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Benam SP, Mirabdali S, Ebrahimi N, Daneshvar M, Vahedi S, Abbasifard F, Rounagh M. Does flaxseed supplementation affect apo-lipoproteins? A GRADE-assessed systematic review and meta-analysis. Prostaglandins Other Lipid Mediat 2024; 174:106872. [PMID: 39002708 DOI: 10.1016/j.prostaglandins.2024.106872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Revised: 07/02/2024] [Accepted: 07/09/2024] [Indexed: 07/15/2024]
Abstract
Several studies indicated the ameliorating effects of flaxseed supplementation on apolipoproteins, although others have conflicting results. Therefore, the present research was conducted in order to accurately and definitively understand the effect of flaxseed on apolipoproteins in adults. All articles published up to Juan 2024 were systematically searched through PubMed, Scopus, Embase, and Web of Science to collect all randomized clinical trials (RCTs). A random effects model was used to measure the combined effect sizes. Also, standardized mean difference (SMD) and 95 % confidence interval (CI) were used to report the combined effect size. Our results showed that flaxseed supplementation significantly reduced apo-BI (SMD: -0.57; 95 % CI: -0.95, -0.19, p = 0.003; I2 = 83.2 %, heterogeneity p < 0.001) and lipo(a) decreased (SMD: -0.34; 95 % CI: -0.59, -0.09, p=0.007; I2=30.3 %, heterogeneity p=0.197). However, flaxseed did not change apo-AI levels (SMD: -0.37; 95 % CI: -0.87, 0.13, p = 0.146; I2 = 89.2 %, p-heterogeneity < 0.001). This meta-analysis has shown that flaxseed supplementation may have beneficial effects on apolipoproteins. Future high-quality, long-term clinical trials are needed to confirm our results.
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Affiliation(s)
| | | | - Negar Ebrahimi
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical sciences, Mashhad, Iran
| | | | - Shima Vahedi
- Food Science and Safety, Chemistry Faculty, Kaunas University of Technology, Kaunas, Lithuania
| | - Fateme Abbasifard
- School of Medicine,Tonekabon Branch,Islamic Azad University, Mazandaran, Iran.
| | - Mahsa Rounagh
- Islamic Azad University Science and Research Branch of Medical Science,Tehran, Iran.
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Wang L, Feng L, Prabahar K, Hernández-Wolters B, Wang Z. The effect of phytosterol supplementation on lipid profile: A critical umbrella review of interventional meta-analyses. Phytother Res 2024; 38:507-519. [PMID: 37905579 DOI: 10.1002/ptr.8052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 09/22/2023] [Accepted: 10/07/2023] [Indexed: 11/02/2023]
Abstract
Despite multiple investigations assessing the impact of phytosterol supplementation on serum lipid levels, there is still a great deal of debate regarding the benefits of this intervention in the management of dyslipidemia. Therefore, we aimed at clarifying this dilemma by conducting the present umbrella review of interventional meta-analyses. Scopus, PubMed, Web of Science, and EMBASE were used to search for pertinent publications on the effect of phytosterol supplementation on the lipid profile in humans up to June 2023. To compute the overall effect size (ES) and confidence intervals (CI), the random-effects model was used. The I2 statistic and Cochrane's Q-test were applied to estimate the heterogeneity among the studies. Seventeen meta-analyses with 23 study arms were included in the umbrella meta-analysis. Data pooled from the 23 eligible arms revealed that phytosterol supplementation reduces low-density lipoprotein cholesterol (LDL-C) (ES = -11.47 mg/dL; 95% CI: -12.76, -10.17, p < 0.001), total cholesterol (TC) (ES = -13.02 mg/dL; 95% CI: -15.68, -10.37, p < 0.001), and triglyceride (TG) (ES = -3.77 mg/dL; 95% CI: -6.04, -1.51, p = 0.001). Subgroup analyses showed that phytosterol administration with dosage ≥2 g/day and duration over 8 weeks and in hypercholesterolemic subjects was more likely to decrease LDL-C, TC, and TG. Phytosterol administration did not significantly modify HDL-C (ES = 0.18 mg/dL; 95% CI: -0.13, -0.51, p = 258) levels when compared to controls. The present umbrella meta-analysis confirms that phytosterol administration significantly reduces LDL-C, TC, and TG, with a greater effect with doses of ≥2 g/day and treatment duration >8 weeks, suggesting its possible application as a complementary therapy for cardiovascular risk reduction. Further studies are needed to determine the efficacy of phytosterols in patients with specific health conditions, as well as to ascertain the adverse effects, the maximum tolerable dose, and the maximum recommended duration of phytosterol administration.
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Affiliation(s)
- Le Wang
- Department of Emergency Medicine, People's Hospital of Huaiyin. Jinan, Jinan, China
- The First Clinical College, Nanjing University of Chinese Medicine, Nanjing, China
| | - Li Feng
- Department of Rehabilitation Medicine, Jinan Huaiyin People's Hospital, Jinan, China
| | - Kousalya Prabahar
- Department of Pharmacy Practice, Faculty of Pharmacy, University of Tabuk, Tabuk, Saudi Arabia
| | - Benjamin Hernández-Wolters
- School of medicine, University Center for Health Science, Universidad de Guadalajara, Guadalajara, Mexico
| | - Zhenxing Wang
- Department of Cardiovascular Medicine, Affiliated Hospital of Nanjing University of Traditional Chinese Medicine, Nanjing, China
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Liu B, Chen K, Chen X, Wang J, Shu G, Ping Z, Zhang S. Health outcomes associated with phytosterols: An umbrella review of systematic reviews and meta-analyses of randomized controlled trials. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2024; 122:155151. [PMID: 37866333 DOI: 10.1016/j.phymed.2023.155151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 08/17/2023] [Accepted: 10/14/2023] [Indexed: 10/24/2023]
Abstract
BACKGROUND Phytosterols (PS), as a kind of plant active ingredients, have many benefits to human health. However, there is currently no comprehensive overview of the clinical evidence and an assessment of the evidence quality. PURPOSE We conducted an umbrella review, which incorporated verification spanning a number of meta-analyses and systematic reviews to clarify the link that existed between PS consuming and health outcomes. METHODS The databases PubMed, Embase, Web of Science and The Cochrane Library were searched for appropriate research and ultimately included 23 articles involving 79 results. Methodological quality and the validity of evidence received designation in the included meta-analyses leveraging the Assessment of Multiple Systematic Reviews (AMSTAR-2) and the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). RESULTS The consumption of PS makes a contribution to the alleviation of metabolic conditions such as hypercholesterolemia, diabetes, obesity, and hypertension. Its most essential function is to decrease cholesterol absorption, leading to dramatically reductions in total cholesterol and low density lipoprotein cholesterol. Furthermore, utilizing PS products can have a favorable impact on managing apolipoprotein levels along with decreasing the probability of obtaining atherosclerotic cardiovascular disease. CONCLUSION This umbrella review summarized a range of beneficial functions of PS to humans, highlighting the promising potential for the development of PS into functional foods.
