio (LAR). We also examined associations among adipokine and cytokine levels.

METHODS

Using a randomized, double-blind, placebo-controlled design, participants (mean age 61.3 ± 2.1) received 1.5 g EPA + 1.0 g DHA (n = 14) or mineral oil (n = 18) daily. Plasma adipokine and cytokine levels were quantified by electrochemiluminescence at all study intervals.

RESULTS

While no between-group differences were detected, there was a reduction in the LAR (by 23%, p=.065) between weeks 4 and 8 among the EPA+DHA group. Adiponectin levels were negatively associated with IL-1β levels at week 4 (p=.02) and TNF-α levels at week 8 (p=.03).

CONCLUSION

Potential benefits of EPA+DHA supplementation among aging populations warrant further study.

Effect of omega-3 fatty acids supplementation on adipokines: a systematic review and meta-analysis of randomized controlled trials

BACKGROUND

Although a large body of literature reported the beneficial effects of omega-3 fatty acids (omega-3 FAs) consumption on adipokines levels, but recent findings from clinical trials are not univocal. The aim of this systematic review and meta-analysis was to evaluate the effect of omega-3 FAs supplements on adipokines.

METHODS

We searched Medline, Web of Science, Scopus, Embase, and Cochrane Library from inception to August 2020 without any particular language limitations. Outcomes were summarized as standardized mean difference (SMD) with 95% confidence intervals (CIs) estimated from Hedge's g and random effects modeling.

RESULTS

Fifty-two trials involving 4,568 participants were included. Omega-3 FAs intake was associated with a significant increase in plasma adiponectin levels (n = 43; 3,434 participants; SMD: 0.21, 95% CI: 0.04, 0.37; p = 0.01; I²= 80.14%). This meta-analysis indicates that supplementing participants with omega-3 fatty acids more than 2000 mg daily and more than 10 weeks resulted in a significant and more favorable improvement in plasma adiponectin levels. However, omega-3 FAs intake had no significant effect on leptin levels (SMD: -0.02, 95% CI: -0.20, 0.17, I²= 54.13%).

CONCLUSION

The evidence supports a beneficial effect of omega-3 FAs intake on serum adiponectin levels but does not appear to impact on leptin concentrations. Larger well-designed RCTs are still required to evaluate the effect of omega-3 FAs on leptin in specific diseases.

Effects of soy consumption on metabolic parameters in patients with metabolic syndrome: A systematic review and meta-analysis

Functional foods like soy have unique effects on health status. Although various dietary modifications have been recommended to ameliorate features of metabolic syndrome (MetS), no meta-analysis has summarized the effect of soy consumption in patients with MetS. PubMed, ISI Web of Science, and Scopus were searched for relevant articles until Jun 2020, resulting in six relevant publications that were included in our meta-analysis. Combining a total of 9 comparisons suggested a significant decrease in serum levels of triglyceride (WMD: -0.29; 95 % CI: -0.49, -0.09 mg/dL), total cholesterol (WMD: -1.46; 95 % CI: -1.70, -1.22 mg/dL), LDL-C (WMD: -0.73; 95 % CI: -0.93, -0.52 mg/dL) and no change in serum HDL-c levels. Combining a total of 7 effect sizes examining soy effects on glycemic parameters indicated that subjects who consumed soy products had lower levels of fasting blood sugar (WMD: -0.90; 95 % CI: -1.12, -0.68 mg/dL), insulin (WMD: -1.06; 95 % CI: -1.29, -0.84 pmol/ L) and HOMA-IR (WMD: -1.08; 95 % CI: -1.31, -0.85) compared with those in the control group. Soy consumption could not significantly change anthropometric measures and blood pressure. Consuming soy products in patients with MetS effectively improved lipid profile and glycemic parameters independent of affecting anthropometric measures.

Can soy isoflavones plus soy protein change serum levels of interlukin-6? A systematic review and meta-analysis of randomized controlled trials

In the present review, we aimed to summarize the effect of soy isoflavones plus soy protein on circulating interlukin-6 (IL-6) in adult participants. Databases including ISI Web of Science, PubMed, Scopus, Cochrane Library, and clinicaltrials.gov were searched up to 23 March 2020. The mean change from baseline of IL-6 concentrations and its SD for intervention and comparison groups were used to calculate the effect size. If the heterogeneity test was statistically significant, DerSimonian and Laird random effects model was used. Cochran's Q test and I-squared statistic were also used to compute the statistical heterogeneity of the intervention's effects. Eighteen studies were known to be eligible for systematic review and 14 studies were selected for meta-analysis. Our meta-analysis results indicated a non-significant effect in serum IL-6 concentrations compared to the comparison group (WMD = 0.03 pg/ml, 95% CI: -0.06, 0.12; p = .459). In subgroup analysis, based on soy isoflavones dosage, it was observed that this combination could reduce IL-6 levels in studies that used isoflavones with dose >84 mg/day (WMD = -0.12 pg/ml 95% CI: -0.24, -0.004; p = .042, I2 = 82.7%) and in articles with a good quality (WMD = -0.15 pg/ml 95% CI: -0.24, -0.05; p = .003, I2 = 62.3%). Performing well-designed intervention studies using a high dose of soy isoflavones is recommended to confirm the beneficial effects of soy ingredients on IL-6.

