Metabolic syndrome and inflammation: a critical review of in vitro and clinical approaches for benefit assessment of plant food supplements

Natural products for managing metabolic syndrome: a scoping review

Introduction

Metabolic syndrome comprises a collection of metabolic disorders stemming from factors like genetic predisposition, inadequate nutrition, stress, decreased physical activity, aging, and ethnicity. Although traditional pharmaceutical treatments exist for metabolic syndrome, their limited popularity is attributed to high costs and adverse effects. Consequently, natural products with fewer side effects have been explored for managing this condition. This literature review aims to explore the role of natural products including herbs, botanicals, vitamins, minerals, probiotics, and dietary supplements in managing metabolic syndrome.

Methods

This scoping review was conducted in five steps, involving the formulation of a research question, the retrieval and extraction of relevant studies, the selection of pertinent studies, the organization of information into tables, and the reporting of results. Data was collected from various databases including Embase, Science Direct, PubMed, Google Scholar, Scopus, and Web of Science, with a focus on studies published from 2010 to the present, available in English and with full-text accessibility.

Results

We identified 1,259 articles, screened their titles, abstracts, and full texts, ultimately incorporating 169 pertinent articles into this review (comprising 90 review articles, 32 trial articles, 6 in vitro articles, 38 in vivo articles, 1 experimental article and 2 observational articles). The study's outcomes revealed that natural products, encompassing plants and their derivatives, vitamins and supplements, as well as probiotics, can exert a beneficial influence on metabolic syndrome by regulating blood sugar, blood pressure, lipid profiles, obesity, and abnormal cholesterol and triglyceride levels.

Conclusion

The current study underscores the significance of natural products in addressing metabolic syndrome. Consequently, it is advisable to conduct further extensive research to assess the efficacy of these products, potentially integrating them into treatment regimens for individuals with metabolic syndrome.

Natural products for managing metabolic syndrome: a scoping review

Introduction

Metabolic syndrome comprises a collection of metabolic disorders stemming from factors like genetic predisposition, inadequate nutrition, stress, decreased physical activity, aging, and ethnicity. Although traditional pharmaceutical treatments exist for metabolic syndrome, their limited popularity is attributed to high costs and adverse effects. Consequently, natural products with fewer side effects have been explored for managing this condition. This literature review aims to explore the role of natural products including herbs, botanicals, vitamins, minerals, probiotics, and dietary supplements in managing metabolic syndrome.

Methods

This scoping review was conducted in five steps, involving the formulation of a research question, the retrieval and extraction of relevant studies, the selection of pertinent studies, the organization of information into tables, and the reporting of results. Data was collected from various databases including Embase, Science Direct, PubMed, Google Scholar, Scopus, and Web of Science, with a focus on studies published from 2010 to the present, available in English and with full-text accessibility.

Results

We identified 1,259 articles, screened their titles, abstracts, and full texts, ultimately incorporating 169 pertinent articles into this review (comprising 90 review articles, 32 trial articles, 6 in vitro articles, 38 in vivo articles, 1 experimental article and 2 observational articles). The study’s outcomes revealed that natural products, encompassing plants and their derivatives, vitamins and supplements, as well as probiotics, can exert a beneficial influence on metabolic syndrome by regulating blood sugar, blood pressure, lipid profiles, obesity, and abnormal cholesterol and triglyceride levels.

Conclusion

The current study underscores the significance of natural products in addressing metabolic syndrome. Consequently, it is advisable to conduct further extensive research to assess the efficacy of these products, potentially integrating them into treatment regimens for individuals with metabolic syndrome.

Testosterone deficiency and the aging male

Testosterone deficiency (TD), also known as male hypogonadism, is a complex syndrome encompassing physical, biochemical, and social aspects that increasingly affects the aging population. TD has been analyzed over recent decades, with an enhanced focus on etiologies relating to aging males. There is debate whether testosterone decline leading to hypogonadism is directly and primarily related to age-specific processes or if it is the subsequent result of accumulating comorbidities throughout a lifetime. Several studies have been done to further characterize this distinction. Chronic comorbidities that have commonly been associated with TD include hypertension (HTN), cardiovascular disease (CVD), diabetes mellitus (DM), obesity, metabolic syndrome (MetS), chronic kidney disease (CKD), and tobacco use. Although clear associations between hypogonadism and aging have been biochemically demonstrated, many large studies have illustrated the concomitant effects of highly prevalent chronic diseases and social behaviors in aging men. Given the significant impact of hypogonadism on the physical and mental health of men, this paper aims to delve into these studies and further define the complex relationship of testosterone deficiency in the aging male.