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Affiliation(s)
- Bing Liu
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Ke Chen
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Xi Chen
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Jian Wang
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Guangjie Shu
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Zhiguang Ping
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Shenshen Zhang
- College of Public Health, Zhengzhou University, Zhengzhou, China; Food Laboratory of Zhongyuan, Luohe, China.
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Gholami Chahkand MS, Esmaeilpour Moallem F, Qezelgachi A, Seifouri K, Pesaran Afsharian A, sheikhzadeh F, poursalehi A, Fani Sadrabadi FS, Saghab Torbati M, Ramezanzade M, Alishiri G, Ansari A, Zare Dehabadi E, Karimi Matloub S, Sheikh Z, Deravi N, Mehrtabar S, Chichagi F, Faal Hamedanchi N, Arzaghi M, Asadi M, Alsadat Dadkhah P, Ansari A. Lipoprotein (a) as a predictor of diabetic retinopathy in patients with type 2 diabetes: A systematic review. Diab Vasc Dis Res 2023; 20:14791641231197114. [PMID: 38018132 PMCID: PMC10685788 DOI: 10.1177/14791641231197114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND Lipoprotein a (LP(a)), an LDL-like lipoprotein, known as a risk factor for cardiovascular diseases, has a controversial association with diabetic retinopathy in patients with type 2 diabetes-the current systematic review aimed to critically assess the association between LP(a) and diabetic retinopathy. METHODS A systematic review of relevant studies was conducted after a thorough search in PubMed, Scopus, and Google Scholar electronic databases. We used English observational, case-control, and prospective cohort studies published up to August 2022, including type 2 diabetic patients as the population, diabetic retinopathy as the outcome, and LP(a) as the intervention. RESULT 17 relevant studies, including 4688 patients with diabetes, were included in this systematic review. While in 13 studies, Lipoprotein(a) was recognized as a risk factor for diabetic retinopathy, only three studies reported no evidence of a relationship between the two. Also, another study showed a mixed outcome of the relationship between LP(a) and diabetic retinopathy. CONCLUSION High serum lipoprotein(a) in patients with type 2 diabetes is considered a risk factor for diabetic retinopathy. However, further large-scaled cohort studies are still required to validate this finding.
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Affiliation(s)
| | | | - Abolfazl Qezelgachi
- Student Research Committee, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Kiana Seifouri
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Farzad sheikhzadeh
- Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Atefe poursalehi
- Student Research Committee, School of Paramedical, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | | | | | - Goharsharieh Alishiri
- Students Research Committee, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Arina Ansari
- Student Research Committee, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Emad Zare Dehabadi
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Zahra Sheikh
- Student Research Committee, School of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Niloofar Deravi
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saba Mehrtabar
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fatemeh Chichagi
- Students’ Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
| | - Neda Faal Hamedanchi
- Faculty of Medicine, Islamic Azad University, Tehran Medical Sciences Branch, Tehran, Iran
| | | | - Mahla Asadi
- Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Akram Ansari
- Medical College, Shantou University, Shantou, China
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Cicero AFG, Fogacci F, Giovannini M, Rizzoli E, Grandi E, D’Addato S, Borghi C. The Effect of Dietary Supplementation with Plant Sterols on Total and LDL-Cholesterol in Plasma Is Affected by Adherence to Mediterranean Diet: Insights from the DESCO Randomized Clinical Study. Nutrients 2023; 15:4555. [PMID: 37960208 PMCID: PMC10649106 DOI: 10.3390/nu15214555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 10/15/2023] [Accepted: 10/25/2023] [Indexed: 11/15/2023] Open
Abstract
Plant sterols are well-known natural lipid-lowering agents. The DESCO (Diet and plant sterols in the control of cholesterolemia) study was a single-center, randomized, double-blind, placebo-controlled, two-way crossover clinical trial designed to investigate the effect of a once-a-day ready-to-drink dietary supplement containing 2.5 g of phytosterols on the lipid profile, also in relation to the quality of the diet, in a cohort of 50 Italian individuals with polygenic hypercholesterolemia and low global cardiovascular risk. Eligible individuals were enrolled in a run-in period of 2 weeks. Then, participants who qualified for continuation in the study were randomly allocated (1:1) to a 3-week treatment with either phytosterols or placebo. After a 2-week washout period, enrolled individuals were crossed over to receive the alternative treatment. Dietary supplementation with phytosterols was associated with significant improvement in plasma levels of total cholesterol (TC; -11.8 ± 4.0 mg/dL, p = 0.016), low-density lipoprotein cholesterol (LDL-C; -7.8 ± 7.7 mg/dL, p = 0.021), and apolipoprotein B-100 (Apo B-100, -3.7 ± 4.1 mg/dL, p = 0.048) compared to baseline. The changes in TC and LDL-C were also significant compared to placebo, and greater adherence to the Mediterranean diet was significantly associated with greater reductions in LDL-C. Dietary supplementation with phytosterols was well tolerated and adherence to treatment was high. According to the findings of DESCO, the once-a-day ready-to-drink dietary supplement we tested is able to quickly and significantly decrease plasma levels of TC, LDL-C, and Apo B-100, with a greater effect in individuals more adhering to the Mediterranean dietary pattern.
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Affiliation(s)
- Arrigo F. G. Cicero
- Hypertension and Cardiovascular Risk Research Group, Medical and Surgical Sciences Department, University of Bologna, 40138 Bologna, Italy; (A.F.G.C.); (M.G.); (E.R.); (E.G.); (S.D.); (C.B.)
