β-glucan from barley and its lipid-lowering capacity: a meta-analysis of randomized, controlled trials

β-Glucan content and in vitro bile-acid binding capacity of Agaricus bisporus and Pleurotus spp

The cholesterol lowering properties of oats and barley, attributed to their high β-glucan content, are well established, but it remains unclear whether mushrooms, also rich in β-glucan, exhibit a similar functionality. We aimed to quantify the β-glucan content of commonly consumed Australian mushrooms and evaluated their bile acid binding capacity, the primary cholesterol lowering mechanism of β-glucan. Raw, boiled and fried Australian grown Agaricus bisporus (button, cup, flat and brown mushrooms) and Pleurotus spp. (shimeji and oyster) along with oats were freeze-dried and the β-glucan content was determined. The bile acid binding capacity of these samples was assessed using an in vitro digestion assay. The β-glucan content of freeze-dried raw A. bisporus mushrooms (4.5-8.1 g per 100 g) was similar to that of oats (7.6 g per 100 g, all p > 0.05), whereas Pleurotus mushrooms contained ∼5 times more β-glucan (32.5-37.4 g, p < 0.05). Boiling increased the β-glucan content of oyster, button, flat and brown mushrooms by 3-7% (p < 0.05), but did not affect the β-glucan content of shimeji or cup mushrooms. Frying had no effect on any mushroom type. The bile acid binding capacity of A. bisporus mushrooms (29-36%) was equivalent to that of raw oats (36%, p > 0.05), whereas the bile acid binding capacity of oyster mushrooms (22%) was lower than that of oats (p < 0.05). Both boiling and frying increased the bile acid binding capacity. The cholesterol lowering effects of A. bisporus mushrooms and the acceptability of consumption at the required levels need to be confirmed by clinical trials.

Regulatory effect of β-glucan secreted by Rhizobium pusense on triglyceride metabolism and their relationships with the modulation of intestinal microbiota in mice fed a high-fat diet

The present study investigated the regulatory effects of β-glucan secreted by Rhizobium pusense (RPG) on triglyceride metabolism and gut microbiota in mice fed a high-fat diet. The results indicated that supplementation with RPG significantly reduced body weight gain, blood glucose levels, and the tissue index of epididymal white adipose tissue (eWAT) and subcutaneous adipose tissue (SAT). Conversely, it increased the tissue index of brown adipose tissue (BAT). Furthermore, RPG supplementation effectively decreased the levels of total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) in the serum. Regarding its influence on the triglyceride (TG) mechanism, RPG decreased TG levels in both serum and liver, while elevating TG levels in feces. Moreover, it moderated the composition of gut microbiota in mice fed a high-fat diet, particularly altering functionally relevant intestinal microbial phylotypes, leading to enhanced levels of short-chain fatty acids (SCFAs) in feces. Additionally, RPG treatment regulated the mRNA and protein levels of genes responsible for TG metabolism in the AMPK pathway, indicating an impact on TG synthesis and excretion in the liver. Pearson's correlation network analysis demonstrated strong correlations between key microbial phylotypes responsive to RPG intervention and parameters associated with TG metabolic disorders. SCFA levels were also found to correlate with the mRNA expression levels of genes involved in TG metabolism. Finally, lipidomics analyses were performed to investigate the underlying mechanisms of RPG intervention (glycerophospholipid metabolic pathway) and to identify potential lipid biomarkers, such as TG (18:2/20:4/22:6), TG (18:1/20:4/22:6), TG (20:1/18:1/22:4), PC (17:0/20:4), TG (18:1/20:4/22:5), PC (22:4/22:6), PC (20:0/22:6), PC (20:0e/20:4), DG (18:3e/18:2), DG (10:0/18:2), DG (18:2/14:2), TG (10:0/18:2/20:4), TG (16:1/14:3/18:2) and TG (16:0/14:2/22:6). Overall, our results suggest that RPG could activate the hepatic AMPK signaling pathway by regulating gut microbiota and metabolites through gut-liver crosstalk to exert a lipid-lowering effect in mice fed a high-fat diet and improve obesity.

Exploring the cholesterol-lowering effects of cereal bran cell wall-enriched diets

Cell wall polysaccharides (dietary fiber) in cereal grains contribute to health benefits. The novelty of the current study was an effort to explore the in vivo therapeutic potential of different cereal bran cell walls against hypercholesterolemia. For this purpose, the cell walls were isolated from different cereal brans (wheat, maize, oats, and barley), and the intake of these cereal bran cell walls was evaluated for their anti-lipidemic activity in normal and hypercholesterolemic rats. The serum taken from the rats was tested for cholesterol, lipid, and triglyceride profiles before and after treatment. The outcomes of the current study have shown that the cereal cell wall has a significant hypercholesterolemia effect. The biochemical parameters of the control animals were within the normal clinical ranges, indicating that the experimental diets were safe. Among cereal bran cell walls, barley bran significantly decreased cholesterol (56.35 ± 1.35 mg/dL), low-density lipoprotein (56.35 ± 1.05 mg/dL), triglycerides (105.29 ± 1.95 mg/dL), and increased high-density lipoprotein level (48.35 ± 1.35 mg/dL). These findings provide conclusive evidence that the cereal cell wall is beneficial in the treatment of hypercholesterolemia and may potentially provide protection against other acute, recurring, or chronic illnesses.

The effects of cereal β-glucans on cardiovascular risk factors and the role of the gut microbiome

The human gut microbiome has emerged as a key influencer of human health and disease, particularly through interactions with dietary fiber. However, national dietary guidelines worldwide are only beginning to capitalize on the potential of microbiome research, which has established the vital role of host-microbe interactions in mediating the physiological effects of diet on overall health and disease. β-glucans have been demonstrated to modulate the composition of the gut microbiota, leading to improved outcomes in cardiovascular disease (CVD). Raised serum cholesterol and blood pressure are important modifiable risk factors in the development of CVD and emerging evidence highlights the role of the gut microbiota in ameliorating such biomarkers and clinical characteristics of the disease. The proposed mechanism of action of β-glucans on the pathophysiological mechanisms of disease have yet to be elucidated. Validating gaps in the literature may substantiate β-glucans as a potential novel dietary therapy against modifiable risk factors for CVD and would further support the public health significance of including a habitual fiber-rich diet.

Tremella fuciformis beverage improves glycated hemoglobin A1c and waist circumference in overweight/obese prediabetic subjects: a randomized controlled trial

BACKGROUND

Prediabetes is increasing worldwide. Previous studies have demonstrated the potential of β-glucan derived from oat or barley to lower blood glucose, body weight, and plasma lipid levels. These findings offer a potentially attractive strategy for reducing the risk of diabetes in prediabetic individuals. However, the effects of β-glucan from Tremella fuciformis on glucose metabolism and anthropometric measurements in humans have yet to be studied. We hypothesized that β-glucan from Tremella fuciformis may improve metabolic parameters in subjects with prediabetes. This study aimed to investigate the effects of a once-daily beverage containing Tremella fuciformis (snow mushroom) on anthropometric measurements, metabolic biomarkers, and insulin sensitivity in overweight/obese subjects with prediabetes.