The effect of soy isoflavones and soy isoflavones plus soy protein on serum concentration of tumor necrosis factor-α? A systematic review and meta-analysis of randomized controlled trials

In this study, we summarized the effect of soy isoflavones and soy isoflavones plus soy protein on serum concentration of tumor necrosis factor-alpha (TNF-α) among adult participants. We systematically searched Scopus, ISI Web of Science, Cochrane Library, PubMed, and clinicaltrials.gov for articles published up to May 2020. Effect size was calculated by mean change from baseline of TNF-α concentrations and its standard deviation (SD) for intervention and comparison groups. If the heterogeneity test was statistically significant, DerSimonian and Laird random effects model was used to estimate the summary of the overall effects and its heterogeneity. Nineteen and fourteen randomized clinical trials were included in our systematic review and meta-analysis, respectively. The result of overall effect size indicated a non-significant effect in serum concentration of TNF-α following soy isoflavones intake (WMD = 0.2 pg/ml, 95% CI: -0.13, 0.53; p = .226) and the combination of soy isoflavones and soy protein intake (WMD = 0.02 pg/ml, 95% CI: -0.02, 0.06; p = .286). Subgroup analyses revealed no significant change in circulatory levels of TNF-α following soy isoflavones plus soy protein intake. In conclusion, the present systematic review and meta-analysis found insufficient evidence that soy isoflavones or the combination of soy isoflavones and soy protein significantly reduce serum concentration of TNF-α.

Functional foods modulating inflammation and metabolism in chronic diseases: a systematic review

Chronic diseases are responsible for approximately 71% global deaths. These are characterized by chronic low-grade inflammation and metabolic alterations. "Functional foods" have been attributed with anti-inflammatory properties, demonstrated in cell lines and murine models; however, studies in humans are inconclusive. The purpose of this systematic review is to identify clinical trials that analyzed changes in inflammatory and metabolic mediators, in response to consumption of specific functional foods. A total of 3581 trials were screened and 88 were included for this review. Foods identified to regulate inflammation included cranberries, grapes, pomegranate, strawberries, wheat, whole grain products, low fat dairy products, yogurt, green tea, cardamom, turmeric, soy foods, almonds, chia seeds, flaxseed, pistachios, algae oil, flaxseed oil and grape seed oil. Clinical trials that focus on a dietary pattern rich in functional foods are necessary to explore if the additive effect of these foods lead to more clinically relevant outcomes.

Effects of soy intake on circulating levels of TNF-α and interleukin-6: a systematic review and meta-analysis of randomized controlled trials

PURPOSE

Pro-inflammatory mediators, including serum tumor necrosis factor alpha (TNF-α) and interleukin-6 (IL-6), can be used as biomarkers to indicate or monitor disease. This study was designed to ascertain the effects of soy products on TNF-α and IL-6 levels.

METHODS

PubMed, EMBASE, Science Direct, Web of Science, Google Scholar and the Cochrane Central Register of Controlled Trials were searched to November 2019 for RCTs around the effects of soy-based products on TNF-α and IL-6. A random effects model was used to calculate overall effect size.

RESULTS

In total, 29 eligible publications were considered in the present systematic review, of which 25 were included in this meta-analysis. The overall effect of soy products on TNF-α and IL-6 levels failed to reach statistical significance (MD = - 0.07; 95% CI - 0.22-0.09; I² 50.9; MD = 0.03; 95% CI - 0.07-0.14; I² 42.1, respectively). According to a subgroup analysis, natural soy products led to a reduction in TNF-α concentration compared with processed soy products (MD = - 0.32; 95% CI - 0.45 to - 0.19; I² 0.0). Moreover, IL-6 reduction was stronger in participants who were affected by different diseases (MD = - 0.04; 95% CI - 0.07 to - 0.02; I² 0.0).

CONCLUSIONS

A review of RCTs published to November 2019 found that natural soy products are effective in lowering TNF-α levels. While the beneficial effects on reduction of IL-6 appeared stronger in individuals affected by different diseases, this finding cannot be generalized to all individuals affected by different diseases.

In Vivo Digestion of Egg Products Enriched with DHA: Effect of the Food Matrix on DHA Bioavailability

The aim of the present study was to determine to what extent the food matrix could affect the release of docosahexaenoic acid (DHA) during digestion and its incorporation into systemic circulation. In this aim, three DHA-enriched egg products having the same composition but different structure were developed: omelet, hard-boiled egg, and mousse. Then, nine pigs fitted with T-shape cannulas at duodenal level and a jugular venous catheter were fed with the DHA-enriched egg products, and duodenal effluents and plasma were collected throughout the postprandial period. Results highlighted an undeniable effect of the food matrix on digestion parameters and DHA bioavailability. The transit of DHA and protein through the duodenum was faster after the ingestion of the mousse than after the ingestion of the omelet and hard-boiled egg. While most of the DHA and protein ingested under the form of mousse had already passed through the duodenum 4.5 h after its ingestion, significantly higher quantities were still present in the case of the omelet and hard-boiled egg. In terms of bioavailability, the omelet was the most efficient vector for delivering DHA into systemic circulation. It supplied 56% and 120% more DHA than the hard-boiled egg and the mousse, respectively.

