Rice Bran Oil Decreases Total and LDL Cholesterol in Humans: A Systematic Review and Meta-Analysis of Randomized Controlled Clinical Trials

Acute and Chronic Ethanol Effects during Adolescence on Neuroimmune Responses: Consequences and Potential Pharmacologic Interventions

Heavy ethanol consumption during adolescence has been linked to neuroimmune response dysregulation and cognitive deficits in the developing adolescent brain. During adolescence, the brain is particularly susceptible to the pharmacological effects of ethanol that are induced by acute and chronic bouts of exposure. Numerous preclinical rodent model studies have used different ethanol administration techniques, such as intragastric gavage, self-administration, vapor, intraperitoneal, and free access, and while most models indicated proinflammatory neuroimmune responses in the adolescent brain, there are various factors that appear to influence this observation. This review synthesizes the most recent findings of the effects of adolescent alcohol use on toll-like receptors, cytokines, and chemokines, as well as the activation of astrocytes and microglia with an emphasis on differences associated with the duration of ethanol exposure (acute vs. chronic), the amount of exposure (e.g., dose or blood ethanol concentrations), sex differences, and the timing of the neuroimmune observation (immediate vs. persistent). Finally, this review discusses new therapeutics and interventions that may ameliorate the dysregulation of neuroimmune maladaptations after ethanol exposure.

The effects of rice bran supplementation for management of blood lipids: A GRADE-assessed systematic review, dose-response meta-analysis, and meta-regression of randomized controlled trials

BACKGROUND

We aimed to conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) to investigate the effects of rice bran supplementation on serum lipid profile levels.

METHODS

We searched PubMed/Medline, Scopus, ISI Web of Science, and Google Scholar using related keywords. Published RCTs exploring the effects of rice bran consumption on lipid profile were searched up to June 2022. Evidence certainty was assessed on the basis of the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. The data were pooled using a random-effects model and reported as weighted mean difference (WMD) and 95% confidence interval (CI) for each outcome.

RESULTS

Meta-analysis of eight RCTs (with 11 effect sizes) showed no significant effect of rice bran supplementation on serum levels of triglyceride (WMD: -11.38 mg/dl; 95% CI: -27.73, 4.96; P = 0.17), total cholesterol (WMD: -0.68 mg/dl; 95% CI: -7.25, 5.88; P = 0.834), low-density lipoprotein cholesterol (WMD: -1.68 mg/dl; 95% CI: -8.46, 5.09; P = 0.627) and high-density lipoprotein cholesterol (WMD: 0.16 mg/dl; 95% CI: -1.52, 1.85; P = 0.848) compared to control group.

CONCLUSION

Our meta-analysis suggests that rice bran supplementation has no significant effects on serum levels of lipid profile components. However, larger studies with longer durations and improved methodological quality are needed before firm conclusions can be reached.

Improving γ-Oryzanol and γ-Aminobutyric Acid Contents in Rice Beverage Amazake Produced with Brown, Milled and Germinated Rices

Rice is an important source of γ-oryzanol (GO) and γ-aminobutyric acid (GABA), which are bioactive compounds that may benefit blood lipid and pressure control. Both GO and GABA can be improved by germination and fermentation. Fermentation with A. oryzae produces Koji, a rice-based starter for Amazake, a naturally sweet beverage. Germinated rice (brown and milled rice), were tested to improve those bioactive compounds during the fermentation process. The resulting Koji was optimised to GO and GABA through a response surface methodology; α-amylase activity and starch content were also assessed. The different rice matrix resulting from the germination largely impacted the biosynthesis of GABA, α-amylase and starch contents. Amazake, obtained by germinated rice, has increased GO and GABA contents when compared to the one obtained from milled rice (from a non-detectable value to 27.65 ± 0.23 mg/100 g for GO and from 163.95 ± 24.7 to 271.53 ± 5.7 mg/100 g for GABA). A panel of 136 Portuguese consumers tasted the beverage in a blind overall tasting test followed by an informed test, using 9-point scales. The consumer scores had a mean value of 4.67 ± 1.9 and 4.9 ± 1.8, meaning that cultural differences may play an important role with regard to liking and accepting Amazake.

