Effects of the Consumption of Prickly Pear Cacti (Opuntia spp.) and its Products on Blood Glucose Levels and Insulin: A Systematic Review

Usefulness of Opuntia spp. on the Management of Obesity and Its Metabolic Co-Morbidities

The plants of the Opuntia genus mainly grow in arid and semi-arid climates. Although the highest variety of wild species is found in Mexico, Opuntia spp. is widely distributed throughout the world. Extracts of these cacti have been described as important sources of bioactive substances that can have beneficial properties for the prevention and treatment of certain metabolic disorders. The objective of this review is to summarise the presently available knowledge regarding Opuntia ficus-indica (nopal or prickly pear), and some other species (O. streptacantha and O. robusta) on obesity and several metabolic complications. Current data show that Opuntia ficus-indica products used in preclinical studies have a significant capacity to prevent, at least partially, obesity and certain derived co-morbidities. On this subject, the potential beneficial effects of Opuntia are related to a reduction in oxidative stress and inflammation markers. Nevertheless, clinical studies have evidenced that the effects are highly contingent upon the experimental design. Moreover, the bioactive compound composition of nopal extracts has not been reported. As a result, there is a lack of information to elucidate the mechanisms of action responsible for the observed effects. Accordingly, further studies are needed to demonstrate whether Opuntia products can represent an effective tool to prevent and/or manage body weight and some metabolic disorders.

Opuntia spp.: An Overview of the Bioactive Profile and Food Applications of This Versatile Crop Adapted to Arid Lands

Opuntia spp. are crops well adapted to adverse environments and have great economic potential. Their constituents, including fruits, cladodes, and flowers, have a high nutritional value and are rich in value-added compounds. Cladodes have an appreciable content in dietary fiber, as well as bioactive compounds such as kaempferol, quercetin, and isorhamnetin. Fruits are a major source of bioactive compounds such as phenolic acids and vitamin C. The seeds are mainly composed of unsaturated fatty acids and vitamin E. The flowers are also rich in phenolic compounds. Therefore, in addition to their traditional uses, the different plant fractions can be processed to meet multiple applications in the food industry. Several bakery products have been developed with the incorporation of cladode flour. Pectin and mucilage obtained from cladodes can act as edible films and coatings. Fruits, fruit extracts, and fruit by-products have been mixed into food products, increasing their antioxidant capacity and extending their shelf life. Betalains, obtained from fruits, can be used as food colorants and demonstrate promising applications as a sensor in food packaging. This work reviews the most valuable components of the different fractions of this plant and emphasizes its most recent food applications, demonstrating its outstanding value.

Biogenic Synthesis of Silver Nanoparticles Using Catharanthus roseus and Its Cytotoxicity Effect on Vero Cell Lines

Background: Type 2 diabetes mellitus (DM2) is a chronic and sometimes fatal condition which affects people all over the world. Nanotherapeutics have shown tremendous potential to combat chronic diseases—including DM2—as they enhance the overall impact of drugs on biological systems. Greenly synthesized silver nanoparticles (AgNPs) from Catharanthus roseus methanolic extract (C. AgNPs) were examined primarily for their cytotoxic and antidiabetic effects. Methods: Characterization of C. AgNPs was performed by UV−vis spectroscopy, Fourier transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), and atomic force microscopy (AFM). The C. AgNPs were trialed on Vero cell line and afterwards on an animal model (rats). Results: The C. AgNPs showed standard structural and functional characterization as revealed by FTIR and XRD analyses. The zetapotential analysis indicated stability while EDX analysis confirmed the formation of composite capping with Ag metal. The cytotoxic effect (IC50) of C. AgNPs on Vero cell lines was found to be 568 g/mL. The animal model analyses further revealed a significant difference in water intake, food intake, body weight, urine volume, and urine sugar of tested rats after treatment with aqueous extract of C. AgNPs. Moreover, five groups of rats including control and diabetic groups (NC1, PC2, DG1, DG2, and DG3) were investigated for their blood glucose and glycemic control analysis. Conclusions: The C. AgNPs exhibited positive potential on the Vero cell line as well as on experimental rats. The lipid profile in all the diabetic groups (DG1-3) were significantly increased compared with both of the control groups (p < 0.05). The present study revealed the significance of C. AgNPs in nanotherapeutics.

