A 6-week supplementation with grape pomace to subjects at cardiometabolic risk ameliorates insulin sensitivity, without affecting other metabolic syndrome markers

Valorization of Grape Pomace: A Review of Phenolic Composition, Bioactivity, and Therapeutic Potential

Vitis vinifera L., commonly known as grapes, is one of the most widely cultivated crops worldwide, with over 80% used for wine production. However, the winemaking process generates substantial residues, including grape pomace (GP), wine lees, and wastewater, which can pose significant environmental and economic challenges. Among these, GP stands out not only as a waste product but also as a rich source of polyphenols-bioactive compounds with recognized antioxidant and anti-inflammatory properties. Recent advancements have expanded the application of GP-derived extracts, particularly in the health and food industries, due to their potent bioactive properties. This review provides a comprehensive overview of the valorization of GP, focusing on its phenolic composition and therapeutic potential. It evokes innovative, environmentally friendly extraction techniques and integrated methods for the chemical analysis of these valuable compounds. Additionally, the health benefits of GP polyphenols are explored, with recent experimental findings examining their metabolism and highlighting the key role of gut microbiota in these processes. These insights contribute to a deeper understanding of the biological activity of GP extracts and underscore their growing significance as a high-added-value product. By illustrating how winemaking by-products can be transformed into natural therapeutic agents, this review emphasizes the importance of sustainable development and eco-friendly waste management practices, significantly contributing to the advancement of a circular economy.

Unexplored Opportunities of Utilizing Food Waste in Food Product Development for Cardiovascular Health

PURPOSE OF REVIEW

Global food production leads to substantial amounts of agricultural and food waste that contribute to climate change and hinder international efforts to end food insecurity and poverty. Food waste is a rich source of vitamins, minerals, fibers, phenolic compounds, lipids, and bioactive peptides. These compounds can be used to create food products that help reduce heart disease risk and promote sustainability. This review examines the potential cardiovascular benefits of nutrients found in different food waste categories (such as fruits and vegetables, cereal, dairy, meat and poultry, and seafood), focusing on animal and clinical evidence, and giving examples of functional food products in each category.

RECENT FINDINGS

Current evidence suggests that consuming fruit and vegetable pomace, cereal bran, and whey protein may lower the risk of cardiovascular disease, particularly in individuals who are at risk. This is due to improved lipid profile, reduced blood pressure and increased flow-mediated dilation, enhanced glucose and insulin regulation, decreased inflammation, as well as reduced platelet aggregation and improved endothelial function. However, the intervention studies are limited, including a low number of participants and of short duration. Food waste has great potential to be utilized as cardioprotective products. Longer-term intervention studies are necessary to substantiate the health claims of food by-products. Technological advances are needed to improve the stability and bioavailability of bioactive compounds. Implementing safety assessments and regulatory frameworks for functional food derived from food waste is crucial. This is essential for maximizing the potential of food waste, reducing carbon footprint, and improving human health.

Verbascoside: comprehensive review of a phenylethanoid macromolecule and its journey from nature to bench

Polyphenolic compounds are among the most widely researched compounds for various therapeutic applications. However, naturally occurring phenylethanoid glycosides are least explored under this class of compounds. One such phenylethanoid glycoside, verbascoside (Vb), abundantly found among 200 species of 23 families, has gained recent attention due to its wide-spectrum therapeutic properties such as antioxidant, antimicrobial, anti-inflammatory, neuroprotective, cardioprotective, skin-protective, and anti-cancer. Despite having multiple therapeutic benefits, due to its large size, the compound has poor bioavailability for oral and topical applications. To meet these limitations, current research on Vb focuses on delivering it through nanoformulations. Presently, most developed formulations are liposome based for various applications, such as corneal epithelial wound healing, anti-neuropathic, anti-wrinkle, anti-hyperalgesia, atopic dermatitis, alopecia, and cutaneous wound healing. Multiple studies have confirmed the least acute and sub-acute toxicity for Vb. Few clinical studies have been performed for the therapeutic application of Vb to manage COVID-19, nephropathy, platelet aggregation, chronic primary glomerulonephritis, and acute hepatitis. Recent studies have shown the immense therapeutic potential of Vb in wound healing, dermatitis, neuroprotection, and anti-cancer activities, which creates a need for developing novel formulations for their respective uses. Long-term toxicity studies and techniques for scaling up Vb production by biotechnological approaches should be emphasized.