Rice bran oil could favorably ameliorate atherogenicity and insulin resistance indices among men with coronary artery disease: post hoc analysis of a randomized controlled trial

BACKGROUND

Despite recent advances in recognizing more reliable indicators to estimate the coronary artery disease (CAD) patients' response to treatment and prognosis, less attention has been paid to evaluating them in clinical trials. Hence, the present research was conducted to study the impact of rice bran oil (RBO) versus sunflower oil (SFO) on various atherogenicity and insulin resistance markers.

METHODS

In the present 8-week randomized controlled trial, 40 CAD men with an average age of 56 years were allocated randomly into the intervention or control group to use RBO or SFO (30 g/day) plus a standardized dietary plan. As a further analysis, eight atherosclerosis-related indices were calculated before and after the study.

RESULTS

Analysis of covariance test in which potential confounders and baseline levels were considered, indicated that using RBO compared to SFO reduced Castelli's risk index I and II (adjusted means:3.29, 1.52 vs. 4.61, 2.20, respectively), atherogenic coefficient (2.29 vs. 3.61), lipoprotein combine index (6.54 vs. 17.53), and cholesterol index (0.46 vs. 1.20) after the trial (P-value ≤ 0.002). Also, the RBO group yielded significantly lower triglyceride glucose index (8.73 vs. 9.13) (P-value = 0.010). Further, marginally significant amelioration in triglyceride/HDL ratio and atherogenic index of plasma (1.48 and 0.13 vs. 1.86 and 0.24 respectively) were noted (P-value = 0.07). Spearman correlation analysis detected significant positive correlations between alterations in TNF-α serum levels (ng/L) and the majority of evaluated indices (P-value < 0.05).

CONCLUSION

Taken together, incorporating 30 g of RBO into the patient's usual diet appeared effective in ameliorating atherogenicity and insulin resistance indicators among men with CAD, probably in relation to its anti-inflammatory properties.

TRIAL REGISTRATION

The protocol of the current trial was retrospectively recorded in the Iranian clinical trial registration system (IRCT) with the registration number of IRCT20190313043045N1 (URL: https://en.irct.ir/trial/38346 ; Registration date: 2019-04-27).

Targeting dyslipidemia by herbal medicines: A systematic review of meta-analyses

ETHNOPHARMACOLOGICAL RELEVANCE

The worldwide increasing prevalence of dyslipidemia has become a global health concern. Various herbal remedies have been claimed to be effective for the treatment of dyslipidemia in traditional and folkloric medicine of different regions clinical trials have been conducted to investigate their efficacy. The aim of the current systematic review is to critically assess the meta-analyses of controlled trials (CT) evaluated herb medicines for dyslipidemia.

MATERIALS AND METHODS

Relevant studies from Web of Science, PubMed, Scopus, and Cochrane Library databases based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist until January 2021 have been searched. All meta-analyses which pooled studies on the effect of herbal medicines on lipid profile including total cholesterol (TC), triglyceride (TG), and low- or high-density lipoprotein cholesterol (LDL-C, HDL-C) were also included. Meta-analyses of in vitro, animal or observational studies were excluded.

RESULTS

The overall of 141 meta-analyses were revealed. Vegetable oils, phytosterols, tea, soy protein, nuts, and curcumin have been studied frequently among the herbal medicines. Among 13 meta-analyses on vegetable oils, the greater reduce of TC (18.95 mg/dl), LDL-C (16.24 mg/dl) and TG (13.69 mg/dl) were exhibited from sunflower oil. Furthermore, rice bran oil (6.65 mg/dl) increased HDL-C significantly. Phytosterols in 12 meta-analyses demonstrated significant improvements in reducing TC, LDL-C and TG as 16.4, 23.7, and 8.85 mg/dl, respectively, and rise in HDL-C as 10.6 mg/dl. The highest reduction in serum level of TC, LDL-C and TG was reported while intake Green tea; 27.57, 24.75, and 31.87 mg/dl, accordingly within 9 meta-analyses. Average improvement of lipid profiles by 6 meta-analyses on plant proteins were 23.2, 21.7, 15.06, and 1.55 mg/dl for TC, LDL-C, TG, and HDL-C, respectively. Among 11 meta-analyses on nuts, almond showed better and significant alleviations in TC (10.69 mg/dl), walnut in LDL-C (9.23 mg/dl), pistachio in TG (22.14 mg/dl), and peanut in HDL-C (2.72 mg/dl). Overall, Curcumin, Curcuminoid, and Turmeric have resulted in the reduction of TC (25.13 mg/dl), LDL-C (39.83 mg/dl), TG (33.65 mg/dl), and an increase in the HDL-C (4.31 mg/dl).

