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Okuka N, Milinkovic N, Velickovic K, Polovina S, Sumarac-Dumanovic M, Minic R, Korčok D, Djordjevic B, Ivanovic ND. Beneficial effects of a new probiotic formulation on adipocytokines, appetite-regulating hormones, and metabolic parameters in obese women. Food Funct 2024; 15:7658-7668. [PMID: 38953736 DOI: 10.1039/d4fo01269k] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/04/2024]
Abstract
Obesity is often accompanied by low-grade chronic inflammation and metabolic syndrome. It has been established that microbiota influences many physiological processes, including the development of obesity, and dysbiosis has been observed in obese individuals. In this study, we aimed to evaluate the impact of a new probiotic formulation, containing two probiotic strains and the bioactive compound octacosanol, on body weight, metabolic parameters, and concentrations of certain adipocytokines and appetite-regulating hormones in obese women. This double blind placebo-controlled supplementary intervention study included twenty-five women in the intervention group and twenty-three in the placebo group, and it lasted 12 weeks. Daily oral supplementation included 7 × 1010 CFU of Lactiplantibacillus plantarum 299v (DSM9843), 5 × 109 CFU of Saccharomyces cerevisiae var. boulardii (DBVPG6763), and 40 mg of octacosanol or placebo. Body weight, metabolic parameters, adipocytokines, and appetite-regulating hormones were assessed before (T0) and after the intervention (T1). After the intervention, significantly lower median concentrations of CRP (p = 0.005) and IL-6 (p = 0.012) were measured in the intervention group than the baseline, while the median concentrations of ghrelin (p = 0.026) and HDL-cholesterol (p = 0.03) were significantly increased. The intervention group had lower CRP levels (p = 0.023) and higher ghrelin levels (p = 0.006) than the placebo group. Significant changes in BMI between groups were not observed. In summary, although the new probiotic formulation showed beneficial effects on IL-6, CRP, HDL, and ghrelin levels, its potential effects on regulating triglyceride, insulin, and glucose levels require further studies before the novel dietary intervention could be considered a useful adjuvant therapy and an effective strategy for the management of obesity and obesity-associated comorbidities.
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Affiliation(s)
- Nina Okuka
- University of Banja Luka, Faculty of Medicine, Department of Bromatology, 78000 Banja Luka, Bosnia and Herzegovina.
| | - Neda Milinkovic
- University of Belgrade, Faculty of Pharmacy, Department of Medical Biochemistry, 11000, Belgrade, Serbia
| | - Ksenija Velickovic
- University of Belgrade, Faculty of Biology, Department of Cell and Tissue Biology, 11000 Belgrade, Serbia
| | - Snezana Polovina
- Clinic for Endocrinology, Diabetes and Diseases of Metabolism, University Clinical Center of Serbia, 11000 Belgrade, Serbia
- Faculty of Pharmacy, Novi Sad, University Business Academy, 21000 Novi Sad, Serbia
| | - Mirjana Sumarac-Dumanovic
- Clinic for Endocrinology, Diabetes and Diseases of Metabolism, University Clinical Center of Serbia, 11000 Belgrade, Serbia
- School of Medicine, University of Belgrade, Clinic for Endocrinology, Diabetes and Diseases of Metabolism, 11000 Belgrade, Serbia
| | - Rajna Minic
- Institute of Virology, Vaccines and Sera "Torlak", Department of Protein Engineering and Biochemistry, 11000 Belgrade, Serbia
| | - Davor Korčok
- Faculty of Pharmacy, Novi Sad, University Business Academy, 21000 Novi Sad, Serbia
| | - Brizita Djordjevic
- University of Belgrade, Faculty of Pharmacy, Department of Bromatology, 11000 Belgrade, Serbia
| | - Nevena Dj Ivanovic
- University of Belgrade, Faculty of Pharmacy, Department of Bromatology, 11000 Belgrade, Serbia
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Okuka N, Schuh V, Krammer U, Polovina S, Sumarac-Dumanovic M, Milinkovic N, Velickovic K, Djordjevic B, Haslberger A, Ivanovic ND. Epigenetic Aspects of a New Probiotic Concept-A Pilot Study. Life (Basel) 2023; 13:1912. [PMID: 37763315 PMCID: PMC10533075 DOI: 10.3390/life13091912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 09/02/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023] Open
Abstract
Several studies report the important role of an altered gut microbiota in the development of obesity, highlighting the potential use of probiotics in the treatment of obesity. The aim of this study is to investigate the effect of a novel probiotic approach on the expression of specific miRNAs and mRNAs associated with obesity in combination with the hypocholesterolemic octacosanol. Twenty overweight/obese women participated in a randomized, placebo-controlled, double-blind study and were randomly divided into two groups: the intervention group (daily one capsule containing Lactobacillus plantarum 299v (DSM9843), Saccharomyces cerevisiae var. boulardii, and 40 mg octacosanol; N = 12) and the placebo group (N = 8). Changes in lipid parameters and expression of miRNAs and mRNAs were assessed before (T0) and after the 12-week intervention (T1). After the intervention, the expression of miR-155-5p (9.38 ± 0.85 vs. 8.38 ± 1.06, p = 0.05) and miR-24-3p (3.42 ± 0.38 vs. 2.71 ± 0.97, p = 0.031) showed significant decreases in the intervention group when compared to the control group. At T1, the expression of miR-155-5p (8.69 ± 1.31 vs. 9.3 ± 0.85, p = 0.04), miR-125b-5p (5.41 ± 1.18 vs. 5.99 ± 1.36, p = 0.049), and TNF-α (10.24 ± 1.66 vs. 11.36 ± 1.12, p = 0.009) were significantly decreased in the intervention group. No changes in lipids and anthropometric parameters were observed. The novel probiotic approach had a positive effect on regulating the expression of certain miRNAs and mRNAs important for regulating inflammation and adipogenesis, which are essential for obesity onset and control.
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Affiliation(s)
- Nina Okuka
- Department of Bromatology, Faculty of Medicine, University of Banja Luka, 78000 Banja Luka, Bosnia and Herzegovina;
| | | | | | - Snezana Polovina
- Clinic for Endocrinology, Diabetes and Diseases of Metabolism, Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Mirjana Sumarac-Dumanovic
- School of Medicine, University of Belgrade, Clinic for Endocrinology, Diabetes and Diseases of Metabolism, 11000 Belgrade, Serbia
| | - Neda Milinkovic
- Department of Medical Biochemistry, Faculty of Pharmacy, University of Belgrade, 11000 Belgrade, Serbia
| | - Ksenija Velickovic
- Department of Cell and Tissue Biology, Faculty of Biology, University of Belgrade; 11000 Belgrade, Serbia
| | - Brizita Djordjevic
- Department of Bromatology, Faculty of Pharmacy, University of Belgrade, 11000 Belgrade, Serbia
| | | | - Nevena Dj. Ivanovic
- Department of Bromatology, Faculty of Pharmacy, University of Belgrade, 11000 Belgrade, Serbia
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Kim KM, Lim YJ, Jang WG. Policosanol Stimulates Osteoblast Differentiation via Adenosine Monophosphate-Activated Protein Kinase-Mediated Expression of Insulin-Induced Genes 1 and 2. Cells 2023; 12:1863. [PMID: 37508527 PMCID: PMC10378419 DOI: 10.3390/cells12141863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 07/12/2023] [Accepted: 07/13/2023] [Indexed: 07/30/2023] Open
Abstract
Policosanol is known as a hypocholesterolemic compound and is derived from plants such as sugar cane and corn. Policosanol can lower blood pressure or inhibit adipogenesis, but its effect on osteogenic differentiation and the molecular mechanism is unclear. This study aims to investigate the effect of policosanol on osteogenic differentiation in MC3T3-E1 cells and zebrafish models. Administration of policosanol into MC3T3-E1 induced the expression of the osteogenic genes such as distal-less homeobox 5 (Dlx5) and runt-related transcription factor 2 (Runx2). Alkaline phosphatase activity and extracellular mineralization also increased. Policosanol promoted activation of adenosine monophosphate-activated protein kinase (AMPK) and insulin-induced genes (INSIGs) expression and regulation of INSIGs modulated osteoblast differentiation. AMPK activation through transfection of the constitutively active form of AMPK (CA-AMPK) increased INSIGs expression, whereas policosanol-induced INSIGs expression was suppressed by inhibitor of AMPK (Com. C). Furthermore, the osteogenic effects of policosanol were verified in zebrafish. Amputated caudal fin rays were regenerated by policosanol treatment. Taken together, these results show that policosanol increases osteogenic differentiation and contributes to fin regeneration in zebrafish via AMPK-mediated INSIGs expression, suggesting that policosanol has potential as an osteogenic agent.
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Affiliation(s)
- Kyeong-Min Kim
- Department of Biotechnology, School of Engineering, Daegu University, Gyeongsan 38453, Republic of Korea
- Research Institute of Anti-Aging, Daegu University, Gyeongsan 38453, Republic of Korea
| | - Young-Ju Lim
- Department of Biotechnology, School of Engineering, Daegu University, Gyeongsan 38453, Republic of Korea
- Research Institute of Anti-Aging, Daegu University, Gyeongsan 38453, Republic of Korea
| | - Won-Gu Jang
- Department of Biotechnology, School of Engineering, Daegu University, Gyeongsan 38453, Republic of Korea
- Research Institute of Anti-Aging, Daegu University, Gyeongsan 38453, Republic of Korea
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Osadnik T, Goławski M, Lewandowski P, Morze J, Osadnik K, Pawlas N, Lejawa M, Jakubiak GK, Mazur A, Schwingschackl L, Gąsior M, Banach M. A network meta-analysis on the comparative effect of nutraceuticals on lipid profile in adults. Pharmacol Res 2022; 183:106402. [PMID: 35988871 DOI: 10.1016/j.phrs.2022.106402] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 08/14/2022] [Accepted: 08/15/2022] [Indexed: 11/24/2022]
Abstract
It is estimated that 2.6 million deaths worldwide can be attributed to hypercholesterolemia. The main reason for non-adherence to statin therapy are the statin-associated muscle symptoms (including nocebo/drucebo effect). In this case, apart from ezetimibe, nutraceuticals are prescribed. We aimed to assess the comparative efficacy of different nutraceuticals in terms of lowering low density lipoprotein cholesterol (LDL-C) and improving lipid profile. Electronic and hand searches were performed until February 2021. The inclusion criteria were the following: (1) randomized trial with any of the reportedly LDL-C lowering nutraceutical: artichoke, berberine, bergamot, garlic, green tea extract, plant sterols/stanols, policosanols, red yeast rice (RYR), silymarin or spirulina. (2) outcome either LDL-C (primary outcome), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C) or serum triglycerides (TG). Random effects network meta-analysis (NMA) was performed to rank the effect of each intervention using frequentist approach. Finally, a total of 131 trials enrolling 13,062 participants were included. All analysed nutraceuticals except for policosanols were more effective in lowering LDL-C (-1.21 [-46.8 mg/dL] to -0.17 [-6.6 mg/dL] mmol/l reduction) and TC (-1.75 [-67.7 mg/dL] to -0.18 [7 mg/dL] mmol/l reduction) than placebo/no intervention. The most effective approaches in terms of LDL-C- and TC-lowering were bergamot and RYR (-1.21 [-46.8 mg/dl] and -0.94 [-36.4 mg/dl] mmol/l) reduction respectively. In conclusion, bergamot and RYR appear to be the most effective nutraceuticals in terms of LDL-C and TC reduction. Evidence for bergamot effect was based on relatively small study group and may require further investigations. Policosanols have no effect on the lipid profile.