- IRCCS Azienda Ospedaliero, Universitaria di Bologna, 40138 Bologna, Italy
| | - Federica Fogacci
- Hypertension and Cardiovascular Risk Research Group, Medical and Surgical Sciences Department, University of Bologna, 40138 Bologna, Italy; (A.F.G.C.); (M.G.); (E.R.); (E.G.); (S.D.); (C.B.)
- Italian Nutraceutical Society (SINut), 40100 Bologna, Italy
| | - Marina Giovannini
- Hypertension and Cardiovascular Risk Research Group, Medical and Surgical Sciences Department, University of Bologna, 40138 Bologna, Italy; (A.F.G.C.); (M.G.); (E.R.); (E.G.); (S.D.); (C.B.)
| | - Elisabetta Rizzoli
- Hypertension and Cardiovascular Risk Research Group, Medical and Surgical Sciences Department, University of Bologna, 40138 Bologna, Italy; (A.F.G.C.); (M.G.); (E.R.); (E.G.); (S.D.); (C.B.)
- IRCCS Azienda Ospedaliero, Universitaria di Bologna, 40138 Bologna, Italy
| | - Elisa Grandi
- Hypertension and Cardiovascular Risk Research Group, Medical and Surgical Sciences Department, University of Bologna, 40138 Bologna, Italy; (A.F.G.C.); (M.G.); (E.R.); (E.G.); (S.D.); (C.B.)
- IRCCS Azienda Ospedaliero, Universitaria di Bologna, 40138 Bologna, Italy
| | - Sergio D’Addato
- Hypertension and Cardiovascular Risk Research Group, Medical and Surgical Sciences Department, University of Bologna, 40138 Bologna, Italy; (A.F.G.C.); (M.G.); (E.R.); (E.G.); (S.D.); (C.B.)
- IRCCS Azienda Ospedaliero, Universitaria di Bologna, 40138 Bologna, Italy
| | - Claudio Borghi
- Hypertension and Cardiovascular Risk Research Group, Medical and Surgical Sciences Department, University of Bologna, 40138 Bologna, Italy; (A.F.G.C.); (M.G.); (E.R.); (E.G.); (S.D.); (C.B.)
- IRCCS Azienda Ospedaliero, Universitaria di Bologna, 40138 Bologna, Italy
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Pérez-Martínez P, Ros E, Pedro-Botet J, Civeira F, Pascual V, Garcés C, Solá R, Pérez-Jiménez F, Mostaza JM. Functional foods and nutraceuticals in the treatment of hypercholesterolemia: Statement of the Spanish Society of Arteriosclerosis 2023. CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE ARTERIOSCLEROSIS 2023; 35:248-261. [PMID: 36932013 DOI: 10.1016/j.arteri.2023.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 02/15/2023] [Indexed: 03/17/2023]
Abstract
In the management of hypercholesterolemia, besides advising a healthy, plant-based diet, it may be useful to recommend functional foods or nutraceutical with cholesterol-lowering properties. Given the progressive increase in the number of these products and their rising use by the population, the Spanish Society of Arteriosclerosis (SEA) has considered it appropriate to review the available information, select the results of the scientifically more robust studies and take a position on their usefulness, to recommend to health professionals and the general population their potential utility in terms of efficacy and their possible benefits and limitations. The following clinical scenarios have been identified in which these products could be used and will be analyzed in more detail in this document: (1) Hypolipidemic treatment in subjects with statin intolerance. (2) Hypolipidemic treatment «a la carte» in individuals in primary prevention. (3) Long-term cardiovascular prevention in individuals with no indication for lipid-lowering therapy. (4) Patients with optimized lipid-lowering treatment who do not achieve therapeutic objectives.
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Affiliation(s)
- Pablo Pérez-Martínez
- Unidad de Lípidos y Arteriosclerosis, Hospital Universitario Reina Sofía/Universidad de Córdoba/Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, España; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, España.
| | - Emilio Ros
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, España; Unidad de Lípidos, Servicio de Endocrinología y Nutrición, Instituto de Investigaciones Biomédicas August Pi i Sunyer, Barcelona, Hospital Clinic, Universidad de Barcelona, Barcelona, España
| | - Juan Pedro-Botet
- Unidad de Lípidos y Riesgo Vascular, Servicio de Endocrinología y Nutrición, Hospital del Mar, Universidad Autónoma de Barcelona, Barcelona, España
| | - Fernando Civeira
- Unidad Clínica y de Investigación en Lípidos y Arteriosclerosis, Servicio de Medicina Interna, Hospital Universitario Miguel Servet, IIS Aragón, Universidad de Zaragoza, Zaragoza, España; CIBER Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, España
| | - Vicente Pascual
- Centro de Salud Palleter, Universidad CEU-Cardenal Herrera, Castellón, España
| | - Carmen Garcés
- Laboratorio de Lípidos, Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, España
| | - Rosa Solá
- Grupo de Nutrición Funcional, Oxidación y Enfermedades Cardiovasculares (NFOC-Salut), Hospital Universitario Sant Joan, Facultad de Medicina y Ciencias de la Salud, Universidad Rovira i Virgili, Reus, Tarragona, España
| | - Francisco Pérez-Jiménez
- Unidad de Lípidos y Arteriosclerosis, Hospital Universitario Reina Sofía/Universidad de Córdoba/Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, España
| | - José M Mostaza
- Unidad de Lípidos y Riesgo Vascular, Servicio de Medicina Interna, Hospital La Paz-Carlos III, Madrid, España
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McClements IF, McClements DJ. Designing healthier plant-based foods: Fortification, digestion, and bioavailability. Food Res Int 2023; 169:112853. [PMID: 37254427 DOI: 10.1016/j.foodres.2023.112853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 04/12/2023] [Accepted: 04/14/2023] [Indexed: 06/01/2023]
Abstract
Many consumers are incorporating more plant-based foods into their diets as a result of concerns about the environmental, ethical, and health impacts of animal sourced foods like meat, seafood, egg, and dairy products. Foods derived from animals negatively impact the environment by increasing greenhouse gas emissions, land use, water use, pollution, deforestation, and biodiversity loss. The livestock industry confines and slaughters billions of livestock animals each year. There are concerns about the negative impacts of some animal sourced foods, such as red meat and processed meat, on human health. The livestock industry is a major user of antibiotics, which is leading to a rise in the resistance of several pathogenic microorganisms to antibiotics. It is often assumed that a plant-based diet is healthier than one containing more animal sourced foods, but this is not necessarily the case. Eating more fresh fruits, vegetables, nuts, and whole grain cereals has been linked to improved health outcomes but it is unclear whether next-generation plant-based foods, such as meat, seafood, egg, and dairy analogs are healthier than the products they are designed to replace. Many of these new products are highly processed foods that contain high levels of saturated fat, sugar, starch, and salt, and low levels of micronutrients, nutraceuticals, and dietary fibers. Moreover, they are often rapidly digested in the gastrointestinal tract because processing disrupts plant tissues and releases the macronutrients. Consequently, it is important to formulate plant-based foods to reduce the levels of nutrients linked to adverse health effects and increase the levels linked to beneficial health effects. Moreover, it is important to design the food matrix so that the macronutrients are not digested and absorbed too quickly, but the micronutrients are highly bioavailable. In this article, we discuss how next-generation plant-based foods can be made healthier by controlling their nutrient profile, digestibility, and bioavailability.