CONCLUSION

The current systematic review shed light on the use of herbal medicines for the management of dyslipidemia. However, more well-conducted CTs are required to determine effective doses of herbal medicines.

Tropical Oil Consumption and Cardiovascular Disease: An Umbrella Review of Systematic Reviews and Meta Analyses

The health effects of saturated fat, particularly tropical oil, on cardiovascular disease are unclear. We investigated the effect of tropical oil (palm and coconut oils), lard, and other common vegetable oils (soybean and rice bran oils) that are widely used in tropical and Asian countries on lipid profiles. We performed an umbrella review of meta-analyses and systematic reviews. Electronic databases (Medline, Scopus, Embase, and Cochrane) were searched up to December 2018 without language restriction. We identified nine meta-analyses that investigated the effect of dietary oils on lipid levels. Replacement of polyunsaturated fatty-acid-rich oils (PUFAs) and monounsaturated FA-rich oils (MUFAs) with palm oil significantly increased low-density lipoprotein cholesterol (LDL-c), by 3.43 (0.44-6.41) mg/dL and 9.18 (6.90-11.45) mg/dL, respectively, and high-density lipoprotein cholesterol (HDL-c), by 1.89 (1.23-2.55) mg/dL and 0.94 (-0.07-1.97) mg/dL, respectively. Replacement of PUFAs with coconut oil significantly increased HDL-c and total cholesterol -by 2.27 (0.93-3.6) mg/dL and 5.88 (0.21-11.55) mg/dL, respectively-but not LDL-c. Substituting lard for MUFAs and PUFAs increased LDL-c-by 8.39 (2.83-13.95) mg/dL and 9.85 (6.06-13.65) mg/dL, respectively-but not HDL-c. Soybean oil substituted for other PUFAs had no effect on lipid levels, while rice bran oil substitution decreased LDL-c. Our findings show the deleterious effect of saturated fats from animal sources on lipid profiles. Replacement of unsaturated plant-derived fats with plant-derived saturated fats slightly increases LDL-c but also increases HDL-c, which in turn may exert a neutral effect on cardiovascular health.

The effects of rice bran oil on left ventricular systolic function, cardiometabolic risk factors and inflammatory mediators in men with coronary artery disease: a randomized clinical trial

BACKGROUND/OBJECTIVE

In the current study, we aimed to explore the effects of rice bran oil (RBO) in adjunct to conventional medical therapy on left ventricular ejection fraction (LVEF), cardiometabolic risk factors, and inflammatory mediators in male patients with coronary artery disease (CAD).

SUBJECTS/METHODS

The present randomized controlled trial included 40 men diagnosed with CAD (mean age = 55.76 years) who were randomly allocated into two groups to receive either 30 grams per day of RBO (intervention group) or sunflower oil (control group) plus a standard diet for eight weeks. At the initial visit, demographic and anthropometric data and blood samples were collected. LVEF levels and serum concentrations of lipid profile, glucose, uric acid, hs-CRP, and TNF-α were investigated.

RESULTS

A total of 37 participants completed the study (n = 18 in the intervention group, n = 19 in the control group). Analysis of covariance (ANCOVA) adjusted for baseline values, age and body mass index revealed that RBO significantly improved LVEF (51.34%) and reduced triglyceride (125.01 mg dl^-1), blood sugar (110.4 mg dl^-1), total cholesterol (123.01 mg dl^-1) and low density lipoprotein (56.88 mg dl^-1) levels compared to sunflower oil ((45.56%), (155.93 mg dl^-1), (128.94 mg dl^-1), (163.93 mg dl^-1) and (83.79 mg dl^-1), respectively) following a 8-week trial (P-values < 0.05). Additionally, the test demonstrated that RBO consuming patients had significantly lower levels of serum uric acid (4.60 mg dl^-1), TNF-α (6.99 ng L^-1) and hs-CRP (2.11 mg L^-1) compared to the control group ((5.92 mg dl^-1), (15.23 ng L^-1), (4.47 mg L^-1), respectively) (P-value < 0.05). However, no significant changes were found regarding weight, blood pressure or serum HDL levels throughout the trial.