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Affiliation(s)
- Tadeusz Osadnik
- Department of Pharmacology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Marcin Goławski
- Department of Pharmacology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Piotr Lewandowski
- Department of Pharmacology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Jakub Morze
- Department of Human Nutrition, Faculty of Food Sciences, University of Warmia and Mazury, Olsztyn, Poland
| | - Kamila Osadnik
- Department of Pharmacology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Natalia Pawlas
- Department of Pharmacology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Mateusz Lejawa
- Department of Pharmacology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Grzegorz K Jakubiak
- Department of Pharmacology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland; Department and Clinic of Internal Medicine, Angiology, and Physical Medicine, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Poland
| | - Agnieszka Mazur
- Department of Pharmacology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Lucas Schwingschackl
- German Institute for Evidence in Medicine, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Mariusz Gąsior
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Maciej Banach
- Department of Preventive Cardiology and Lipidology, Medical University of Lodz (MUL), Lodz, Poland.
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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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Turini E, Sarsale M, Petri D, Totaro M, Lucenteforte E, Tavoschi L, Baggiani A. Efficacy of Plant Sterol-Enriched Food for Primary Prevention and Treatment of Hypercholesterolemia: A Systematic Literature Review. Foods 2022; 11:foods11060839. [PMID: 35327262 PMCID: PMC8954273 DOI: 10.3390/foods11060839] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 03/10/2022] [Accepted: 03/12/2022] [Indexed: 01/27/2023] Open
Abstract
Plant sterols/phytosterols (PSs) are molecules with a similar structure to cholesterol that have a recognized effect on elevated LDL concentrations (LDL-c). PSs are used as a natural therapy against elevated LDL-c in combination with a healthy diet and exercise. A systematic review was performed to evaluate the efficacy of PS-enriched foods in the treatment of hypercholesterolemia. Randomized controlled clinical studies reporting the use of PS-enriched foods to reduce LDL-c among adult individuals were retrieved and assessed for risk of bias. Meta-analyses were performed to assess changes in LDL-c by treatment, food matrix, LDL-c range, sterols dosage and risk of bias (RoB). In the 13 studies analyzed, LDL-c in PS-treated participants decreased by an average of 12.14 (8.98; 15.29) mg/dL. PS administration was statistically more effective in patients with LDL-c ≥ 140 mg/dL and for PS dosages > 2 g/day. It can be concluded that PSs can be used as an important primary prevention measure for hypercholesterolemia and as tertiary prevention for cardiovascular events in patients who already have mild to moderate LDL-c. However, in severe hypercholesterolemia and in cases of familial hypercholesterolemia, it is necessary to combine dietary treatment with the use of statins.
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Affiliation(s)
- Elisa Turini
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via San Zeno 37, 56123 Pisa, Italy; (M.S.); (M.T.); (L.T.); (A.B.)
- Correspondence:
| | - Miriana Sarsale
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via San Zeno 37, 56123 Pisa, Italy; (M.S.); (M.T.); (L.T.); (A.B.)
- Department of Pharmacy, University of Pisa, 56123 Pisa, Italy
| | - Davide Petri
- Department of Clinical and Experimental Medicine, University of Pisa, 56123 Pisa, Italy; (D.P.); (E.L.)
| | - Michele Totaro
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via San Zeno 37, 56123 Pisa, Italy; (M.S.); (M.T.); (L.T.); (A.B.)
| | - Ersilia Lucenteforte
- Department of Clinical and Experimental Medicine, University of Pisa, 56123 Pisa, Italy; (D.P.); (E.L.)
| | - Lara Tavoschi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via San Zeno 37, 56123 Pisa, Italy; (M.S.); (M.T.); (L.T.); (A.B.)
| | - Angelo Baggiani
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via San Zeno 37, 56123 Pisa, Italy; (M.S.); (M.T.); (L.T.); (A.B.)
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Nutraceuticals in Paediatric Patients with Dyslipidaemia. Nutrients 2022; 14:nu14030569. [PMID: 35276928 PMCID: PMC8840379 DOI: 10.3390/nu14030569] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 01/13/2022] [Accepted: 01/25/2022] [Indexed: 12/16/2022] Open
Abstract
Coronary heart disease (CHD) is the main cause of death and morbidity in the world. Childhood is a critical period during which atherosclerosis may begin to develop; in the presence of familial hypercholesterolaemia (FH), the lifelong elevation of LDL cholesterol levels greatly accelerates atherosclerosis. Lowering LDL-C levels is associated with a well-documented reduction in cardiovascular disease risk. Current guidelines support the dietary and lifestyle approach as the primary strategy of intervention in children and adolescents with FH. Nutraceuticals (functional foods or dietary supplements of plant or microbial origin) are included in the EU guidelines as lifestyle interventions and may provide an additional contribution in reducing LDL levels when pharmacological therapy is not yet indicated. Meta-analyses of randomised clinical trials have demonstrated that the same nutraceuticals improve lipid profile, including lowering LDL-C, total cholesterol and triglyceride levels. In this narrative review, starting from current scientific evidence, we analyse the benefits and limitations of the nutraceuticals in children and adolescents with dyslipidaemia, and we try to evaluate their use and safety in clinical practice.
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Zhou H, Zhao Y, Peng W, Han W, Wang Z, Ren X, Wang D, Pan G, Lin Q, Wang X. Effect of Sodium Tanshinone IIA Sulfonate Injection on Blood Lipid in Patients With Coronary Heart Disease: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. Front Cardiovasc Med 2021; 8:770746. [PMID: 34901229 PMCID: PMC8652084 DOI: 10.3389/fcvm.2021.770746] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Accepted: 11/03/2021] [Indexed: 11/28/2022] Open
Abstract
Background: Lipid-lowering therapy is very important in secondary prevention of coronary heart disease (CHD). In many clinical trials, it has been found that Sodium Tanshinone IIA Sulfonate Injection (STS) have a lipid-lowering effect while reducing major cardiovascular events in patients with CHD. However, up to now, there is no system review on the effectiveness and safety of STS affecting blood lipids. Purpose: The aim of this review is to systematically assess the effects of STS on blood lipid levels in patients with CHD. Methods: Until Mar 2021, five databases (PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure, and Wanfang Database) were searched for randomized controlled trials (RCTs) about STS treating patients with CHD. Risk bias was assessed for included studies according to Cochrane handbook. The primary outcome was total cholesterol (TC). The secondary outcomes were triglycerides (TG), low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c), and adverse events (AEs). Results: A total of 27 trials including 2,445 CHD patients met the eligibility criteria. Most trials had high risks in random sequence generation, allocation concealment, blinding of patients and personal, blinding of outcome assessment. Meta-analysis showed that STS significantly reduced plasma TC levels [MD = −1.34 mmol/l 95% CI (−1.59, −1.09), p < 0.00001, I2 = 98%], TG levels [MD = −0.49 mmol/l 95% CI (−0.62, −0.35), p < 0.00001, I2 = 97%], LDL-c levels [MD = −0.68 mmol/l (−0.80, −0.57), p < 0.00001, I2 = 96%], increased HDL-c levels [MD = 0.26 mmol/l (0.15, 0.37), p < 0.00001, I2 = 97%], without increasing the incidence of AEs [RR = 1.27 95% CI (0.72, 2.27), p = 0.94, I2 = 0%] in patients with CHD. Conclusion: STS can safely and effectively reduce plasma TC, TG and LDL-c levels in patients with CHD, and improve plasma HDL-c levels. However, these findings require careful recommendation due to the low overall quality of RCTs at present. More multi-center, randomized, double-blind, placebo-controlled trials which are designed follow the CONSORT 2010 guideline are needed.
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Affiliation(s)
- Hufang Zhou
- Cardiovascular Diseases Center, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Ying Zhao
- Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Wenhua Peng
- Cardiovascular Diseases Center, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Wenbo Han
- Beijing University of Chinese Medicine Third Affiliated Hospital, Beijing, China
| | - Zichen Wang
- Cardiovascular Diseases Center, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Xiaoxia Ren
- Cardiovascular Diseases Center, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Dayang Wang
- Cardiovascular Diseases Center, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Guozhong Pan
- Cardiovascular Diseases Center, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Qian Lin
- Changping District Hospital of Integrated Traditional Chinese and Western Medicine, Beijing, China
| | - Xian Wang
- Cardiovascular Diseases Center, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
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9
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Adel Mehraban MS, Tabatabaei-Malazy O, Rahimi R, Daniali M, Khashayar P, Larijani B. Targeting dyslipidemia by herbal medicines: A systematic review of meta-analyses. JOURNAL OF ETHNOPHARMACOLOGY 2021; 280:114407. [PMID: 34252530 DOI: 10.1016/j.jep.2021.114407] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 05/18/2021] [Accepted: 07/08/2021] [Indexed: 12/18/2022]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE The worldwide increasing prevalence of dyslipidemia has become a global health concern. Various herbal remedies have been claimed to be effective for the treatment of dyslipidemia in traditional and folkloric medicine of different regions clinical trials have been conducted to investigate their efficacy. The aim of the current systematic review is to critically assess the meta-analyses of controlled trials (CT) evaluated herb medicines for dyslipidemia. MATERIALS AND METHODS Relevant studies from Web of Science, PubMed, Scopus, and Cochrane Library databases based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist until January 2021 have been searched. All meta-analyses which pooled studies on the effect of herbal medicines on lipid profile including total cholesterol (TC), triglyceride (TG), and low- or high-density lipoprotein cholesterol (LDL-C, HDL-C) were also included. Meta-analyses of in vitro, animal or observational studies were excluded. RESULTS The overall of 141 meta-analyses were revealed. Vegetable oils, phytosterols, tea, soy protein, nuts, and curcumin have been studied frequently among the herbal medicines. Among 13 meta-analyses on vegetable oils, the greater reduce of TC (18.95 mg/dl), LDL-C (16.24 mg/dl) and TG (13.69 mg/dl) were exhibited from sunflower oil. Furthermore, rice bran oil (6.65 mg/dl) increased HDL-C significantly. Phytosterols in 12 meta-analyses demonstrated significant improvements in reducing TC, LDL-C and TG as 16.4, 23.7, and 8.85 mg/dl, respectively, and rise in HDL-C as 10.6 mg/dl. The highest reduction in serum level of TC, LDL-C and TG was reported while intake Green tea; 27.57, 24.75, and 31.87 mg/dl, accordingly within 9 meta-analyses. Average improvement of lipid profiles by 6 meta-analyses on plant proteins were 23.2, 21.7, 15.06, and 1.55 mg/dl for TC, LDL-C, TG, and HDL-C, respectively. Among 11 meta-analyses on nuts, almond showed better and significant alleviations in TC (10.69 mg/dl), walnut in LDL-C (9.23 mg/dl), pistachio in TG (22.14 mg/dl), and peanut in HDL-C (2.72 mg/dl). Overall, Curcumin, Curcuminoid, and Turmeric have resulted in the reduction of TC (25.13 mg/dl), LDL-C (39.83 mg/dl), TG (33.65 mg/dl), and an increase in the HDL-C (4.31 mg/dl). CONCLUSION The current systematic review shed light on the use of herbal medicines for the management of dyslipidemia. However, more well-conducted CTs are required to determine effective doses of herbal medicines.