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Xu Y, Mo G, Yao Y, Li C. The effects of vegetarian diets on glycemia and lipid parameters in adult patients with overweight and obesity: a systematic review and meta-analysis. Eur J Clin Nutr 2023:10.1038/s41430-023-01283-x. [PMID: 36964271 DOI: 10.1038/s41430-023-01283-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 03/08/2023] [Accepted: 03/10/2023] [Indexed: 03/26/2023]
Abstract
Several randomized controlled trials have reported the effects of vegetarian diets on blood lipids and glucose homeostasis in adults, but not in overweight or obese individuals. Thus, the purpose of this study was to evaluate the effects of vegetarian diets on blood lipids and glucose homeostasis in overweight or obese adults by systematic review and meta-analysis. We searched Medline, Embase, and the Cochrane Library through October 2021. We chose to include overweight or obese patients in the studies of the vegetarian diet for metabolic control. Seven trials with a total of 783 overweight or obese adult were included in the meta-analysis. The analysis of the data revealed that the vegetarian diets significantly reduced low-density lipoprotein cholesterol (LDL-C) (WMD, -0.31; 95% CI, -0.46 to -0.16), total cholesterol (TC) (WMD, -0.37; 95% CI, -0.52 to -0.22), and HbA1c (WMD (%), -0.33; 95% CI, -0.55 to -0.11). The vegetarian diets had an elevated effect on blood triglycerides (WMD, 0.29; 95% CI, 0.11-0.47). However, there were no significant effects of vegetarian diets on high-density lipoprotein cholesterol (HDLC), Fasting plasma glucose(FPG), and HOMA-IR in these individuals. The results of this study suggest that vegetarian diets effectively reduce LDL-C, TC, and HbA1c levels, thus functioning as a promising therapeutic strategy for improving the metabolic dysfunction in overweight or obese individuals. However, further large-scale clinical trials are required to confirm the validity of these findings.
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Affiliation(s)
- Yang Xu
- The First College for Clinical Medicine, Guangxi Medical University, Guangxi, China
| | - Guli Mo
- The First College for Clinical Medicine, Guangxi Medical University, Guangxi, China
| | - Yu Yao
- The First College for Clinical Medicine, Guangxi Medical University, Guangxi, China
| | - Chuan Li
- Department of Pediatrics, The Second Affiliated Hospital of Guangxi Medical University, Guangxi, China.
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Jiménez-Sánchez A, Martínez-Ortega AJ, Remón-Ruiz PJ, Piñar-Gutiérrez A, Pereira-Cunill JL, García-Luna PP. Therapeutic Properties and Use of Extra Virgin Olive Oil in Clinical Nutrition: A Narrative Review and Literature Update. Nutrients 2022; 14:nu14071440. [PMID: 35406067 PMCID: PMC9003415 DOI: 10.3390/nu14071440] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/24/2022] [Accepted: 03/25/2022] [Indexed: 02/06/2023] Open
Abstract
Extra virgin olive oil (EVOO) is a cornerstone of the Mediterranean diet (MedD). In this narrative review, we synthesize and illustrate the various characteristics and clinical applications of EVOO and its components—such as oleic acid, hydroxytyrosol, and oleuropein—in the field of clinical nutrition and dietetics. The evidence is split into diet therapy, oleic acid-based enteral nutrition formulations and oral supplementation formulations, oleic acid-based parenteral nutrition, and nutraceutical supplementation of minor components of EVOO. EVOO has diverse beneficial health properties, and current evidence supports the use of whole EVOO in diet therapy and the supplementation of its minor components to improve cardiovascular health, lipoprotein metabolism, and diabetes mellitus in clinical nutrition. Nevertheless, more intervention studies in humans are needed to chisel specific recommendations for its therapeutic use through different formulations in other specific diseases and clinical populations.
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Affiliation(s)
- Andrés Jiménez-Sánchez
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Avda. Manuel Siurot s/n, 41013 Seville, Spain; (P.J.R.-R.); (A.P.-G.); (J.L.P.-C.)
- Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Avda. Manuel Siurot s/n, 41013 Seville, Spain;
- Correspondence: (A.J.-S.); (P.P.G.-L.)
| | - Antonio Jesús Martínez-Ortega
- Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Avda. Manuel Siurot s/n, 41013 Seville, Spain;
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Torrecárdenas, C. Hermandad de Donantes de Sangre, s/n, 04009 Almería, Spain
| | - Pablo Jesús Remón-Ruiz
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Avda. Manuel Siurot s/n, 41013 Seville, Spain; (P.J.R.-R.); (A.P.-G.); (J.L.P.-C.)
- Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Avda. Manuel Siurot s/n, 41013 Seville, Spain;
| | - Ana Piñar-Gutiérrez
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Avda. Manuel Siurot s/n, 41013 Seville, Spain; (P.J.R.-R.); (A.P.-G.); (J.L.P.-C.)
- Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Avda. Manuel Siurot s/n, 41013 Seville, Spain;
| | - José Luis Pereira-Cunill
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Avda. Manuel Siurot s/n, 41013 Seville, Spain; (P.J.R.-R.); (A.P.-G.); (J.L.P.-C.)
- Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Avda. Manuel Siurot s/n, 41013 Seville, Spain;
| | - Pedro Pablo García-Luna
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Avda. Manuel Siurot s/n, 41013 Seville, Spain; (P.J.R.-R.); (A.P.-G.); (J.L.P.-C.)
- Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Avda. Manuel Siurot s/n, 41013 Seville, Spain;
- Correspondence: (A.J.-S.); (P.P.G.-L.)
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10
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Hamedi-Kalajahi F, Zarezadeh M, Dehghani A, Musazadeh V, Kolahi A, Shabbidar S, Djafarian K. A systematic review and meta-analysis on the impact of oral vitamin E supplementation on apolipoproteins A1 and B100. Clin Nutr ESPEN 2021; 46:106-114. [PMID: 34857183 DOI: 10.1016/j.clnesp.2021.09.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 09/10/2021] [Accepted: 09/16/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND AND AIM Cardiovascular diseases (CVDs) are the number one cause of mortality worldwide. Apolipoprotein B (ApoB), apolipoprotein A1 (ApoA1), and ApoB/ApoA1 ratio are considered as predictors of CVD alongside with lipid profile. Evidence suggest that nutrients with antioxidant properties, especially vitamin E, are essential for a healthy cardiovascular system. The aim of present meta-analysis was to determine the effect alpha-tocopherol on ApoA1 and ApoB levels. METHODS PubMed-Medline and SCOPUS databases and Google Scholar were searched up to July 2021. Random-effects model was employed to perform meta-analysis. In order to find heterogeneity sources, subgroup analysis was performed. Trim and fill analysis was performed in case of presence of publication bias. Quality assessment was performed using Cochrane Collaboration's tool. RESULTS Seven eligible studies, involving 1284 individuals were included. Mean age of participants ranged between 25.4 and 59 years. There was no significant effect of vitamin E supplementation on Apo A1 (SMD = 0.22 IU/d; 95% CI: -0.38, 0.28; P = 0.481) and Apo B levels (SMD = -0.62 IU/d; 95% CI: -1.94, 0.70; P = 0.360). CONCLUSION No remarkable effect of vitamin E supplementation was observed on ApoA1 and ApoB levels in adults. Additional studies investigating the influence of vitamin E on apolipoproteins as primary outcome with larger sample size are suggested.
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Affiliation(s)
- Fateme Hamedi-Kalajahi
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Meysam Zarezadeh
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran; Nutrition Research Center, Department of Clinical Nutrition, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Azadeh Dehghani
- Department of Community Nutrition, Faculty of Nutrition and Food Science, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Vali Musazadeh
- Nutrition Research Center, Department of Clinical Nutrition, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ahmadreza Kolahi
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Sakineh Shabbidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
| | - Kourosh Djafarian
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
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11
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Shavakhi M, Sahebkar A, Shirban F, Bagherniya M. The efficacy of herbal medicine in the treatment of recurrent aphthous stomatitis: A systematic review of randomized clinical trials. Phytother Res 2021; 36:672-685. [PMID: 34816511 DOI: 10.1002/ptr.7332] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 09/09/2021] [Accepted: 10/23/2021] [Indexed: 01/08/2023]
Abstract
This systematic review was undertaken with the main aim of assessing the therapeutic effects of herbal medicines in recurrent aphthous stomatitis (RAS). A comprehensive search was performed in PubMed, Scopus, ISI Web of Science, and Google Scholar up to July 2021 to identify randomized clinical trials investigated the effects of herbal medicines on RAS. Thirty-three papers comprising 2,113 patients met the eligibility criteria, of which 30 studies had a high quality based on the Jadad scale. Totally, 22 out of 30 studies which assessed the pain showed that herbal agents significantly decreased the pain compared with the control group or placebo. In 17 out of 25 studies that evaluated ulcer size, herbal agents significantly reduced the size of ulcers compared with the control or placebo groups. In 15 out of 18 studies that assessed the healing time, herbal agents significantly reduced healing time in the intervention groups compared with the placebo or control groups. Few adverse events were reported only in four studies. Findings of the current review indicated medicinal plants and phytochemicals as effective and safe agents that for the treatment of RAS.
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Affiliation(s)
- Mojgan Shavakhi
- Department of Orthodontics, Dental Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amirhossein Sahebkar
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran.,Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,School of Medicine, The University of Western Australia, Perth, Australia.,School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farinaz Shirban
- Department of Orthodontics, Dental Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Bagherniya
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.,Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.,Anesthesia and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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12
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Zhang Y, Zhang T, Liang Y, Jiang L, Sui X. Dietary Bioactive Lipids: A Review on Absorption, Metabolism, and Health Properties. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2021; 69:8929-8943. [PMID: 34161727 DOI: 10.1021/acs.jafc.1c01369] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Dietary lipids are an indispensable source of energy and nutrition in human life. Numerous studies have shown that dietary bioactive lipids have many health benefits, including prevention or treatment of chronic diseases. The different chemical compositions and structural characteristics of bioactive lipids not only affect their digestion, absorption, and metabolism but also affect their health properties. In this review, the major dietary bioactive lipids (fatty acids, carotenoids, phytosterols, phenolic lipids, fat-soluble vitamins, and sphingomyelins) in foods are systematically summarized, from the aspects of composition, digestion, absorption, metabolism, source, structural characteristics, and their health properties. In particular, the relationship between the compositional and structural changes of bioactive lipids and their absorption and metabolism is discussed as well as their effect on health properties. This review provides a comprehensive summary toward health properties of dietary bioactive lipids.