CONCLUSION

Consumption of 30 grams per day RBO within a standard diet could be considered an effective non-pharmacological approach in improving LVEF, cardiometabolic risk factors, and inflammatory state in CAD. However, future trials are recommended for more clarification.

The impact of rice bran oil consumption on the serum lipid profile in adults: a systematic review and meta-analysis of randomized controlled trials

Dyslipidemia/hyperlipidemia is recognized among the risk factors for lifestyle related diseases. A healthy diet, rich in vegetable oils such as rice bran oil (RBO), may aid to improve serum lipid levels. Thus, the aim of this study was to assess the effects of rice bran oil (RBO) consumption on serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c) and triglyceride (TG) levels in adults. The following online databases were searched for manuscripts published until October 7^th 2020: PubMed/Medline, Scopus, Clarivate Analytics' Web of Science, Cochrane Central Register of Controlled Trials, and Google Scholar. The effect sizes were expressed as weighted mean difference (WMD) with 95% confidence intervals (CI). A total of 8 eligible trials with 14 effect sizes were included in this meta-analysis. Our analysis revealed that the consumption of RBO significantly decreased serum TC (WMD: -7.29 mg/dL, 95% CI: -11.32, -3.25, P = 0.000), LDL-c (WMD: -7.62 mg/dL, 95% CI: -11.10, -4.14, P = 0.000) and TG (WMD: -9.19 mg/dL, 95% CI: -17.99, -0.38, P = 0.041) levels. So, available evidence suggests that RBO consumption can significantly decrease serum TC, LDL-c and TG levels. Hence, it may play a role in reducing dyslipidemia/hyperlipidemia risk.

Two Blends of Refined Rice Bran, Flaxseed, and Sesame Seed Oils Affect the Blood Lipid Profile of Chinese Adults with Borderline Hypercholesterolemia to a Similar Extent as Refined Olive Oil

BACKGROUND

Individual vegetable oils have a characteristic fatty acids (FA) composition and unique phytonutrient profiles, enabling formulation of oil blends that may have health-promoting effects.

OBJECTIVE

The primary objective of this study was to investigate effects of 2 oil blends made with refined rice bran, flaxseed, and sesame oils, with distinct monounsaturated to saturated FA, polyunsaturated to saturated FA, and omega-3 (n-3) to omega-6 FA ratios and different phytonutrient concentrations on blood lipid profile, compared with refined olive oil as a control. The secondary outcomes were other markers of cardiometabolic health.

METHODS

A parallel-design, randomized controlled trial compared consumption of 30 g of allocated intervention oil per day for a period of 8 wk. The study recruited 143 borderline hypercholesterolemic (LDL cholesterol: 3.06-4.51 mmol/L) Chinese volunteers between 50 and 70 y old and with a BMI (kg/m2) ≤27.5. All outcomes were measured every 2 wk, and the time × treatment interactions and the main effects of treatment and time were analyzed using an intention-to-treat approach.

RESULTS

Compared with baseline (week 0), there were significant reductions during the post-intervention time points in serum total cholesterol (-3.47%; P < 0.0001), LDL cholesterol (-4.16%; P < 0.0001), triglycerides (-10.3%; P < 0.0001), apoB (-3.93%; P < 0.0001), total to HDL-cholesterol (-3.44%; P < 0.0001) and apoB to apoA1 (-3.99%; P < 0.0001) ratios, systolic and diastolic blood pressures (-3.32% and -3.16%, respectively; both P < 0.0001), and serum glucose (-1.51%; P < 0.05) and a small but significant increase in body weight (+0.7%; P < 0.001) for all 3 intervention oils but no effects of intervention on HDL-cholesterol or apoA1 concentration. No significant effects of treatment or time × treatment interactions were found.

CONCLUSIONS

Using blended vegetable oils that are extensively consumed in Asia, this study found that specific oil blends can improve blood lipid profile and other cardiometabolic parameters, to a similar extent as refined olive oil, in Chinese adults with borderline hypercholesterolemia. This trial is registered at www.clinicaltrials.gov as NCT03964857.