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Affiliation(s)
- Mohammad Sadegh Adel Mehraban
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Traditional Medicine, School of Persian Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Ozra Tabatabaei-Malazy
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Roja Rahimi
- Department of Traditional Pharmacy, School of Persian Medicine, Tehran University of Medical Sciences, Tehran, Iran; PhytoPharmacology Interest Group (PPIG), Universal Scientific Education and Research Network (USERN), Tehran, Iran.
| | - Marzieh Daniali
- Toxicology and Diseases Group (TDG), Pharmaceutical Sciences Research Center (PSRC), The Institute of Pharmaceutical Sciences (TIPS), Tehran University of Medical Sciences, Tehran, Iran; Department of Toxicology and Pharmacology, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Patricia Khashayar
- Center for Microsystem Technology, Imec and Ghent University, Gent-Zwijnaarde, 9052, Belgium; Osteoporosis Research Center, Endocrinpology & Metabolism Clinical Science Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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10
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Derosa G, Colletti A, Maffioli P, D'Angelo A, Lupi A, Zito GB, Mureddu GF, Raddino R, Fedele F, Cicero AFG. Lipid-lowering nutraceuticals update on scientific evidence. J Cardiovasc Med (Hagerstown) 2021; 21:845-859. [PMID: 32639326 DOI: 10.2459/jcm.0000000000000970] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
: Cardiovascular diseases (CVDs) are the main cause of mortality worldwide. Risk factors of CVD can be classified into modifiable (smoking, hypertension, diabetes, hypercholesterolemia) through lifestyle changes or taking drug therapy and not modifiable (age, ethnicity, sex and family history). Elevated total cholesterol (TC) and low-density lipoprotein-cholesterol (LDL-C) levels have a lead role in the development of coronary heart disease (CHD), while high levels of high-density lipoprotein-cholesterol (HDL-C) seem to have a protective role.The current treatment for dyslipidemia consists of lifestyle modification or drug therapy even if not pharmacological treatment should be always considered in addition to lipid-lowering medications.The use of lipid-lowering nutraceuticals alone or in association with drug therapy may be considered when the atherogenic cholesterol goal was not achieved.These substances can be classified according to their mechanisms of action into natural inhibitors of intestinal cholesterol absorption, inhibitors of hepatic cholesterol synthesis and enhancers of the excretion of LDL-C. Nevertheless, many of them are characterized by mixed or unclear mechanisms of action.The use of these nutraceuticals is suggested in individuals with borderline lipid profile levels or with drug intolerance, but cannot replace standard lipid-lowering treatment in patients at high, or very high CVD risk.Nutraceuticals can also have vascular effects, including improvement in endothelial dysfunction and arterial stiffness, as well as antioxidative properties. Moreover, epidemiological and clinical studies reported that in patients intolerant of statins, many nutraceuticals with demonstrated hypolipidemic effect are well tolerated.
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Affiliation(s)
- Giuseppe Derosa
- Department of Internal Medicine and Therapeutics, University of Pavia, Fondazione IRCCS Policlinico San Matteo, PAVIA; SINut (Italian Society of Nutraceuticals)
| | - Alessandro Colletti
- Department of Medical and Surgical Sciences, University of Bologna, BOLOGNA; SINut (Italian Society of Nutraceuticals)
| | - Pamela Maffioli
- Department of Internal Medicine and Therapeutics, University of Pavia, Fondazione IRCCS Policlinico San Matteo, PAVIA; SINut (Italian Society of Nutraceuticals)
| | - Angela D'Angelo
- Department of Internal Medicine and Therapeutics, University of Pavia, Fondazione IRCCS Policlinico San Matteo, PAVIA; SINut (Italian Society of Nutraceuticals)
| | - Alessandro Lupi
- Cardiology Unit, Ospedali Riuniti di Domodossola e Verbania, OMEGNA; CFC (Federative College of Cardiology)
| | - Giovanni B Zito
- ASL Naples 3 SOUTH, NAPLES; ARCA (Regional Association of Ambulatorial Cardiologists)
| | - Gian Francesco Mureddu
- Cardiology Unit - San Giovanni Addolorata Hospital, ROME; AICPR (Italian Association of Clinical, Preventive and Rehabilitative Cardiology)
| | - Riccardo Raddino
- Cardiology Unit, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health University, Cardiothoracic Department, Spedali Civili of Brescia, BRESCIA; SIRC (Italian Society of Cardiovascular Research)
| | - Francesco Fedele
- Department of Cardiovascular, Respiratory, Anesthesiology, Nephrology and Geriatric Sciences, Sapienza University of Rome, ROME; INCRC (Cardiovascular Research Consortium)
| | - Arrigo F G Cicero
- Department of Medical and Surgical Sciences, University of Bologna, BOLOGNA; SINut (Italian Society of Nutraceuticals)
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11
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Kim KM, Kim CH, Cho KH, Jang WG. Policosanol attenuates Pi-induced calcification via AMPK-mediated INSIGs expression in rat VSMCs. Clin Exp Pharmacol Physiol 2021; 48:1336-1345. [PMID: 34053129 DOI: 10.1111/1440-1681.13530] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 05/25/2021] [Accepted: 05/26/2021] [Indexed: 12/25/2022]
Abstract
Policosanol is a hypocholesterolemic derived from sugar cane and corn that downregulates blood cholesterol levels. It can further lower blood pressure and reduce liver inflammation. Policosanol can also affect vascular calcification, however, its molecular mechanisms are not well understood. This study investigated the effect of policosanol on vascular calcification and its molecular mechanism. Policosanol decreased the expression of inorganic phosphate (Pi)-induced osteogenic genes such as distal-less homeobox 5 (Dlx5) and runt-related transcription factor 2 (Runx2). In addition, following policosanol treatment, adenosine monophosphate-activated protein kinase (AMPK) phosphorylation increased in a time-dependent manner. The constitutively active form of AMPK (CA-AMPK) dramatically suppressed Pi-induced Dlx5 and Runx2 protein levels. Inactivation of AMPK using compound C (Com. C; AMPK inhibitor) recovered policosanol-suppressed Alizarin Red S staining levels. Insulin-induced genes (INSIGs) were induced by CA-AMPK, their overexpression suppressed Pi-induced Dlx5 and Runx2 expression. Taken together, the results demonstrate that policosanol inhibits Pi-induced vascular calcification by regulating AMPK-induced INSIG expression in vascular smooth muscle cells.
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Affiliation(s)
- Kyeong-Min Kim
- Department of Biotechnology, College of Engineering, Daegu University, Gyeongbuk, Republic of Korea.,Research institute of Anti-Aging, Daegu University, Gyeongbuk, Republic of Korea
| | | | - Kyung-Hyun Cho
- LipoLab, Yeungnam University, Gyeongsan, Republic of Korea
| | - Won-Gu Jang
- Department of Biotechnology, College of Engineering, Daegu University, Gyeongbuk, Republic of Korea.,Research institute of Anti-Aging, Daegu University, Gyeongbuk, Republic of Korea
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12
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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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13
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Monticolo F, Palomba E, De Santis R, Assentato L, Triscino V, Langella MC, Lanzotti V, Chiusano ML. anti-HCoV: A web resource to collect natural compounds against human coronaviruses. Trends Food Sci Technol 2020; 106:1-11. [PMID: 32982062 PMCID: PMC7505852 DOI: 10.1016/j.tifs.2020.09.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 07/29/2020] [Accepted: 09/14/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND A novel coronavirus, the SARS-CoV2, was revealed to be the cause of COVID19, the pandemic disease that already provoked more than 555.324 deaths in the world (July 10, 2020). No vaccine treatment has been defined against SARS-CoV2 or other human coronaviruses (HCoVs), including those causing epidemic infections, neither appropriate strategies for prevention and care are yet officially suggested. SCOPE AND APPROACH We reviewed scientific literature on natural compounds that were defined as potentially effective against human coronaviruses. Our desk research identified non-chemically modified natural compounds that were shown (in vitro) and/or predicted (in silico) to act against one or more phases of human coronaviruses cell cycle.We selected all available information, merged and annotated the data to define a comprehensive list of natural compounds, describing their chemical classification, the source, the action, the specific target in the viral infection. Our aim was to collect possible compounds for prevention and care against human coronaviruses. KEY FINDINGS AND CONCLUSIONS The definition of appropriate interventions against viral diseases need a comprehensive view on the infection dynamics and on necessary treatments. Viral targeting compounds to be exploited in food sciences could be of relevant interest to this aim.We collected 174 natural compounds showing effects against human infecting coronaviruses, providing a curated annotation on actions and targets.The data are available in anti-HCoV, a web accessible resource to be exploited for testing and in vivo trials. The website is here launched to favour a community based cooperative effort to call for contribution and expand the collection. To be ready to fight.
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Affiliation(s)
- Francesco Monticolo
- Department of Agricultural Sciences, Università degli studi di Napoli Federico II, Reggia di Portici - Via Università, 100 - 80055, Portici (NA), Italy
| | - Emanuela Palomba
- Department of Research Infrastructures for marine biological resources (RIMAR), Stazione Zoologica "Anton Dohrn", Villa Comunale 80121 - Napoli, Italy
| | - Rosa De Santis
- Department of Agricultural Sciences, Università degli studi di Napoli Federico II, Reggia di Portici - Via Università, 100 - 80055, Portici (NA), Italy
| | - Lorenzo Assentato
- Department of Agricultural Sciences, Università degli studi di Napoli Federico II, Reggia di Portici - Via Università, 100 - 80055, Portici (NA), Italy
| | - Viviana Triscino
- Department of Agricultural Sciences, Università degli studi di Napoli Federico II, Reggia di Portici - Via Università, 100 - 80055, Portici (NA), Italy
| | - Maria Chiara Langella
- Department of Agricultural Sciences, Università degli studi di Napoli Federico II, Reggia di Portici - Via Università, 100 - 80055, Portici (NA), Italy
| | - Virginia Lanzotti
- Department of Agricultural Sciences, Università degli studi di Napoli Federico II, Reggia di Portici - Via Università, 100 - 80055, Portici (NA), Italy
| | - Maria Luisa Chiusano
- Department of Agricultural Sciences, Università degli studi di Napoli Federico II, Reggia di Portici - Via Università, 100 - 80055, Portici (NA), Italy.,Department of Research Infrastructures for marine biological resources (RIMAR), Stazione Zoologica "Anton Dohrn", Villa Comunale 80121 - Napoli, Italy
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14
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Vergallo C. Nutraceutical Vegetable Oil Nanoformulations for Prevention and Management of Diseases. NANOMATERIALS (BASEL, SWITZERLAND) 2020; 10:E1232. [PMID: 32599957 PMCID: PMC7353093 DOI: 10.3390/nano10061232] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 06/21/2020] [Accepted: 06/22/2020] [Indexed: 12/11/2022]
Abstract
The scientific community is becoming increasingly interested in identifying, characterizing, and delivering nutraceuticals, which constitutes a multi-billion-dollar business. These bioactive agents are claimed to exhibit several health benefits, including the prevention and treatment of diseases such as arthritis, cancer, osteoporosis, cataracts, Alzheimer's, and Huntington's diseases, heart, brain and metabolic disorders, etc. Nutraceuticals are typically consumed as part of a regular human diet and are usually present within foods, comprising vegetable oil, although at low levels and variable composition. Thus, it is difficult to control the type, amount and frequency of their ingestion by individuals. Nanoformulations about vegetable oil-based bioactive compounds with nutraceutical properties are useful for overcoming these issues, while improving the uptake, absorption, and bioavailability in the body. The purpose of this current study is to review papers on such nanoformulations, particularly those relevant for health benefits and the prevention and management of diseases, as well as bioactives extracted from vegetable oils enhancing the drug effectiveness, retrieved through bibliographic databases by setting a timespan from January 2000 to April 2020 (about 1758 records).