The effects of soy supplementation on inflammatory biomarkers: A systematic review and meta-analysis of randomized controlled trials

BACKGROUND

Soy products contain several compounds with anti-inflammatory properties like genistein and daidzein which reported to act through different pathways. Present study conducted considering the inconsistent results and lack of any comprehensive review regarding randomized controlled trials which assess the effect of soy products on inflammatory markers.

METHODS

Following electronic databases were searched up to March 2020: PubMed, Scopus, ISI web of science, and Cochrane Library All randomized trials which assessed the effect of soy product supplementation on c-reactive protein (CRP), tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) were included for last analysis. Treatment effects were expressed as mean difference (MD) and the standard deviation (SD) of outcomes. To estimate the overall effect the random-effects model was employed.

RESULTS

Finally, 51 randomized trial were included for present study. Last analysis showed that soy product supplementation lead to significant reduction in CRP (MD -0.27 mg/L; 95% CI: -0.51, -0.02, p = 0.028) but it did not affect IL-6 (MD 0.0 pg/ml; 95% CI: -0.06, 0.06, p = 0.970) and TNF-α (MD = -0.04 pg/ml; 95% CI: -0.11, 0.03, p = 0.252). Subgroup analysis showed that soy supplementation had a significant impact on decreasing IL-6 and TNF-α levels when studies had a long-term intervention (≥12 weeks) and used low dose isoflavone (<100 mg/day).

CONCLUSION

In conclusion, present systematic review and meta-analysis found a significant reduction in CRP levels after soy supplementation whiles IL-6 and TNF-α did not affect.

Systematic review of marine-derived omega-3 fatty acid supplementation effects on leptin, adiponectin, and the leptin-to-adiponectin ratio

Increasing evidence suggests that adipokines, leptin and adiponectin, produced and secreted by adipocytes, are involved in regulating systemic inflammation and may be important targets for interventions to reduce the chronic systemic inflammation linked to some conditions common in aging (e.g., atherosclerosis). Lower leptin levels and higher adiponectin levels in peripheral circulation have been associated with less systemic inflammation. While some studies have shown that marine-derived omega-3 fatty acids (eicosapentaenoic acid [EPA] and/or docosahexaenoic acid [DHA]) have effects on leptin and adiponectin in the context of inflammation, the extent of their effects remain unclear. The purpose of this systematic review was to summarize findings from randomized, controlled trials that measured effects of EPA+DHA supplementation on circulating levels of leptin and adiponectin to determine the state of the science. PubMed, CINAHL, Web of Science, Scopus, and Cochrane Trials were searched up to June 2018 for studies meeting inclusion criteria. Thirty-one studies included in this review were conducted in 16 countries. Eighteen studies reported lower leptin and/or higher adiponectin levels with EPA+DHA supplementation versus placebo at study end point (9 reported statistically significant differences), but doses, supplementation duration, and population characteristics varied across studies. In 9 studies reporting significantly lower leptin and/or higher adiponectin levels the EPA+DHA dose was 0.52 to 4.2 g/day for 4 to 24 weeks. Additional studies are warranted which assess dose parameters and patient populations similar to studies reporting significant effects of EPA+DHA on leptin or adiponectin in order to evaluate the extent of reproducibility before recommending EPA+DHA as a therapy to target these adipokines.

The effect of soya consumption on inflammatory biomarkers: a systematic review and meta-analysis of clinical trials

Inflammation is a major cause of chronic diseases. Several studies have investigated the effects of soya intake on inflammatory biomarkers; however, the results are equivocal. The aim of this study was to conduct a systematic review and meta-analysis of clinical trials that evaluated the effect of soya consumption on inflammatory biomarkers. Medline, Scopus, ISI Web of Science and Google Scholar were systematically searched, up to and including May 2020, for clinical trials that evaluated the effects of soya and soya products on TNF-α, IL-6, IL-2, IL-1β and interferon γ (IFN-γ) in adults. A random effects method was used to calculate overall effects, and subgroup analyses were performed to discern probable sources of inter-study heterogeneity. A total of twenty-eight clinical trials were included. Although soya consumption reduced TNF-α (Hedges' g = -0·28; 95 % CI -0·49, -0·07), it had no significant effect on IL-6 (Hedges' g = 0·07, 95 % CI -0·14, 0·28), IL-2 (mean difference (MD) = -1·38 pg/ml; 95 % CI -3·07, 0·31), IL-1β (MD = -0·02 pg/ml; 95 % CI -0·08, 0·03) and IFN-γ (MD = 1685·82 pg/ml; 95 % CI -1604·86, 4976·50). Subgroup analysis illustrated a reduction in TNF-α in parallel designed studies, at dosages ≥100 mg of isoflavones, and in unhealthy subjects. The present study showed that high doses of isoflavones in unhealthy subjects may yield beneficial effects on TNF-α.