METHODS

In this double-blind RCT, 56 participants were randomly assigned to receive either a Tremella fuciformis beverage or placebo daily for 12 weeks. All parameters were assessed at baseline and after the intervention.

RESULTS

After 12 weeks, participants in the intervention group exhibited significant improvements in glycated hemoglobin A1c (HbA1C; 6.03 ± 0.26% at baseline vs. 5.96 ± 0.25% at 12 weeks, p = 0.047, Cohen's d = 0.39) and waist circumference (95.2 ± 12.51 cm at baseline vs. 93.46 ± 11.48 cm at 12 weeks, p = 0.022, Cohen's d = 0.45). There were no adverse events reported.

CONCLUSION

This exploratory study demonstrated that Tremella fuciformis beverage consumption may improve HbA1C and waist circumference in overweight/obese prediabetic individuals. Further research, including larger-scale RCTs and mechanistic studies, is needed to confirm these findings and optimize the therapeutic potential of Tremella fuciformis derivatives in managing prediabetes and preventing type 2 diabetes.

TRIAL REGISTRATION

Registered in Thai Clinical Trials Registry (14/07/2021, TCTR20210714004).

Causal relationship of cereal intake and type with cardiovascular disease: a Mendelian randomization study

Background

Observational studies have suggested that cereal consumption is associated with a reduced risk of cardiovascular disease (CVD). However, the potential causal relationship is not clear. We aimed to investigate the association of cereal intake and cereal type with CVD risk.

Methods

Two-step Mendelian randomization (MR) analysis was performed to confirm the causal association of cereal intake and cereal type with the risk of several common CVDs. Furthermore, two-step MR analysis was used to explore the mediating effect of cardiovascular metabolic factors, and multivariable MR analysis was used to assess the impact of socioeconomic status, such as education and income, on the causal association.

Results

The MR analysis indicated that genetically predicted cereal intake is associated with reduced risk of large artery stroke (LAS) (odd ratio (OR): 0.421; 95% confidence interval (CI) [0.193, 0.918]; p = 0.030), and muesli as the primary cereal intake is associated with reduced risk of coronary heart disease (CHD) (OR: 0.100; 95% CI [0.023, 0.437]; p = 0.002), myocardial infarction (MI) (OR: 0.101; 95% CI [0.020, 0.509]; p = 0.005), heart failure (OR: 0.210; 95% CI [0.064, 0.684]; p = 0.010), ischemic stroke (IS) (OR: 0.130; 95% CI [0.029, 0.591]; p = 0.008), LAS (OR: 0.017; 95% CI [0.0004, 0.737]; p = 0.034), and small-vessel stroke (OR: 0.021; 95% CI [0.001, 0.708]; p = 0.005). In contrast, genetically predicted biscuits as the primary cereal intake increased the risk of CHD (OR: 6.557; 95% CI [1.197, 36.031]; p = 0.031), and other cereals, such as cornflakes, as the primary cereal intake increased the risk of CHD (OR: 3.803; 95% CI [1.194, 12.111]; p = 0.024), MI (OR: 4.240; 95% CI [1.185, 15.174]; p = 0.026), stroke (OR: 3.154; 95% CI [1.070, 9.298]; p = 0.037), and IS (OR: 3.736; 95% CI [1.185, 11.782]; p = 0.024). Multivariable MR analysis underscored the significant role of education and income in the causal association, and two-step MR analysis indicated that body mass index, lipids, and blood glucose exerted important mediating effects in the causal association.

Conclusion

The findings of our study underscore the causal beneficial influence of muesli as the primary cereal intake on CVDs. A reasonable consumption of muesli may provide primary prevention of CVDs.

Metabolomics reveals the effects of Lactiplantibacillus plantarum dy-1 fermentation on the lipid-lowering capacity of barley β-glucans in an in vitro model of gut-liver axis

Bioactive polysaccharides known as the biological response modifiers, can directly interact with intestinal epithelium cells (IEC) and regulate key metabolic processes such as lipid metabolism. Here, the coculture of Caco-2/HT29 monolayer (>400 Ω × cm2) and HepG2 cells was developed to mimic the gut-liver interactions. This system was used to investigate the effects of raw and fermented barley β-glucans (RBG and FBG) on lipid metabolism by directly interacting with IEC. Both RBG and FBG significantly and consistently reduced the lipid droplets and triacylglycerol levels in monoculture and coculture of HepG2 overloaded with oleic acid. Notably, FBG significantly and distinctly elevated PPARα (p < 0.05) and PPARα-responsive ACOX-1 (p < 0.01) gene expressions, promoting lipid degradation in cocultured HepG2. Moreover, the metabolomics analyses revealed that FBG had a unique impact on extracellular metabolites, among them, the differential metabolite thiomorpholine 3-carboxylate was significantly and strongly correlated with PPARα (r = -0.68, p < 0.01) and ACOX-1 (r = -0.76, p < 0.01) expression levels. Taken together, our findings suggest that FBG-mediated gut-liver interactions play a key role in its lipid-lowering effects that are superior to those of RBG. These results support the application of Lactiplantibacillus fermentation for improving hypolipidemic outcomes.

Healthy regulation of Tibetan Brassica rapa L. polysaccharides on alleviating hyperlipidemia: A rodent study

Hyperlipidemia is a common metabolic disorder, which can lead to obesity, hypertension, diabetes, atherosclerosis and other diseases. Studies have shown that polysaccharides absorbed by the intestinal tract can regulate blood lipids and facilitate the growth of intestinal flora. This article aims to investigate whether Tibetan turnip polysaccharide (TTP) plays a protective role in blood lipid and intestinal health via hepatic and intestinal axes. Here we show that TTP helps to reduce the size of adipocytes and the accumulation of liver fat, playing a dose-dependent effect on ADPN levels, suggesting an effect on lipid metabolism regulation. Meantime, TTP intervention results in the downregulation of intercellular cell adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1) and serum inflammatory factors (interleukin-6 (IL-6), interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α)), implying that TTP suppresses the progression of inflammation in the body. The expression of key enzymes associated with cholesterol and triglyceride synthesis, such as 3-hydroxy-3-methylglutaryl coenzyme A reductase (HMGCR), cholesterol 7α-hydroxylase (CYP7A1), peroxisome proliferator-activated receptors γ (PPARγ), acetyl-CoA carboxylase (ACC), fatty acid synthetase (FAS) and sterol-regulatory element binding proteins-1c (SREBP-1c), can be modulated by TTP. Furthermore, TTP also alleviates the damage to intestinal tissues caused by high-fat diet, restores the integrity of the intestinal barrier, improves the composition and abundance of the intestinal flora and increases the levels of SCFAs. This study provides a theoretical basis for the regulation of body rhythm by functional foods and potential intervention in patients with hyperlipidemia.

Whole grain consumption and risk of radiographic knee osteoarthritis: a prospective study from the Osteoarthritis Initiative

OBJECTIVES

To assess the association of whole grain consumption with the risk of incident knee OA.