Health-Promoting Properties and the Use of Fruit Pomace in the Food Industry-A Review

Fruit pomace, a by-product of the fruit industry, includes the skins, seeds, and pulp most commonly left behind after juice extraction. It is produced in large quantities: apple residues alone generate approximately 4 million tons of waste annually, which is a serious problem for the processing industry but also creates opportunities for various applications. Due to, among other properties, their high content of dietary fiber and polyphenolic compounds, fruit residues are used to design food with functional features, improving the nutritional value and health-promoting, technological, and sensory properties of food products. This article presents the health-promoting (antioxidant, antidiabetic, anti-inflammatory, and antibacterial) properties of fruit pomace. Moreover, the possibilities of their use in the food industry are characterized, with particular emphasis on bread, sweet snack products, and extruded snacks. Attention is paid to the impact of waste products from the fruit industry on the nutritional value and technological and sensory characteristics of these products. Fruit pomace is a valuable by-product whose use in the food industry can provide a sustainable solution for waste management and contribute to the development of functional food products with targeted health-promoting properties.

Selected fruit pomaces: Nutritional profile, health benefits, and applications in functional foods and feeds

The utmost objective of every nation is to achieve zero hunger and ensure the health and well-being of its population. However, in impoverished nations, particularly in rural areas, such issues persist on a daily basis. Currently, there is a growing demand for fruit consumption due to their potential health benefits. Surprisingly, their most prevalent by-product is pomace, which is produced in millions of tonnes and is usually discarded as waste after processing or consumption. Even food produced with these kinds of raw resources can contribute to the objective of eradicating world hunger. Owing to these advantages, scientists have begun evaluating the nutritional content of various fruit pomace varieties as well as the chemical composition in different bioactive constituents, which have significant health benefits and can be used to formulate a variety of food products with notable nutraceutical and functional potential. So, the purpose of this review is to understand the existing familiarity of nutritional and phytochemical composition of selected fruit pomaces, those derived from pineapple, orange, grape, apple, and tomato. Furthermore, this article covers pre-clinical and clinical investigations conducted on the selected fruit pomace extracts and/or powder forms and its incorporation into food products and animal feed. Adding fruit pomaces reduces the glycemic index, increases the fibre content and total polyphenolic contents, and reduces the cooking loss, etc. In animal feeds, incorporating fruit pomaces improves the antioxidant enzyme activities, humoral immune system, and growth performance and reduces methane emission.

Fruit waste: a current perspective for the sustainable production of pharmacological, nutraceutical, and bioactive resources

Fruits are crucial components of a balanced diet and a good source of natural antioxidants, that have proven efficacy in various chronic illnesses. Various kinds of waste generated from fruit industries are considered a global concern. By utilizing this fruit waste, the international goal of "zero waste" can be achieved by sustainable utilization of these waste materials as a rich source of secondary metabolites. Moreover, to overcome this waste burden, research have focused on recovering the bioactive compounds from fruit industries and obtaining a new strategy to combat certain chronic diseases. The separation of high-value substances from fruit waste, including phytochemicals, dietary fibers, and polysaccharides which can then be used as functional ingredients for long-term health benefits. Several novel extraction technologies like ultrasound-assisted extraction (UAE), pressurized liquid extraction (PLE), and supercritical fluid extraction (SFE) could provide an alternative approach for successful extraction of the valuable bioactives from the fruit waste for their utilization as nutraceuticals, therapeutics, and value-added products. Most of these waste-derived secondary metabolites comprise polyphenols, which have been reported to have anti-inflammatory, insulin resistance-treating, cardiovascular disease-maintaining, probiotics-enhancing, or even anti-microbial and anti-viral capabilities. This review summarizes the current knowledge of fruit waste by-products in pharmacological, biological, and probiotic applications and highlights several methods for identifying efficacious bioactive compounds from fruit wastes.

Uncovering the promising role of grape pomace as a modulator of the gut microbiome: An in-depth review

Grape pomace is the primary wine coproduct consisting primarily of grape seeds and skins. Grape pomace holds immense potential as a functional ingredient to improve human health while its valorization can be beneficial for industrial sustainability. Pomace contains bioactive compounds, including phenols and oligosaccharides, most of which reach the colon intact, enabling interaction with the gut microbiome. Microbial analysis found that grape pomace selectively promotes the growth of many commensal bacteria strains, while other types of bacteria, including various pathogens, are highly sensitive to the pomace and its components and are inactivated. In vitro studies showed that grape pomace and its extracts inhibit the growth of pathogenic bacteria in Enterobacteriaceae family while increasing the growth and survival of some beneficial bacteria, including Bifidobacterium spp. and Lactobacillus spp. Grape pomace supplementation in mice and rats improves their gut microbiome complexity and decreases diet-induced obesity as well as related illnesses, including insulin resistance, indicating grape pomace could improve human health. A human clinical trial found that pomace, regardless of its phenolic content, had cardioprotective effects, suggesting that dietary fiber induced those health benefits. To shed light on the active components, this review explores the potential prebiotic capacity of select bioactive compounds in grape pomace.