Hemoglobin A1c, hemoglobin glycation index, and triglyceride and glucose index: Useful tools to predict low feed intake associated with glucose intolerance in lactating sows

The aim of the present study was to evaluated hemoglobin A1c (HbA1c), the hemoglobin glycation index (HGI), and triglyceride and glucose (TG) index as predictive indicators for low feed intake in lactating sows due to glucose intolerance. Cactus (Opuntia ficus-indica) was included in sow diets as a modulating factor of glucose. Thirty-six sows were separated into three groups (Gs). Although the three groups received a conventional diet during gestation and lactation, 2.0 kg per sow per day of steam-cooked cactus (G1) and fresh cactus (G2) were added to the lactation diet as a glycemic modulating factor, with G3 serving as the control group. Glycemia was assessed via glucometer (blood glucose concentrations), HbA1c and HGI. For each indicator of glycemia the triglycerides and glucose (TG) index was evaluated. The highest blood glucose concentration was observed on day 3 of lactation (88.2 mg/dL). The average glycemic concentrations obtained from HbA1c on farrowing day (61.6 mg/dL) and day 21 of lactation (65.6 mg/dL) were lower (p<0.05) than those measured by a glucometer on the same days (71.8 and 77.7 mg/dL for farrowing day and day 21 of lactation, respectively). At farrowing, the TG index obtained from the HGI indicated that 83.0% of sows were glucose intolerant, compared to 100% according to the TG index obtained from a glucometer. At weaning, 50% of G2 did not show glucose intolerance when the TG index was calculated using the HGI, compared to 54% when it was calculated with blood glucose concentrations measured by a glucometer. All G3 sows presented glucose intolerance, regardless of the test used. The HbA1c, HGI, and TG index tests are viable alternatives to predict low feed intake due to glucose intolerance in lactating sows.

Prickly Pear Cacti (Opuntia spp.) Cladodes as a Functional Ingredient for Hyperglycemia Management: A Brief Narrative Review

The worldwide prevalence of obesity is increasing along with its comorbidities, including type 2 diabetes mellitus (T2DM). From a pathophysiological perspective, T2DM arises as a consequence of insulin resistance and pancreatic β-cell dysfunction, which together induce chronic hyperglycemia. The pharmacological treatment of T2DM specifically focuses on its management, rather than remission, with a lack of pharmacological agents to prevent the onset of the disease. Considering the role of unhealthy dietary patterns on the development of T2DM, identifying novel food ingredients and bioactive substances may provide new avenues by which to address the T2DM epidemic. In this brief review, we have summarized the latest findings on the consumption of the prickly pear (PP; Opuntia spp.) cladode as a potential nutritional tool for the management of hyperglycemia. The consumption of prickly pear cladodes was reported to exert hypoglycemic effects, making it a potential cost-effective nutritional intervention for the management of T2DM. Several studies have demonstrated that the consumption of prickly pear cladodes and the related products reduced post-prandial glucose levels. The cladodes’ high fiber content may be implicated in improving glycemic control, by affecting glucose absorption and effectively slowing its release into the blood circulation. Given these potential hypoglycemic effects, prickly pear cladodes may represent a potential functional food ingredient to improve glycemic control and counter the negative metabolic effects of the modern Western diet. Nonetheless, in consideration of the lack of evidence on the chronic effects of the prickly pear cladode, future research aimed at evaluating its long-term effects on glycemic control is warranted.