MATERIAL AND METHODS

We followed 2846 participants in the Osteoarthritis Initiative ages 45-79 years. Participants were free from radiographic knee OA (Kellgren-Lawrence grade <2) in at least one knee at baseline. Dietary data from baseline were obtained using the Block Brief Food Frequency Questionnaire. We defined radiographic knee OA incidence as a Kellgren-Lawrence grade ≥2 during the subsequent 96 months. Cox proportional hazards models were used to assess the association between whole grain food intake and the risk of incident knee OA.

RESULTS

During the 96 month follow-up, 518 participants (691 knees) developed incident radiographic knee OA. Higher total whole grain consumption was significantly associated with a lower knee OA risk [hazard ratio (HR)quartile 4vs1 = 0.66 (95% CI 0.52, 0.84), P for trend < 0.01] after adjusting for demographic and socio-economic factors, clinical factors and other dietary factors related to OA. Consistently, a significant inverse association of dark bread consumption with knee OA risk was observed [HRquartile 4vs1 = 0.68 (95% CI 0.53, 0.87), P for trend < 0.01). In addition, we observed a significant inverse association between higher cereal fibre intake and reduced knee OA risk [HRquartile 4vs1 = 0.61 (95% CI 0.46, 0.81), P for trend < 0.01).

CONCLUSIONS

Our findings revealed a significant inverse association of whole grain consumption with knee OA risk. These findings provide evidence that eating a diet rich in whole grains may be a potential nutritional strategy to prevent knee OA.

Modulation of Postprandial Plasma Concentrations of Digestive Hormones and Gut Microbiota by Foods Containing Oat ß-Glucans in Healthy Volunteers

Cereal β-glucans are beneficial health ingredients that reduce cholesterolemia and postprandial glycaemia. However, their impact on digestive hormones and gut microbiota is not yet fully established. Two randomized, double-blind, controlled studies were conducted. In the first study, 14 subjects ingested a breakfast with or without β-glucan from oats (5.2 g). Compared to the control, β-glucan increased orocecal transit time (p = 0.028) and decreased mean appetite score (p = 0.014) and postprandial plasma ghrelin (p = 0.030), C-peptide (p = 0.001), insulin (p = 0.06), and glucose (p = 0.0006). β-glucan increased plasma GIP (p = 0.035) and PP (p = 0.018) without affecting leptin, GLP-1, PYY, glucagon, amylin, or 7α-hydroxy-4-cholesten-3-one, a biomarker of bile acid synthesis. In the second study, 32 subjects were distributed into 2 groups to ingest daily foods with (3 g/day) or without β-glucan for 3 weeks; stools were collected before/after treatment. No changes in fecal microbiota composition/diversity (deep sequencing) were detected with β-glucans. These results indicate that acute intake of 5 g β-glucan slows transit time and decreases hunger sensation and postprandial glycaemia without affecting bile-acid synthesis, these changes being associated with decreased plasma insulin, C-peptide, and ghrelin, and increased plasma GIP and PP. However, regular daily intake of 3 g β-glucan is not sufficient to have an effect on fecal microbiota composition.

Effect of a regular consumption of traditional and roasted oat and barley flakes on blood lipids and glucose metabolism-A randomized crossover trial

Background

Regular consumption of the soluble dietary fiber β-glucan is associated with decreased total cholesterol (TC), low-density lipoprotein (LDL) cholesterol and blood glucose. Barley and oat flakes as natural sources of β-glucan were roasted to improve sensory quality. The aim of this study was to investigate whether roasting of barley and oat flakes changes the physiological impact of the β-glucan-rich flakes on glucose and lipid metabolism.

Method

A five-armed randomized crossover trial design was used. The intervention study was conducted from May 2018 to May 2019 and included 32 healthy subjects with moderately increased LDL cholesterol (≥2.5 mmol/L). During the 3-week intervention periods, 80 g of roasted or traditional barley or oat flakes, or four slices of white toast bread per day were consumed for breakfast. At the start and the end of each intervention, fasting and postprandial blood was taken. The intervention periods were separated by 3-week wash-out periods.

Results

During the interventions with the cereal flakes, TC and LDL cholesterol concentrations were significantly reduced compared to baseline values by mean differences of 0.27-0.33 mmol/L and 0.21-0.30 mmol/L, respectively (p < 0.05), while high-density lipoprotein (HDL) cholesterol was only reduced after the intervention with barley flakes (p < 0.05). After the intervention period with toast, TC and HDL cholesterol increased (p < 0.05). The fasting levels of triglycerides, fasting blood glucose and insulin did not change in any group. The effects of traditional and roasted varieties on blood lipids did not differ between the groups.

Conclusion

The regular consumption of traditional or roasted barley and oat flakes contributes to the management of cardiovascular diseases by improving TC and LDL cholesterol.

Clinical trial registration

https://clinicaltrials.gov/ct2/show/NCT03648112, identifier NCT03648112.

Associations between dietary fiber intake and cardiovascular risk factors: An umbrella review of meta-analyses of randomized controlled trials

Although several meta-analyses have revealed the beneficial effects of dietary fiber intake on human health, some have reported inconsistent findings. The purpose of this work was to perform an umbrella meta-analysis to evaluate the relevant evidence and elucidate the effect of dietary fiber intake on glycemic control, lipid profiles, systematic inflammation, and blood pressure. Eligible studies were searched in several electronic databases, including Web of Science, PubMed, Scopus, and the Cochrane Library, up to March 2022. A total of 52 meta-analyses involving 47,197 subjects were identified to assess the pooled effect size. Overall, higher dietary fiber intake was significantly associated with reductions in parameters involving glycemic control, including fasting plasma glucose (ES = -0.55, 95% CI: -0.73, -0.38, P < 0.001), fasting plasma insulin (ES = -1.22, 95% CI: -1.63, -0.82, P < 0.001), homeostasis model assessment of insulin resistance (HOMA-IR) (ES = -0.43, 95% CI: -0.60, -0.27, P < 0.001), and glycosylated hemoglobin (HbA1c) (ES = -0.38, 95% CI: -0.50, -0.26, P < 0.001). In terms of lipid profiles, higher dietary fiber intake was associated with significant reductions in the serum level of total cholesterol (ES = -0.28, 95% CI: -0.39, -0.16, P < 0.001) and low-density lipoprotein cholesterol (ES = -0.25, 95% CI: -0.34, -0.16, P < 0.001), but not triglycerides (ES = -0.001, 95% CI: -0.006, 0.004, P = 0.759) and high-density lipoprotein cholesterol (ES = -0.002, 95% CI: -0.004, 0.000, P = 0.087). Higher dietary fiber intake was also significantly associated with improved tumor necrosis factor-alpha serum levels (ES = -0.78, 95% CI: -1.39, -0.16, P = 0.013), while no significant effect was observed for C-reactive protein (ES = -0.14, 95% CI: -0.33, 0.05, P = 0.156). Finally, blood pressure was also significantly improved following higher dietary fiber intake (systolic blood pressure: ES = -1.72, 95% CI: -2.13, -1.30, P < 0.001; diastolic blood pressure: ES = -0.67, 95% CI: -0.96, -0.37, P < 0.001). Subgroup analysis revealed that the study population and type of dietary fiber could be partial sources of heterogeneity. In conclusion, the present umbrella meta-analysis provides evidence for the role of dietary fiber supplementation in the improvement of established cardiovascular risk factors.