Plant bioactive compounds from Mediterranean diet improve risk factors for metabolic syndrome

Mediterranean (Med) dietary pattern consists of moderate or high consumption of foods that are linked to reduced risk factors for metabolic syndrome (MetS). This comprehensive review evaluates studies on Med diet-representative foods and beverages, such as red wine and olive oil, to understand the inverse associations of Med diet and MetS. The intake of dietary fibre, unsaturated fatty acids, vitamins, and polyphenols - including flavonoids and stilbenes - help to explain the benefits of Med diet on abdominal adiposity, glucose intolerance, hyperlipidaemia, and high blood pressure to some extent. Antioxidant and anti-inflammatory properties of polyphenols as well as the effects of unsaturated fatty acids on lipid metabolism are part of the underlying mechanisms. Overall, this review shows that dietary interventions using Med diet components improve MetS health markers in humans and/or rodents.

Three Varieties of Grape Pomace, with Distinctive Extractable:Non-Extractable Polyphenol Ratios, Differentially Reduce Obesity and Its Complications in Rats Fed a High-Fat High-Fructose Diet

Grape pomace is a commonly discarded by-product characterized by high extractable (EPP) and non-extractable (NEPP) polyphenol contents which exhibits anti-obesogenic effects. However, the relevance of each fraction needs to be elucidated. In this work, we examined the effects of three pomaces with different concentrations of EPPs and NEPPs on metabolic alterations associated with obesity. The NEPP:EPP ratio of the grape pomaces was 1.48 for Malbec, 1.10 for Garnacha, and 5.76 for Syrah grape varieties. Rats fed a high-fat high-fructose diet supplemented with Malbec grape pomace (HFFD + MAL) Syrah grape pomace (HFFD + SYR) or Garnacha grape pomace (HFFD + GAR) showed significantly less weight gain: 20%, 15%, and 12% less, respectively, compared to HFFD controls. The adiposity index was also significantly decreased by 20% in the HFFD + MAL and HFFD + SYR groups, and by 13% in the HFFD + GAR group. Serum triglycerides were significantly decreased by 46% in the HFFD + MAL group and by 31% in the HFFD + GAR group, compared to the HFFD group, but not in the HFFD + SYR group. All pomace supplementations regulated postprandial glucose in an oral glucose tolerance test. Therefore, grape pomaces containing both EPPs and NEPPs exert beneficial effects on body weight and glucose homeostasis, while EPPs seem to control triglyceride levels more effectively.

Polyphenols: a route from bioavailability to bioactivity addressing potential health benefits to tackle human chronic diseases

Chronic pathologies or non-communicable diseases (NCDs) include cardiovascular diseases, metabolic syndrome, neurological diseases, respiratory disorders and cancer. They are the leading global cause of human mortality and morbidity. Given their chronic nature, NCDs represent a growing social and economic burden, hence urging the need for ameliorating the existing preventive strategies, and for finding novel tackling therapies. NCDs are highly correlated with unhealthy lifestyle habits (such as high-fat and high-glucose diet, or sedentary life). In general, lifestyle approaches that might improve these habits, including dietary consumption of fresh vegetables, fruits and fibers, may contrast NCD symptoms and prolong life expectancy of affected people. Polyphenols (PPLs) are plant-derived molecules with demonstrated biological activities in humans, which include: radical scavenging and anti-oxidant activities, capability to modulate inflammation, as well as human enzymes, and even to bind nuclear receptors. For these reasons, PPLs are currently tested, both preclinically and clinically, as dietary adjuvants for the prevention and treatment of NCDs. In this review, we describe the human metabolism and bioactivity of PPLs. Also, we report what is currently known about PPLs interaction with gastro-intestinal enzymes and gut microbiota, which allows their biotransformation in many different metabolites with several biological functions. The systemic bioactivity of PPLs and the newly available PPL-delivery nanosystems are also described in detail. Finally, the up-to-date clinical studies assessing both safety and efficacy of dietary PPLs in individuals with different NCDs are hereby reported. Overall, the clinical results support the notion that PPLs from fruits, vegetables, but also from leaves or seeds extracts, are safe and show significant positive results in ameliorating symptoms and improving the whole quality of life of people with NCDs.

The α-Amylase and α-Glucosidase Inhibition Capacity of Grape Pomace: A Review

The concept of functional foods is gaining more importance due to its role in maintaining a healthy status and preventing some metabolic diseases. The control of diabetes, in particular type-2 (T2DM), could be considered a big challenge since it involves other factors such as eating habits. From the pharmacological point of view, inhibiting digestive enzymes, such as α-amylase and α-glucosidase, is one of the mechanisms mainly used by synthetic drugs to control this disease; however, several side effects are described. For that reason, using bioactive compounds may appear as an alternative without presenting the complications synthetic drugs available on the market have. The winemaking industry generates tons of waste annually, and grape pomace (GP) is the most important. GP is recognized for its nutritional value and as a source of bioactive compounds that are helpful for human health. This review highlights the importance of GP as a possible source of α-amylase and α-glucosidase inhibitors. Also, it is emphasized the components involved in this bioactivity and the possible interactions among them. Especially, some phenolic compounds and fiber of GP are the main ones responsible for interfering with the human digestive enzymes. Preliminary studies in vitro confirmed this bioactivity; however, further information is required to allow the specific use of GP as a functional ingredient inside the market of products recommended for people with diabetes.