Opuntia genus in Human Health: A Comprehensive Summary on Its Pharmacological, Therapeutic and Preventive Properties. Part 1

Opuntia spp. is a diverse and widely distributed genus in Africa, Asia, Australia, and America. Mexico has the largest number of wild species; mainly O. streptacantha, O. hyptiacantha, O. albicarpa, O. megacantha and O. ficus-indica. The latter being the most cultivated and domesticated species. Throughout history, plants and their phytochemicals have played an important role in health care and Opuntia spp. has shown a high nutritional, medicinal, pharmaceutical, and economic impacts. Its main bioactive compounds include pigments (carotenoids, betalains and betacyanins), vitamins, flavonoids (isorhamnetin, kaempferol, quercetin) and phenolic compounds. Together, they favor the different plant parts and are considered phytochemically important and associated with control, progression and prevention of some chronic and infectious diseases. This first review (Part 1), compiles information from published research (in vitro, in vivo, and clinical studies) on its preventive effects against atherosclerotic cardiovascular diseases, diabetes and obesity, hepatoprotection, effects on human infertility and chemopreventive and/or antigenotoxic capacity. The aim is to provide scientific evidences of its beneficial properties and to encourage health professionals and researchers to expand studies on the pharmacological and therapeutic effects of Opuntia spp.

Complementary and Alternative Therapies for Weight Loss: A Narrative Review

Despite various strategies, overweight and obesity problems are still increasingly prevalent worldwide with serious health outcomes. Consequently, the continuous demand for more effective, safe and acceptable therapies for reducing body weight is also escalating—including complementary and alternative therapies (CATs). The aim of this review is to provide a summary of the most commonly- and recently-used CATs, with evaluation of their safety and efficacy for weight loss. Electronic scientific databases such as Scopus, PubMed and EBSCO Host were explored for articles that reported CATs for overweight and obesity treatment from 2015 to December 2019. Only systematic reviews, meta-analysis and randomized controlled trials (RCTs) published in English were included. Studies whereby CATs were not utilized for reducing body weight were excluded. Eight systematic reviews and meta-analyses and 11 additional RCTs with 765 participants (50.2% overweight and 49.8% obese) related to hypnotherapy, acupuncture and dietary supplements met the inclusion criteria. Their results suggested that spirulina, chitosan, probiotic, EPA + DHA, vitamin D, fiber, and herbal extract supplementation may all provide small reductions in body weight (ranging from 1-10 kg). Interestingly, hypnotherapy and acupuncture reported significantly greater reduction in body weight compared with placebo (p < 0.001 and p < 0.0001, respectively). Nonetheless, the evidence is still relatively limited and not encouraging to provide a definitive conclusion due to the methodological shortcomings and the presence of adverse events in chitosan and fiber supplementation. Hence, studies of this nature need to be further replicated and improved to corroborate the efficacy and safety of the CATs to combat weight issues.

Preoperative Management of Surgical Patients Using Dietary Supplements: Society for Perioperative Assessment and Quality Improvement (SPAQI) Consensus Statement

The widespread use of complementary products poses a challenge to clinicians in the perioperative period and may increase perioperative risk. Because dietary supplements are regulated differently from traditional pharmaceuticals and guidance is often lacking, the Society for Perioperative Assessment and Quality Improvement convened a group of experts to review available literature and create a set of consensus recommendations for the perioperative management of these supplements. Using a modified Delphi method, the authors developed recommendations for perioperative management of 83 dietary supplements. We have made our recommendations to discontinue or continue a dietary supplement based on the principle that without a demonstrated benefit, or with a demonstrated lack of harm, there is little downside in temporarily discontinuing an herbal supplement before surgery. Discussion with patients in the preoperative visit is a crucial time to educate patients as well as gather vital information. Patients should be specifically asked about use of dietary supplements and cannabinoids, as many will not volunteer this information. The preoperative clinic visit provides the best opportunity to educate patients about the perioperative management of various supplements as this visit is typically scheduled at least 2 weeks before the planned procedure.