Nanomedicine of Plant Origin for the Treatment of Metabolic Disorders

Metabolic disorders are major clinical challenges of health that are progressing globally. A concurrence of metabolic disorders such as obesity, insulin resistance, atherogenic dyslipidemia, and systematic hypertension leads to metabolic syndrome. Over the past years, the metabolic syndrome leads to a five- and two-fold rise in diabetes mellitus type II and cardiovascular diseases. Natural products specifically plant extracts have insulin-sensitizing, anti-inflammatory, and antioxidant properties and are also considered as an alternative option due to few adverse effects. Nanotechnology is one of the promising strategies, which improves the effectiveness of treatment and limits side effects. This review mainly focuses on plant extract-based nanosystems in the management of the metabolic syndrome. Numerous nano-drug delivery systems, i.e., liposomes, hydrogel nanocomposites, nanoemulsions, micelles, solid lipid, and core–shell nanoparticles, have been designed using plant extracts. It has been found that most of the nano-formulations successfully reduced oxidative stress, insulin resistance, chronic inflammation, and lipid profile in in vitro and in vivo studies as plant extracts interfere with the pathways of metabolic syndrome. Thus, these novel plant-based nanosystems could act as a promising candidate for clinical applications.

Phytosomes as Innovative Delivery Systems for Phytochemicals: A Comprehensive Review of Literature

Nowadays, medicinal herbs and their phytochemicals have emerged as a great therapeutic option for many disorders. However, poor bioavailability and selectivity might limit their clinical application. Therefore, bioavailability is considered a notable challenge to improve bio-efficacy in transporting dietary phytochemicals. Different methods have been proposed for generating effective carrier systems to enhance the bioavailability of phytochemicals. Among them, nano-vesicles have been introduced as promising candidates for the delivery of insoluble phytochemicals. Due to the easy preparation of the bilayer vesicles and their adaptability, they have been widely used and approved by the scientific literature. The first part of the review is focused on introducing phytosome technology as well as its applications, with emphasis on principles of formulations and characterization. The second part provides a wide overview of biological activities of commercial and non-commercial phytosomes, divided by systems and related pathologies. These results confirm the greater effectiveness of phytosomes, both in terms of biological activity or reduced dosage, highlighting curcumin and silymarin as the most formulated compounds. Finally, we describe the promising clinical and experimental findings regarding the applications of phytosomes. The conclusion of this study encourages the researchers to transfer their knowledge from laboratories to market, for a further development of these products.

Nanophytomedicines for the Prevention of Metabolic Syndrome: A Pharmacological and Biopharmaceutical Review

Metabolic syndrome includes a series of metabolic abnormalities that leads to diabetes mellitus and cardiovascular diseases. Plant extracts, due to their unique advantages like anti-inflammatory, antioxidant, and insulin sensitizing properties, are interesting therapeutic options to manage MetS; however, the poor solubility and low bioavailability of lipophilic bioactive components in the herbal extracts are two critical challenges. Nano-scale delivery systems are suitable to improve delivery of herbal extracts. This review, for the first time, focuses on nanoformulations of herbal extracts in MetS and related complications. Included studies showed that several forms of nano drug delivery systems such as nanoemulsions, solid lipid nanoparticles, nanobiocomposites, and green-synthesized silver, gold, and zinc oxide nanoparticles have been developed using herbal extracts. It was shown that the method of preparation and related parameters such as temperature and type of polymer are important factors affecting physicochemical stability and therapeutic activity of the final product. Many of these formulations could successfully decrease the lipid profile, inflammation, oxidative damage, and insulin resistance in in vitro and in vivo models of MetS-related complications. Further studies are still needed to confirm the safety and efficacy of these novel herbal formulations for clinical application.