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Chardonnay Marc as a New Model for Upcycled Co-products in the Food Industry: Concentration of Diverse Natural Products Chemistry for Consumer Health and Sensory Benefits

Research continues to provide compelling insights into potential health benefits associated with diets rich in plant-based natural products (PBNPs). Coupled with evidence from dietary intervention trials, dietary recommendations increasingly include higher intakes of PBNPs. In addition to health benefits, PBNPs can drive flavor and sensory perceptions in foods and beverages. Chardonnay marc (pomace) is a byproduct of winemaking obtained after fruit pressing that has not undergone fermentation. Recent research has revealed that PBNP diversity within Chardonnay marc has potential relevance to human health and desirable sensory attributes in food and beverage products. This review explores the potential of Chardonnay marc as a valuable new PBNP ingredient in the food system by combining health, sensory, and environmental sustainability benefits that serves as a model for development of future ingredients within a sustainable circular bioeconomy. This includes a discussion on the potential role of computational methods, including artificial intelligence (AI), in accelerating research and development required to discover and commercialize this new source of PBNPs.

In Vivo Evaluation of the Cardiometabolic Potential of Grape Pomace: Effect of Applying Instant Controlled Pressure Drop

Grape pomace (GP) is a source of polyphenols which may be present as free structures or associated with dietary fiber. Instant controlled pressure drop (DIC) is a technology which can modify the association of polyphenols with food matrixes, but how these modifications affect the health benefits associated with GP remains to be elucidated. In this study, in rats fed a high-fat-fructose diet (HFF), we evaluated the in vivo cardiometabolic effects of the modification of polyphenols in GP caused by DIC at 0.2 MPa for 60 s (DIC1) and 0.4 MPa for 120 s (DIC2). These treatments increased anthocyanin and total flavonoid contents, respectively, while all the supplementations caused significant improvements in insulin resistance and plasma triacylglycerols. Thus, the bioactive compounds present in GP (including a major fraction of non-extractable proanthocyanidins) caused these modifications independently of the specific polyphenol profiles which may have resulted from these DIC treatments. Additionally, only intact GP led to an increase in HDL cholesterol, while only DIC2-treated GP improved hepatic steatosis. In conclusion, GP always improves insulin sensitivity in this animal model of obesity, while the different compositions of GP modified by DIC may be associated with other cardiometabolic parameters.

Antioxidant and Anti-Inflammatory Actions of Polyphenols from Red and White Grape Pomace in Ischemic Heart Diseases

Grape pomace (GP) represents a very reliable source of polyphenols because it could be found globally as a remnant of the wine industry. During the winemaking process, two types of GP are generated: red GP and white GP, according to the produced wine, red or white. Grape pomace represents a viable source of polyphenols, mainly flavanols, procyanidins anthocyanins, and resveratrol which possess antioxidant and anti-inflammatory activities. Multiple differences were observed between red and white GP in terms of their antioxidant and anti-inflammatory activity in both in vitro and in vivo studies. Although most studies are focused on the antioxidant and anti-inflammatory effect of red grape pomace, there are still many variables that need to be taken into consideration, as well as extensive study of the white GP. It was observed that in both in vitro and in vivo studies, the GP polyphenols have a direct antioxidant activity by acting as a free radical scavenger or donating a hydrogen atom. It also possesses an indirect antioxidant and anti-inflammatory activity by reducing mitochondrial reactive oxygen species (ROS) generation, malondialdehyde (MDA), tumor necrosis factor-alpha (TNF-α), interleukin-1-beta (IL-1β), interleukin-6 (IL-6), nuclear factor kappa-light-chain-enhancer of activated B cells (NF- κβ), and inhibitor of nuclear factor kappa-B kinase subunit beta (Iκκβ) levels or nitrate oxide-4 (NOX4) expression and by increasing the levels of antioxidants enzymes like superoxide dismutase (SOD), catalase (CAT) glutathione reductase (GRx) and glutathione peroxidase(GPx). Besides these activities, many beneficial effects in ischemic heart diseases were also observed, such as the maintenance of the ventricular function as close as possible to normal, and the prevention of infarcted area extension. In this context, this review intends to present the actual knowledge of grape pomace’s potential antioxidant and anti-inflammatory activity in ischemic heart disease, knowledge gathered from existing in vitro and in vivo studies focused on this.