A systematic review and meta-analysis of the effects of soy on serum hs-CRP

BACKGROUND & AIM

The results of studies about the effect of soy products on serum highly sensitive C-reactive protein (hs-CRP) are inconsistent. The aim of this systematic review and meta-analysis of randomized clinical trials (RCTs) was to investigate the effect of soy products intake on serum hs-CRP concentration.

METHODS

We searched PubMed, EMBASE, Science Direct, ISI Web of Science, Google Scholar and Cochrane Central Register of Controlled Trials up to December 2016 without language restrictions. Random-effect model was used for quantitative data synthesis.

RESULTS

Thirty-six studies were included in our analyses. A meta-analysis revealed a non-significant reduction in serum hs-CRP concentrations following soy products consumption, -0.19 (mg/L) (95% CI: -0.49 to 0.09; I2 = 95.6%). Subgroup analyses suggested that natural soya products may reduce plasma levels of CRP by -0.18 mg/L (95% CI: -0.28 to -0.08; I2: 11.6) in comparison to other source of isoflavones (soya extracts, supplements). Moreover, the effect was stronger among subjects with baseline hs-CRP concentrations of less than 2.52 mg/L, -0.15 (95% CI: -0.27 to -0.02; I2: 34.6). A meta-regression analysis revealed that dosage of isoflavones seems to be a strong predictor of the effect of soya on serum hs-CRP levels.

CONCLUSION

Present review of RCTs published up to December 2016 did not provide strong evidence regarding the beneficial effect of soya products consumption on blood hs-CRP concentrations. However, it appears that natural soya products may reduce plasma levels of hs-CRP in comparison to other source of isoflavones. Large and well-designed studies are recommended to confirm this conclusion.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42018069371.

Effect ofBifidobacterium lactisHN019 on inflammatory markers and oxidative stress in subjects with and without the metabolic syndrome

Beneficial effects of probiotics have been reported on body weight, lipid and carbohydrate metabolism, inflammatory state and oxidative stress in healthy subjects and in many metabolic and inflammatory diseases. The aim of this study was to evaluate the effects ofBifidobacterium lactisHN019 on inflammatory state and nitro-oxidative stress in patients with and without the metabolic syndrome (MetS). The usual diets of the thirty-three subjects were supplemented with probiotic milk for 90 d. Inflammatory markers and oxidative measurements were performed. In relation to the baseline values, subjects in both groups showed a decrease in homocysteine (P=0·02 andP=0·03, respectively), hydroperoxides (P=0·02 andP=0·01, respectively) and IL-6 levels (P=0·02). Increases in adiponectin (P=0·04) and nitric oxide metabolites (NOx,P=0·001) levels were only seen in the group with the MetS in relation to the baseline values, whereas only the individuals without the MetS had increases in total radical-trapping antioxidant parameter levels (P=0·002). In conclusion,B. lactisHN019 have several beneficial effects on inflammatory and oxidative biomarkers in healthy subjects and the MetS patients. Patients with the MetS showed a specific improvement in adiponectin and NOx levels, whereas a specific favourable effect was shown in the antioxidant defenses in healthy subjects. If the results obtained in the present study are confirmed, supplementation of fermented milk with probiotics in healthy subjects and patients with the MetS must be further discussed.

Targeting mTORs by omega-3 fatty acids: A possible novel therapeutic strategy for neurodegeneration?

Neurodegenerative diseases (NDs) such as Parkinson's (PD), Alzheimer's (AD), Huntington's disease (HD), and amyotrophic lateral sclerosis (ALS) cause significant world-wide morbidity and mortality. To date, there is no drug of cure for these, mostly age-related diseases, although approaches in delaying the pathology and/or giving patients some symptomatic relief have been adopted for the last few decades. Various studies in recent years have shown the beneficial effects of omega-3 poly unsaturated fatty acids (PUFAs) through diverse mechanisms including anti-inflammatory effects. This review now assesses the potential of this class of compounds in NDs therapy through specific action against the mammalian target of rapamycin (mTOR) signaling pathway. The role of mTOR in neurodegenerative diseases and targeted therapies by PUFAs are discussed.

Metabolic syndrome components are associated with oxidative stress in overweight and obese patients

OBJECTIVE

The aim of this study is to evaluate the influence of the body mass index (BMI) and the metabolic syndrome (MetS) parameters on oxidative and nitrosative stress in overweight and obese subjects.

SUBJECTS AND METHODS

Individuals were divided into three groups: the control group (G1, n = 131) with a BMI between 20 and 24.9 kg/m2, the overweight group (G2, n = 120) with a BMI between 25 and 29.9 kg/m2 and the obese group (G3, n = 79) with a BMI ≥ 30 kg/m2.