An Optimized Protein Extraction Method for Gel-Free Proteomic Analysis of Opuntia Ficus-Indica

Opuntia spp. is an economically important vegetable crop with high stress-tolerance and health benefits. However, proteomic analysis of the plant has been difficult due to the composition of its succulent cladodes; the abundant polysaccharides interfere with protein extraction. To facilitate proteomic analysis of this plant, we present a rapid and simple protein extraction method for Opuntia ficus-indica (L.) Miller. The optimized method produced highly reproducible protein patterns and was compatible with a gel-free quantitative workflow without the need for additional purification. We successfully analyzed the cladode mesocarp and exocarp tissues, resulting in the identification of 319 proteins. In addition, we used this method to examine the relative changes in the Opuntia proteome in response to salt stress to determine whether physiological changes could be captured. Qualified observations were obtained, revealing that salt stress increased phosphoenolpyruvate carboxylase abundance and decreased ribulose-bisphosphate carboxylase in young O. ficus-indica plants. These findings suggest that Crassulacean acid metabolism is promoted under salinity. This study highlights the efficacy of our optimized protein extraction method for elucidating the metabolic adaptations of Opuntia using gel-free proteomic analysis.

Molecular mechanisms from insulin-mimetic effect of vitamin D: treatment alternative in Type 2 diabetes mellitus

Diabetes mellitus is a complex and multifactorial disease with a global prevalence that exceeds 425 million people. Type 2 diabetes mellitus (T2DM) is characterized by a state of insulin resistance, which leads to metabolic alterations that aggravate the state of health of people. Vitamin D deficiency appears to play an important role in the triggering mechanisms of insulin resistance. In this review, an analysis is made of the biochemical mechanisms associated with the insulin-mimetic effect of vitamin D, its supplementation being a possible nutritional strategy for the T2DM treatment. The current scientific evidence is extensive regarding the dose of vitamin D used for an insulin-mimetic effect. However, clinical trials and systematic reviews show statistical differences on glucose, insulin, and glycated hemoglobin levels of patients with T2DM, associated with activation mechanisms of transcription factors related to genes of the glucide metabolism and the insulin receptor, and the regulation of intracellular Ca2+ insulin concentrations. Likewise, an indirect mechanism associated with antioxidant and anti-inflammatory effects has been shown that also leads to sensitivity to the insulin receptor. The use of a specific dose of vitamin D could be an effective alternative in the T2DM treatment, which would reduce the risk of complications derived from hyperglycemia.

Pasta Supplemented with Opuntia ficus-indica Extract Improves Metabolic Parameters and Reduces Atherogenic Small Dense Low-Density Lipoproteins in Patients with Risk Factors for the Metabolic Syndrome: A Four-Week Intervention Study

Food supplementation with Opuntia ficus-indica (OFI) has been associated with a significant reduction in total cholesterol, body fat, hyperglycemia and blood pressure. Since OFI may also have antioxidant and anti-atherogenic properties, we hypothesized that its supplementation might reduce atherogenic lipoproteins, including small, dense low-density lipoproteins (sdLDL). Forty-nine patients (13 men and 36 women, mean age: 56 ± 5 years) with one or two criteria for the metabolic syndrome weekly consumed 500 g of pasta supplemented with 3% OFI extract (30% of insoluble polysaccharides with high antioxidant power) for 1 month. The full LDL subclass profile was assessed by gel electrophoresis (Lipoprint, Quantimetrix, Redondo Beach, CA, USA). After 1 month of pasta supplementation, waist circumference (p = 0.0297), plasma glucose (p < 0.0001), triglycerides (p = 0.0137), plasma creatinine (p = 0.0244), urea and aspartate transaminase (p < 0.0001 for each) significantly decreased. A percentage increase in larger, less atherogenic LDL-1 (p = 0.0002), with a concomitant reduction in smaller, denser LDL-2 (p < 0.0001) and LDL-3 (p = 0.0004), were found. LDL-4 and-5 decreased, although not significantly. This is the first intervention study suggesting that pasta enriched with an OFI extract may have beneficial effects on some metabolic parameters and the LDL particle sizes, reducing atherogenic sdLDL. Future studies will help to establish if these findings impact cardiovascular outcomes.