Overview of Nutraceuticals and Cardiometabolic Diseases following Socio-Economic Analysis

The importance of functional food and nutraceutical products to deal with cardiometabolic diseases (CMDs) and metabolic syndrome (MetS) has gained attention in the past few years. The aim of this narrative review is to highlight the potential and effectiveness of nutraceutical in the improvement of CMDs and MetS biomarkers, alongside their burden of disease and economic health expenditure. A science database search was conducted between May and June 2021. A total of 35 studies were included in this paper. We included male and female subjects, children, and adults, in good health or with cardiovascular or metabolic disease. CMDs and MetS have gradually become worldwide health problems, becoming two of the major causes of morbidity and mortality in western countries. The results indicate a positive link between daily consumption of nutraceutical products and an improvement in cardiometabolic and anthropometric biomarkers. In this paper we included a wide range of nutraceutical products. Most of them showed promising data, indicating that nutraceuticals could provide a new therapeutic treatment to reduce prevalence and pharmaceutical expenditures attributed to CMDs and MetS. Unfortunately, there is a huge vacuum of data on nutraceutical usage, savings, and burden reduction. Therefore, further clinical and pharmaco-economic research in the field is highly required.

Interactions between Ascophyllum nodosum Seaweeds Polyphenols and Native and Gelled Corn Starches

The effect of several blending procedures between Ascophyllum nodosum seaweed flour (AF) and corn starch (CS) on the interactions between polyphenols and starch was studied in this paper. These methods comprised the blending of AF with native starch (NT) with previously gelled starch gel (GL) and promoting the gelling of corn starch in the presence of AF (CGL). Different AF-CS (g/g) ratios (from 1:0.5 to 1:25) were studied. The liquid phase was chemically characterized by polyphenols (TPC) and carbohydrates content. The antioxidant activity of the liquid phase after achieving the solid-liquid equilibrium was determined by DPPH, ABTS, and FRAP methods. The solid phase was characterized by FT-IR and SEM techniques. The Halsey model successfully fitted the equilibrium TPC in liquid and polyphenols adsorbed/retained by the solid phase of tested systems. NT samples showed lower polyphenols sorption than gelled samples. The differences found between samples obtained with GL and CGL methods suggested different interactions between polyphenols and starch. Specifically, physisorption is predominant in the case of the GL method, and molecular trapping of polyphenols in the starch gel structure is relevant for the CGL method. Results allowed us to determine the enhancement of the retention of polyphenols to achieve starchy foods with high bioactivity.

Effect of Dietary Phenolic Compounds on Incidence of Cardiovascular Disease in the SUN Project; 10 Years of Follow-Up

The health benefits of plant-based diets have been reported. Plant-based diets found in Spain and other Mediterranean countries differ from typical diets in other countries. In the Mediterranean diet, a high intake of phenolic compounds through olives, olive oil, and red wine may play an important role in cardiovascular prevention. Prospective studies carried out in Mediterranean countries may provide interesting insights. A relatively young Mediterranean cohort of 16,147 Spanish participants free of cardiovascular disease (CVD) was followed (61% women, mean (SD) age 37(12) years at baseline) for a median of 12.2 years. Dietary intake was repeatedly assessed using a 136-item validated food frequency questionnaire, and (poly)phenol intake was obtained using the Phenol-Explorer database. Participants were classified as incident cases of CVD if a medical diagnosis of myocardial infarction, stroke, or cardiovascular death was medically confirmed. Time-dependent Cox regression models were used to assess the relationship between (poly)phenol intake and the incidence of major CVD. A suboptimal intake of phenolic compounds was independently associated with a higher risk of CVD, multivariable-adjusted hazard ratio for the lowest versus top 4 quintiles: 1.85 (95% CI: 1.09–3.16). A moderate-to-high dietary intake of phenolic compounds, especially flavonoids, is likely to reduce CVD incidence in the context of a Mediterranean dietary pattern.

Hypertension- and glycaemia-lowering effects of a grape-pomace-derived seasoning in high-cardiovascular risk and healthy subjects. Interplay with the gut microbiome

Purpose: Grape pomace (GP) is a winery by-product rich in polyphenols and dietary fibre. Some recent results suggest that GP-derived extracts could be promising additives in food, specially recommended for low-salt diets. The hypothesis tested in this paper is that the regular consumption of GP-derived seasonings could help in the control of hypertension and glycaemia. Methods: A randomized intervention study (6 weeks) was performed in high-risk cardiovascular subjects (n = 17) and in healthy subjects (n = 12) that were randomly allocated into intervention (2 g day^-1 of GP seasoning) or control (no seasoning consumed) groups. Blood samples, faeces, urine and blood pressure (BP) were taken at the baseline and at the end of the intervention. Faecal samples were analysed for microbiota composition (16S rRNA gene sequencing) and microbial-derived metabolites (short chain fatty acids and phenolic metabolites). Results: Among the clinical parameters studied, BP and fasting blood glucose significantly decreased (p < 0.05) after the seasoning intervention, but not for the control group. Notably, application of a novel approach based on ASV (Amplicon Sequence Variant) co-occurrence networks allowed us to identify some bacterial communities whose relative abundances were related with metadata. Conclusion: Our primary findings suggest that GP-seasoning may help in the modulation of cardiometabolic risk factors, mainly in the early stages. Furthermore, it evidences modulation of gut microbiota and functional bacterial communities by grape pomace, which might mediate the cardiometabolic effects of this by-product.