A Three-Day Intervention With Granola Containing Cereal Beta-Glucan Improves Glycemic Response and Changes the Gut Microbiota in Healthy Individuals: A Crossover Study

Intake of soluble fibers including beta-glucan, is known to improve post-prandial glycemic response. The mechanisms have been attributed to the viscous gel forming in the stomach and small intestine, giving a longer absorption time. However, recent evidence suggests a link between intake of beta-glucan and improved glycemic regulation at subsequent meals through the gut microbiota. We investigated the short-term effect of granola with different amounts of cereal beta-glucan on glycemic response and gut microbiota. After a two-week run-in period (baseline), fourteen healthy, normal weight adults completed a dose-response dietary crossover study. Different amounts of cereal beta-glucan (low: 0.8 g, medium: 3.2 g and high: 6.6 g) were provided in granola and eaten with 200 ml low-fat milk as an evening meal for three consecutive days. Blood glucose and insulin were measured fasted and after an oral glucose tolerance test (OGTT) the following day, in addition to peptide YY (PYY) and glucagon-like peptide (GLP-2), fasting short chain fatty acids (SCFA) in blood, breath H2, and gut microbiota in feces. Only the intervention with medium amounts of beta-glucan decreased blood glucose and insulin during OGTT compared to baseline. Fasting PYY increased with both medium and high beta-glucan meal compared to the low beta-glucan meal. The microbiota and SCFAs changed after all three interventions compared to baseline, where acetate and butyrate increased, while propionate was unchanged. Highest positive effect size after intake of beta-glucan was found with Haemophilus, followed by Veillonella and Sutterella. Furthermore, we found several correlations between different bacterial taxa and markers of glycemic response. In summary, intake of granola containing 3.2 g cereal beta-glucan as an evening meal for three consecutive days reduced the glycemic response after an OGTT 0-180 min and changed gut microbiota composition. Since we cannot rule out that other fiber types have contributed to the effect, more studies are needed to further explore the effect of cereal beta-glucan on glycemic regulation.

Clinical Trial Registration

[www.clinicaltrials.gov], identifier [NCT03293693].

Highland barley Monascus purpureus Went extract ameliorates high-fat, high-fructose, high-cholesterol diet induced nonalcoholic fatty liver disease by regulating lipid metabolism in golden hamsters

ETHNOPHARMACOLOGICAL RELEVANCE

Hepatocyte lipid accumulation is the main feature in the early stage of nonalcoholic fatty liver disease (NAFLD). Highland barley Monascus purpureus Went (HBMPW), a fermentation product of Hordeum vulgare Linn. var. nudum Hook. f. has traditionally been used as fermented foods in Tibet with the effect of reducing blood lipid in folk medicine.

AIM OF THE STUDY

This study investigated the protective effects and molecular mechanism of highland barley Monascus purpureus Went extract (HBMPWE) on NAFLD in syrian golden hamster fed with high-fat, high-fructose, high-cholesterol diet (HFFCD).

MATERIALS AND METHODS

HFFCD-induced NAFLD golden hamster model was established and treated with HBMPWE. Liver index, biochemical index, and hematoxylin and eosin (HE) staining were observed. Liver metabolomics and western blot analysis were employed.

RESULTS

Our study found that HBMPWE ameliorated HFFCD induced dyslipidemia, weight gain and elevated the liver index. In addition, HBMPWE treatment significantly attenuated lipid accumulation in the liver and modulated lipid metabolism (sphingolipid, glycerophospholipid). Our data demonstrated that HBMPWE not only regulated the expression of proteins related to fatty acid synthesis and decomposition (SREBP-1/ACC/FAS/AceS1, PPARα/ACSL/CPT1/ACOX1), but also regulated the expression of proteins related to cholesterol synthesis and clearance (HMGCR, LDLR, CYP7A1).

CONCLUSIONS

HBMPWE improved NAFLD through multiple pathways and multiple targets in body metabolism and could be used as a functional food to treat NAFLD and other lipid metabolic disorders.

Classification of the Occurrence of Dyslipidemia Based on Gut Bacteria Related to Barley Intake

Barley is a grain rich in β-glucan, a soluble dietary fiber, and its consumption can help maintain good health and reduce the risk of metabolic disorders, such as dyslipidemia. However, the effect of barley intake on the risk of dyslipidemia has been found to vary among individuals. Differences in gut bacteria among individuals may be a determining factor since dietary fiber is metabolized by gut bacteria and then converted into short-chain fatty acids with physiological functions that reduce the risk of dyslipidemia. This study examined whether gut bacteria explained individual differences in the effects of barley intake on dyslipidemia using data from a cross-sectional study. In this study, participants with high barley intake and no dyslipidemia were labeled as “responders” to the reduced risk of dyslipidemia based on their barley intake and their gut bacteria. The results of the 16S rRNA gene sequencing showed that the fecal samples of responders (n = 22) were richer in Bifidobacterium, Faecalibacterium, Ruminococcus 1, Subdoligranulum, Ruminococcaceae UCG-013, and Lachnospira than those of non-responders (n = 43), who had high barley intake but symptoms of dyslipidemia. These results indicate the presence of certain gut bacteria that define barley responders. Therefore, we attempted to generate a gut bacteria-based responder classification model through machine learning using random forest. The area under the curve value of the classification model in estimating the effect of barley on the occurrence of dyslipidemia in the host was 0.792 and the Matthews correlation coefficient was 0.56. Our findings connect gut bacteria to individual differences in the effects of barley on lipid metabolism, which could assist in developing personalized dietary strategies.

Functional analysis of co-expression networks of zebrafish ace2 reveals enrichment of pathways associated with development and disease

Human Angiotensin I Converting Enzyme 2 (ACE2) plays an essential role in blood pressure regulation and SARS-CoV-2 entry. ACE2 has a highly conserved, one-to-one ortholog (ace2) in zebrafish, which is an important model for human diseases. However, the zebrafish ace2 expression profile has not yet been studied during early development, between genders, across different genotypes, or in disease. Moreover, a network-based meta-analysis for the extraction of functionally enriched pathways associated with differential ace2 expression is lacking in the literature. Herein, we first identified significant development-, tissue-, genotype-, and gender-specific modulations in ace2 expression via meta-analysis of zebrafish Affymetrix transcriptomics datasets (n_datasets = 107); and the correlation analysis of ace2 meta-differential expression profile revealed distinct positively and negatively correlated local functionally enriched gene networks. Moreover, we demonstrated that ace2 expression was significantly modulated under different physiological and pathological conditions related to development, tissue, gender, diet, infection, and inflammation using additional RNA-seq datasets. Our findings implicate a novel translational role for zebrafish ace2 in organ differentiation and pathologies observed in the intestines and liver.