RESULTS

G3 presented higher advanced oxidation protein products (AOPPs) in relation to G1 and G2 (p = 0.001 and p = 0.011, respectively) whereas G2 and G3 had lower levels of nitric oxide (NO) (p = 0.009 and p = 0.048, respectively) compared to G1. Adjusted for the presence of MetS to evaluate its influence, the levels of AOPPs did not differ between the groups, whereas NO remained significantly lower. Data adjusted by the BMI showed that subjects with higher triacylglycerol levels had higher AOPPs (p = 0.001) and decreased total radical-trapping antioxidant parameter/uric Acid (p = 0.036). Subjects with lower high-density lipoprotein (HDL) levels and patients with higher blood pressure showed increased AOPPs (p = 0.001 and p = 0.034, respectively) and lower NO levels (p = 0.017 and p = 0.043, respectively). Subjects who presented insulin resistance had higher AOPPs (p = 0.024).

CONCLUSIONS

Nitrosative stress was related to BMI, and protein oxidation and nitrosative stress were related to metabolic changes and hypertension. MetS components were essential participants in oxidative and nitrosative stress in overweight and obese subjects.

Lifestyle recommendations for the prevention and management of metabolic syndrome: an international panel recommendation

The importance of metabolic syndrome (MetS) lies in its associated risk of cardiovascular disease and type 2 diabetes, as well as other harmful conditions such as nonalcoholic fatty liver disease. In this report, the available scientific evidence on the associations between lifestyle changes and MetS and its components is reviewed to derive recommendations for MetS prevention and management. Weight loss through an energy-restricted diet together with increased energy expenditure through physical activity contribute to the prevention and treatment of MetS. A Mediterranean-type diet, with or without energy restriction, is an effective treatment component. This dietary pattern should be built upon an increased intake of unsaturated fat, primarily from olive oil, and emphasize the consumption of legumes, cereals (whole grains), fruits, vegetables, nuts, fish, and low-fat dairy products, as well as moderate consumption of alcohol. Other dietary patterns (Dietary Approaches to Stop Hypertension, new Nordic, and vegetarian diets) have also been proposed as alternatives for preventing MetS. Quitting smoking and reducing intake of sugar-sweetened beverages and meat and meat products are mandatory. Nevertheless, there are inconsistencies and gaps in the evidence, and additional research is needed to define the most appropriate therapies for MetS. In conclusion, a healthy lifestyle is critical to prevent or delay the onset of MetS in susceptible individuals and to prevent cardiovascular disease and type 2 diabetes in those with existing MetS. The recommendations provided in this article should help patients and clinicians understand and implement the most effective approaches for lifestyle change to prevent MetS and improve cardiometabolic health.

n-3 Polyunsaturated Fatty Acids and Metabolic Syndrome Risk: A Meta-Analysis

The associations between n-3 polyunsaturated fatty acids (PUFAs) and metabolic syndrome (MetS) risk have demonstrated inconsistent results. The present study aimed to investigate whether higher circulating n-3 PUFAs and dietary n-3 PUFAs intake have a protective effect on MetS risk. A systematic literature search in the PubMed, Scopus, and Chinese National Knowledge Infrastructure (CNKI) databases was conducted up to March 2017. Odd ratios (ORs) from case-control and cross-sectional studies were combined using a random-effects model for the highest versus lowest category. The differences of n-3 PUFAs between healthy subjects and patients with MetS were calculated as weighted mean difference (WMD) by using a random-effects model. Seven case-control and 20 cross-sectional studies were included. A higher plasma/serum n-3 PUFAs was associated with a lower MetS risk (Pooled OR = 0.63, 95% CI: 0.49, 0.81). The plasma/serum n-3 PUFAs in controls was significantly higher than cases (WMD: 0.24; 95% CI: 0.04, 0.43), especially docosapentaenoic acid (DPA) and docosahexaenoic acid (DHA). However, no significant association was found between dietary intake of n-3 PUFAs or fish and MetS risk. The present study provides substantial evidence of a higher circulating n-3 PUFAs associated with a lower MetS risk. The circulating n-3 PUFAs can be regarded as biomarkers indicating MetS risk, especially DPA and DHA.

Nutritional anti-inflammatories in the treatment and prevention of type 2 diabetes mellitus and the metabolic syndrome

AIMS

Obesity-fuelled metabolic syndrome and diabetes is now a global epidemic. There is increasing evidence that these and other chronic conditions have common inflammatory antecedents. There is an interest in nutritionally based anti-inflammatory treatments for type 2 diabetes and metabolic syndrome. The aim of this review is to examine the evidence from a 5-year period; 2011-2016, for nutritionally based anti-inflammatory treatments for the Metabolic Syndrome and Type 2 Diabetes Mellitus.

METHODS

A literature search produced a total number of 1377 records, of which 26 papers were evaluated.

RESULTS

Literature was analysed and tabulated according to date, outcome measures and results.

CONCLUSION

The evidence is strong for use of polyphenolic compounds, fish oils and vitamins in reducing inflammation biomarkers, however the impact on metabolic control is less evident.