Grape pomace reduces the severity of non-alcoholic hepatic steatosis and the development of steatohepatitis by improving insulin sensitivity and reducing ectopic fat deposition in mice

While non-alcoholic fatty liver disease (NAFLD) represents the common cause of chronic liver disease, specific therapies are currently unavailable. The wine industry produces millions of tons of residue (pomace), which contains high levels of bioactive phytochemicals. The aim of this study was to clarify the potential benefits of grape pomace for the treatment of NAFLD at different levels of severity, and to clarify the mechanism of action. C57Bl/6 mice were given high fat diet (HFD) or western diet (WD) as models of obesity and hepatic steatosis or steatohepatitis, respectively, with or without pomace supplementation (50-250 mg/day). Pomace inhibited food intake, and reduced serum leptin and body weight gain. Ectopic fat deposition was reduced, while white adipose tissue mass was preserved. In addition, pomace improved glucose tolerance and insulin sensitivity, prevented the development of adipose tissue inflammation, and reduced hepatic steatosis. Higher expression of genes involved in fatty acids transport and oxidation was observed in adipose tissue, while lipogenic genes were attenuated in the liver of pomace-treated mice. In WD-fed mice, pomace reduced the severity of hepatic steatosis and inflammation and improved blood lipid profile, but was ineffective in reversing hepatic damage of advanced NASH. In conclusion, pomace improved insulin sensitivity and reduced ectopic fat deposition, leading to a healthier metabolic profile. Pomace may hold the potential as a supplement with beneficial health outcomes for the prevention and treatment of hepatic steatosis and other obesity-related pathologies.

Potential Relationship between the Changes in Circulating microRNAs and the Improvement in Glycaemic Control Induced by Grape Pomace Supplementation

MicroRNAs (miRNAs) represent important tools in medicine and nutrition as new biomarkers, and can act as mediators of nutritional and pharmacological interventions. The aim of the present study was to analyse the effect of grape pomace supplementation on the expression of seven selected miRNAs and their potential relationship with the observed positive effect on glycaemic control, in order to shed light on the mechanism underlying the beneficial effect of this dietary intervention. For this purpose, plasma samples were obtained from 49 subjects with metabolic syndrome. After supplementation with grape pomace (6 weeks), these subjects were categorised as responders (n = 23) or non-responders (n = 26) according to the changes in their fasting insulin rate. MiRNA expression at baseline and at the end of the supplementation was analysed by RT-PCR, and the MiRecords Database was used to identify potential target genes for the studied miRNAs. The increase observed in miR-23a in the whole cohort was present in both subgroups of participants. The increase in miR-181a was significant among non-responders but not responders. The decrease in miR-30c and miR-222 was found in the responders, but not in the non-responders. No changes were observed in miR-10a, miR-151a, miR-181a, and miR-let-7a expressions. After analysing these results, a potential involvement of the reduced expression of miR-30c and miR-222, two microRNAs associated with insulin resistance and diabetes, in the improvement of glycaemic control produced by grape pomace administration, can be proposed. Further research is needed to confirm the involvement of glycolytic enzymes, PI3K, AMPK, and IRS-1 in the effect of grape pomace, as suggested by the changes induced in microRNAs.

Individual Diet Modification Reduces the Metabolic Syndrome in Patients Before Pharmacological Treatment

Modification of lifestyle, including healthy nutrition, is the primary approach for metabolic syndrome (MetS) therapy. The aim of this study was to estimate how individual nutrition intervention affects the reduction of MetS components. Subjects diagnosed with MetS were recruited in the Lomza Medical Centre. The study group consisted of 90 participants and was divided into one intervention group (individual nutrition education group (INEG)) and one control group (CG). The research was conducted over 3 months. The following measurements were obtained during the first visit and after completion of the 3 months intervention: body mass, waist circumference, body composition, blood pressure, fasting glucose, and blood lipids. Dietary assessments were performed before and post-intervention using 3-day 24-h dietary recalls. Dietary knowledge was evaluated with the KomPAN questionnaire. The total polyphenol content of the diet was calculated. Sociodemographic and lifestyle characteristics were collected from a self-reported questionnaire. The physical activity was assessed by the short version of the International Physical Activity Questionnaire (IPAQ). It was found that the individual nutrition education was an effective method to improve the knowledge, dietary habits, and physical activity of the study participants. The modification of the diet in terms of higher intake of polyphenols (flavonoids and anthocyanins), fiber, polyunsaturated fatty acids (PUFA), PUFA n-3, and lower intake of saturated fatty acids (SFA) had a significant impact on the improvement of some MetS risk factors (waist circumference, fasting glucose, and HDL-cholesterol).