Whole-Grain Intake in the Mediterranean Diet and a Low Protein to Carbohydrates Ratio Can Help to Reduce Mortality from Cardiovascular Disease, Slow Down the Progression of Aging, and to Improve Lifespan: A Review

Increase in the aging population is a phenomenon all over the world. Maintaining good functional ability, good mental health, and cognitive function in the absence of severe disease and physical disability define successful aging. A healthy lifestyle in middle age predisposes successful aging. Longevity is the result of a multifactorial phenomenon, which involves feeding. Diets that emphasize fruit and vegetables, whole grains rather than refined grains, low-fat dairy, lean meats, fish, legumes, and nuts are inversely associated with mortality or to a lower risk of becoming frail among elderly subjects. A regular physical activity and a regular intake of whole grain derivatives together with the optimization of the protein/carbohydrate ratio in the diet, where the ratio is significantly less than 1 such as in the Mediterranean diet and the Okinawan diet, reduces the risk of developing aging-related diseases and increases healthy life expectancy. The purpose of our review was to analyze cohort and case-control studies that investigated the effects of cereals in the diet, especially whole grains and derivatives as well as the effects of a diet with a low protein-carbohydrate ratio on the progression of aging, mortality, and lifespan.

The role of biofactors in the prevention and treatment of age-related diseases

The present demographic changes toward an aging society caused a rise in the number of senior citizens and the incidence and burden of age-related diseases (such as cardiovascular diseases [CVD], cancer, nonalcoholic fatty liver disease [NAFLD], diabetes mellitus, and dementia), of which nearly half is attributable to the population ≥60 years of age. Deficiencies in individual nutrients have been associated with increased risks for age-related diseases and high intakes and/or blood concentrations with risk reduction. Nutrition in general and the dietary intake of essential and nonessential biofactors is a major determinant of human health, the risk to develop age-related diseases, and ultimately of mortality in the older population. These biofactors can be a cost-effective strategy to prevent or, in some cases, even treat age-related diseases. Examples reviewed herein include omega-3 fatty acids and dietary fiber for the prevention of CVD, α-tocopherol (vitamin E) for the treatment of biopsy-proven nonalcoholic steatohepatitis, vitamin D for the prevention of neurodegenerative diseases, thiamine and α-lipoic acid for the treatment of diabetic neuropathy, and the role of folate in cancer epigenetics. This list of potentially helpful biofactors in the prevention and treatment of age-related diseases, however, is not exhaustive and many more examples exist. Furthermore, since there is currently no generally accepted definition of the term biofactors, we here propose a definition that, when adopted by scientists, will enable a harmonization and consistent use of the term in the scientific literature.

Dietary Fiber: An Opportunity for a Global Control of Hyperlipidemia

Dietary fiber has a long history in the intervention study of hyperlipidemia. In this review, current understandings of structures, sources, and natures of various kinds of dietary fibers (DFs) were analyzed first. Available evidences for the use of different varieties of DFs in the lipid-lowering action both in vitro and in vivo were subsequently classified, including both soluble ones, such as glucans, pectins, and gums, and insoluble ones, including arabinooxylans and chitosans, in order to draw a primary conclusion of their dose and molecular weight relationship with lipid-lowering effect. Their potential mechanisms, especially the related molecular mechanism of protective action in the treatment and prevention of hyperlipidemia, were summarized at last. Five major mechanisms are believed to be responsible for the antihyperlipidemic benefits of DFs, including low levels of energy, bulking effect, viscosity, binding capacity, and fermentation thus ameliorating the symptoms of hyperlipidemia. From the molecular level, DFs could possibly affect the activities of HMG-CoA reductase, LDL receptors, CYP7A1, and MAPK signaling pathway as well as other lipid metabolism-related target genes. In summary, dietary fibers could be used as alternative supplements to exert certain lipid-lowering effects on humans. However, more clinical evidence is needed to strengthen this proposal and its fully underlying mechanism still requires more investigation.

Depletion and bridging flocculation of oil droplets in the presence of β-glucan, arabinoxylan and pectin polymers: Effects on lipolysis

The aim of this study was to investigate the influence of food polysaccharides from different sources on microstructural and rheological properties, and in vitro lipolysis of oil-in-water emulsions of canola oil stabilised by whey protein isolate. The polysaccharides used were β-glucan (BG) from oat, arabinoxylan (AX) from wheat, and pectin (PTN) from apple. All polysaccharides added at 1 % w/v increased the viscosity of emulsions and promoted flocculation but with different mechanisms, BG and AX by depletion flocculation and PTN by bridging flocculation. Depletion flocculation was associated with an increase in viscosity of BG or AX-stabilised emulsions compared with BG/AX alone, whereas bridging flocculation with PTN caused a decrease in viscosity. All three polysaccharides reduced lipid digestion rate and extent, but the bridging flocculation induced by PTN had the greatest effect. This study has implications for better understanding the influence of carbohydrate polymers from cereals and fruits on lipid digestibility.

High β-Glucan Barley Supplementation Improves Glucose Tolerance by Increasing GLP-1 Secretion in Diet-Induced Obesity Mice

The aim of this study was to investigate the underlying mechanism for the improvement of glucose tolerance following intake of high β-glucan barley (HGB) in terms of intestinal metabolism. C57BL/6J male mice were fed a fatty diet supplemented with HGB corresponding to 5% of dietary fiber for 83 days. An oral glucose tolerance test was performed at the end of the experimental period. The concentration of short-chain fatty acids (SCFAs) in the cecum was analyzed by GC–MS (gas chromatography–mass spectrometry). The mRNA expression levels related to L cell function in the ileum were measured by real-time PCR. Glucagon-like peptide-1 (GLP-1) levels in the portal vein and cecal content were assessed by enzyme-linked immunosorbent assay. GLP-1-producing L cells of the ileum were quantified by immunohistochemistry. HGB intake improved glucose tolerance and increased the cecal levels of SCFAs, acetate, and propionate. The number of GLP-1-positive L cells in the HGB group was significantly higher than in the control group. GLP-1 levels in the portal vein and cecal GLP-1 pool size in the HGB group were significantly higher than the control group. In conclusion, we report improved glucose tolerance after HGB intake induced by an increase in L cell number and subsequent rise in GLP-1 secretion.

Emerging science on benefits of whole grain oat and barley and their soluble dietary fibers for heart health, glycemic response, and gut microbiota

The aim of this work is to review the major mechanisms by which consumption of whole grain oats and barley, and β-glucans, reduces the risk of coronary heart disease, type 2 diabetes, and other noncommunicable chronic conditions. These effects have been predominantly explained by the role of soluble dietary fibers and smaller bioactive compounds, such as phenolic compounds, in oats and barley. These help to reduce the level of serum low-density lipoprotein cholesterol, decreasing postprandial blood glucose and modulating gut microbiota. In the present review, the role of viscosity development of the intestinal content by β-glucans in these mechanisms is discussed, as well as the impact of processing conditions altering the composition or the physicochemical characteristics of β-glucans.