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Affiliation(s)
- Cristian Vergallo
- Department of Biological and Environmental Science and Technology (Di.S.Te.B.A.), University of Salento, 73010 Lecce, Italy
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15
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Ferro Y, Mazza E, Salvati M, Santariga E, Giampà S, Spagnuolo R, Doldo P, Pujia R, Coppola A, Gazzaruso C, Pujia A, Montalcini T. Effects of a Portfolio-Mediterranean Diet and a Mediterranean Diet with or without a Sterol-Enriched Yogurt in Individuals with Hypercholesterolemia. Endocrinol Metab (Seoul) 2020; 35:298-307. [PMID: 32615714 PMCID: PMC7386117 DOI: 10.3803/enm.2020.35.2.298] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 04/03/2020] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND A growing number of functional foods have been proposed to reduce cholesterol levels and the Portfolio Diet, which includes a combination of plant sterols, fibres, nuts, and soy protein, reduces low density lipoprotein cholesterol (LDL-C) from 20% to 30% in individuals with hyperlipidaemia. In this pilot study, the aim was to investigate whether a Mediterranean Diet incorporating a new and simple combination of cholesterol-lowering foods, excluding soy and nuts (namely the Portfolio-Mediterranean Diet), would reduce LDL-C levels, in the short-term, better than a Mediterranean Diet plus a sterol-enriched yogurt or a Mediterranean Diet alone. METHODS We retrospectively evaluated 24 individuals on a Portfolio-Mediterranean Diet and 48 matched individuals on a Mediterranean Diet with or without a sterol-enriched yogurt (24 each groups) as controls. RESULTS At follow-up (after 48±12 days), we observed an LDL reduction of 21±4, 23±4, and 44±4 mg/dL in the Mediterranean Diet alone, Mediterranean Diet plus yogurt and Portfolio-Mediterranean Diet respectively (P<0.001). CONCLUSION A Portfolio-Mediterranean Diet, incorporating a new combination of functional foods such as oats or barley, plant sterols, chitosan, and green tea but not soy and nuts, may reduce LDL of 25% in the short term in individuals with hypercholesterolemia.
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Affiliation(s)
- Yvelise Ferro
- Department of Health Science, University Magna Grecia, Catanzaro,
Italy
| | - Elisa Mazza
- Nutrition Unit, Department of Medical and Surgical Science, University Magna Grecia, Catanzaro,
Italy
| | - Mariantonietta Salvati
- Nutrition Unit, Department of Medical and Surgical Science, University Magna Grecia, Catanzaro,
Italy
| | - Emma Santariga
- Nutrition Unit, Department of Medical and Surgical Science, University Magna Grecia, Catanzaro,
Italy
| | - Salvatore Giampà
- Nutrition Unit, Department of Medical and Surgical Science, University Magna Grecia, Catanzaro,
Italy
| | - Rocco Spagnuolo
- Department of Clinical and Experimental Medicine, University Magna Grecia, Catanzaro,
Italy
| | - Patrizia Doldo
- Department of Clinical and Experimental Medicine, University Magna Grecia, Catanzaro,
Italy
| | - Roberta Pujia
- Department of Health Science, University Magna Grecia, Catanzaro,
Italy
| | - Adriana Coppola
- Department of Internal and Emergency Medicine and Centre for Applied Clinical Research, Beato Matteo Institute, Vigevano,
Italy
| | - Carmine Gazzaruso
- Department of Internal and Emergency Medicine and Centre for Applied Clinical Research, Beato Matteo Institute, Vigevano,
Italy
| | - Arturo Pujia
- Nutrition Unit, Department of Medical and Surgical Science, University Magna Grecia, Catanzaro,
Italy
| | - Tiziana Montalcini
- Department of Clinical and Experimental Medicine, University Magna Grecia, Catanzaro,
Italy
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16
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Zhao CH, Zhao C, Ye HQ, Xi CY, Zou ZP, Zhou XH, Hou PP, Zhang TH. Hypolipidemic activity of low-cholesterol ovum oil of Rana chensinensis and phytosterol (stigmasterol) in rats. J Zhejiang Univ Sci B 2020; 20:613-616. [PMID: 31168975 DOI: 10.1631/jzus.b1900018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The ovum oil of forest frog has various health beneficial functions. In the current research, we evaluated the hypolipidemic effects of the low-cholesterol ovum oil from the forest frog and its combination with stigmasterol in rats.
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Affiliation(s)
- Chang-Hui Zhao
- College of Food Science and Engineering, Jilin University, Changchun 130062, China
| | - Chao Zhao
- College of Food Science and Engineering, Jilin University, Changchun 130062, China
| | - Hai-Qing Ye
- College of Food Science and Engineering, Jilin University, Changchun 130062, China
| | - Chun-Yu Xi
- College of Food Science and Engineering, Jilin University, Changchun 130062, China
| | - Zheng-Ping Zou
- College of Food Science and Engineering, Jilin University, Changchun 130062, China
| | - Xin-Hui Zhou
- College of Food Science and Engineering, Jilin University, Changchun 130062, China
| | - Ping-Ping Hou
- College of Food Science and Engineering, Jilin University, Changchun 130062, China
| | - Tie-Hua Zhang
- College of Food Science and Engineering, Jilin University, Changchun 130062, China
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17
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Venturelli A, Brighenti V, Mascolo D, Pellati F. A new strategy based on microwave-assisted technology for the extraction and purification of beeswax policosanols for pharmaceutical purposes and beyond. J Pharm Biomed Anal 2019; 172:200-205. [PMID: 31060032 DOI: 10.1016/j.jpba.2019.04.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 04/04/2019] [Accepted: 04/08/2019] [Indexed: 10/27/2022]
Abstract
Policosanols (PCs) are a mixture of long chain primary aliphatic alcohols mainly known for their ability to reduce cholesterol level. Due to this property, there is an increasing interest in the extraction process of these compounds. In this context, beeswax, a natural product produced by honey bees of the genus Apis, is a promising source for their extraction and purification. The present research work was aimed at the development of a new procedure for the extraction and purification of PCs from yellow beeswax by using microwave-assisted technology, which hitherto has never been applied to this mixture. The developed process comprises three main steps: 1) microwave-assisted trans-esterification; 2) microwave-assisted hydrolysis; 3) final purification by means of preparative liquid chromatography. The final step is responsible for the increased purity of PCs, thanks to the removal of undesired compounds, such as natural paraffins. The predominant alcohols investigated in this work are tetracosanol (C24OH), hexacosanol (C26OH), octacosanol (C28OH), triacontanol (C30OH) and dotriacontanol (C32OH). Compound identification was performed using GC-EI-MS, while GC-FID analysis was chosen for the quantification of the main fatty alcohols present in the product. This new method represents a useful tool for the production of PCs from beeswax to be used in pharmaceuticals and nutraceuticals for human use, feed and veterinary supplements.
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Affiliation(s)
| | - Virginia Brighenti
- Tydock Pharma s.r.l., Strada Gherbella, 294, 41126, Modena, Italy; Department of Life Sciences, University of Modena and Reggio Emilia, Via G. Campi 103, 41125, Modena, Italy
| | - Danilo Mascolo
- Confindustria Emilia-Romagna, Via Barberia 13, 40123, Bologna, Italy
| | - Federica Pellati
- Department of Life Sciences, University of Modena and Reggio Emilia, Via G. Campi 103, 41125, Modena, Italy.
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18
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Effectiveness and Safety of Dietetic Supplementation of a New Nutraceutical on Lipid Profile and Serum Inflammation Biomarkers in Hypercholesterolemic Patients. Molecules 2018; 23:molecules23051168. [PMID: 29757945 PMCID: PMC6099501 DOI: 10.3390/molecules23051168] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 04/25/2018] [Accepted: 04/25/2018] [Indexed: 02/07/2023] Open
Abstract
Background: To assess the effectiveness and safety of a new nutraceutical (NC) on lipid profile, inflammation biomarkers and creatine phosphokinase (CPK) serum levels in hypercholesterolemic patients. Methods: 40 patients underwent hypolipemic treatment with NC. Initial and final (after 12 weeks) screening included medical history, physical examination, and measurement of serum lipid profile (total cholesterol, HDL-cholesterol, LDL-cholesterol, and triglycerides), hepatic (GOT, GPT, γGT), and renal (serum creatinine and urea) functions, CPK level and many inflammation biomarkers (hs-CRP and fibrinogen). At the screening visit, all patients were instructed to follow a normocaloric and hypolipidic diet during the study period. Results: The treatment with supplementation of NC demonstrated a significant reduction of serum total cholesterol (224 ± 11.2 mg/dL vs. 178 ± 10.7; p < 0.001), LDL-cholesterol (141 ± 10.6 vs. 116 + 10.1; p < 0.001), triglycerides (183 ± 13 vs. 159 ± 11.5; p < 0.01), serum inflammatory biomarkers as hs-CRP (2.24 ± 0.83 vs. 1.76 ± 0.61 mg/dL; p < 0.01), fibrinogen (315 ± 43 vs. 199 ± 41 mg/dL; p < 0.01) and a significantly increase of HDL-cholesterol (44 ± 7 vs. 53 ± 7 mg/dL; p < 0.01). Hepatic and renal function and serum CPK were normal. No adverse events was reported. Conclusions: The treatment with NC has demonstrated a significant reduction of LDL-cholesterol (−17.73%), total cholesterol (−20.53%) and triglycerides (−13.1%), with a significant increase of HDL-cholesterol values (+20.45%). The improvement of lipid profile was associated with a significant reduction of serum inflammation biomarkers as hs-PCR (−27%) and fibrinogen (−36.8%) with good tolerability profile.
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19
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Cicero AFG, Colletti A, Bajraktari G, Descamps O, Djuric DM, Ezhov M, Fras Z, Katsiki N, Langlois M, Latkovskis G, Panagiotakos DB, Paragh G, Mikhailidis DP, Mitchenko O, Paulweber B, Pella D, Pitsavos C, Reiner Ž, Ray KK, Rizzo M, Sahebkar A, Serban MC, Sperling LS, Toth PP, Vinereanu D, Vrablík M, Wong ND, Banach M. Lipid-lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel. Nutr Rev 2017; 75:731-767. [PMID: 28938795 DOI: 10.1093/nutrit/nux047] [Citation(s) in RCA: 213] [Impact Index Per Article: 30.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
In recent years, there has been growing interest in the possible use of nutraceuticals to improve and optimize dyslipidemia control and therapy. Based on the data from available studies, nutraceuticals might help patients obtain theraputic lipid goals and reduce cardiovascular residual risk. Some nutraceuticals have essential lipid-lowering properties confirmed in studies; some might also have possible positive effects on nonlipid cardiovascular risk factors and have been shown to improve early markers of vascular health such as endothelial function and pulse wave velocity. However, the clinical evidence supporting the use of a single lipid-lowering nutraceutical or a combination of them is largely variable and, for many of the nutraceuticals, the evidence is very limited and, therefore, often debatable. The purpose of this position paper is to provide consensus-based recommendations for the optimal use of lipid-lowering nutraceuticals to manage dyslipidemia in patients who are still not on statin therapy, patients who are on statin or combination therapy but have not achieved lipid goals, and patients with statin intolerance. This statement is intended for physicians and other healthcare professionals engaged in the diagnosis and management of patients with lipid disorders, especially in the primary care setting.
