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Hariharan R, Cameron J, Menon K, Mesinovic J, Jansons P, Scott D, Lu ZX, de Courten M, Feehan J, de Courten B. Carnosine supplementation improves glucose control in adults with pre-diabetes and type 2 diabetes: A randomised controlled trial. Nutr Metab Cardiovasc Dis 2024; 34:485-496. [PMID: 38172006 DOI: 10.1016/j.numecd.2023.10.012] [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] [Received: 05/23/2023] [Revised: 09/19/2023] [Accepted: 10/11/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND AND AIMS Type 2 diabetes (T2DM) is a major cause of morbidity and mortality globally. Carnosine, a naturally occurring dipeptide, has anti-inflammatory, antioxidant, and anti-glycating effects, with preliminary evidence suggesting it may improve important chronic disease risk factors in adults with cardiometabolic conditions. METHODS AND RESULTS In this randomised controlled trial, 43 adults (30%F) living with prediabetes or T2DM consumed carnosine (2 g) or a matching placebo daily for 14 weeks to evaluate its effect on glucose metabolism assessed via a 2-h 75 g oral glucose tolerance test. Secondary outcomes included body composition analysis by dual energy x-ray absorptiometry (DEXA), calf muscle density by pQCT, and anthropometry. Carnosine supplementation decreased blood glucose at 90 min (-1.31 mmol/L; p = 0.02) and 120 min (-1.60 mmol/L, p = 0.02) and total glucose area under the curve (-3.30 mmol/L; p = 0.04) following an oral glucose tolerance test. There were no additional changes in secondary outcomes. The carnosine group results remained significant before and after adjustment for age, sex, and change in weight (all>0.05), and in further sensitivity analyses accounting for missing data. There were no significant changes in insulin levels. CONCLUSION This study provides preliminary support for larger trials evaluating carnosine as a potential treatment for prediabetes and the initial stages of T2DM. Likely mechanisms may include changes to hepatic glucose output explaining the observed reduction in blood glucose without changes in insulin secretion following carnosine supplementation.
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Affiliation(s)
- Rohit Hariharan
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton VIC, Australia
| | - James Cameron
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton VIC, Australia; Monash Cardiovascular Research Centre, Monash Heart, Monash Health, Clayton VIC, Australia
| | - Kirthi Menon
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton VIC, Australia
| | - Jakub Mesinovic
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton VIC, Australia; Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong VIC, Australia
| | - Paul Jansons
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton VIC, Australia; Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong VIC, Australia
| | - David Scott
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton VIC, Australia; Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong VIC, Australia
| | - Zhong X Lu
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton VIC, Australia; Monash Health Pathology, Clayton, VIC, Australia
| | - Maximilian de Courten
- Mitchell Institute for Health and Education Policy, Victoria University, Melbourne VIC, Australia; Institute for Health and Sport, Victoria University, Footscray, VIC, Australia
| | - Jack Feehan
- Mitchell Institute for Health and Education Policy, Victoria University, Melbourne VIC, Australia; Institute for Health and Sport, Victoria University, Footscray, VIC, Australia
| | - Barbora de Courten
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton VIC, Australia; School of Health and Biomedical Sciences, RMIT, Bundoora, Australia.
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Afrisham R, Farrokhi V, Ghanavati M, Asbaghi O, Mohammadi S, Mohammadian M, Taghvaei-Yazdeli T, Safaei-Kooyshahi S, Jadidi Y, Ashtary-Larky D. The effects of beetroot and nitrate supplementation on body composition: a GRADE-assessed systematic review and meta-analysis. Br J Nutr 2023; 130:1343-1356. [PMID: 36847169 DOI: 10.1017/s000711452300034x] [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] [Indexed: 03/01/2023]
Abstract
This systematic review and meta-analysis aimed to investigate the effects of beetroot (BR) or nitrate supplements on body composition indices. A systematic search was conducted for randomised controlled trials (RCT) published up to August 2022 among online databases including Scopus, PubMed/Medline, Web of Science and Embase. Meta-analyses were carried out using a random-effects model. The I2 index was used to assess the heterogeneity of RCT. A total of twelve RCT met the inclusion criteria for this meta-analysis. The pooled effect size of included studies indicated that BR or nitrate supplementation did not change body weight (weighted mean differences (WMD): -0·14 kg, 95 % CI -1·22, 1·51; P = 0·836; I2 = 0 %), BMI (WMD: -0·07 kg/m2, 95 % CI -0·19,0·03; P = 0·174, I2 = 0 %), fat mass (WMD: -0·26 kg, 95 % CI -1·51, 0·98; P = 0·677, I2 = 0 %), waist circumference (WMD: -0·28 cm, 95 % CI -2·30, 1·74; P = 0·786, I2 = 0 %), body fat percentage (WMD: 0·18 %, 95 % CI -0·62, 0·99; P = 0·651, I2 = 0 %), fat-free mass (WMD: 0·31 kg, 95 % CI -0·31, 1·94; P = 0·703, I2 = 0 %) and waist-to-hip ratio (WMD: 0, 95 % CI -0·01, 0·02; P = 0·676, I2 = 0 %). Subgroup analyses based on trial duration, BR or nitrate dose, study design, baseline BMI and athletic status (athlete v. non-athlete) demonstrated similar results. Certainty of evidence across outcomes ranged from low to moderate. This meta-analysis study suggests that BR or nitrate supplements cannot efficiently ameliorate body composition indices regardless of supplement dosage, trial duration and athletic status.
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Affiliation(s)
- Reza Afrisham
- Department of Clinical Laboratory Sciences, Faculty of Allied Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Vida Farrokhi
- Department of Hematology, Faculty of Allied Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Matin Ghanavati
- National Nutrition and Food Technology Research Institute, (Faculty of Nutrition Sciences and Food Technology), Shahid Beheshti University of Medical Sciences, Teheran, Iran
| | - Omid Asbaghi
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shooka Mohammadi
- Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mehrnaz Mohammadian
- Department of Exercise Physiology, Islamic Azad University of Ahvaz, Ahvaz, Iran
| | - Tahereh Taghvaei-Yazdeli
- Department of Hematology, Faculty of Allied Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Shayan Safaei-Kooyshahi
- Department of Clinical Laboratory Sciences, Faculty of Allied Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Yasaman Jadidi
- Department of Clinical Laboratory Sciences, Faculty of Allied Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Damoon Ashtary-Larky
- Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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