Effect of thermally treated barley dietary fiber against hypercholesterolemia

Dietary fiber is a nondigestible constituent of vegetal foods, formed by insoluble and soluble dietary fiber. The intake of dietary fiber, especially soluble dietary fiber, is limited and demands researcher's attention. The modification of cereal's dietary fiber, predominantly insoluble fiber, could be one possible solution. The current study evaluated the comparative effects of several thermal treatments on the modification of insoluble dietary fiber in barley and explored their therapeutic potential in vivo against hypercholesterolemia. The two cultivars of barley, Haider-93 and Jau-87, were thermally treated using different techniques, and dietary fiber was extracted. Successively, the intake of these dietary fibers was evaluated for its antilipidemic activity in normal and hypercholesterolemic rats. In the first phase, thermal treatments especially cooking without soaking increased the soluble fiber (68.08%). The roasting all increased the soluble fiber contents, however, at relatively lower rate (53.91%). The results of efficacy study revealed that biochemical parameters in control animals were within the normal clinical ranges, thus appraising the safe status of the experimental diets. The thermally treated barley fiber decreased total cholesterol (12.14%-12.63%), low-density lipoprotein (14.12%-14.85%), and triglycerides (2.25%-4.32%). The study recorded increasing trends for high-density lipoprotein in both normal and hypercholesterolemic rats. In the nutshell, thermal modification of dietary fiber increased the ratio of soluble to insoluble dietary fiber that improved its hypocholesterolemic potential. The thermally treated barley dietary fiber is effective in reducing the lipid profile in Sprague-dawley rats than untreated dietary fiber and, therefore, can be considered as a functional food and ingredient to cope different lifestyle diseases.

Effect of Lactobacillus plantarum fermented barley on plasma glycolipids and insulin sensitivity in subjects with metabolic syndrome

Fermented barley (FB) flour by Lactobacillus plantarum is richer in dietary fiber, polyphenols, gamma-aminobutyric acid, and other biologically active ingredients. This study aimed to determine the impacts of fermented barley - wheat flour compound noodle (FBWN) on glucose and fat metabolism in subjects with metabolic syndrome. This was a single-blinded and parallel 10-week clinical trial study. Subjects were randomly assigned into the trial group (FBWN) and whole wheat noodles group (WWN), and were measured on the beginning of week 3 and the ending of week 10. The glucose level at 30 and 60 min was significantly decreased after FBWN intervention. Levels of fasting blood glucose, HbA1c, and TG were all declined after FBWN intervention compared to before in the trial group. Moreover, the fat mass, fat rate, and visceral fat were decreased by 6.48, 7.19, 6.3 kg after FBWN intervention, respectively, while muscle mass and basal metabolic rate rose 7.44 kg and 252.60 kcal. PRACTICAL APPLICATIONS: Many studies have illustrated that the extraction of fermented barley held the activities of anti-obesity, antitumor, and so on. Moreover, this present study evaluated the effects of fermented barley by Lactobacillus plantarum on patients with metabolic syndrome. Results indicated that FB benefits the subjects on improving plasma glycolipids and insulin sensitivity, decreasing visceral fat level, and increasing satiety. The findings showed that the products of FB may be beneficial to dietary manipulations, thus, reducing the burden of patients.

Recent progress in the use of functional foods for older adults: A narrative review

The number and proportion of older adults are increasing globally, and it is predicted that in 2020, there will be 723 million people worldwide aged 66 and older. In recent decades, numerous studies showed that healthy eating is positively associated with better nutritional status and quality of life, and the decreased incidence of noncommunicable diseases. As older adults become health conscious, the demand for foods and beverages rich in nutrients and bioactive compounds has increased. The increased demand for healthy food stimulated a recent rapid increase in designing, producing, and marketing functional foods to prevent or correct nutrient deficiencies and to improve the nutritional status of older adults. These functional products contain and/or are enriched with dietary fiber; omega-3 polyunsaturated fatty acids; phytoestrogens; polyphenols; carotenoids such as alpha- and beta-carotene; lutein and zeaxanthin; pre-, pro-, and synbiotics; and plant sterols and stanols. A limited number of publications have thoroughly addressed the effect of functional foods on the nutritional status of older adults. The goal of this review was to review existing recent research on the role of functional foods in healthy and active aging.

The Cholesterol-Lowering Effect of Oats and Oat Beta Glucan: Modes of Action and Potential Role of Bile Acids and the Microbiome

Consumption of sufficient quantities of oat products has been shown to reduce host cholesterol and thereby modulate cardiovascular disease risk. The effects are proposed to be mediated by the gel-forming properties of oat β-glucan which modulates host bile acid and cholesterol metabolism and potentially removes intestinal cholesterol for excretion. However, the gut microbiota has emerged as a major factor regulating cholesterol metabolism in the host. Oat β-glucan has been shown to modulate the gut microbiota, particularly those bacterial species that influence host bile acid metabolism and production of short chain fatty acids, factors which are regulators of host cholesterol homeostasis. Given a significant role for the gut microbiota in cholesterol metabolism it is likely that the effects of oat β-glucan on the host are multifaceted and involve regulation of microbe-host interactions at the gut interface. Here we consider the potential for oat β-glucan to influence microbial populations in the gut with potential consequences for bile acid metabolism, reverse cholesterol transport (RCT), short-chain fatty acid (SCFA) production, bacterial metabolism of cholesterol and microbe-host signaling.

A Crucial Role for Diet in the Relationship Between Gut Microbiota and Cardiometabolic Disease

Cardiometabolic disease (CMD), such as type 2 diabetes mellitus and cardiovascular disease, contributes significantly to morbidity and mortality on a global scale. The gut microbiota has emerged as a potential target to beneficially modulate CMD risk, possibly via dietary interventions. Dietary interventions have been shown to considerably alter gut microbiota composition and function. Moreover, several diet-derived microbial metabolites are able to modulate human metabolism and thereby alter CMD risk. Dietary interventions that affect gut microbiota composition and function are therefore a promising, novel, and cost-efficient method to reduce CMD risk. Studies suggest that fermentable carbohydrates can beneficially alter gut microbiota composition and function, whereas high animal protein and high fat intake negatively impact gut microbiota function and composition. This review focuses on the role of macronutrients (i.e., carbohydrate, protein, and fat) and dietary patterns (e.g., vegetarian/vegan and Mediterranean diet) in gut microbiota composition and function in the context of CMD.

GUT Microbiome-GUT Dysbiosis-Arterial Hypertension: New Horizons

Arterial hypertension is a progressive cardiovascular syndrome arising from complex and interrelated etiologies. The human microbiome refers to the community of microorganisms that live in or on the human body. They influence human physiology by interfering in several processes such as providing nutrients and vitamins in Phase I and Phase II drug metabolism. The human gut microbiota is represented mainly by Firmicutes and Bacteroidetes and to a lesser degree by Actinobacteria and Proteobacteria, with each individual harbouring at least 160 such species. Gut microbiota contributes to blood pressure homeostasis and the pathogenesis of arterial hypertension through production, modification, and degradation of a variety of microbial-derived bioactive metabolites. Animal studies and to a lesser degree human research has unmasked relative mechanisms, mainly through the effect of certain microbiome metabolites and their receptors, outlining this relationship. Interventions to utilize these pathways, with probiotics, prebiotics, antibiotics and fecal microbiome transplantation have shown promising results. Personalized microbiome-based disease prediction and treatment responsiveness seem futuristic. Undoubtedly, a long way of experimental and clinical research should be pursued to elucidate this novel, intriguing and very promising horizon.