Soy and fish as features of the Japanese diet and cardiovascular disease risks

In the World Health Organization (WHO)-coordinated Cardiovascular Disease and Alimentary Comparison Study, isoflavones (I; biomarker for dietary soy) and taurine (T; biomarker for dietary fish) in 24-hour-urine (24U) were inversely related to coronary heart disease (CHD) mortality. High levels of these biomarkers are found in Japanese people, whose CHD mortality is lowest among developed countries. We analyzed the association of these biomarkers with cardiovascular disease risk in the Japanese to know their health effects within one ethnic population. First, to compare the Japanese intake of I and T with international intakes, the ratios of 24UI and 24UT to creatinine from the WHO Study were divided into quintiles for analysis. The ratio for the Japanese was the highest in the highest quintiles for both I and T, reaching 88.1%, far higher than the average ratio for the Japanese (26.3%) in the total study population. Second, 553 inhabitants of Hyogo Prefecture, Japan, aged 30 to 79 years underwent 24-U collection and blood analyses. The 24UT and 24UI were divided into tertiles and adjusted for age and sex. The highest T tertile, compared with the lowest tertile, showed significantly higher levels of high-density lipoprotein-cholesterol (HDL-C), total cholesterol, 24U sodium (Na) and potassium (K). The highest I tertile showed significantly higher folate, 24UNa and 24UK compared with the lowest tertile. The highest tertile of both T and I showed significantly higher HDL-C, folate, and 24UNa and 24UK compared with the lowest tertile. Thus, greater consumption of fish and soy were significantly associated with higher HDL-C and folate levels, possibly a contributor to Japan having the lowest CHD mortality and longest life expectancy among developed countries. As these intakes were also associated with a high intake of salt, a low-salt intake of fish and soy should be recommended for healthy life expectancy.

The Effect of Reduced Dietary Fat and Soy Supplementation on Circulating Adipocytokines in Postmenopausal Women: A Randomized Controlled 2-Month Trial

The reduced risk of breast cancer observed in Asia has been linked with diets rich in soy foods, and observational studies suggest that regular soy food intake is related to lower circulating levels of some inflammatory markers which have been implicated in breast cancer risk. However, short-term intervention studies with soy-based diets in small numbers of women have shown few significant changes in adipocytokine levels. This 8-wk dietary intervention study in 57 healthy postmenopausal women investigated whether soy food supplementation (50 mg isoflavones or 15 g soy protein in the form of tofu) or a very low-fat diet (11.3% of total energy), similar to the traditional Asian diet, is associated with beneficial effects on serum levels of the following adipocytokines: TNF-α, IL-6, adiponectin, and resistin. We found no statistically significant changes in the levels of these adipocytokines in association with the very low-fat diet or soy supplementation. Only the change in TNF-α levels between the very low-fat and control diet groups had borderline statistical significance. We conclude that ingestion of a very low-fat diet or a soy food supplemented diet for 8 wk does not significantly alter important circulating adipocytokines.

The Role of Adiponectin in Cardiometabolic Diseases: Effects of Nutritional Interventions

Adiponectin is an adipocyte-derived hormone abundantly present in plasma that exerts its effects through the activation of 3 receptors. Its concentrations are negatively regulated by the accumulation of visceral fat, and clinical studies implicate hypoadiponectinemia in the pathogenesis of diabetes mellitus type 2, coronary artery disease, hypertension, and left ventricular hypertrophy. In contrast, high concentrations of adiponectin are associated with a decreased risk of coronary artery disease, with an improvement in the differentiation of preadipocytes into adipocytes, and with increased endothelial nitric oxide production. Therefore, adiponectin appears to be an important molecule involved in limiting the pathogenesis of obesity-linked disorders, and it may have potential benefits in the treatment and prevention of cardiovascular disease. Caloric restriction, moderate alcohol consumption, and consuming a Mediterranean diet increase adiponectin concentrations, and current evidence suggests a positive, dose-dependent relation between ω-3 (n-3) fatty acid intake and circulating concentrations of adiponectin. Recently, it was reported that the administration of aged garlic extract and a single food intervention with pistachios can increase adiponectin concentrations in individuals with metabolic syndrome. Moreover, the Mediterranean diet is associated with higher adiponectin concentrations. Additional studies are needed to evaluate the potential benefits of increasing adiponectin by nutritional interventions in the treatment and prevention of cardiometabolic diseases.

Effects of Soy Flour Fortified Bread Consumption on Cardiovascular Risk Factors According to APOE Genotypes in Overweight and Obese Adult Women: A Cross-over Randomized Controlled Clinical Trial

Recent studies suggest that inclusion of soy product in the diet may have favorable effects on relief of cardiovascular diseases (CVDs) and risk factors. These effects might be associated with the presence of specific polymorphism in gene. The aim of this study was to examine the effects of consumption of soy flour fortified bread on cardiovascular risk factors in overweight and obese women according to APOE genotype. In a randomized cross-over clinical trial 30 overweight and obese women received a mild weight loss diet and assigned to a regular diet and a soy bread diet, each for 6 weeks and a washout period for 20 days. Subjects in the soy bread diet were asked to replace 120 grams of their daily usual bread intake with equal amount of soy bread. No significant effects of soy bread on serum lipid, systolic blood pressure and anthropometric indices were observed compared to the regular diet (p > 0.05). For diastolic blood pressure (DBP), comparison of mean differences between two groups showed a marginally significant effect of soy bread (p = 0.06). Compared to regular diet, soy bread had a significant effect on DBP in E2 genotype group (ε2/ε2) (p = 0.03). Having ε2 allele may influences responses of CVD risk factor to soy bread consumption. However more nutrigenetic studies are required.