Sopa de elote (Zea mays) tipo crema con mucílago de nopal (Opuntia spp.) como espesante, sus características físicas y aceptación sensorial

El mucílago de nopal (Opuntia spp.) es un polisacárido calificado como nutracéutico por sus efectos positivos en la fisiología de los humanos. Por otro lado, el mucílago puede usarse como espesante, ya que al hidratarse forma hidrocoloides. El objetivo de este estudio fue adicionar mucílago de nopal a la sopa de elote tipo crema y evaluar su efecto espesante y aceptación sensorial. El mucílago se extrajo de cladodios de Opuntia spp. de las variantesAtlixco, Milpa Alta, Toluca, Tobarito y Tuna Blanca. Las concentraciones evaluadas fueron 0.7 y 1.0% y se incluyó almidón como testigo. Con algunas excepciones, la sopa de los 10 tratamientos con mucílago mostró pH (entre 6.09 y 6.32) y viscosidad (entre 6.043 y 1.623 Pa s) sin diferencias significativas (p > 0.05) respecto a los testigos; además, mostró la misma saturación (entre 17.47º y 18.49º), mayor luminosidad (entre 46.15 y 47.72º) y menos color (entre 78.36 y 79.52º). La aceptabilidad sensorial por viscosidad, excepto con mucílago de Atlixco y de Toluca (17 y 7% menor, respectivamente), y la aceptabilidad sensorial global con el mucílago, de las cinco variantes fue hasta 19% menor que la de los testigos. Tendrá que ponderarse el beneficio de adicionar mucílago de nopal a la sopa de elote, para usarse como alimento funcional, sobre su aceptabilidad global.

The Effect of Cladode Drying Techniques on the Prebiotic Potential and Molecular Characteristics of the Mucilage Extracted from Opuntia ficus-indica and Opuntia joconostle

The dry, powdered cladodes of Opuntia ficus-indica are often-used in over-the-counter (OTC) pharmaceutical formulations. Gentle drying techniques, such as lyophilization and vacuum drying are compared with convection drying for the cladodes and also compared with another species of economic importance, Opuntia joconostle. The heteropolysaccharide purified from the mucilage extracted from the dried powders were investigated in their monosaccharide composition (HPAEC-PAD, TLC), mineral and protein content, molecular dimensions (SEC) and fermentability by probiotic bacteria (Bioscreen technique) for evaluation of the prebiotic potential of the mucilage. The heteropolysaccharide is composed of galactose, arabinose, xylose, galacturonic acid and rhamnose. O. ficus-indica includes an additional 13% of glucose coming from an α-glucan. The content of Ca (0.3%) and Mg (0.4%) is relatively low in both species; the content of protein adds up to 1.5% in O. ficus-indica but is significantly lower in O. joconostle with 0.8%. The average molecular mass Mw of the extracted mucilage ranges from 3.7 to 4.7 × 105 g∙mol−1 for both species; only the mucilage from long-time convection drying (C2) delivers a lower average Mw of 2.6 × 105 g∙mol−1, due to partial breakdown of the mucilage matrix. All tested probiotic strains utilized the mucilage to some extent; C2 being the most active, and thus confirms the prebiotic potential of cladode’s powder and its derived products. In general, the molecular dimensions and prebiotic potential are not extremely sensitive to the drying treatment, yet temperature and drying time can modify the cladode’s powder to a profile with better prebiotic characteristics.