Radiation Degradation of β-Glucan with a Potential for Reduction of Lipids and Glucose in the Blood of Mice

: Water-soluble and low molecular weight (Mw) β-glucans were successfully prepared by γ-irradiation of water-insoluble yeast β-glucans. The radiation dose used for the degradation of yeast β-glucan was remarkably reduced by increasing the pH of the sample or combining with hydrogen peroxide treatment. Radiation-degraded β-glucans with molecular weights in the range of 11-48 kDa reduced the total cholesterol, triglyceride, low density lipoprotein (LDL) cholesterol, and glucose levels in the blood of administered mice. The decreasing levels of both lipid and glucose indexes in the blood of tested mice strongly depended on the molecular weight of the β-glucan, and the radiation-degraded β-glucan with a molecular weight of about 25 kDa was found to be the most effective for the reduction of blood lipid and glucose levels. Particularly, the oral administration of 25 kDa β-glucan, with a daily dose of about 2 mg per head, reduced the total cholesterol, triglyceride, LDL-cholesterol, and glucose levels in the blood of tested mice to about 47.4%, 48.5%, 45.7%, and 47.2%, respectively. The effects on the reduction of blood lipid and glucose levels were also found to be stable after 20 days of stopping administration. These results indicate that the degraded β-glucan with a molecular weight of about 25 kDa prepared by γ-ray irradiation is a very promising ingredient that can be used in nutraceutical food for therapeutics of diabetic and dyslipidemia.

Impact of different roasting conditions on chemical composition, sensory quality and physicochemical properties of waxy-barley products

Roasting improves sensory properties and differentially modulates health-related compounds of barley products.

Perceptions of college students in consuming whole grain foods made with Brewers' Spent Grain

One-third of all food produced for human consumption is wasted producing landfill accumulation and greenhouse gas emissions. Brewers' Spent Grains (BSGs) are the leftover grains from beer production, and each year approximately 30 million tons of BSG is generated globally by the brewing industry. Reclaiming BSG as a potential human food source is an opportunity for reducing food waste in the food supply chain. Six focus groups were conducted using 37 college students to determine their consumption of whole grains, perceptions of whole grains versus refined grains, and interest in or barriers related to consuming and purchasing foods made with BSG. Focus groups were transcribed verbatim and analyzed using constant comparative analysis to identify themes and discover relationships among the study aims. Thirteen themes emerged from focus group discussions with Concept of Health, Sensory, and Experience with BSG representing the top three discussed. Participants believed whole grains are healthier and contain more nutrients than refined grains. Most participants enjoyed the BSG foods provided; however, some noted a darker appearance and lingering fiber particles or aftertaste. Findings indicate participants who are hereditary whole grain consumers are acculturated to whole grain sensory attributes and nutritional benefits and would be more receptive to consuming BSG foods in future studies. We concluded most focus group participants were open to tasting BSG foods, but hereditary whole grain consumers should be the target consumer audience, and educating consumers on sensory attributes, potential health benefits, and environmental benefits is necessary to overcome the barriers associated with BSG.

Barley β-glucan increases fecal bile acid excretion and short chain fatty acid levels in mildly hypercholesterolemic individuals

The cholesterol-lowering effect of barley β-glucan has been proposed to be the result of a pleiotropic effect, which involves several biological mechanisms such as gut fermentation, inhibition of intestinal cholesterol absorption and increased bile acid excretion and its synthesis. However, one of the recent studies from our laboratory indicated that increased bile acid excretion and subsequent increase in its synthesis, but not the inhibition of cholesterol absorption or synthesis might be responsible for the cholesterol-lowering effect of barley β-glucan. Accordingly, the primary objective of the present study was to investigate the concentration of bile acids (BA), neutral sterols (NS) and short chain fatty acids (SCFA) excreted through the feces by mildly hypercholesterolemic subjects who consumed diets containing barley β-glucan with varying molecular weights (MW) and concentrations. In a controlled, four phase, crossover trial, 30 mildly hypercholesterolemic but otherwise healthy subjects were randomly assigned to receive breakfast containing 3 g high MW (HMW), 5 g low MW (LMW), 3 g LMW barley β-glucan or a control diet for 5 weeks. The concentrations of BA, NS and SCFA in the feces were measured at the end of each treatment phase. Compared to the other treatment groups, 3 g day-1 HMW barley β-glucan consumption resulted in increased lithocholic acid (LCA) excretion (P < 0.001) but not LMW β-glucan, even at the high dose of 5 g day-1. Increased fermentability of fibre was also evident from a significant increase in fecal total SCFA concentrations in response to the 3 g HMW β-glucan diet compared to the 3 g LMW barley β-glucan and control diet (P = 0.0015). In summary, the current results validate our previous report on the role of fecal bile acid excretion in cholesterol lowering through the consumption of barley β-glucan. In addition, increased SCFA concentrations indicate that an increase in β-glucan molecular weight promotes hindgut fermentation, which might also be playing a role in attenuating cholesterol levels.

Anti-hypercholesterolemic impacts of barley and date palm fruits on the ovary of Wistar albino rats and their offspring

A high cholesterol diet is related to ovarian dysfunction and infertility which has been increased among young ages consuming processed food products. The present study was conducted to evaluate the role of a high cholesterol diet on the ovaries of young female rats via assessments of histopathology, immunohistochemistry, oxidative stress and apoptic markers. Also, mating of hypercholesterolemic female rats was carried out to measure the fertility and numbers of their offspring. At the same time, phytotherapy was carried out through supplementing the diet with barley and/ or date palm fruits (10%) during the experiment to assess the phyto-therapeutic impacts in attenuation of drastic hypercholesterolemic effects. Hypercholesterolemic diet-fed rats exhibited damage of the ovarian follicles and increased follicular atresia. Furthermore, expression of cleaved caspase-3 was upregulated, while PCNA was downregulated in granulosa, theca and stroma cells. Hypercholesterolemic female rats showed marked depletion of antioxidative enzymes, increased lipid peroxidation and apoptotic markers. Alterations to the female serum hormones were detected. Offspring maternally fed on hypercholesterolemic diet showed a significant decrease of body weight and altered sex ratio. However, concomitant supplementation of barley and or date fruits to hypercholesterolemic groups revealed marked improvement of ovarian structure and function. On the basis of these evidences, it is believed that the enhanced synergistic effects of barley and/or date palm fruits in the amelioration of ovarian structure and functions were elicited by the potential antioxidant activity of their phytomicronutrients, polyphenols, β-glucan and trace elements. These materials scavenge free radicals from inflamed cells that can be used to establish an effective and novel therapeutic strategy for activating ovarian cell regeneration.

The gut microbiome and hypertension

PURPOSE OF REVIEW

The mammalian mucosal surfaces are densely inhabited by a diverse microbial ecosystem termed the microbiota. Among these highly heterogeneous populations, the largest and richest is the gut microbiota, recently suggested to affect various physiological traits and susceptibility to disease. Novel metagenomic and metabolomic approaches, which have been developed in the past decade, have enabled the elucidation of the contribution of the microbiota to metabolic, immunologic, neurologic and endocrine homeostasis.

RECENT FINDINGS

Dysbiosis, the alteration in the gut microbiota composition and function, has been lately associated with the pathogenesis of multifactorial diseases such as obesity, diabetes and cardiovascular disorders. Recent studies have also suggested associations between dysbiosis and essential hypertension, a common chronic medical condition affecting 20% or more of the adult population worldwide, which is considered a major causative factor for heart disease, stroke, chronic renal failure, blindness and dementia.