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Affiliation(s)
- Yan Zhang
- College of Food Science, Northeast Agricultural University, Harbin, Heilongjiang 150030, People's Republic of China
- College of Horticulture and Landscape Architecture, Northeast Agricultural University, Harbin, Heilongjiang 150030, People's Republic of China
- National-Local Joint Engineering Research Center for Development and Utilization of Small Fruits in Cold Regions, Northeast Agricultural University, Harbin, Heilongjiang 150030, People's Republic of China
| | - Tianyi Zhang
- College of Food Science, Northeast Agricultural University, Harbin, Heilongjiang 150030, People's Republic of China
| | - Yan Liang
- College of Food Science, Northeast Agricultural University, Harbin, Heilongjiang 150030, People's Republic of China
| | - Lianzhou Jiang
- College of Food Science, Northeast Agricultural University, Harbin, Heilongjiang 150030, People's Republic of China
| | - Xiaonan Sui
- College of Food Science, Northeast Agricultural University, Harbin, Heilongjiang 150030, People's Republic of China
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13
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Hoang T, Kim J. Phytonutrient supplements and metabolic biomarkers of cardiovascular disease: An umbrella review of meta-analyses of clinical trials. Phytother Res 2021; 35:4171-4182. [PMID: 33724587 DOI: 10.1002/ptr.7079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 02/22/2021] [Accepted: 02/24/2021] [Indexed: 12/20/2022]
Abstract
Phytonutrients exert several pharmacological effects on humans. In this study, we performed an umbrella review of the association of phytonutrient supplements (PNSs) with biomarkers of cardiovascular disease. Relevant published systematic reviews and meta-analyses of clinical trials were identified by searching PubMed, Embase, and Cochrane Library until July 4, 2020. Weighted mean differences (WMDs) and 95% confidence intervals (CIs) for summarized effects and I2 statistics of heterogeneity were extracted from individual studies or reanalyzed using a random-effects model. Of the 50 included studies, pooled effects of PNSs on blood pressure, lipid profiles, and glycemic control were reported in 16, 25, and 14 articles, respectively. The findings appeared to be highly heterogeneous among individual trials of included systematic reviews and meta-analyses. Ginger (WMD = -6.36 mmHg, 95% CI = -11.27, -1.46) and Hibiscus sabdariffa (WMD = -7.58 mmHg, 95% CI = -9.69, -5.46) were associated with lowered systolic blood pressure, whereas Aloe vera, Nigella sativa, and spirulina were associated with beneficial effects on both lipid profiles and glycemic control. In summary, this umbrella review has provided up-to-date evidence for the effect of PNSs on biomarkers related to hypertension, dyslipidemia, and diabetes. The results must be interpreted with caution due to potential heterogeneity.
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Affiliation(s)
- Tung Hoang
- Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Republic of Korea
| | - Jeongseon Kim
- Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Republic of Korea
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14
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Teasdale SB, Marshall S, Abbott K, Cassettari T, Duve E, Fayet-Moore F. How should we judge edible oils and fats? An umbrella review of the health effects of nutrient and bioactive components found in edible oils and fats. Crit Rev Food Sci Nutr 2021; 62:5167-5182. [PMID: 33706623 DOI: 10.1080/10408398.2021.1882382] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Dietary guidelines for many Western countries base their edible oil and fat recommendations solely on saturated fatty acid content. This study aims to demonstrate which nutritional and bioactive components make up commonly consumed edible oils and fats; and explore the health effects and strength of evidence for key nutritional and bioactive components of edible oils. An umbrella review was conducted in several stages. Food composition databases of Australia and the United States of America, and studies were examined to profile nutrient and bioactive content of edible oils and fats. PUBMED and Cochrane databases were searched for umbrella reviews, systematic literature reviews of randomized controlled trials or cohort studies, individual randomized controlled trials, and individual cohort studies to examine the effect of the nutrient or bioactive on high-burden chronic diseases (cardiovascular disease, type 2 diabetes mellitus, obesity, cancer, mental illness, cognitive impairment). Substantial systematic literature review evidence was identified for fatty acid categories, tocopherols, biophenols, and phytosterols. Insufficient evidence was identified for squalene. The evidence supports high mono- and polyunsaturated fatty acid compositions, total biophenol content, phytosterols, and possibly high α-tocopherol content as having beneficial effects on high-burden health comes. Future dietary guidelines should use a more sophisticated approach to judge edible oils beyond saturated fatty acid content.
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Affiliation(s)
- Scott B Teasdale
- Department of Science, Nutrition Research Australia, Sydney, Australia.,School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Skye Marshall
- Department of Science, Nutrition Research Australia, Sydney, Australia.,Bond University Nutrition & Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia
| | - Kylie Abbott
- Department of Science, Nutrition Research Australia, Sydney, Australia
| | - Tim Cassettari
- Department of Science, Nutrition Research Australia, Sydney, Australia.,Department of Translational Science, Nutrition Research Australia, Sydney, Australia
| | - Emily Duve
- Department of Science, Nutrition Research Australia, Sydney, Australia.,Department of Translational Science, Nutrition Research Australia, Sydney, Australia
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15
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Ren X, Zhang Z, Yan Z. Association Between Lipoprotein (A) and Diabetic Nephropathy in Patients With Type 2 Diabetes Mellitus: A Meta-Analysis. Front Endocrinol (Lausanne) 2021; 12:633529. [PMID: 33841331 PMCID: PMC8024696 DOI: 10.3389/fendo.2021.633529] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 01/19/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Lipoprotein (a) [Lp (a)] has been well recognized as a risk factor of cardiovascular disease. However, the association between serum Lp (a) and diabetic nephropathy in patients with type 2 diabetes mellitus (T2DM) remains unknown. We performed a meta-analysis to comprehensively evaluate the above association. METHODS Observational studies aiming to evaluate the independent association between serum Lp (a) and diabetic nephropathy in T2DM patients were identified by systematic search of PubMed and Embase databases. A random-effect model which incorporated the potential intra-study heterogeneity was used for the meta-analysis. RESULTS Eleven observational studies with 9304 T2DM patients were included. Results showed that compared to those with the lowest Lp (a), patients with the highest Lp (a) level had higher odds of diabetic nephropathy (adjusted odds ratio [OR]: 1.63, 95% confidence interval [CI]: 1.25-2.14, I2 = 54%, P < 0.001). Meta-analysis of studies in which Lp (a) was presented as continuous variables showed consistent result (adjusted OR: 1.13 for 1 mg/dl increment of Lp (a), 95% CI: 1.03-1.24, I2 = 36%, P = 0.008). Subgroup analyses showed that study characteristics such as definitions of diabetic nephropathy and study design did not significantly affect the association (P for subgroup difference all > 0.05). CONCLUSIONS Higher serum Lp (a) in patients with T2DM is independently associated with higher odds of diabetic nephropathy. Large scale prospective cohort studies are needed to validate this finding. Moreover, the potential influence of Lp (a) lowering on renal function in T2DM patients may be further investigated.
