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Sekome K, Gómez-Olivé FX, Sherar LB, Esliger DW, Myezwa H. Sociocultural perceptions of physical activity and dietary habits for hypertension control: voices from adults in a rural sub-district of South Africa. BMC Public Health 2024; 24:2194. [PMID: 39138450 PMCID: PMC11320885 DOI: 10.1186/s12889-024-19320-0] [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: 08/14/2023] [Accepted: 07/01/2024] [Indexed: 08/15/2024] Open
Abstract
BACKGROUND Over half of adults from rural South Africa are hypertensive. Apart from pharmaceutical treatment, lifestyle changes such as increasing physical activity and reducing dietary salt have been strongly advocated for the control of hypertension. However, the control rates of hypertension for adults in rural South Africa are low. In this paper we explore whether this is due to the recommended lifestyle intervention not aligning with the individual's socio-cultural determinants of behaviour change. AIM To explore the social and cultural beliefs, perceptions and practices regarding physical activity and diet as a hypertension control intervention on hypertensive adults living in a rural sub-district in South Africa. METHODS Nine focus group discussions were conducted with hypertensive adults aged 40 years and above from Bushbuckridge sub-district in Mpumalanga Province of South Africa using a semi-structured interview guide. Each session began with introductions of the discussion theme followed by a short discussion on what the participants know about hypertension and the normal blood pressure readings. Physical activity and dietary habits were then introduced as the main subject of discussion. Probing questions were used to get more insight on a specific topic. A thematic analysis approach was used to generate codes, categories, and themes. A manual approach to data analysis was chosen and data obtained through transcripts were analysed inductively. FINDINGS Participants had a lack of knowledge about blood pressure normal values. Perceived causes of hypertension were alluded to psychosocial factors such as family and emotional-related issues. Physical activity practices were influenced by family and community members' attitudes and gender roles. Factors which influenced dietary practices mainly involved affordability and availability of food. To control their hypertension, participants recommend eating certain foods, emotional control, taking medication, exercising, praying, correct food preparation, and performing house chores. CONCLUSION Lifestyle interventions to control hypertension for adults in a rural South African setting using physical activity promotion and dietary control must consider the beliefs related to hypertension control of this population.
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Affiliation(s)
- Kganetso Sekome
- Department of physiotherapy, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Johannesburg, 2193, South Africa.
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, South Africa.
| | - Francesc Xavier Gómez-Olivé
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Lauren B Sherar
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, South Africa
| | - Dale W Esliger
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, South Africa
| | - Hellen Myezwa
- School of Therapeutic Science, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Laczkó-Zöld E, Csupor-Löffler B, Kolcsár EB, Ferenci T, Nan M, Tóth B, Csupor D. The metabolic effect of Momordica charantia cannot be determined based on the available clinical evidence: a systematic review and meta-analysis of randomized clinical trials. Front Nutr 2024; 10:1200801. [PMID: 38274207 PMCID: PMC10808600 DOI: 10.3389/fnut.2023.1200801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 12/27/2023] [Indexed: 01/27/2024] Open
Abstract
Several studies have shown that Momordica charantia L. (Cucurbitaceae, bitter melon) has beneficial effects on metabolic syndrome (MetS) parameters and exerts antidiabetic, anti-hyperlipidemic, and anti-obesity activities. Since the findings of these studies are contradictory, the goal of this systematic review and meta-analysis was to assess the efficacy of bitter melon in the treatment of metabolic syndrome, with special emphasis on the anti-diabetic effect. Embase, Cochrane, PubMed, and Web of Science databases were searched for randomized controlled human trials (RCTs). The meta-analysis was reported according to the PRISMA statement. The primary outcomes of the review are body weight, BMI, fasting blood glucose, glycated hemoglobin A1c, systolic blood pressure, diastolic blood pressure, serum triglyceride, HDL, LDL, and total cholesterol levels. Nine studies were included in the meta-analysis with 414 patients in total and 4-16 weeks of follow-up. In case of the meta-analysis of change scores, no significant effect could be observed for bitter melon treatment over placebo on fasting blood glucose level (MD = -0.03; 95% CI: -0.38 to 0.31; I2 = 34%), HbA1c level (MD = -0.12; 95% CI: -0.35 to 0.11; I2 = 56%), HDL (MD = -0.04; 95% CI: -0.17 to 0.09; I2 = 66%), LDL (MD = -0.10; 95% CI: -0.28 to 0.08; I2 = 37%), total cholesterol (MD = -0.04; 95% CI: -0.17 to 0.09; I2 = 66%,), body weight (MD = -1.00; 95% CI: -2.59-0.59; I2 = 97%), BMI (MD = -0.42; 95% CI: -0.99-0.14; I2 = 95%), systolic blood pressure (MD = 1.01; 95% CI: -1.07-3.09; I2 = 0%) and diastolic blood pressure levels (MD = 0.24; 95% CI: -1.04-1.53; I2 = 0%). Momordica treatment was not associated with a notable change in ALT, AST, and creatinine levels compared to the placebo, which supports the safety of this plant. However, the power was overall low and the meta-analyzed studies were also too short to reliably detect long-term metabolic effects. This highlights the need for additional research into this plant in carefully planned clinical trials of longer duration.