SUMMARY

In this review, we discuss the accumulating research pointing to possible interplays between the gut microbiome and hypertension and highlight future prospects by which utilization of microbiome-related techniques may be incorporated into the diagnosis and therapeutic arsenal of hypertension management.

Key attributes of global partnerships in food and nutrition to align research agendas and improve public health

Partnerships among academia, government, and industry have emerged in response to global challenges in food and nutrition. At a workshop reviewing international partnerships, we concluded that to build a partnership, partners must establish a common goal, identify barriers, and engage all stakeholders to ensure project sustainability. To be effective, partnerships must synchronize methodologies and adopt evidence-based processes, and be led by governmental or nonprofit organizations to ensure trust among partners and with the public.

The Effect of Soluble Fiber Supplementation on Metabolic Syndrome Profile among Newly Diagnosed Type 2 Diabetes Patients

Diets with high fiber content improve most metabolic syndrome (MetS) profile in non-diabetic individuals, but there is scarce information about the role of fiber intake in patients with the MetS and diabetes. The objective of this study is to determine whether soluble fiber supplementation improve MetS profile for 8 weeks of intervention in newly diagnosed type 2 diabetes (T2D) adult patients. After one week of dietary stabilization phase, 36 newly diagnosed T2D patients were stratified to different strata according to sex, age, fasting blood sugar (FBS), and waist circumference (WC). Then they were randomly allocated into 2 groups. The psyllium group (n = 18) received 10.5 g of psyllium daily for 8 weeks. The control group (n = 18) maintained their regular diet for 8 weeks. Soluble fiber supplementation showed significant reduction in the majority of MetS profile; FBS (43.55 mg/dL, p < 0.001), triglyceride (37.89 mg/dL, p < 0.001), total cholesterol (20.32 mg/dL, p < 0.001), systolic blood pressure (7.50 mmHg, p < 0.001), diastolic blood pressure (2.78 mmHg, p = 0.013), and WC (2.54 cm, p < 0.001) in the intervention group compared with the control group after 8 weeks of intervention. The high-density lipoprotein cholesterol was reduced in both groups, but this reduction was insignificant. The improvement in the MetS profile was enhanced by combining psyllium to the normal diet. Consumption of foods containing moderate amounts of these fibers may improve MetS profile in newly diagnosed T2D patients. This study was registered in Current Controlled Trials (PHRC/HC/28/15).

β-glucans and cholesterol (Review)

Hypercholesterolemia is one of primary risk factors of cardiovascular disease, together with metabolic syndrome, hypertension and diabetes. Although progress has been made, the search for novel methods of preventing and treating dyslipidemia is ongoing and current therapies for cardiovascular disease induce various side effects. β-glucans are linear unbranched polysaccharides found in various natural sources, such as mushrooms. Due to their structure they are able to interact with innate immunity receptors, however they also act as dietary fibers in the digestive tract. As there are two forms of β-glucans, insoluble and soluble forms, they are able to interact with lipids and biliary salts in the bowel and consequently reduce cholesterol levels. Therefore, they may be developed as a suitable therapeutic option to treat patients with dyslipidemia, as they are natural molecules that do not induce any significant side effects. The current review discusses the evidence supporting the effects of β-glucans on cholesterol levels.

Recent perspectives on the role of nutraceuticals as cholesterol-lowering agents

PURPOSE OF REVIEW

Reduction in circulating cholesterol is an important step in lowering cardiovascular risk. Although statins are the most frequently prescribed cholesterol-lowering medication, there remains a significant portion of patients who require alternative treatment options. Nutraceuticals are increasingly popular as cholesterol-lowering agents. Despite the lack of long-term trials evaluating their use on cardiovascular endpoints and mortality, several studies have demonstrated their potential cholesterol-lowering effects. The purpose of this review is to provide an update on the role of nutraceuticals as cholesterol-lowering agents. The present review will focus on individual nutraceutical compounds, which have shown modest cholesterol-lowering abilities, as well as combination nutraceuticals, which may offer potential additive and/or synergistic effects.

RECENT FINDINGS

Berberine, red yeast rice, and plant sterols have moderate potential as cholesterol-lowering agents. Combination nutraceuticals, including the proprietary formulation, Armolipid Plus, appear to confer additional benefit on plasma lipid profiles, even when taken with statins and other agents.

SUMMARY

Although robust, long-term clinical trials to examine the effects of nutraceuticals on clinical outcomes are still required, their cholesterol-lowering ability, together with their reported tolerance and safety, offer a pragmatic option for lowering plasma cholesterol levels.

Dietary Fiber Is Beneficial for the Prevention of Cardiovascular Disease: An Umbrella Review of Meta-analyses

Objective

The purpose of this study was to review previously published meta-analyses on the effectiveness of dietary fiber on cardiovascular disease.

Methods

An umbrella review of all published meta-analyses was performed. A PubMed search from January 1, 1980, to January 31, 2017, was conducted using the following search strategy: (fiber OR glucan OR psyllium OR fructans) AND (meta-analysis OR systematic review). Only English-language publications that provided quantitative statistical analysis on cardiovascular disease, lipid concentrations, or blood pressure were retrieved.

Results

Thirty-one meta-analyses were retrieved for inclusion in this umbrella review, and all meta-analyses comparing highest versus lowest dietary fiber intake reported statistically significant reductions in the relative risk (RR) of cardiovascular disease mortality (RR = 0.77-0.83), as well as the incidences of cardiovascular disease (RR = 0.72-0.91), coronary heart disease (RR = 0.76-0.93), and stroke (RR = 0.83-0.93). Meta-analyses on supplementation studies using β-glucan or psyllium fibers also reported statistically significant reductions in both total serum and low-density lipoprotein cholesterol concentrations.

Conclusion

This review suggests that individuals consuming the highest amounts of dietary fiber intake can significantly reduce their incidence and mortality from cardiovascular disease. Mechanistically, these beneficial effects may be due to dietary fibers' actions on reducing total serum and low-density lipoprotein cholesterol concentrations between 9.3 to 14.7 mg/dL and 10.8 to 13.5 mg/dL, respectively.

Lipid Lowering with Soluble Dietary Fiber

Consumption of dietary soluble fibers has been associated with health benefits such as reduced lipid levels, lower blood pressure, improved blood glucose control, weight loss, improved immune function, and reduced inflammation. Many of these health benefits relate to a reduced risk of developing cardiovascular disease. In this paper, we have reviewed recent studies on the hypocholesterolemic effects of dietary soluble fibers as well as fiber-rich foods. Findings include the following: (a) consumption of water-soluble, viscous-forming fibers can reduce total and low-density lipoprotein cholesterol levels by about 5-10 %; (b) minimal changes of high-density lipoprotein cholesterol or triglyceride levels were observed; (c) cholesterol-lowering properties of soluble fibers depend on their physical and chemical properties; and (d) medium to high molecular weight fibers are more effective in reducing lipid levels. Hypocholesterolemic benefits were also observed with some fiber-rich foods, such as whole oats, whole barley, legumes, peas, beans, flax seeds, apples, and citrus foods.