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Affiliation(s)
- Arrigo F G Cicero
- Department of Medicine and Surgery Sciences, University of Bologna, Bologna, Italy; and Italian Society of Nutraceuticals
| | - Alessandro Colletti
- Department of Medicine and Surgery Sciences, University of Bologna, Bologna, Italy; and Italian Society of Nutraceuticals
| | - Gani Bajraktari
- Clinic of Cardiology, University Clinical Centre of Kosovo, Prishtina, Kosovo; Medical Faculty, University of Prishtina, Prishtina, Kosovo; and Kosovo Society of Cardiology
| | - Olivier Descamps
- Department of Internal Medicine, Centres Hospitaliers Jolimont, Haine Saint-Paul, Belgium; and Belgian Atherosclerosis Society
| | - Dragan M Djuric
- Institute of Medical Physiology "Richard Burian," Faculty of Medicine, University of Belgrade, Belgrade, Serbia; and Serbian Association for Arteriosclerosis, Thrombosis and Vascular Biology Research
| | - Marat Ezhov
- Russian Cardiology Research and Production Centre, Moscow, Russia; and Russian National Atherosclerosis Society
| | - Zlatko Fras
- Preventive Cardiology Unit, Department of Vascular Medicine, Division of Internal Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia; Chair for Internal Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia; and Slovenian Society of Cardiology
| | - Niki Katsiki
- Second Department of Propaedeutic Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippocration Hospital, Thessaloniki, Greece
| | - Michel Langlois
- Department of Laboratory Medicine, AZ Sint-Jan Hospital, Bruges, Belgium; and Belgian Atherosclerosis Society
| | - Gustavs Latkovskis
- Faculty of Medicine and Institute of Cardiology and Regenerative Medicine, University of Latvia, Riga, Latvia; and Baltic Atherosclerosis Society
| | - Demosthenes B Panagiotakos
- School of Health Science and Education, Department of Nutrition and Dietetics, Harokopio University of Athens, Athens, Greece
| | - Gyorgy Paragh
- Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary; and Hungarian Atherosclerosis Society
| | - Dimitri P Mikhailidis
- Department of Clinical Biochemistry, Royal Free Campus, University College London Medical School, University College London, London, UK
| | - Olena Mitchenko
- Dyslipidaemia Department, Institute of Cardiology AMS of Ukraine, Kiev, Ukraine; and Ukrainian Atherosclerosis Society
| | - Bernhard Paulweber
- 1st Department of Internal Medicine, Paracelsus Private Medical University, Salzburg, Austria; and Austrian Atherosclerosis Society
| | - Daniel Pella
- 1st Department of Internal Medicine, Faculty of Medicine, Pavol Jozef Safarik University, Košice, Slovakia; and Slovak Association of Atherosclerosis
| | - Christos Pitsavos
- Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece; and Hellenic Atherosclerosis Society
| | - Željko Reiner
- University Hospital Centre Zagreb, School of Medicine University of Zagreb, Department of Internal Medicine, Zagreb, Croatia; and Croatian Atherosclerosis Society
| | - Kausik K Ray
- Department of Primary Care and Public Health, Imperial College, London, UK
| | - Manfredi Rizzo
- Biomedical Department of Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy; and Euro-Mediterranean Institute of Science and Technology, Palermo, Italy
| | - Amirhossein Sahebkar
- Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maria-Corina Serban
- Center for Interdisciplinary Research, and Department of Functional Sciences, University of Medicine and Pharmacy "Victor Babes," Timisoara, Romania
| | - Laurence S Sperling
- Division of Cardiology, Emory University, Emory Clinical Cardiovascular Research Institute, Atlanta, Georgia, USA
| | - Peter P Toth
- Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, Maryland, USA; and Preventive Cardiology, CGH Medical Center, Sterling, Illinois, USA
| | - Dragos Vinereanu
- University of Medicine and Pharmacy "Carol Davila," Bucharest, Romania; Department of Cardiology, University and Emergency Hospital, Bucharest, Romania; and Romanian Society of Cardiology
| | - Michal Vrablík
- Third Department of Internal Medicine, First Medical Faculty, Charles University, Prague, Czech Republic; and Czech Atherosclerosis Society
| | - Nathan D Wong
- Heart Disease Prevention Program, Division of Cardiology, University of California, Irvine, California, USA
| | - Maciej Banach
- Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Poland; Polish Mother's Memorial Hospital Research Institute, Lodz, Poland; Cardiovascular Research Centre, University of Zielona Gora, Zielona Gora, Poland; Lipid and Blood Pressure Meta-Analysis Collaboration Group; and Polish Lipid Association
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Cicero AF, Colletti A, Bajraktari G, Descamps O, Djuric DM, Ezhov M, Fras Z, Katsiki N, Langlois M, Latkovskis G, Panagiotakos DB, Paragh G, Mikhailidis DP, Mitchenko O, Paulweber B, Pella D, Pitsavos C, Reiner Ž, Ray KK, Rizzo M, Sahebkar A, Serban MC, Sperling LS, Toth PP, Vinereanu D, Vrablík M, Wong ND, Banach M. Lipid lowering nutraceuticals in clinical practice: position paper from an International Lipid Expert Panel. Arch Med Sci 2017; 13:965-1005. [PMID: 28883839 PMCID: PMC5575230 DOI: 10.5114/aoms.2017.69326] [Citation(s) in RCA: 191] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Accepted: 07/28/2017] [Indexed: 02/05/2023] Open
Affiliation(s)
- Arrigo F.G. Cicero
- Department of Medicine and Surgery Sciences, University of Bologna, Bologna, Italy; Italian Society of Nutraceuticals (SINut)
| | - Alessandro Colletti
- Department of Medicine and Surgery Sciences, University of Bologna, Bologna, Italy; Italian Society of Nutraceuticals (SINut)
| | - Gani Bajraktari
- Clinic of Cardiology, University Clinical Centre of Kosovo, Prishtina, Kosovo; Medical Faculty, University of Prishtina, Prishtina, Kosovo; Kosovo Society of Caridology
| | - Olivier Descamps
- Institute of Medical Physiology “Richard Burian“, Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Serbian Association for Arteriosclerosis, Thrombosis and Vascular Biology Research
| | - Dragan M. Djuric
- Institute of Medical Physiology “Richard Burian“, Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Serbian Association for Arteriosclerosis, Thrombosis and Vascular Biology Research
| | - Marat Ezhov
- Russian Cardiology Research and Production Centre, Moscow, Russia; Russian National Atherosclerosis Society
| | - Zlatko Fras
- Preventive Cardiology Unit, Department of Vascular Medicine, Division of Internal Medicine, University Medical Centre Ljubljana, Slovenia; Chair for Internal Medicine, Faculty of Medicine, University of Ljubljana, Slovenia; Slovenian Society of Cardiology
| | - Niki Katsiki
- Second Department of Propaedeutic Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippocration Hospital, Thessaloniki, Greece
| | - Michel Langlois
- Department of Laboratory Medicine, AZ Sint-Jan Hospital, Bruges, Belgium; Belgian Atheroclerosis Society
| | - Gustavs Latkovskis
- Faculty of Medicine and Institute of Cardiology and Regenerative Medicine, University of Latvia, Riga, Latvia; Baltic Atherosclerosis Society
| | - Demosthenes B. Panagiotakos
- School of Health Science and Education, Department of Nutrition and Dietetics, Harokopio University of Athens, Athens, Greece
| | - Gyorgy Paragh
- Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary; Hungarian Atherosclerosis Society
| | - Dimitri P. Mikhailidis
- Department of Clinical Biochemistry, Royal Free Campus, Medical School, University College London (UCL), London, UK
| | - Olena Mitchenko
- 13Dyslipidaemia Department, Institute of Cardiology AMS of Ukraine, Ukraine; Ukrainian Atherosclerosis Society
| | - Bernhard Paulweber
- First Department of Internal Medicine, Paracelsus Private Medical University, Salzburg, Austria; Austrian Atheroclerosis Society (AAS)
| | - Daniel Pella
- 1 Department of Internal Medicine, Faculty of Medicine, Pavol Jozef Safarik University, Košice, Slovakia; Slovak Association of Atherosclerosis
| | - Christos Pitsavos
- Cardiology Clinic, School of Medicine, University of Athens, Greece; Hellenic Atherosclerosis Society
| | - Željko Reiner
- University Hospital Centre Zagreb, School of Medicine University of Zagreb, Department of Internal Medicine, Zagreb, Croatia; Croatian Atherosclerosis Society
| | - Kausik K. Ray
- Department of Primary Care and Public Health, Imperial College, London, UK
| | - Manfredi Rizzo
- Biomedical Department of Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy; Euro-Mediterranean Institute of Science and Technology, Palermo, Italy
| | - Amirhossein Sahebkar
- Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maria-Corina Serban
- Center for Interdisciplinary Research, University of Medicine and Pharmacy “Victor Babes”, Timisoara, Romania; Department of Functional Sciences, University of Medicine and Pharmacy “Victor Babes”, Timisoara, Romania
| | - Laurence S. Sperling
- Division of Cardiology, Emory University, Emory Clinical Cardiovascular Research Institute, Atlanta, Georgia, USA
| | - Peter P. Toth
- The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, USA; Preventive Cardiology, CGH Medical Center, Sterling, Illinois, USA
| | - Dragos Vinereanu
- University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania; Department of Cardiology, University and Emergency Hospital, Bucharest, Romania; Romanian Society of Cardiology
| | - Michal Vrablík
- Third Department of Internal Medicine, First Medical Faculty, Charles University, Prague, Czech Republic; Czech Atherosclerosis Society
| | - Nathan D. Wong
- Heart Disease Prevention Program, Division of Cardiology, University of California, Irvine, USA
| | - Maciej Banach
- Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Poland; Polish Mother’s Memorial Hospital Research Institute (PMMHRI), Lodz, Poland; Cardiovascular Research Centre, University of Zielona Gora, Zielona Gora, Poland; Lipid and Blood Pressure Meta-Analysis Collaboration (LBPMC) Group; Polish Lipid Association (PoLA)
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Lee JH, Jia Y, Thach TT, Han Y, Kim B, Wu C, Kim Y, Seo WD, Lee SJ. Hexacosanol reduces plasma and hepatic cholesterol by activation of AMP-activated protein kinase and suppression of sterol regulatory element-binding protein-2 in HepG2 and C57BL/6J mice. Nutr Res 2017; 43:89-99. [DOI: 10.1016/j.nutres.2017.05.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 05/11/2017] [Accepted: 05/13/2017] [Indexed: 12/25/2022]
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Abstract
Dyslipidaemia is characterized by increased blood levels of total or LDL cholesterol and triglycerides, or decreased HDL cholesterol levels, and is a risk factor for cardiovascular disease. Dyslipidaemia has a high worldwide prevalence, and many patients are turning to alternatives to pharmacotherapy to manage their lipid levels. Lifestyle modification should be emphasized in all patients to reduce cardiovascular risk and can be initiated before pharmacotherapy in primary prevention of cardiovascular disease. Many functional foods and natural health products have been investigated for potential lipid-lowering properties. Those with good evidence for a biochemical effect on plasma lipid levels include soy protein, green tea, plant sterols, probiotic yogurt, marine-derived omega-3 fatty acids and red yeast rice. Other products such as seaweed, berberine, hawthorn and garlic might confer some limited benefit in certain patient groups. Although none of these products can reduce lipid levels to the same extent as statins, most are safe to use in addition to other lifestyle modifications and pharmacotherapy. Natural health products marketed at individuals with dyslipidaemia, such as policosanol, guggulsterone and resveratrol, have minimal definitive evidence of a biochemical benefit. Additional research is required in this field, which should include large, high-quality randomized controlled trials with long follow-up periods to investigate associations with cardiovascular end points.
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Affiliation(s)
- Paola M Hunter
- Department of Medicine and Robarts Research Institute, Schulich School of Medicine and Dentistry, Western University, 4288A-1151 Richmond Street North, London, Ontario N6A 5B7, Canada
| | - Robert A Hegele
- Department of Medicine and Robarts Research Institute, Schulich School of Medicine and Dentistry, Western University, 4288A-1151 Richmond Street North, London, Ontario N6A 5B7, Canada
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Pirro M, Vetrani C, Bianchi C, Mannarino MR, Bernini F, Rivellese AA. Joint position statement on "Nutraceuticals for the treatment of hypercholesterolemia" of the Italian Society of Diabetology (SID) and of the Italian Society for the Study of Arteriosclerosis (SISA). Nutr Metab Cardiovasc Dis 2017; 27:2-17. [PMID: 27956024 DOI: 10.1016/j.numecd.2016.11.122] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 11/17/2016] [Accepted: 11/17/2016] [Indexed: 12/19/2022]
Abstract
AIM Evidence showed that LDL-cholesterol lowering is associated with a significant cardiovascular risk reduction. The initial therapeutic approach to hypercholesterolemia includes dietary modifications but the compliance to recommendations is often inadequate. Some dietary components with potential cholesterol-lowering activity are present in small amounts in food. Therefore, in recent years the use of "nutraceuticals" (i.e., nutrients and/or bioactive compounds with potential beneficial effects on human health) has become widespread. Such substances may be added to foods and beverages, or taken as dietary supplements (liquid preparations, tablets, capsules). In the present manuscript, the cholesterol-lowering activity of some nutraceuticals (i.e. fiber, phytosterols, soy, policosanol, red yeast rice and berberine) will be discussed along with: 1) the level of evidence on the cholesterol-lowering efficacy emerging from clinical trial; 2) the possible side effects associated with their use; 3) the categories of patients who could benefit from their use. DATA SYNTHESIS Based on the current literature, the cholesterol-lowering effect of fiber, phytosterols and red yeast rice is consistent and supported by a good level of evidence. Over berberine, there is sufficient evidence showing significant cholesterol-lowering effects, although the results come from studies carried out almost exclusively in Asian populations. Data on the effects of soy are conflicting and, therefore, the strength of recommendation is quite low. The evidence on policosanol is inconclusive. CONCLUSION Although health benefits may arise from the use of nutraceuticals with cholesterol-lowering activity, their use might be also associated with possible risks and pitfalls, some of which are common to all nutraceuticals whereas others are related to specific nutraceuticals.