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Affiliation(s)
- Eszter Laczkó-Zöld
- Department of Pharmacognosy and Phytotherapy, "George Emil Palade" University of Medicine, Pharmacy, Sciences, and Technology of Târgu Mureş, Târgu Mureş, Romania
| | - Boglárka Csupor-Löffler
- Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, Hungary
| | - Edina-Blanka Kolcsár
- Department of Pharmacognosy and Phytotherapy, "George Emil Palade" University of Medicine, Pharmacy, Sciences, and Technology of Târgu Mureş, Târgu Mureş, Romania
| | - Tamás Ferenci
- Physiological Controls Research Center, Óbuda University, Budapest, Hungary
- Department of Statistics, Corvinus University of Budapest, Budapest, Hungary
| | - Monica Nan
- Pharmacy Department, Encompass Health Rehabilitation Hospital of Round Rock, Round Rock, TX, United States
| | - Barbara Tóth
- Institute of Clinical Pharmacy, University of Szeged, Szeged, Hungary
| | - Dezső Csupor
- Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Pécs, Hungary
- Institute of Clinical Pharmacy, University of Szeged, Szeged, Hungary
- Institute of Pharmacognosy, University of Szeged, Szeged, Hungary
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Aljuraiban GS, Gibson R, Chan DS, Van Horn L, Chan Q. The Role of Diet in the Prevention of Hypertension and Management of Blood Pressure: An Umbrella Review of Meta-Analyses of Interventional and Observational Studies. Adv Nutr 2024; 15:100123. [PMID: 37783307 PMCID: PMC10831905 DOI: 10.1016/j.advnut.2023.09.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 09/12/2023] [Accepted: 09/26/2023] [Indexed: 10/04/2023] Open
Abstract
High blood pressure (BP) is a major pathological risk factor for the development of several cardiovascular diseases. Diet is a key modifier of BP, but the underlying relationships are not clearly demonstrated. This is an umbrella review of published meta-analyses to critically evaluate the wide range of dietary evidence from bioactive compounds to dietary patterns on BP and risk of hypertension. PubMed, Embase, Web of Science, and Cochrane Central Register of Controlled Trials were searched from inception until October 31, 2021, for relevant meta-analyses of randomized controlled trials or meta-analyses of observational studies. A total of 175 publications reporting 341 meta-analyses of randomized controlled trials (145 publications) and 70 meta-analyses of observational studies (30 publications) were included in the review. The methodological quality of the included publications was assessed using Assessment of Multiple Systematic Reviews 2 and the evidence quality of each selected meta-analysis was assessed using NutriGrade. This umbrella review supports recommended public health guidelines for prevention and control of hypertension. Dietary patterns including the Dietary Approaches to Stop Hypertension and the Mediterranean-type diets that further restrict sodium, and moderate alcohol intake are advised. To produce high-quality evidence and substantiate strong recommendations, future research should address areas where the low quality of evidence was observed (for example, intake of dietary fiber, fish, egg, meat, dairy products, fruit juice, and nuts) and emphasize focus on dietary factors not yet conclusively investigated.
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Affiliation(s)
- Ghadeer S Aljuraiban
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Kingdom of Saudi Arabia.
| | - Rachel Gibson
- Department of Nutritional Sciences, King's College London, London, United Kingdom; Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.
| | - Doris Sm Chan
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.
| | - Linda Van Horn
- Department of Preventive Medicine, Northwestern University, Chicago, IL, United States.
| | - Queenie Chan
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.
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Bahari H, Taheri S, Namkhah Z, Barghchi H, Arzhang P, Nattagh-Eshtivani E. Effects of sumac supplementation on lipid profile: A systematic review and meta-analysis of randomized controlled trials. Phytother Res 2024; 38:241-252. [PMID: 37864474 DOI: 10.1002/ptr.8046] [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: 03/28/2023] [Revised: 09/25/2023] [Accepted: 09/29/2023] [Indexed: 10/22/2023]
Abstract
This systematic review aimed to gather data on the effects of sumac supplementation on lipid profile. A systematic literature search was carried out using electronic databases (PubMed, Scopus, and Web of Science) up to March 2023 to identify eligible randomized controlled trials (RCTs) assessing the effects of sumac intake on lipid profile as an outcome. All participants enrolled in our study were adult individuals who consumed sumac, in various forms, as an intervention. The included articles were assessed using the Cochrane risk of bias assessment tool. Heterogeneity tests of the selected trials were performed using the I2 statistic. Random effects models were assessed based on the heterogeneity tests, and pooled data were determined as the weighted mean difference with a 95% confidence interval. In total, seven RCTs with a total sample size of 570 subjects were included. This study found a significant decrease in total cholesterol (TC) (weighted mean difference [WMD]: -10.01 mg/dL; 95% CI: -18.67, -1.34), triglyceride (TG) (WMD: -8.52 mg/dL; 95% CI: -14.79, -2.25), and low-density lipoprotein (LDL)-C levels (WMD: -9.25 mg/dL; 95% CI: -14.56, -3.93); Moreover, a significant increase was observed in high-density lipoprotein (HDL)-C concentration (WMD: 2.97 mg/dL; 95% CI: 0.75, 5.19). The reduction in TG and TC was greater in studies with a duration of ≥12 compared to <12 weeks. The increase in HDL-C was greater in participants with an intervention duration of ≥12 compared to <12 weeks. Moreover, subgroup analysis based on the dose of sumac suggested a significant reduction in TC and LDL, specifically for doses below 3 g. Consumption of sumac significantly decreased serum TC, LDL-C, and TG concentrations. This study suggested significantly positive effects on HDL-C by intake of sumac. Longer interventions (>12 weeks) have a more favorable impact on TC, LDL-C, and HDL-C, while sumac doses below 3 g/day show greater effects on TC and LDL-C. These findings underscore the potential of sumac supplementation as a valuable approach to lipid profile management.