Dietary Melatonin Protects Against Behavioural, Metabolic, Oxidative, and Organ Morphological Changes in Mice that are Fed High-Fat, High- Sugar Diet

BACKGROUND

Metabolic syndrome is a complex pattern of disorders that occur jointly and is associated with an increased risk of cardiovascular and cerebrovascular disease. Therefore the need for more-efficient options of treatment has become imperative.

OBJECTIVE

This study examined the effect of dietary-melatonin in the management of behavioural, metabolic, antioxidant, and organ changes due to high-fat/high-sugar (HFHS) diet-induced metabolic syndrome in mice.

METHODS

Mice were randomly assigned into five groups of ten animals each. Groups were normal control [fed standard diet (SD)], HFHS control, and 3 groups of melatonin incorporated into HFHS at 2.5, 5, and 10 mg/kg of feed. Mice were fed for seven weeks, and body weight was assessed weekly. Open-field behaviours, radial-arm, and Y-maze spatial memory were scored at the end of the experimental period. Twenty-four hours after the last behavioural test, blood was taken for estimation of blood glucose levels after an overnight fast. Animals were then euthanised, and blood was taken for estimation of plasma insulin, leptin, and adiponectin levels, and serum lipid profile. The liver, kidneys, and brain were excised and processed for general histology, while homogenates of the liver and whole brain were used to assess oxidative stress parameters.

RESULTS

Results showed that dietary melatonin (compared to HFHS diet) was associated with a decrease in body weight, food intake, and novelty-induced behaviours; and an increase in spatial-working memory scores. A decrease in glucose, insulin, leptin, and malondialdehyde levels; and an increase in adiponectin levels and superoxide dismutase activity were also observed. Histomorphological/ histomorphometric examination revealed evidence of organ injury with HFHS diet, and varying degrees of amelioration with melatonin-supplemented diet.

CONCLUSION

In conclusion, dietary melatonin supplementation may have beneficial effects in the management of the metabolic syndrome.

Phenolic profiles and anti-inflammatory activities of sixteen table grape (Vitis vinifera L.) varieties

Several studies have shown that fresh grape and its derivatives contain phenolic compounds exhibiting antioxidant and health promoting effects, particularly in relation to the cardiovascular system. In this study, two methods were developed to characterize sixteen varieties of table and wine grapes: (1) a LC-MS method to identify major and minor phenolic compounds; and (2) a HPLC-DAD method to quantify the most representative compounds. Sixty-seven molecules belonging to different classes of phenolic compounds were identified: anthocyanins, flavan-3-ols, flavonols, stilbenes and organic acids. In parallel, the free radical scavenging activity and anti-inflammatory activities of the 16 grape varieties were evaluated. The results showed a good correlation between the total phenolic content and the biological activity. Extracts from Exalta and Albarossa grape varieties were the most active in reducing IL-8 release by gastric epithelial cells (IC50 = 8.48 μg mL-1 and 6.68 μg mL-1, respectively), a biomarker of inflammatory processes. The observed biological activities were mainly associated with skin and seed extracts/portions. The interest in studying table grapes and their non-fermented derivatives as sources of healthy compounds has increased in the last few years and our findings suggest that table grapes and their fresh derivatives, in addition to wine, could be involved in the health promoting effects of the Mediterranean diet.

Anti-nociceptive and anti-inflammatory effects of Withania somnifera root in fructose fed male rats

BACKGROUND

Insulin resistance is a metabolic disorder which affects the diabetes mellitus pathophysiology and alters the cell excitability. This study has been designed to evaluate the anti-nociceptive and anti-inflammatory effects of chronic administration of Withania somnifera root (WSR) in fructose drinking water rats.

METHODS

An experiment was carried out on 48 Wistar-Albino male rats, weighting 200±30 g, which were divided into six groups (n=8): control group (C), control morphine (CM), W. somnifera group (WS) which received WSR (62.5 mg/g diet), W. somnifera naloxone group (WSN) which received WSR and naloxone, fructose (F) group which received fructose drinking water and FWS group which received fructose-enriched drinking water and WSR during the trial period. A biphasic pain response was induced after intraplantar injection of formalin (50 μL, 1%). Pain behavior was measured using Dubuisson methods. The obtained data were analyzed by SPSS software V. 18, using ANOVA and Tukey test. Results were expressed as mean±SD. Statistical differences were considered significant at p<0.05.