Dietary ω-3 polyunsaturated fatty acids decrease retinal neovascularization by adipose-endoplasmic reticulum stress reduction to increase adiponectin

BACKGROUND

Retinopathy of prematurity (ROP) is a vision-threatening disease in premature infants. Serum adiponectin (APN) concentrations positively correlate with postnatal growth and gestational age, important risk factors for ROP development. Dietary ω-3 (n-3) long-chain polyunsaturated fatty acids (ω-3 LCPUFAs) suppress ROP and oxygen-induced retinopathy (OIR) in a mouse model of human ROP, but the mechanism is not fully understood.

OBJECTIVE

We examined the role of APN in ROP development and whether circulating APN concentrations are increased by dietary ω-3 LCPUFAs to mediate the protective effect in ROP.

DESIGN

Serum APN concentrations were correlated with ROP development and serum ω-3 LCPUFA concentrations in preterm infants. Mouse OIR was then used to determine whether ω-3 LCPUFA supplementation increases serum APN concentrations, which then suppress retinopathy.

RESULTS

We found that in preterm infants, low serum APN concentrations positively correlate with ROP, and serum APN concentrations positively correlate with serum ω-3 LCPUFA concentrations. In mouse OIR, serum total APN and bioactive high-molecular-weight APN concentrations are increased by ω-3 LCPUFA feed. White adipose tissue, where APN is produced and assembled in the endoplasmic reticulum, is the major source of serum APN. In mouse OIR, adipose endoplasmic reticulum stress is increased, and APN production is suppressed. ω-3 LCPUFA feed in mice increases APN production by reducing adipose endoplasmic reticulum stress markers. Dietary ω-3 LCPUFA suppression of neovascularization is reduced from 70% to 10% with APN deficiency. APN receptors localize in the retina, particularly to pathologic neovessels.

CONCLUSION

Our findings suggest that increasing APN by ω-3 LCPUFA supplementation in total parental nutrition for preterm infants may suppress ROP.

Fish oil N-3 fatty acids increase adiponectin and decrease leptin levels in patients with systemic lupus erythematosus

Cardiovascular disease (CVD) has emerged as an important cause of death in patients with systemic lupus erythematosus (SLE). Reduced adiponectin and elevated leptin levels may contribute to CVD in SLE patients. The purpose of this study was to verify the effects of fish oil (FO) on adiponectin and leptin in patients with SLE. Biochemical and disease activity analysis were performed. Patients with SLE were divided in two groups: patients who used fish oil for four months and patients who did not use fish oil. Patients with SLE who used FO had a significant decrease in SLE disease activity index (SLEDAI) score (p ˂ 0.023) in relation to baseline. SLE patients who used fish oil had increased adiponectin levels (p ˂ 0.026) and decreased leptin levels (p ˂ 0.024) compared to baseline values, whereas there were no differences in adiponectin and leptin levels in patients with SLE who did not use fish oil. In conclusion, the findings of increased serum adiponectin an decreased leptin levels after 120 days in the fish oil group, reinforce the importance of evaluating prospective studies of fish and fish oil fish ingestion on these adipokines in an attempt to decrease cardiovascular risk factors in patients with SLE.

Effect of dietary lipids on circulating adiponectin: a systematic review with meta-analysis of randomised controlled trials

Different dietary interventions have been identified as potential modifiers of adiponectin concentrations, and they may be influenced by lipid intake. We identified studies investigating the effect of dietary lipids (type/amount) on adiponectin concentrations in a systematic review with meta-analysis. A literature search was conducted until July 2013 using databases such as Medline, Embase and Scopus (MeSH terms: ‘adiponectin’, ‘dietary lipid’, ‘randomized controlled trials (RCT)’). Inclusion criteria were RCT in adults analysing adiponectin concentrations with modification of dietary lipids. Among the 4930 studies retrieved, fifty-three fulfilled the inclusion criteria and were grouped as follows: (1) total dietary lipid intake; (2) dietary/supplementary n-3 PUFA; (3) conjugated linoleic acid (CLA) supplementation; (4) other dietary lipid interventions. Diets with a low fat content in comparison to diets with a high-fat content were not associated with positive changes in adiponectin concentrations (twelve studies; pooled estimate of the difference in means: − 0·04 (95 % CI − 0·82, 0·74) μg/ml). A modest increase in adiponectin concentrations with n-3 PUFA supplementation was observed (thirteen studies; 0·27 (95 % CI 0·07, 0·47) μg/ml). Publication bias was found by using Egger's test (P= 0·01) and funnel plot asymmetry. In contrast, CLA supplementation reduced the circulating concentrations of adiponectin compared with unsaturated fat supplementation (seven studies; − 0·74 (95 % CI − 1·38, − 0·10) μg/ml). However, important sources of heterogeneity were found as revealed by the meta-regression analyses of both n-3 PUFA and CLA supplementation. Results of new RCT would be necessary to confirm these findings.