Modifications of Gut Microbiota after Grape Pomace Supplementation in Subjects at Cardiometabolic Risk: A Randomized Cross-Over Controlled Clinical Trial

Polyphenols are dietary bioactive compounds able to induce modifications in the gut microbiota profile, although more clinical studies are needed. With this aim, a randomized cross-over clinical trial was conducted, where 49 subjects at cardiometabolic risk (exhibiting at least two metabolic syndrome factors) were supplemented with a daily dose of 8 g of grape pomace (GP) for 6 weeks, with an equivalent control (CTL) period. The levels of total bacteria and Bacteroidetes, Firmicutes, Lactobacilliales, Bacteroides and Prevotella were estimated in fecal DNA by quantitative real-time PCR (qPCR), while fecal short-chain fatty acids (SCFAs) were assessed by gas chromatography. Several cardiometabolic markers were evaluated in blood samples. GP reduced insulin levels only in half of the participants (responders). GP supplementation did not cause significant modifications in the microbiota profile of the whole group, except for a tendency (p = 0.059) towards a decrease in the proportion of Lactobacilliales, while it increased the proportion of Bacteroides in non-responder subjects. The reduction of insulin levels in subjects at cardiometabolic risk upon GP supplementation appears not to be induced by changes in the major subgroups of gut microbiota. Further studies at the species level may help to elucidate the possible role of microbiota in GP-induced insulinemic status.

Effect of grape polyphenols on selected inflammatory mediators: A systematic review and meta-analysis randomized clinical trials

Grapes contain different polyphenols and might prevent inflammation by reducing Nitric Oxide (NO) inactivation through antioxidative enzymes. The aim of this article was to demonstrate the effects of grape polyphenols on the selected inflammatory mediators, such as interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-a), and high-sensitivity C-reactive protein (hs-CRP). To find papers assessing the effects of grape polyphenols on inflammatory mediators, electronic data bases, including ISI web of science, PubMed/Medline, SCOPUS, and Google scholar, were searched up to March 2019. Delphi checklist was used for evaluating the qualities of the included articles. The protocol was registered in PROSPERO (No. CRD42019116695). The mean changes in the intervention and control groups were calculated by subtracting the end values from the baselines. Then, the difference between the two changes was measured and utilized as the effect size in meta-analysis. 9 and 8 articles were included in the systematic review and meta-analysis, respectively. Our results indicated that grape polyphenols did not reduce hs-CRP levels, but omission of one article could lead to a significant reduction in hs-CRP (Weight Mean Difference (WMD): −0.54 mg/L, 95 % CI: −1.02, -0.06; P=0.026, I²=0.0 %). Regarding IL-6 and TNF-α, no significant changes were observed in the intervention compared to the control group (WMD: 0.04 pg/mL, 95 % CI: −0.02, 0.28; P=0.744, I²=0.0 %, WMD: -0.10 pg/mL, 95 % CI: −0.25, 0.05; P=0.183, I²=0.0 %, respectively). We found no beneficial effects of grape polyphenols on the selected inflammatory mediators. Still, more studies with higher doses of polyphenols, longer treatment durations, different sources of grape polyphenols, and larger numbers of participants are required.

The Effect of Isolated and Synthetic Dietary Fibers on Markers of Metabolic Diseases in Human Intervention Studies: A Systematic Review

Observational studies provide strong evidence for the health benefits of dietary fiber (DF) intake; however, human intervention studies that supplement isolated and synthetic DFs have shown inconsistent results. Therefore, we conducted a systematic review to summarize the effects of DF supplementation on immunometabolic disease markers in intervention studies in healthy adults, and considered the role of DF dose, DF physicochemical properties, intervention duration, and the placebo used. Five databases were searched for studies published from 1990 to 2018 that assessed the effect of DF on immunometabolic markers. Eligible studies were those that supplemented isolated or synthetic DFs for ≥2 wk and reported baseline data to assess the effect of the placebo. In total, 77 publications were included. DF supplementation reduced total cholesterol (TC), LDL cholesterol, HOMA-IR, and insulin AUC in 36-49% of interventions. In contrast, <20% of the interventions reduced C-reactive protein (CRP), IL-6, glucose, glucose AUC, insulin, HDL cholesterol, and triglycerides. A higher proportion of interventions showed an effect if they used higher DF doses for CRP, TC, and LDL cholesterol (40-63%), viscous and mixed plant cell wall DFs for TC and LDL cholesterol (>50%), and longer intervention durations for CRP and glucose (50%). Half of the placebo-controlled studies used digestible carbohydrates as the placebo, which confounded findings for IL-6, glucose AUC, and insulin AUC. In conclusion, interventions with isolated and synthetic DFs resulted mainly in improved cholesterol concentrations and an attenuation of insulin resistance, whereas markers of dysglycemia and inflammation were largely unaffected. Although more research is needed to make reliable recommendations, a more targeted supplementation of DF with specific physicochemical properties at higher doses and for longer durations shows promise in enhancing several of its health effects.