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Affiliation(s)
- M Pirro
- Unit of Internal Medicine, Department of Medicine, University of Perugia, Perugia, Italy; Italian Society for the Study of Arteriosclerosis (SISA), Italy
| | - C Vetrani
- Department of Clinical Medicine and Surgery, "Federico II" University, Naples, Italy; Italian Society of Diabetology (SID), Italy
| | - C Bianchi
- Italian Society of Diabetology (SID), Italy; Unit of Diabetology and Metabolic Diseases, Department of Medical Area "Azienda Ospedaliero-Universitaria Pisana", Pisa, Italy
| | - M R Mannarino
- Unit of Internal Medicine, Department of Medicine, University of Perugia, Perugia, Italy; Italian Society for the Study of Arteriosclerosis (SISA), Italy
| | - F Bernini
- Italian Society for the Study of Arteriosclerosis (SISA), Italy; Department of Pharmacy, University of Parma, Parma, Italy
| | - A A Rivellese
- Department of Clinical Medicine and Surgery, "Federico II" University, Naples, Italy; Italian Society of Diabetology (SID), Italy.
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Gonzalez L, Helkin A, Gahtan V. Dyslipidemia Part 2: Review of Dyslipidemia Treatment in Patients With Noncoronary Vascular Disease. Vasc Endovascular Surg 2016; 50:119-35. [PMID: 26983668 DOI: 10.1177/1538574416628655] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Dyslipidemia is one of the major modifiable risk factors associated with atherosclerotic cardiovascular disease. Appropriate modification of lipid profiles reduces the progression of atherosclerosis in vessel walls across all vascular beds. The management of dyslipidemia has evolved over the last several decades, especially since the discovery of 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors, also known as statins. Statin use in atherosclerotic heart disease is well described in observational and prospective placebo-controlled studies, citing both lipid-lowering and pleiotropic effects. However, the effect of statins and other lipid-lowering agents on noncoronary arterial beds (the aorta, arteries to the extremities, renal, and carotid arteries) is less understood. This article is part 2 of a 2-part review, with part 1 having focused on lipid metabolism and the downstream effects of lipids on the development of atherosclerosis. The current review (part 2) will discuss trials, retrospective reviews, and observational cohort studies regarding the use of statins and/or other lipid-lowering drugs for primary and secondary prevention of peripheral noncoronary atherosclerotic disease.
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Affiliation(s)
- Lorena Gonzalez
- Department of Veterans Affairs Healthcare Network Upstate New York at Syracuse, Syracuse, NY, USA Department of Surgery, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Alex Helkin
- Department of Veterans Affairs Healthcare Network Upstate New York at Syracuse, Syracuse, NY, USA Department of Surgery, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Vivian Gahtan
- Department of Veterans Affairs Healthcare Network Upstate New York at Syracuse, Syracuse, NY, USA Department of Surgery, SUNY Upstate Medical University, Syracuse, NY, USA
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Effects of long-term supplementation of policosanol on blood cholesterol/glucose levels and 3-hydroxy-3-methylglutaryl coenzyme a reductase activity in a rat model fed high cholesterol diets. Food Sci Biotechnol 2016; 25:899-904. [PMID: 30263351 DOI: 10.1007/s10068-016-0147-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2016] [Revised: 03/03/2016] [Accepted: 03/14/2016] [Indexed: 02/08/2023] Open
Abstract
Policosanol is a well-defined nutraceutical for the management of blood cholesterol levels. The present study examined (i) the effect of policosanol supplementation on blood cholesterol and glucose levels and (ii) changes in hepatic cholesterol biosynthesis using 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMG-CoA reductase) activity in Wistar rats fed high cholesterol diets. The Wistar rats were assigned randomly to high-cholesterol diets (1.25% cholesterol) with or without policosanol (8.0 mg/kg body weight) for 6 weeks. Compared with the control group, dietary treatment with policosanol resulted in a significant decrease of blood cholesterol (p<0.01), blood glucose (p<0.01), triglyceride (p<0.001), and low density lipoprotein-cholesterol levels (p<0.01) and HMG-CoA reductase activity (p<0.001) in the liver. These results indicate that policosanol decreases blood cholesterol levels by suppressing cholesterol biosynthesis via decrease of HMG-CoA activity. Policosanol has the potential to be developed into an effective dietary strategy for both postprandial hyperglycemia and hypercholesterolemia.
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26
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Intérêt des compléments alimentaires dans les hyperlipidémies. ACTUALITES PHARMACEUTIQUES 2016. [DOI: 10.1016/j.actpha.2016.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Pastor-Villaescusa B, Rangel-Huerta OD, Aguilera CM, Gil A. A Systematic Review of the Efficacy of Bioactive Compounds in Cardiovascular Disease: Carbohydrates, Active Lipids and Nitrogen Compounds. ANNALS OF NUTRITION AND METABOLISM 2015; 66:168-181. [DOI: 10.1159/000430960] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Accepted: 04/26/2015] [Indexed: 11/19/2022]
Abstract
Background/Aims: The prevalence of cardiovascular diseases (CVD) is rising and it is the prime cause of death in all developed countries. Bioactive compounds (BACs) can play a role in CVD prevention and treatment. To examine the scientific evidence supporting BACs groups' efficacy in CVD prevention and treatment, we conducted a systematized review. Methods: All available information on Medline, LILACS and EMBASE; all randomized controlled trials (RCTs) with prospective, parallel or crossover designs in humans in which the BACs effect was compared with that of placebo/control. Vascular homeostasis, blood pressure, endothelial function, oxidative stress and inflammatory biomarkers were considered primary outcomes. Results: We selected 26 articles, verifying their quality based on the Scottish Intercollegiate Guidelines Network, establishing diverse quality levels of scientific evidence according to the design and bias risk of a study. Grades of recommendation were included, depending on the evidence strength of antecedents. Conclusions: Evidence shows that certain BACs' derivative from active lipids and nitrogen compounds, mainly from horse chestnut seed extract, sterol plants, allium derivatives, and certain doses of beta-glucans, can be helpful in decreasing the prevalence of CVD risk factors. However, further rigorous evidence is necessary to support and prove BACs' effect on CVD prevention and treatment.
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Byun AR, Chun H, Lee J, Lee SW, Lee HS, Shim KW. Effects of a Dietary Supplement with Barley Sprout Extract on Blood Cholesterol Metabolism. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2015; 2015:473056. [PMID: 26101533 PMCID: PMC4458530 DOI: 10.1155/2015/473056] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 05/06/2015] [Indexed: 11/17/2022]
Abstract
Objective. Barley sprout (Hordeum vulgare L.) contains 4.97% fat, 52.6% polysaccharide, and 34.1% protein along with a variety of vitamins, minerals, and polyphenolic compounds. Hexacosanol is one such compound from the barley leaf that might improve cholesterol metabolism by decreasing cholesterol synthesis. Method. Therefore, this study was conducted to investigate the effects of barley sprout extract on serum lipid metabolism in healthy volunteers (n = 51). Subjects were randomly divided into two groups: one group consumed a single capsule of barley leaf extract daily (n = 25, 42.48 ± 13.58 years) and the other consumed placebo capsules (n = 26, 40.54 ± 11.1 years) for 12 weeks. Results. After 12 weeks, total cholesterol and low-density lipoprotein- (LDL-) cholesterol were not lower in the barley sprout extract group compared to the placebo group (p = 0.415 and p = 0.351, resp.) and no differences in clinical or laboratory findings were observed between both groups. Conclusion. Our study failed to show significant lipid-lowering effects of barley sprout extract, possibly due to dosage, duration of therapy, and small sample size. Despite our nonsignificant findings, barley sprout has a possibility as a functional health food; therefore future research is needed.
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Affiliation(s)
- A Ri Byun
- Department of Family Medicine, Ewha Woman's University Mokdong Hospital, Ewha Woman's University School of Medicine, Seoul, Republic of Korea
| | - Hyejin Chun
- Health Promotion Center, Ewha Woman's University Mokdong Hospital, Seoul 158-710, Republic of Korea
| | - Jin Lee
- Department of Family Medicine, Ewha Woman's University Mokdong Hospital, Ewha Woman's University School of Medicine, Seoul, Republic of Korea
| | - Sang Wha Lee
- Department of Family Medicine, Ewha Woman's University Mokdong Hospital, Ewha Woman's University School of Medicine, Seoul, Republic of Korea
| | - Hong Soo Lee
- Department of Family Medicine, Ewha Woman's University Mokdong Hospital, Ewha Woman's University School of Medicine, Seoul, Republic of Korea
| | - Kyung Won Shim
- Department of Family Medicine, Ewha Woman's University Mokdong Hospital, Ewha Woman's University School of Medicine, Seoul, Republic of Korea
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Yanai H, Katsuyama H, Hamasaki H, Abe S, Tada N, Sako A. Effects of Dietary Fat Intake on HDL Metabolism. J Clin Med Res 2014; 7:145-9. [PMID: 25584098 PMCID: PMC4285059 DOI: 10.14740/jocmr2030w] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2014] [Indexed: 11/11/2022] Open
Abstract
High-density lipoprotein (HDL) is a lipoprotein which has anti-atherogenic property by reversing cholesterol transport from the peripheral tissues to liver. Low HDL-cholesterol (HDL-C) as well as high low-density lipoprotein-cholesterol (LDL-C) is associated with the development of coronary heart diseases (CHD). Various epidemiological studies have suggested that the development of CHD increase in individuals with less than 40 mg/dL of HDL-C. In spite of accumulation of evidences suggesting a significant association between low HDL-C and CHD, effects of dietary factors on HDL metabolism remained largely unknown. We reviewed published articles about effects of dietary fat intake on HDL metabolism. The substitution of fatty acids (FA) for carbohydrates is beneficially associated with HDL metabolism. Monounsaturated FA intake may not affect HDL-C. Trans-FA is significantly associated with reduction of HDL-C, and is also adversely related with total cholesterol/HDL-C. Fish oils consumption, especially docosahexaenoic acid consumption, may be favorably associated with HDL metabolism. Although plant sterols and stanols may not affect HDL-C, policosanol intake is associated with a clinically significant decrease in the LDL/HDL ratio.