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Affiliation(s)
- Hossein Bahari
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Shaghayegh Taheri
- Department of Clinical Biochemistry, School of Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | - Zahra Namkhah
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hanieh Barghchi
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Pishva Arzhang
- Qods Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Elyas Nattagh-Eshtivani
- Department of Nutrition, Food Sciences and Clinical Biochemistry, School of Medicine, Social Determinants of Health Research Center, Gonabad University of Medical Science, Gonabad, Iran
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Chong Tai LI, Ahmed S, Chokshi RR. Ischemic Colitis in a Young Female Following Herbal Supplement Ingestion. Cureus 2023; 15:e45315. [PMID: 37846238 PMCID: PMC10577007 DOI: 10.7759/cureus.45315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2023] [Indexed: 10/18/2023] Open
Abstract
Ischemic colitis is typically considered a disease of the elderly, given their atherosclerotic risk factors and other comorbidities. Ischemic colitis in the younger population is considered very uncommon. We present an interesting case of a young female presenting with abdominal pain and hematochezia found to have ischemic colitis on pathological biopsy results after a colonoscopy. She was an otherwise healthy female with no medical problems prior to her hospitalization but endorsed recent use of a bitter herbal tea to relieve her symptoms. Here, we review potential causes of ischemic colitis, including herbal remedies, which have been linked to causing hypercoagulable and hypotensive states.
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Affiliation(s)
| | - Syed Ahmed
- Internal Medicine, Broward Health Medical Center, Fort Lauderdale, USA
| | - Rajiv R Chokshi
- Internal Medicine, Broward General Medical Center, Fort Lauderdale, USA
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Choudhury PPN, Choudhury S. GC-MS profiling and bioactivity prediction of compounds from Momordica charantia L. extract. Bioinformation 2022; 18:1009-1015. [PMID: 37654833 PMCID: PMC10465785 DOI: 10.6026/973206300181009] [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: 09/02/2022] [Revised: 10/31/2022] [Accepted: 10/31/2022] [Indexed: 09/02/2023] Open
Abstract
Momordica species are vegetable crops, belonging to the family of Cucurbitaceae. For the present study plant samples of Momordica charantia were collected from different parts of Barak Valley of Assam, India. Hyphenated technique Gas Chromatography-Mass Spectroscopy (GC-MS) of the chromatographically separated components of the plant extract was performed to identify some of the principles. All the isolated compounds exhibited notable interaction with the enzyme Bone morphogenic protein upon in silico screening. All the compounds were screened in silico for toxicity and then docked with the target enzyme individually. It was found that these compounds are interacting with the target enzyme and is able to inhibit the enzyme activity more efficiently as compared to the reference ligand.
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Affiliation(s)
| | - Sudip Choudhury
- Center for Soft Matter, Department of Chemistry, Assam University, Silchar, 788011, India
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Anti-hyperglycemic activity of HPLC-fractionated Momordica charantia seed extract enriched in a novel napin-like protein in experimental diabetic rats and its validation with recombinant napin-like protein. CURRENT RESEARCH IN BIOTECHNOLOGY 2022. [DOI: 10.1016/j.crbiot.2022.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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Hosseini R, Ferns GA, Sahebkar A, Mirshekar MA, Jalali M. Response to commentary on 'zinc supplementation is associated with a reduction in serum markers of inflammation and oxidative stress in adults: A systematic review and meta-analysis of randomized controlled trials'. Cytokine 2021; 141:155460. [PMID: 33601291 DOI: 10.1016/j.cyto.2021.155460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 01/30/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Razieh Hosseini
- Student Research Committee, Department of Nutrition, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Gordon A Ferns
- Brighton & Sussex Medical School, Division of Medical Education, Falmer, Brighton, Sussex, UK
| | - 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
| | - Mohammad Ali Mirshekar
- Clinical Immunology Research Center, Zahedan University of Medical Sciences, Zahedan, Iran; Department of Physiology, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Mohammad Jalali
- Nutrition Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
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