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16
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Trautwein EA, McKay S. The Role of Specific Components of a Plant-Based Diet in Management of Dyslipidemia and the Impact on Cardiovascular Risk. Nutrients 2020; 12:E2671. [PMID: 32883047 PMCID: PMC7551487 DOI: 10.3390/nu12092671] [Citation(s) in RCA: 98] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/1970] [Revised: 08/25/2020] [Accepted: 08/31/2020] [Indexed: 02/07/2023] Open
Abstract
Convincing evidence supports the intake of specific food components, food groups, or whole dietary patterns to positively influence dyslipidemia and to lower risk of cardiovascular diseases (CVD). Specific macro- and micro-components of a predominantly plant-based dietary pattern are vegetable fats, dietary fibers, and phytonutrients such as phytosterols. This review summarizes the current knowledge regarding effects of these components on lowering blood lipids, i.e., low-density lipoprotein cholesterol (LDL-C) and on reducing CVD risk. The beneficial role of a plant-based diet on cardiovascular (CV) health has increasingly been recognized. Plant-based dietary patterns include a Mediterranean and Nordic diet pattern, the dietary approaches to stop hypertension (DASH), and Portfolio diet, as well as vegetarian- or vegan-type diet patterns. These diets have all been found to lower CVD-related risk factors like blood LDL-C, and observational study evidence supports their role in lowering CVD risk. These diet patterns are not only beneficial for dyslipidemia management and prevention of CVD but further contribute to reducing the impact of food choices on environmental degradation. Hence, the CV health benefits of a predominantly plant-based diet as a healthy and environmentally sustainable eating pattern are today recommended by many food-based dietary as well as clinical practice guidelines.
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Affiliation(s)
| | - Sue McKay
- Upfield Research & Development, 3071 JL Rotterdam, The Netherlands;
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17
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Safari Z, Farrokhzad A, Ghavami A, Fadel A, Hadi A, Rafiee S, Mokari-Yamchi A, Askari G. The effect of barberry (Berberis vulgaris L.) on glycemic indices: A systematic review and meta-analysis of randomized controlled trials. Complement Ther Med 2020; 51:102414. [PMID: 32507431 DOI: 10.1016/j.ctim.2020.102414] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 03/26/2020] [Accepted: 04/17/2020] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVE We performed a meta-analysis to evaluate the efficacy of barberry (Berberis vulgaris L.) supplementation on glycemic indices in adults. METHODS A comprehensive search was conducted in PubMed, Scopus, Cochrane Library, and ISI Web of Science from inception up to January 2020, to identify randomized controlled trials (RCTs) investigating the effect of barberry supplementation on glycemic markers including fasting blood sugar (FBS) concentrations, insulin levels, homeostatic model assessment for insulin resistance (HOMA-IR), and glycosylated hemoglobin (HbA1c) percentage. The results of this meta-analysis were reported, based on the random effects model. RESULTS In total, 7 studies, comprising 452 participants, were included in the systematic review. The meta-analysis revealed that barberry significantly reduces insulin levels (Hedges's: -0.67; 95% CI: -1.31 to -0.03, P = 0.04, I2 = 73.3%). However, no considerable changes was observed for FBS levels (WMD: -8.06 mg/dL; 95% CI: -20.46 to 4.33, P = 0.23, I2 = 96.1%), HbA1c percentage (WMD: -0.83 %; 95% CI: -2.33 to 0.67, P = 0.27, I2 = 88.3%), and HOMA-IR index (WMD: -0.55; 95% CI: -1.60 to 0.50, P = 0.30, I2 = 99.4%). CONCLUSION The present study suggests that although barberry supplementation significantly improves insulin levels; however, other glycemic indices might not be affected. However, more high-quality RCTs with longer duration are needed to further clarify the effects of barberry on blood glucose control, especially among patients with diabetes.
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Affiliation(s)
- Zahra Safari
- Student Research Committee, Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Abed Ghavami
- Student Research Committee, Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Abdulmnannan Fadel
- School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Amir Hadi
- Halal Research Center of IRI, FDA, Tehran, Iran.
| | - Sahar Rafiee
- Student Research Committee, Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amin Mokari-Yamchi
- Student Research Committee, Department of Community Nutrition, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Gholamreza Askari
- Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.
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18
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Ghaedi E, Ghavami A, Miraghajani M. In reply to letter to editor (Meta-analysis of phytosterols supplementation and blood pressure: A concern regarding misleading data). Clin Nutr 2020; 39:2329-2330. [PMID: 32389448 DOI: 10.1016/j.clnu.2020.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 04/15/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Ehsan Ghaedi
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran; Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Abed Ghavami
- Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Maryam Miraghajani
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; The Early Life Research Unit, Division of Child Health, Obstetrics and Gynaecology, University of Nottingham, Nottingham, UK.
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19
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Salehi-Sahlabadi A, Varkaneh HK, Shahdadian F, Ghaedi E, Nouri M, Singh A, Farhadnejad H, Găman MA, Hekmatdoost A, Mirmiran P. Effects of Phytosterols supplementation on blood glucose, glycosylated hemoglobin (HbA1c) and insulin levels in humans: a systematic review and meta-analysis of randomized controlled trials. J Diabetes Metab Disord 2020; 19:625-632. [PMID: 32550215 DOI: 10.1007/s40200-020-00526-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 04/03/2020] [Indexed: 02/06/2023]
Abstract
Background In the literature, there are still controversies regarding the effect of phytosterol(PS) supplementation on fasting blood sugar (FBS), insulin levels and glycosylated hemoglobin (HbA1c) in humans. We aimed to assess the impact of PS supplementation on FBS, HbA1c and insulin levels by conducting a systematic review and meta-analysis of the available randomized controlled trials (RCTs). Methods A comprehensive search was conducted to identify all RCTs published up to May 2019 in the following databases: PubMed-MEDLINE, Web of Science, Cochrane Library and Scopus. The mean difference with 95% confidence intervals (CIs) was pooled using a random-effects model (DerSimonian-Laird method). Results Twenty-six arms from 20 RCTs were included in the present meta-analysis. Our findings show that PS supplementation decreases insulin levels (mean difference [MD]: -6.426 μU/ml, 95% CI: -7.187, -5.665, P- value = 0.000). However, PS supplementation did not have significant effects on FBS and HbA1c levels. Following PS supplementation, significant changes in FBS (mean difference [MD]: -1.942 mg/dl, 95% CI: -3.637, -0.246, P- value = 0.025) and HbA1c (mean difference [MD]: -0.059%, 95% CI: -0.114, -0.004, P- value = 0.035) based on PS dosage (mg/d) were recorded. Conclusions In patients with a baseline BMI <25 kg/m2, PS consumption significantly increased FBS levels. Patients who consumed 1-2 g/day of PS had a lower FBS and lower HbA1c levels.