Phytochemicals and Gastrointestinal Cancer: Cellular Mechanisms and Effects to Change Cancer Progression

Gastrointestinal (GI) cancer is a prevailing global health disease with a high incidence rate which varies by region. It is a huge economic burden on health care providers. GI cancer affects different organs in the body such as the gastric organs, colon, esophagus, intestine, and pancreas. Internal and external factors like smoking, obesity, urbanization, genetic mutations, and prevalence of Helicobacter pylori and Hepatitis B and Hepatitis C viral infections could increase the risk of GI cancer. Phytochemicals are non-nutritive bioactive secondary compounds abundantly found in fruits, grains, and vegetables. Consumption of phytochemicals may protect against chronic diseases like cardiovascular disease, neurodegenerative disease, and cancer. Multiple studies have assessed the chemoprotective effect of selected phytochemicals in GI cancer, offering support to their potential towards reducing the pathogenesis of the disease. The aim of this review was to summarize the current knowledge addressing the anti-cancerous effects of selected dietary phytochemicals on GI cancer and their molecular activities on selected mechanisms, i.e., nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB), detoxification enzymes, adenosine monophosphate activated protein kinase (AMPK), wingless-related integration site/β-catenin (wingless-related integration site (Wnt) β-catenin, cell apoptosis, phosphoinositide 3-kinases (PI3K)/ protein kinase B AKT/ mammalian target of rapamycin (mTOR), and mitogen-activated protein kinase (MAPK). In this review phytochemicals were classified into four main categories: (i) carotenoids, including lutein, lycopene, and β-carotene; (ii) proanthocyanidins, including quercetin and ellagic acid; (iii) organosulfur compounds, including allicin, allyl propyl disulphide, asparagusic acid, and sulforaphane; and (iv) other phytochemicals including pectin, curcumins, p-coumaric acid and ferulic acid. Overall, phytochemicals improve cancer prognosis through the downregulation of β-catenin phosphorylation, therefore enhancing apoptosis, and upregulation of the AMPK pathway, which supports cellular homeostasis. Nevertheless, more studies are needed to provide a better understanding of the mechanism of cancer treatment using phytochemicals and possible side effects associated with this approach.

Exploiting the bioactive properties of γ-oryzanol from bran of different exotic rice varieties

The rice industry is one of the most significant food industries since rice is a widely consumed cereal in the world. As a result of this substantial production, the rice industry has a significant amount of side streams, including bran, representing millions of tons of raw materials mainly designated to animal feed. Rice bran is a rich source of γ-oryzanol, a bioactive compound with substantial health benefits. In this perspective, different bran rice samples from distinct germplasm origins (Philippines, Italy and Portugal) were studied for their γ-oryzanol content by HPLC-PDA, cytotoxicity in four human tumour cell lines, hepatotoxicity in a normal cell line and for their antimicrobial effects on different bacterial and fungal strains. The Ballatinao sample presented the strongest activity against all the tumour cell lines, and was also the sample showing the highest amount of γ-oryzanol, suggesting its contribution to the exhibited cytotoxic properties. Regarding the antimicrobial activity, the tested samples were able to inhibit the majority of bacterial and fungal strains, with the Portuguese Ceres sample being the one presenting the highest bacterial inhibition and the Maluit and Dinorado samples, the highest fungal inhibition. Overall, the results show that rice bran extracts may be considered as potential candidates for antimicrobial agents when incorporated into food matrices.

Virgin rice bran oil alleviates hypertension through the upregulation of eNOS and reduction of oxidative stress and inflammation in L-NAME-induced hypertensive rats

OBJECTIVE

Endothelial dysfunction associated with reduction in nitric oxide (NO) bioavailability plays an important role in development of hypertension. Consumption of a diet rich in antioxidants appears to lower the risk for hypertension. Virgin rice bran oil (VRBO) possesses antioxidant, anti-inflammatory, and hypocholesterolemic activities. However, to our knowledge, the antihypertensive effect of VRBO has not been investigated. The aim of this study was to examine the antihypertensive effect of VRBO in N^ω-nitro-l-arginine methyl ester (L-NAME)-induced hypertensive rats and its underlying mechanisms.