RESULTS

The results showed that the insulin resistance index, blood sugar, insulin, IL-6, TNF-α, and acute and chronic pain score in the F group were significantly increased in comparison with the control group, but these parameters in the FWS group were significantly decreased compared with the F group (p<0.001).

CONCLUSIONS

Our findings indicated that chronic oral administration of WSR has analgesic and anti-inflammatory effects in fructose drinking water rats and causes improved insulin resistance index.

Biomarkers of Metabolic Syndrome: Biochemical Background and Clinical Significance

Biomarkers of the metabolic syndrome are divided into four subgroups. Although dividing them in groups has some limitations, it can be used to draw some conclusions. In a first part, the dyslipidemias and markers of oxidative stress are discussed, while inflammatory markers and cardiometabolic biomarkers are reviewed in a second part. For most of them, the biochemical background and clinical significance are discussed, although here also a well-cut separation cannot always be made. Altered levels cannot always be claimed as the cause, risk, or consequence of the syndrome. Several factors are interrelated to each other and act in a concerted, antagonistic, synergistic, or modulating way. Most important conclusions are summarized at the end of every reviewed subgroup. Genetic biomarkers or influences of various food components on concentration levels are not included in this review article.

The Nociceptive and Anti-Inflammatory Effects of Artemisia dracunculus L. Aqueous Extract on Fructose Fed Male Rats

Aim & Objective. Artemisia dracunculus L. (Tarragon) species have been used as a traditional medicine. The present study was designed to evaluate the nociceptive and anti-inflammatory effects of A. dracunculus L. leaf aqueous extract on fructose drinking water (FDW) in male rats. Materials & Methods. Forty-eight Wistar-albino male rats weighing 200–250 g were divided into control (C), control extract (CE), FDW, and FDWE groups (n = 12). Group C did not receive any agents; Group CE did 100 mg/kg A. dracunculus L. aqueous extract on a daily basis for duration of four weeks. FDW Group received fructose drinking water (10%, weight/volume) but did not receive any agents during trial period. FDWE group received 100 mg/kg A. dracunculus L. aqueous extract during trial period. At the end of experiment, a biphasic pain response was induced following interplanetary injection of formalin (50 µL, 1%). Obtained data were analyzed using SPSS software version 17 and using ANOVA and Tukey post hoc tests. Results were expressed as mean ± SE. Statistical differences were considered significant at P < 0.05. Results. Our findings revealed that acute and chronic pain scores in FDW group are significantly higher than other ones and A. dracunculus L. aqueous extract causes significant decreasing of this parameter in FDWE group (P < 0.001). Moreover, IL6 and TNF values in this group were significantly decreased compared to FDW group (P < 0.05). Conclusion. Results in the present study show that FDW causes the pain response score to increase and cause proinflammatory cytokines in rat model but A. dracunculus L. leaf aqueous extract improves values of these parameters.

Mechanisms of enhanced insulin secretion and sensitivity with n-3 unsaturated fatty acids

The widespread acceptance that increased dietary n-3 polyunsaturated fatty acids (PUFAs), especially α-linolenic acid (ALA), eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), improve health is based on extensive studies in animals, isolated cells and humans. Visceral adiposity is part of the metabolic syndrome, together with insulin resistance, dyslipidemia, hypertension and inflammation. Alleviation of metabolic syndrome requires normalization of insulin release and responses. This review assesses our current knowledge of the mechanisms that allow n-3 PUFAs to improve insulin secretion and sensitivity. EPA has been more extensively studied than either ALA or DHA. The complex actions of EPA include increased G-protein-receptor-mediated release of glucagon-like peptide 1 (GLP-1) from enteroendocrine L-cells in the intestine, up-regulation of the apelin pathway and down-regulation of other control pathways to promote insulin secretion by the pancreatic β-cells, together with suppression of inflammatory responses to adipokines, inhibition of peroxisome proliferator-activated receptor α actions and prevention of decreased insulin-like growth factor-1 secretion to improve peripheral insulin responses. The receptors involved and the mechanisms of action probably differ for ALA and DHA, with antiobesity effects predominating for ALA and anti-inflammatory effects for DHA. Modifying both GLP-1 release and the actions of adipokines by n-3 PUFAs could lead to additive improvements in both insulin secretion and sensitivity.