Effect of soy product kinako and fish oil on serum lipids and glucose metabolism in women with metabolic syndrome

OBJECTIVES

At the doses typically used to treat hypertriacylglycerolemia, fish oil may increase low-density lipoprotein (LDL) cholesterol and blood glucose levels. The aim of the present study was to verify whether soy could attenuate the effects of fish oil on blood lipids and carbohydrate metabolism in patients with metabolic syndrome.

METHODS

Sixty-five women (47.9 ± 9.98 y) were studied with the use of a parallel, randomized design. The control group maintained the usual diet; the second group received 29.14 g/d of soy (kinako); the third group received 3 g/d of fish oil n-3 fatty acids; and the fourth group received fish oil (3 g/d) and kinako (29.14 g/d). Assessments were performed at baseline and after 45 and 90 d.

RESULTS

In relation to baseline values, fish oil increased (P < 0.05) total and LDL cholesterol, glucose, insulin, and homeostasis model assessment of insulin resistance levels after 90 d. Comparisons among groups demonstrated a decrease (P < 0.05) in total cholesterol in the fish oil and kinako group after 90 d as compared with the fish oil group. LDL cholesterol decreased (P < 0.01) in the kinako group as compared with the fish oil group. Blood glucose and homeostasis model assessment of insulin resistance levels decreased after 90 d (P < 0.01 and P < 0.05, respectively) and insulin levels decreased (P < 0.05) after 45 d when the kinako group was compared with the fish oil group.

CONCLUSIONS

The present study showed that kinako moderates the adverse effects of high doses of fish oil on LDL cholesterol, total cholesterol, and glucose metabolism levels.

Hypertension is associated with serologically active disease in patients with systemic lupus erythematosus: role of increased Th1/Th2 ratio and oxidative stress

OBJECTIVES

To determine whether disease activity verified by laboratorial parameters is associated with a higher frequency of hypertension in patients with systemic lupus erythematosus (SLE) without renal impairment and to investigate factors that could influence this hypertension.

METHOD

This study included 102 controls, 70 patients with inactive SLE, and 53 patients with active SLE without renal impairment. We evaluated T helper type 1 (Th1)/Th2 lineage cytokines, nitric oxide (NO), insulin resistance (IR), and oxidative stress.

RESULTS

Patients with active SLE had a higher probability of developing hypertension compared to controls [odds ratio (OR) 3.833, 95% confidence interval (CI) 1.806-8.137, p < 0.0003] and patients with inactive SLE (OR 2.215, 95% CI 1.032-4.752, p = 0.0394). Active SLE patients had a higher interleukin (IL)-12/IL-4 ratio (p < 0.05) than both controls and inactive SLE patients. Protein oxidation was significantly higher in patients with active SLE than in the control group and in patients with inactive SLE (p < 0.01 and p < 0.05, respectively). Multivariate analysis revealed an association between the presence of hypertension and he levels of glucose (p = 0.0276), insulin (p = 0.0498), hydroperoxides (p = 0.0221), IFN-γ (p = 0.0494), IL-17 (p = 0.0272), IL-12/IL-10 (p = 0.0373), IFN-γ/IL-10 (p = 0.0142), IFN-γ/IL-4 (p = 0.0320), and adiponectin (p = 0.0433).

CONCLUSIONS

Patients with active SLE without renal impairment had an increased frequency of high blood pressure (43.4%) compared with patients with inactive SLE (25.7%) and controls (16.7%). Hypertension was associated with serologically active disease and was influenced by an increased Th1/Th2 ratio and oxidative stress.

Reduced-energy cranberry juice increases folic acid and adiponectin and reduces homocysteine and oxidative stress in patients with the metabolic syndrome

The metabolic syndrome (MetS) comprises pathological conditions that include insulin resistance, arterial hypertension, visceral adiposity and dyslipidaemia, which favour the development of CVD. Some reports have shown that cranberry ingestion reduces cardiovascular risk factors. However, few studies have evaluated the effect of this fruit in subjects with the MetS. The objective of the present study was to assess the effect of reduced-energy cranberry juice consumption on metabolic and inflammatory biomarkers in patients with the MetS, and to verify the effects of cranberry juice concomitantly on homocysteine and adiponectin levels in patients with the MetS. For this purpose, fifty-six individuals with the MetS were selected and divided into two groups: control group (n36) and cranberry-treated group (n20). After consuming reduced-energy cranberry juice (0·7 litres/d) containing 0·4 mg folic acid for 60 d, the cranberry-treated group showed an increase in adiponectin (P= 0·010) and folic acid (P= 0·033) and a decrease in homocysteine (P< 0·001) in relation to baseline values and also in comparison with the controls (P< 0·05). There was no significant change in the pro-inflammatory cytokines TNF-α, IL-1 and IL-6. In relation to oxidative stress measurements, decreased (P< 0·05) lipoperoxidation and protein oxidation levels assessed by advanced oxidation protein products were found in the cranberry-treated group when compared with the control group. In conclusion, the consumption of cranberry juice for 60 d was able to improve some cardiovascular risk factors. The present data reinforce the importance of the inverse association between homocysteine and adiponectin and the need for more specifically designed studies on MetS patients.