METHODS

Hypertension was induced in rats by administration of L-NAME, after which VRBO, lisinopril (Lis), or VRBO + Lis was administered. Studies were then conducted on the hemodynamics of vascular responses to vasoactive substances, plasma angiotensin-converting enzyme (ACE), plasma nitrate/nitrite, oxidative stress, and inflammatory markers.

RESULTS

L-NAME administration induced hemodynamic changes including elevation of blood pressure, increased peripheral vascular resistance, and endothelial dysfunction. Reduction in plasma nitrate/nitrite, overproduction of vascular superoxide, and increases in plasma ACE, malondialdehyde, protein carbonyl, and plasma tumor necrosis factor-α were observed in L-NAME hypertensive rats. The changes were associated with a marked decrease in endothelial NO synthase expression, increased expression of gp91^phoxand vascular cell adhesion molecule-1, and activation of nuclear factor-κB in aortic tissues. Administration of either VRBO or Lis significantly mitigated all of these deleterious effects. The combination of VRBO and Lis was more effective than either treatment alone.

CONCLUSIONS

The antihypertensive effect of VRBO may be mediated by restoration of hemodynamics, increased NO bioavailability, and alleviation of oxidative stress and inflammation. VRBO has an additive effect on antihypertensive medication.

Dietary natural products as emerging lipoprotein(a)-lowering agents

Elevated plasma lipoprotein(a) (Lp(a)) levels are associated with an increased risk of cardiovascular disease (CVD). Hitherto, niacin has been the drug of choice to reduce elevated Lp(a) levels in hyperlipidemic patients but its efficacy in reducing CVD outcomes has been seriously questioned by recent clinical trials. Additional drugs may reduce to some extent plasma Lp(a) levels but the lack of a specific therapeutic indication for Lp(a)-lowering limits profoundly reduce their use. An attractive therapeutic option is natural products. In several preclinical and clinical studies as well as meta-analyses, natural products, including l-carnitine, coenzyme Q ₁₀ , and xuezhikang were shown to significantly decrease Lp(a) levels in patients with Lp(a) hyperlipoproteinemia. Other natural products, such as pectin, Ginkgo biloba, flaxseed, red wine, resveratrol and curcuminoids can also reduce elevated Lp(a) concentrations but to a lesser degree. In conclusion, aforementioned natural products may represent promising therapeutic agents for Lp(a) lowering.

The impact of pycnogenol supplementation on plasma lipids in humans: A systematic review and meta-analysis of clinical trials

The effects of pycnogenol on plasma lipids are controversial. A systematic review and meta-analysis of clinical trials were conducted to obtain a conclusive result in humans. PubMed, Scopus, and Google Scholar were systematically searched until March 2018, to explore the clinical trials that examined the effect of pycnogenol supplementation on lipid parameters among adult human. Methodological quality of the eligible studies was evaluated using the Cochrane Collaboration's tool. To estimate the effect size, changes in blood lipids were implemented. Results were pooled using a random effects model. Potential sources of heterogeneity were explored by subgroup analysis. A systematic review and meta-analysis of 14 clinical trials with 1,065 participants suggested a significant increase in plasma concentration of high density lipoprotein cholesterol (HDL-C; 3.27 mg/dL; 95% CI [0.19, 6.36]; p = 0.038). In contrast, plasma levels of total cholesterol (TC; -4.45 mg/dL, 95% CI [-11.24, 2.34]; p = 0.199), triacylglycerol (TAG; -3.64 mg/dL; 95% CI [-17.89, 10.61]; p = 0.616), and low density lipoprotein cholesterol (LDL-C; -3.61 mg/dl; 95% CI [-8.76, 1.55]; p = 0.171) were not altered. Adjustment for confounding variables was poor in included studies. Also, these studies did not assess dietary lipid intake. The results indicate that pycnogenol supplementation improves levels of HDL-C; however, the changes in TC, TAG, and LDL-C were not clinically relevant. Since there are few phytochemicals that have a significant increasing effect on HDL-C levels, pycnogenol may have important role in prevention of cardiovascular diseases.