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Affiliation(s)
- Hidekatsu Yanai
- Department of Internal Medicine, National Center for Global Health and Medicine, Kohnodai Hospital, Chiba, Japan
| | - Hisayuki Katsuyama
- Department of Internal Medicine, National Center for Global Health and Medicine, Kohnodai Hospital, Chiba, Japan
| | - Hidetaka Hamasaki
- Department of Internal Medicine, National Center for Global Health and Medicine, Kohnodai Hospital, Chiba, Japan
| | - Shinichi Abe
- The Jikei University School of Medicine, Tokyo, Japan
| | - Norio Tada
- The Jikei University School of Medicine, Tokyo, Japan
| | - Akahito Sako
- Department of Internal Medicine, National Center for Global Health and Medicine, Kohnodai Hospital, Chiba, Japan
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Policosanol attenuates statin-induced increases in serum proprotein convertase subtilisin/kexin type 9 when combined with atorvastatin. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2014; 2014:926087. [PMID: 25478000 PMCID: PMC4247936 DOI: 10.1155/2014/926087] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Accepted: 10/29/2014] [Indexed: 11/18/2022]
Abstract
Objective. Statin treatment alone has been demonstrated to significantly increase plasma proprotein convertase subtilisin/kexin type 9 (PCSK9) levels. The effect of policosanol combined with statin on PCSK9 is unknown. Methods. Protocol I: 26 patients with atherosclerosis were randomly assigned to receive either atorvastatin 20 mg/d or policosanol 20 mg/d + atorvastatin 20 mg/d for 8 weeks. Protocol II: 15 healthy volunteers were randomly assigned to either policosanol 20 mg/d or a control group for 12 weeks. Serum levels of PCSK9 were determined at day 0 and the end of each protocol. Results. Protocol I: atorvastatin 20 mg/d significantly increased serum PCSK9 level by 39.4% (256 ± 84 ng/mL versus 357 ± 101 ng/mL, P = 0.002). However, policosanol 20 mg/d + atorvastatin 20 mg/d increased serum PCSK9 level by only 17.4% without statistical significance (264 ± 60 ng/mL versus 310 ± 86 ng/mL, P = 0.184). Protocol II: there was a trend toward decreasing serum PCSK9 levels in the policosanol group (289 ± 71 ng/mL versus 235 ± 46 ng/mL, P = 0.069). Conclusion. Policosanol combined with statin attenuated the statin-induced increase in serum PCSK9 levels. This finding indicates that policosanol might have a modest effect of lowering serum PCSK9 levels.
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Solà R, Valls RM, Puzo J, Calabuig JR, Brea A, Pedret A, Moriña D, Villar J, Millán J, Anguera A. Effects of poly-bioactive compounds on lipid profile and body weight in a moderately hypercholesterolemic population with low cardiovascular disease risk: a multicenter randomized trial. PLoS One 2014; 9:e101978. [PMID: 25084280 PMCID: PMC4118855 DOI: 10.1371/journal.pone.0101978] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2013] [Accepted: 06/10/2014] [Indexed: 11/19/2022] Open
Abstract
A dietary supplement (AP, Armolipid Plus) that combines red yeast rice extract, policosanol, berberine, folic acid, coenzyme Q10 and asthaxantine can have beneficial effects on cardiovascular disease (CVD) biomarkers. The aim of this study was to assess whether the intake of AP, in combination with dietary recommendations, reduces serum low density lipoprotein cholesterol (LDL-c) concentrations and other CVD biomarkers in patients with hypercholesterolemia. Eligible patients were recruited from the outpatient clinics of six Spanish hospitals Hospital Virgen del Rocío (Sevilla); Hospital San Jorge (Huesca); Hospital San Pedro (Logroño); Hospital Gregorio Marañón (Madrid), Hospital la Fe (Valencia) and Hospital Universitari Sant Joan (Reus) as recruiting and coordinating center. 102 participants (mean age ± SD; 50.91±11.61; 32 men) with low CVD, with mild-to-moderately elevated LDL-c (between 3.35 mmol/L and 4.88 mmol/L) without hypolipemic therapy were randomized in a double-blind, parallel, controlled, multicenter trial commencing January 2012 and ending December 2012. Among the exclusion criteria were any concomitant chronic disease, triglycerides (TG) >3.97 mmol/L, pregnant or lactating, and history of CVD. At 12 weeks, compared to placebo, AP reduced LDL-c by −6.9%, apolipoprotein (Apo) B-100 by −6.6% and total cholesterol/HDL-c ratio by −5.5%, the ApoB/ApoA1 ratio by −8.6%, while increasing ApoA1 by +2.5% (p<0.05). AP consumption was associated with modest mean weight loss of −0.93 kg (95%CI: -1.74 to -0.12; P = 0.02) compared with control group while dietary composition remained unchanged in the AP group. The AP product was well tolerated. In conclusion, AP, combined with dietary recommendations, reduced LDL-c levels as well as total cholesterol/HDL-c and ApoB/ApoA1 ratios, while increasing Apo A1, all of which are improvements in CVD risk indicators. AP is a product which could benefit patients having moderate hyperlipidemia and excess body weight.
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Affiliation(s)
- Rosa Solà
- Unitat de Recerca de Lipids i Arteriosclerosi, CIBERDEM, Servei de Medicina Interna, Hospital Universitari de San Joan, IISPV, Facultat de Medicina, Universitat Rovira i Virgili, Reus, Spain
- * E-mail:
| | - Rosa-M Valls
- Unitat de Recerca de Lipids i Arteriosclerosi, CIBERDEM, Servei de Medicina Interna, Hospital Universitari de San Joan, IISPV, Facultat de Medicina, Universitat Rovira i Virgili, Reus, Spain
| | - José Puzo
- Unidad de Lípidos y Laboratorio de Bioquímica, Hospital Universitario San Jorge, Huesca, Spain
| | - José-Ramón Calabuig
- Departamento de Medicina Interna, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Angel Brea
- Unidad de Lípidos, Servicio de Medicina Interna, Hospital Universitario San Pedro, Logroño, Spain
| | - Anna Pedret
- Unitat de Recerca de Lipids i Arteriosclerosi, CIBERDEM, Servei de Medicina Interna, Hospital Universitari de San Joan, IISPV, Facultat de Medicina, Universitat Rovira i Virgili, Reus, Spain
| | - David Moriña
- Centre Tecnològic de Nutrició i Salut, Reus, Spain
| | - José Villar
- Unidad de Hipertensión y Lípidos, Hospital Universitario Virgen del Rocio, Sevilla, Spain
| | - Jesús Millán
- Servicio de Medicina Interna, Hospital Universitario Gregorio Marañón, Madrid, Spain
| | - Anna Anguera
- Medical Department, Rottapharm S.L., Barcelona, Spain
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Ruscica M, Gomaraschi M, Mombelli G, Macchi C, Bosisio R, Pazzucconi F, Pavanello C, Calabresi L, Arnoldi A, Sirtori CR, Magni P. Nutraceutical approach to moderate cardiometabolic risk: Results of a randomized, double-blind and crossover study with Armolipid Plus. J Clin Lipidol 2014; 8:61-8. [DOI: 10.1016/j.jacl.2013.11.003] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Revised: 10/07/2013] [Accepted: 11/04/2013] [Indexed: 10/26/2022]
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Powell M, D'Arcy MB. LIQUID-PHASE SEPARATION OF STRUCTURALLY-SIMILAR STEROIDS USING PHENYL STATIONARY PHASES. J LIQ CHROMATOGR R T 2013. [DOI: 10.1080/10826076.2013.778635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Barrat E, Zaïr Y, Ogier N, Housez B, Vergara C, Maudet C, Lescuyer JF, Bard JM, Carpentier YA, Cazaubiel M, Peltier SL. A combined natural supplement lowers LDL cholesterol in subjects with moderate untreated hypercholesterolemia: a randomized placebo-controlled trial. Int J Food Sci Nutr 2013; 64:882-9. [DOI: 10.3109/09637486.2013.809405] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Fihn SD, Gardin JM, Abrams J, Berra K, Blankenship JC, Dallas AP, Douglas PS, Foody JM, Gerber TC, Hinderliter AL, King SB, Kligfield PD, Krumholz HM, Kwong RYK, Lim MJ, Linderbaum JA, Mack MJ, Munger MA, Prager RL, Sabik JF, Shaw LJ, Sikkema JD, Smith CR, Smith SC, Spertus JA, Williams SV. 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart disease: executive summary: a report of the American College of Cardiology Foundation/American Heart Association task force on practice guidelines, and the American College of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Circulation 2012. [PMID: 23182125 DOI: 10.1016/j.jacc.2012.07.013] [Citation(s) in RCA: 1231] [Impact Index Per Article: 102.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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36
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Fihn SD, Gardin JM, Abrams J, Berra K, Blankenship JC, Dallas AP, Douglas PS, Foody JM, Gerber TC, Hinderliter AL, King SB, Kligfield PD, Krumholz HM, Kwong RYK, Lim MJ, Linderbaum JA, Mack MJ, Munger MA, Prager RL, Sabik JF, Shaw LJ, Sikkema JD, Smith CR, Smith SC, Spertus JA, Williams SV, Anderson JL. 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology Foundation/American Heart Association task force on practice guidelines, and the American College of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Circulation 2012; 126:e354-471. [PMID: 23166211 DOI: 10.1161/cir.0b013e318277d6a0] [Citation(s) in RCA: 465] [Impact Index Per Article: 38.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Cobiac LJ, Magnus A, Lim S, Barendregt JJ, Carter R, Vos T. Which interventions offer best value for money in primary prevention of cardiovascular disease? PLoS One 2012; 7:e41842. [PMID: 22844529 PMCID: PMC3402472 DOI: 10.1371/journal.pone.0041842] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2011] [Accepted: 06/29/2012] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Despite many decades of declining mortality rates in the Western world, cardiovascular disease remains the leading cause of death worldwide. In this research we evaluate the optimal mix of lifestyle, pharmaceutical and population-wide interventions for primary prevention of cardiovascular disease. METHODS AND FINDINGS In a discrete time Markov model we simulate the ischaemic heart disease and stroke outcomes and cost impacts of intervention over the lifetime of all Australian men and women, aged 35 to 84 years, who have never experienced a heart disease or stroke event. Best value for money is achieved by mandating moderate limits on salt in the manufacture of bread, margarine and cereal. A combination of diuretic, calcium channel blocker, ACE inhibitor and low-cost statin, for everyone with at least 5% five-year risk of cardiovascular disease, is also cost-effective, but lifestyle interventions aiming to change risky dietary and exercise behaviours are extremely poor value for money and have little population health benefit. CONCLUSIONS There is huge potential for improving efficiency in cardiovascular disease prevention in Australia. A tougher approach from Government to mandating limits on salt in processed foods and reducing excessive statin prices, and a shift away from lifestyle counselling to more efficient absolute risk-based prescription of preventive drugs, could cut health care costs while improving population health.
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Affiliation(s)
- Linda J Cobiac
- School of Population Health, The University of Queensland, Herston, Queensland, Australia.
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Fate of dietary phytosteryl/-stanyl esters: analysis of individual intact esters in human feces. Eur J Nutr 2012; 52:997-1013. [DOI: 10.1007/s00394-012-0407-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2012] [Accepted: 06/18/2012] [Indexed: 10/28/2022]
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Dipti SS, Bergman C, Indrasari SD, Herath T, Hall R, Lee H, Habibi F, Bassinello PZ, Graterol E, Ferraz JP, Fitzgerald M. The potential of rice to offer solutions for malnutrition and chronic diseases. RICE (NEW YORK, N.Y.) 2012; 5:16. [PMID: 24279770 PMCID: PMC4883736 DOI: 10.1186/1939-8433-5-16] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2011] [Accepted: 04/02/2012] [Indexed: 05/05/2023]
Abstract
It is internationally accepted that malnutrition and chronic diseases in developing countries are key limitations to achieving the Millennium Development Goals. In many developing countries, rice is the primary source of nutrition. In those countries, the major forms of malnutrition are Fe-induced anaemia, Zn deficiency and Vitamin A deficiency, whereas the major chronic disease challenges are Type II diabetes, cardiovascular disease and some cancers. There is a growing corpus of evidence regarding both limitations and opportunities as to how rice could be an effective vehicle by which to tackle key nutrition and health related problems in countries with limited resources. Rice breeding programs are able to focus on developing new varieties carrying enhanced amounts of either Fe, Zn or beta-carotene because of large public investment, and the intuitive link between providing a mineral/vitamin to cure a deficiency in that mineral/vitamin. By contrast, there has been little investment in progressing the development of particular varieties for potential impact on chronic diseases. In this review article we focus on the broad battery of evidence linking rice-related nutritional limitations to their impact on a variety of human health issues. We discuss how rice might offer sometimes even simple solutions to rectifying key problems through targeted biofortification strategies and finally, we draw attention to how recent technological (-omics) developments may facilitate untold new opportunities for more rapidly generating improved rice varieties specifically designed to meet the current and future nutritional needs of a rapidly expanding global population.