Impact of Grape Products on Lipid Profile: A Meta-Analysis of Randomized Controlled Studies

Background: Growing evidence shows that grape polyphenols can improve cardiovascular risk factors. Although there are clear data supporting a beneficial effect of grape supplementation on blood pressure and glucose metabolism, the effects of grape polyphenols on lipid metabolism are still controversial. Objective: We performed a meta-analysis of randomized controlled trials (RCTs) to assess the effect of grape products on lipid profile. Design: A systematic search was performed in the PubMed, Web of Science, Scopus, and EMBASE databases without any language or publication year restriction. The reference lists of all retrieved articles were manually reviewed. RCTs evaluating the impact of grape products/juice/extracts on lipid profile were included. Difference in total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), oxidized low-density lipoprotein cholesterol (oxLDL-C), apolipoprotein (apo) A, apo B before and after administration of grape products or placebo were expressed as mean differences (MD) with pertinent 95% confidence intervals (95% CI). The impact of clinical and demographic features on effect size was assessed by meta-regression. Results: The administration of grape products is associated with a significant improvement of lipid profile, as evidenced by changes in TC (MD: −7.6 mg/dL (−0.2 mmol/L); 95% CI: −10.8, −4.4; p < 0.001), HDL-C (MD: 1.4 mg/dL (0.04 mmol/L); 95% CI: 0.8, 1.9; p < 0.001, I² = 74.7%, p < 0.001), LDL-C (−6.3 mg/dL (−0.16 mmol/L); 95% CI: −9.5, −3.0; p < 0.001), oxLDL-C (MD: −4.5 U/L; 95% CI: −7.5, −1.5; p = 0.003, I² = 90.6%, p < 0.001), apo B (MD: −2.4 mg/dL (−0.05 µmol/L); 95% CI: −4.5, −0.3; p = 0.026), and TG (MD: −14.5 mg/dL (−0.16 mmol/L); 95% CI: −17.7, −11.2; p < 0.001) levels in subjects receiving grape products compared to placebo. With regard to the extent of the lipid-lowering effect, compared to baseline values, the highest reduction was reported for LDL-C (MD: −5.6 mg/dL (−0.14 mmol/L); 95% CI: −9.5, −1.7; p = 0.005) and for oxLDL-C (MD: −5.0 U/L; 95% CI: −8.8, −1.2; p = 0.010, I² = 0%, p = 0.470). Conclusions: Grape polyphenols exert a favorable effect on lipid profile in humans by significantly reducing plasma levels of LDL-C and oxLDL-C.

The Bioprotective Effects of Polyphenols on Metabolic Syndrome against Oxidative Stress: Evidences and Perspectives

Polyphenols are the general designation of various kinds of phytochemicals, mainly classified as flavonoids and nonflavonoids. Polyphenolic compounds have been confirmed to exhibit numerous bioactivities and potential health benefits both in vivo and in vitro. Dietary polyphenols have been shown to significantly alleviate several manifestations of metabolic syndrome, namely, central obesity, hypertension, dyslipidemia, and high blood sugar. This review is aimed at discussing the bioprotective effects and related molecular mechanisms of polyphenols, mainly by increasing antioxidant capacity or oxygen scavenging capacity. Polyphenols can exert their antioxidative activity by balancing the organic oxidoreductase enzyme system, regulating antioxidant responsive signaling pathways, and restoring mitochondrial function. These data are helpful for providing new insights into the potential biological effects of polyphenolic compounds and the development of future antioxidant therapeutics.

Effects of acute intake of grape/pomegranate pomace dietary supplement on glucose metabolism and oxidative stress in adults with abdominal obesity

A controlled acute, cross-over clinical study (NCT02710461) was performed in order to evaluate the effects on glucose metabolism of a grape/pomegranate pomace dietary supplement in subjects with abdominal obesity (aged 40-60, n = 20). A standard 75 g oral glucose tolerance test (OGTT) was administered alone, together with or 10 h after the consumption of 10 g of the dietary supplement, rich in both extractable (0.4 g) and non-extractable (1.4 g) polyphenols. The dietary supplement did not ameliorate glucose or insulin at any sampling time. No improvement in antioxidant capacity was observed in plasma or urine, concordant with no increased urine polyphenol excretion. A tendency towards improved insulin sensitivity was observed when the product was consumed 10 h before glucose solution. These results suggest that a single realistic dose of grape/pomegranate pomace is not able to clearly improve glucose metabolism; chronic intake remains to be evaluated.