Effects of Canola Oil Consumption on Lipid Profile: A Systematic Review and Meta-Analysis of Randomized Controlled Clinical Trials

Hyperlipidemia is a well- known risk factor of cardiovascular disease. A healthy diet containing vegetable oils such as canola oil (CO) may help to reduce serum lipids. This study aimed to quantify the effects of CO on lipid parameters using a systematic review and meta-analysis of randomized controlled trials. PubMed, Web of Science, Scopus, ProQuest, and Embase were systematically searched until December 2017, with no time and design restrictions. Also, a manual search was performed to find extra relevant articles. Lipid parameters including total cholesterol (TC), low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL), triglycerides (TG), apolipoprotein A1 (Apo A1), and apolipoprotein B (Apo B) were entered the meta-analysis. Weighed mean difference (WMD) and 95% confidence interval (CI) were stated as the effect size. Sensitivity analyses and prespecified subgroup were conducted to evaluate potential heterogeneity. Twenty-seven trials, comprising 1359 participants, met the eligibility criteria. Results of this study showed that CO consumption significantly reduced TC (-7.24 mg/dl, 95% CI, -12.1 to -2.7), and LDL (-6.4 mg/dl, 95% CI, -10.8 to -2), although it had no effects on HDL, TG, Apo B, and Apo A1. Effects of CO on TC and LDL significantly decreased after CO consumption in subgroups of >50 years of age participants and >30 intervention duration subgroup. Moreover, CO decreased LDL and TC compared to sunflower oil and saturated fat. This meta-analysis suggested that CO consumption improves serum TC and LDL, which could postpone heart disease progression. Key Teaching Points CO consumption could decrease serum TC and LDL, although it had no effects on other blood lipids. There was an overall significant effect of canola oil on TC and LDL compared to sunflower oil and saturated fats. CO could have beneficial effects on serum TC and LDL just when consumed longer than 30 days. CO consumption improved lipid profiles in participants older than 50 years.

The Role of Nutraceuticals in Statin Intolerant Patients

Statins are the most common drugs administered for patients with cardiovascular disease. However, due to statin-associated muscle symptoms, adherence to statin therapy is challenging in clinical practice. Certain nutraceuticals, such as red yeast rice, bergamot, berberine, artichoke, soluble fiber, and plant sterols and stanols alone or in combination with each other, as well as with ezetimibe, might be considered as an alternative or add-on therapy to statins, although there is still insufficient evidence available with respect to long-term safety and effectiveness on cardiovascular disease prevention and treatment. These nutraceuticals could exert significant lipid-lowering activity and might present multiple non-lipid-lowering actions, including improvement of endothelial dysfunction and arterial stiffness, as well as anti-inflammatory and antioxidative properties. The aim of this expert opinion paper is to provide the first attempt at recommendation on the management of statin intolerance through the use of nutraceuticals with particular attention on those with effective low-density lipoprotein cholesterol reduction.

Cholesterol-Lowering Nutraceuticals Affecting Vascular Function and Cardiovascular Disease Risk

PURPOSE OF REVIEW

The aim of this review is to provide an update on the effects of the dietary supplementation with cholesterol-lowering nutraceuticals and nutraceutical combinations affecting vascular function and CV risk in clinical interventional studies.

RECENT FINDINGS

Current evidence supports the mild-to-moderate cholesterol-lowering efficacy of red yeast rice, berberine, plant sterols, fibers, and some nutraceutical combinations whereas data on the individual cholesterol-lowering action of other nutraceuticals are either less striking or even inconclusive. There is also promising evidence on the vascular protective effects of some of the aforementioned nutraceuticals. However, except for red yeast rice, clinical interventional studies have not investigated their impact on CV outcomes. Evidence of both cholesterol-lowering and vascular protection is a prerogative of few single nutraceuticals and nutraceutical combinations, which may support their clinical use; however, caution on their uncontrolled adoption is necessary as they are freely available on the market and, therefore, subject to potential misuse.