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Affiliation(s)
- Sharifa Sultana Dipti
- Grain Quality and Nutrition Centre, International Rice Research Institute (IRRI), DAPO, 7777 Metro Manila, Philippines
- International Network for Quality Rice, Metro Manila, Philippines
| | - Christine Bergman
- Department of Food and Beverage, University of Nevada-Las Vegas, Las Vegas, NV 89154 USA
- International Network for Quality Rice, Metro Manila, Philippines
| | - Siti Dewi Indrasari
- Indonesian Center for Rice Research (ICRR), BB Padi, Jl. Raya 9, Sukamandi, Subang, 41256 Jawa Barat Indonesia
- International Network for Quality Rice, Metro Manila, Philippines
| | - Theja Herath
- Industrial Technology Institute, Colombo 7, Bauddhaloka Mawatha, 363 Sri Lanka
- International Network for Quality Rice, Metro Manila, Philippines
| | - Robert Hall
- Plant Research International, PO Box 98, 6700AB Wageningen, The Netherlands
- Centre for BioSystems Genomics, P.O. Box 98, 6700AB Wageningen, The Netherlands
- International Network for Quality Rice, Metro Manila, Philippines
| | - Hueihong Lee
- Faculty of Agriculture and Food Sciences, Universiti Putra Malaysia, Nyabau Road, 97000 Bintulu Sarawak, Malaysia
- International Network for Quality Rice, Metro Manila, Philippines
| | - Fatemeh Habibi
- Rice Research Institute of Iran (RRII), Km5 Tehran Rd, 41996-13475 Rasht, I.R Iran
- International Network for Quality Rice, Metro Manila, Philippines
| | - Priscila Zaczuk Bassinello
- Embrapa Arroz e Feijão, Rodovia GO-462, Km 12, Zona Rural C.P. 179, Santo Antônio de Goiás, GO 75375-000 Brazil
- International Network for Quality Rice, Metro Manila, Philippines
| | - Eduardo Graterol
- Fundación para la Investigación Agrícola DANAC, Apartado Postal 182, San Felipe, Estado Yaracuy Venezuela
- International Network for Quality Rice, Metro Manila, Philippines
| | - Julie P Ferraz
- Institute of Science, Diabetes Foundation Marikina, Philippines, Healthserve Hospital, and Calamba Doctors Hospital, Laguna, Philippines
| | - Melissa Fitzgerald
- Grain Quality and Nutrition Centre, International Rice Research Institute (IRRI), DAPO, 7777 Metro Manila, Philippines
- International Network for Quality Rice, Metro Manila, Philippines
- Grain Quality and Nutrition Centre, International Rice Research Institute (IRRI), DAPO 7777 Metro Manila, Philippines
- School of Agriculture and Food Science, University of Queensland, St Lucia, 4072 Australia
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LDL-cholesterol-lowering effect of a dietary supplement with plant extracts in subjects with moderate hypercholesterolemia. Eur J Nutr 2012; 52:547-57. [DOI: 10.1007/s00394-012-0357-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2012] [Accepted: 04/03/2012] [Indexed: 12/17/2022]
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41
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Underbakke G, McBride PE. Dyslipidemias. Integr Med (Encinitas) 2012. [DOI: 10.1016/b978-1-4377-1793-8.00039-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Backes JM, Gibson CA, Ruisinger JF, Moriarty PM. Modified-Policosanol Does Not Reduce Plasma Lipoproteins in Hyperlipidemic Patients When Used Alone or in Combination with Statin Therapy. Lipids 2011; 46:923-9. [DOI: 10.1007/s11745-011-3591-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2011] [Accepted: 06/22/2011] [Indexed: 10/18/2022]
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Huang J, Frohlich J, Ignaszewski AP. The Impact of Dietary Changes and Dietary Supplements on Lipid Profile. Can J Cardiol 2011; 27:488-505. [DOI: 10.1016/j.cjca.2010.12.077] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2010] [Accepted: 12/26/2010] [Indexed: 01/24/2023] Open
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Scientific Opinion on the substantiation of health claims related to policosanols from sugar cane wax and maintenance of normal blood LDL-cholesterol concentrations (ID 1747, 1748, 1864, 1951, 1954, 4693) and maintenance of normal blood HDL-cholesterol co. EFSA J 2011. [DOI: 10.2903/j.efsa.2011.2255] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Affuso F, Ruvolo A, Micillo F, Saccà L, Fazio S. Effects of a nutraceutical combination (berberine, red yeast rice and policosanols) on lipid levels and endothelial function randomized, double-blind, placebo-controlled study. Nutr Metab Cardiovasc Dis 2010; 20:656-661. [PMID: 19699071 DOI: 10.1016/j.numecd.2009.05.017] [Citation(s) in RCA: 87] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2008] [Revised: 05/25/2009] [Accepted: 05/25/2009] [Indexed: 10/20/2022]
Abstract
BACKGROUND AND AIMS Some nutraceuticals are prescribed as lipid-lowering substances. However, doubts remain about their efficacy. We evaluated the effects of a nutraceutical combination (NC), consisting of 500 mg berberine, 200mg red yeast rice and 10mg policosanols, on cholesterol levels and endothelial function in patients with hypercholesterolemia. METHODS AND RESULTS In this single centre, randomized, double-blind, placebo-controlled study, 50 hypercholesterolemic patients (26 males and 24 females, mean age 55±7 years, total cholesterol 6.55±0.75 mmol/l, BMI 28±3.5) were randomized to 6 weeks of treatment with a daily oral dose of NC (25 patients) or placebo (25 patients). In a subsequent open-label extension of 4 weeks, the whole sample received NC. The main outcome measure was decrease total cholesterol (C) levels in the NC arm. Secondary outcome measures were decreased low-density lipoprotein cholesterol (LDL-C) and triglyceride levels, and improved endothelial-dependent flow-mediated dilation (FMD) and insulin sensitivity in relation to NC. Evaluation of absolute changes from baseline showed significant reductions in NC versus placebo for C and LDL-C (C: -1.14±0.88 and -0.03±0.78 mmol/l, p<0.001; LDL-C: -1.06±0.75 and -00.4±0.54 mmol/l, p<0.001), and a significant improvement of FMD (3±4% and 0±3% respectively, p<0.05). After the extension phase, triglyceride levels decreased significantly from 1.57±0.77 to 1.26±0.63 mmol/l, p<0.05 and insulin sensitivity improved in a patient subgroup with insulin resistance at baseline (HOMA: from 3.3±0.4 to 2.5±1.3, p<0.05). No adverse effect was reported. CONCLUSIONS This NC reduces cholesterol levels. The reduction is associated with improved endothelial function and insulin sensitivity.
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Affiliation(s)
- F Affuso
- Department of Internal Medicine, Cardiovascular and Immunologic Sciences, University of Naples Federico II, Naples, Italy
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Gyles CL, Carlberg JG, Gustafson J, Davlut DA, Jones PJH. Economic valuation of the potential health benefits from foods enriched with plant sterols in Canada. Food Nutr Res 2010; 54:5113. [PMID: 20941328 PMCID: PMC2952539 DOI: 10.3402/fnr.v54i0.5113] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2010] [Revised: 05/11/2010] [Accepted: 09/03/2010] [Indexed: 11/25/2022] Open
Abstract
Background Increased consumption of foods containing plant sterols has the potential to reduce the incidence of coronary heart disease (CHD) and thus reduce costs associated with treating that disease in a significant way. This paper reports the results of an investigation of the potential monetary benefits of allowing foods enriched with plant sterols to be marketed in Canada. Objective The objective of this research was to estimate the annual savings that would accrue to Canada's single-payer publicly funded health care system if plant sterols were approved for use. If foods containing plant sterols are consumed at a sufficient rate, a reduction in CHD should follow. Given the significant costs associated with CHD, approval of plant sterols in Canada has important public policy implications. Design This research employs a variation of traditional cost-of-illness analysis entailing four steps: (1) estimation of a ‘success rate’ (proportion of persons who would consume plant sterols at the necessary rate); (2) presumption of blood cholesterol reduction due to plant sterol consumption; (3) assumption of reduction in CHD that follows from blood cholesterol reduction; and (4) calculation of cost savings associated with reduced incidence of CHD. Results Calculations were carried out for four scenarios: ideal, optimistic, pessimistic, and very pessimistic. It was estimated that between $38 million (very pessimistic scenario) and $2.45 billion (ideal scenario) could be saved annually by Canada's health care system with plant sterol-enriched food products being made available for sale. Conclusion Significant expenditure reductions within Canada's publicly funded health care system could be realized with plant sterols approved for sale. Reduced CHD resulting from lower blood cholesterol levels would lessen the financial burden of disease in Canada.
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Affiliation(s)
- Collin L Gyles
- Department of Agribusiness & Agricultural Economics, University of Manitoba, Winnipeg, Canada
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Abstract
This article discusses alternative therapies for secondary prevention and treatment of major cardiac disorders: congestive heart failure, hypertension, dyslipidemias, and peripheral vascular disease. The role of various therapies (eg, herbal and botanic preparations, supplements, mind/body interventions, other alternative modalities of care) are addressed relative to each disease state and will hopefully give the practitioner or student a readily accessible suite of integrative therapies for common cardiac illnesses.
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Affiliation(s)
- Coleman Pratt
- Department of Family and Community Medicine, Tulane University Health Science Center, School of Medicine, 1430 Tulane Avenue TB3, New Orleans, LA 70112, USA.
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Affiliation(s)
- Jennifer M. Malinowski
- Nesbitt College of Pharmacy and Nursing, Wilkes University, Wilkes-Barre, PA, and Clinical Pharmacist, Lipid Management Clinic, Geisinger Lake Scranton, Scranton, PA
| | - Monica M. Gehret
- Lebanon Veterans Affairs. Medical Center, Lebanon, PA; at the time of writing she was pharmacy student, Wilkes University
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Talati R, Sobieraj DM, Makanji SS, Phung OJ, Coleman CI. The Comparative Efficacy of Plant Sterols and Stanols on Serum Lipids: A Systematic Review and Meta-Analysis. ACTA ACUST UNITED AC 2010; 110:719-26. [DOI: 10.1016/j.jada.2010.02.011] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2009] [Accepted: 11/16/2009] [Indexed: 11/30/2022]
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50
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Sakouhi F, Boukhchina S, Absalon C, Fouquet E, Kallel H. Policosanol characterization and accumulation during ripening of Tunisian
Olea europaea
L. fruits. EUR J LIPID SCI TECH 2010. [DOI: 10.1002/ejlt.200900076] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- Faouzi Sakouhi
- Laboratoire de Biochimie des Lipides, Département de Biologie, Faculté des Sciences de Tunis, El Manar, Tunisie
| | - Sadok Boukhchina
- Laboratoire de Biochimie des Lipides, Département de Biologie, Faculté des Sciences de Tunis, El Manar, Tunisie
| | - Christelle Absalon
- Centre d'Etude Structurale et d'Analyse des Molécules Organiques, Institut des Sciences Moléculaires, Université de Bordeaux, Bordeaux, France
| | - Eric Fouquet
- Centre d'Etude Structurale et d'Analyse des Molécules Organiques, Institut des Sciences Moléculaires, Université de Bordeaux, Bordeaux, France
| | - Habib Kallel
- Laboratoire de Biochimie des Lipides, Département de Biologie, Faculté des Sciences de Tunis, El Manar, Tunisie
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