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Affiliation(s)
- Ammar Salehi-Sahlabadi
- Student Research Committee, Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamed Kord Varkaneh
- Student Research Committee, Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farnaz Shahdadian
- Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran, Isfahan, Iran
| | - Ehsan Ghaedi
- Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Mehran Nouri
- Students' Research Committee, School of Nutrition and Food Science, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ambrish Singh
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool St, Hobart, Tasmania TAS 7000 Australia
| | - Hossein Farhadnejad
- Student Research Committee, Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Azita Hekmatdoost
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology, Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parvin Mirmiran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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20
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Shekarchizadeh-Esfahani P, Arab A, Ghaedi E, Hadi A, Jalili C. Effects of cardamom supplementation on lipid profile: A systematic review and meta-analysis of randomized controlled clinical trials. Phytother Res 2019; 34:475-485. [PMID: 31755188 DOI: 10.1002/ptr.6543] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 10/15/2019] [Accepted: 10/19/2019] [Indexed: 12/11/2022]
Abstract
Cardiovascular disease is a highly prevalent issue worldwide and one of its main manifestations, dyslipidemia, needs more attention. Recent studies have suggested that cardamom has favorable effects beyond lipid lowering, but the result are contradictory. Our objective was to conduct a systematic review and meta-analysis on randomized controlled trials (RCTs) that assessed the effect of cardamom on lipids. The search included PubMed, Scopus, ISI Web of Science, Google Scholar, and the Cochrane library (up to March, 2019) to identify RCTs investigating the effects of cardamom supplementation on serum lipid parameters. Weighted mean differences (WMDs) were pooled using a random-effect model. Meta-analysis of data from five eligible RCTs showed that cardamom supplementation did not significantly change the concentrations of total cholesterol (WMD: -6.11 mg/dl, 95% CI [-13.06, 0.83], I2 = 0.0%), low-density lipoprotein cholesterol (WMD: -4.31 mg/dl, 95% CI [-9.75, 1.13], I2 = 0.0%), or high-density lipoprotein cholesterol (WMD: 1.75 mg/dl, 95% CI [-1.95 to 5.46], I2 = 71.4%). However, a significant reduction was observed in serum triglyceride (TG; WMD: -20.55 mg/dl, 95% CI [-32.48, -8.63], I2 = 0.0%) levels after cardamom supplementation. Cardamom might be able to change TG, but for confirming the results, more studies exclusively on dyslipidemia patients and considering the intake of lipid lowering agents as exclusion criteria are necessary.
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Affiliation(s)
- Parivash Shekarchizadeh-Esfahani
- Department of General Courses, School of Management and Medical Information Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Arman Arab
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ehsan Ghaedi
- Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences (TUMS), Tehran, Iran.,Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Hadi
- Halal Research Center of IRI, FDA, Tehran, Iran
| | - Cyrus Jalili
- Medical Biology Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
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21
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Askarpour M, Hadi A, Symonds ME, Miraghajani M, Sheikhi A, Ghaedi E. Efficacy of l-carnitine supplementation for management of blood lipids: A systematic review and dose-response meta-analysis of randomized controlled trials. Nutr Metab Cardiovasc Dis 2019; 29:1151-1167. [PMID: 31561944 DOI: 10.1016/j.numecd.2019.07.012] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 07/04/2019] [Accepted: 07/16/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND AIM l-carnitine has an important role in fatty acid metabolism and could therefore act as an adjuvant agent in the improvement of dyslipidemia. The purpose of present systematic review and meta-analysis was to critically assess the efficacy of l-carnitine supplementation on lipid profiles. METHODS AND RESULTS We performed a systematic search of all available randomized controlled trials (RCTs) in the following databases: Scopus, PubMed, ISI Web of Science, The Cochrane Library. Mean difference (MD) of any effect was calculated using a random-effects model. In total, there were 55 eligible RCTs included with 58 arms, and meta-analysis revealed that l-carnitine supplementation significantly reduced total cholesterol (TC) (56 arms-MD: -8.53 mg/dl, 95% CI: -13.46, -3.6, I2: 93%), low-density lipoprotein-cholesterol (LDL-C) (47 arms-MD: -5.48 mg/dl, 95% CI: -8.49, -2.47, I2: 94.5) and triglyceride (TG) (56 arms-MD: -9.44 mg/dl, 95% CI: -16.02, -2.87, I2: 91.8). It also increased high density lipoprotein-cholesterol (HDL-C) (51 arms-MD:1.64 mg/dl, 95% CI:0.54, 2.75, I2: 92.2). l-carnitine supplementation reduced TC in non-linear fashion based on dosage (r = 21.11). Meta-regression analysis indicated a linear relationship between dose of l-carnitine and absolute change in TC (p = 0.029) and LDL-C (p = 0.013). Subgroup analyses showed that l-carnitine supplementation did not change TC, LDL-C and TG in patients under hemodialysis treatment. Intravenous l-carnitine and lower doses (>2 g/day) had no effect on TC, LDL-C and triglycerides. CONCLUSION l-carnitine supplementation at doses above 2 g/d has favorable effects on patients' lipid profiles, but is modulated on participant health and route of administration.
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Affiliation(s)
- Moein Askarpour
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Hadi
- Halal Research Center of IRI, FDA, Tehran, Iran; Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Michael E Symonds
- The Early Life Research Unit, Academic Division of Child Health, Obstetrics and Gynaecology, and Nottingham Digestive Disease Centre and Biomedical Research Centre, The School of Medicine, University of Nottingham, Nottingham, NG7 2UH, UK
| | - Maryam Miraghajani
- The Early Life Research Unit, Academic Division of Child Health, Obstetrics and Gynaecology, and Nottingham Digestive Disease Centre and Biomedical Research Centre, The School of Medicine, University of Nottingham, Nottingham, NG7 2UH, UK; Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Sheikhi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Ehsan Ghaedi
- Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences (TUMS), Tehran, Iran; Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
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