Dietary Wheat Bran Oil Is Equally as Effective as Rice Bran Oil in Reducing Plasma Cholesterol

Rice bran oil (RBO) possesses a plasma cholesterol-lowering activity, while effect of wheat bran oil (WBO) on plasma cholesterol remains unknown. The present study compared the cholesterol-lowering activity of WBO with that of RBO in hamsters. Fifty-four male hamsters were divided into seven groups fed either a noncholesterol diet (NCD) or one of six high-cholesterol diets, namely HCD diet (0.2% cholesterol +9.5% lard), HCD+C diet (0.2% cholesterol +9.5% lard +0.5% cholestyramine), WL diet (0.2% cholesterol +4.8% Lard +4.8% WBO), WH diet (0.2% cholesterol +9.5% WBO), RL diet (0.2% cholesterol +4.8% Lard +4.8% RBO), and RH diet (0.2% cholesterol +9.5% RBO). Plasma total cholesterol (TC) in HCD group was 327.4 ± 31.8 mg/dL, while plasma TC in two WBO and two RBO groups was 242.2 ± 20.8, 243.1 ± 31.7, 257.1 ± 16.3, and 243.4 ± 46.0 mg/dL, respectively, leading to a decrease in plasma TC by 22-26% ( P < 0.01). No significant difference in cholesterol-lowering potency was seen between WBO and RBO. Plasma cholesterol-lowering activity of WBO and RBO was accompanied by down-regulation of hepatic 3-hydroxy-3-methylglutaryl-CoA reductase and fatty acid synthase, while up-regulation of cholesterol-7α-hydroxylase. WL, WH, RL, and RH diets increased the fecal excretion of total neutral sterols by 72.8%, 106.9%, 5.4%, and 36.8% ( P < 0.01) respectively. Results indicated WBO and RBO could inhibit cholesterol absorption via down-regulation of intestinal Niemann-Pick C1 like 1 protein, acyl CoA:cholesterol acyltransferase 2, and ATP binding cassette transporter 5. In summary, WBO was equally effective as RBO in decreasing plasma cholesterol in hypercholesterolemia hamsters.

The relationship between lipid phytochemicals, obesity and its related chronic diseases

This review focuses on phytochemicals in oils, and summarizes the mechanisms of the anti-obesity effects of these compounds in in vitro studies, animal models, and human trials.

Lipid-lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel

In recent years, there has been growing interest in the possible use of nutraceuticals to improve and optimize dyslipidemia control and therapy. Based on the data from available studies, nutraceuticals might help patients obtain theraputic lipid goals and reduce cardiovascular residual risk. Some nutraceuticals have essential lipid-lowering properties confirmed in studies; some might also have possible positive effects on nonlipid cardiovascular risk factors and have been shown to improve early markers of vascular health such as endothelial function and pulse wave velocity. However, the clinical evidence supporting the use of a single lipid-lowering nutraceutical or a combination of them is largely variable and, for many of the nutraceuticals, the evidence is very limited and, therefore, often debatable. The purpose of this position paper is to provide consensus-based recommendations for the optimal use of lipid-lowering nutraceuticals to manage dyslipidemia in patients who are still not on statin therapy, patients who are on statin or combination therapy but have not achieved lipid goals, and patients with statin intolerance. This statement is intended for physicians and other healthcare professionals engaged in the diagnosis and management of patients with lipid disorders, especially in the primary care setting.

Anti-hyperlipidemic effect of rice bran polysaccharide and its potential mechanism in high-fat diet mice

The evaluation of the lipid-lowering effect of rice bran polysaccharides (RBP) and identification of the related genes of lipid metabolism. RBP, rice bran polysaccharide; HFD, high fat diet.

Potential relevance of microRNAs in inter-species epigenetic communication, and implications for disease pathogenesis

MicroRNAs are short non-protein coding RNA molecules involved in the epigenetic regulation of gene expression. Recently, extracellular microRNAs have been described in body fluids that might enable epigenetic communication between distant tissues. Being highly conserved molecules, exogenous xeno-microRNAs from different species could affect gene expression in the host even in a cross-kingdom fashion. Several data underline the relevance of microRNA-mediated communication between virus and host, and there are some experimental data showing that plant- or animal-derived dietary microRNAs might have gene expression modulating activity in humans. Milk-derived microRNAs might be involved in the "epigenetic priming" of the baby. Exogenous microRNAs might be hypothesized to be implicated in disease pathogenesis, e.g. in tumors. Major questions remain to be addressed including the amount of xeno-microRNAs needed for biological action or routes for microRNA delivery. In this brief review, experimental data and hypotheses on the potential pathogenic inter-species relevance of microRNA are presented.