Physico-chemical changes in cladodes of Opuntia ficus-indica as a function of the growth stage and harvesting areas

The physicochemical properties of cladodes Opuntia ficus-indica (OFI) vary widely during maturation. However, few studies have been performed to evaluate changes in chemical characteristics on the pad depending on the maturity stages. Chemical proximate analysis like the content of total sugars, protein, dry matter, pH, conductivity and ash, depending on the variation of weight of the pad and the growing region was done to determine the changes of characteristics of nopal. Significant changes in physicochemical properties were observed among harvesting sites and during the growing stages. The principal component analysis was then performed to evaluate the relationship between harvesting sites, growth stages, and physicochemical properties. Results highlighted that Sidi El Aidi can be categorized as a poor ecotype among the studied ecotypes, besides, overall harvesting sites pH and proteins had a significant negative correlation with ash, total sugars, reducing sugars, conductivity proteins decrease with increasing age of nopals while total sugars, reducing sugars, and ash content showed the opposite trend. The high total sugar content, minerals of nopal pad (weight higher than 200 g) and proteins (weight lower than 200 g) could be an interesting source of these important components for human diets and also could be used in food, cosmetics, and pharmaceutical industry.

Traditional Mexican foods as functional agents in the treatment of cardiometabolic risk factors

Major cardiometabolic risk phenotypes include insulin resistance (IR), hyperinsulinemia, overweight, obesity and dyslipidemia, which contribute to the current prevalent chronic disease pandemia worldwide. Among traditional treatments, dietary habits represent one of the most difficult and controversial aspects to implement in handling metabolic disturbances. The use of herbal remedies by latinos and hispanics, as part of self-care of metabolic diseases has been well documented in several studies, mainly because they are "natural", consistent with their culture, family-related, accessible, and affordable. Phytochemicals are present in fruits, vegetables and various plants, and constitute nonessential nutrients such as vitamins or minerals, many of them being consumed in a popular way or used as herbal remedies or dietary supplements. In this narrative review, we present evidence on traditional endemic Mexican foods such as cacao, corn, common bean, prickle pear, chili, avocado and salba-chia as functional agents to improve the metabolic status in risk phenotypes.

Antioxidant and Antimicrobial Properties of Semi-Processed Frozen Prickly Pear Juice as Affected by Cultivar and Harvest Time

Consumer interest toward natural ingredients is creating a growing trend in the food industry and research for the development of natural products such as colorants, antimicrobials and antioxidants. Semi-processed frozen prickly pear (Opuntia ficus-indica (L.) Mill.) juices (PPJs), obtained from three cultivars with white, red and yellow pulp, with different harvest times ("Agostani" and "Bastardoni"), were characterized for betalains, total phenolics, flavonoids, carotenoids, antioxidant capacity (by 2,2-diphenyl-1-picryl-hydrazyl-hydrate (DPPH)) and antimicrobial potential against foodborne pathogenic bacteria. Through chemical assays, PPJs showed high contents of total polyphenols, flavonoids and betalains and marked antioxidant capacity. PPJs from the first harvest ("Agostani") revealed the significantly highest amount of polyphenols in white cultivar and of betacyanin and betaxanthin in yellow and red cultivars; antioxidant capacity was significantly higher in "Agostani" PPJs than in "Bastardoni" ones. Regarding antimicrobial potential, all PPJs revealed good antibacterial activity, particularly against Salmonella enterica as evidenced by the widest inhibition haloes. These results encourage the suitability of the first flowering prickly pear fruits, with low market value as fresh fruit but with high nutritional features, to be processed as semi-finished product. In particular, its use as ingredient in foods with high risk of Salmonella contamination may act as a natural preservative.

Opuntia Fruits as Food Enriching Ingredient, the First Step towards New Functional Food Products

Prickly pear (Opuntia ficus indica (L.) Mill.) is a rich source of vitamins C, B1, B2, A, and E, minerals such as calcium, potassium, magnesium, iron, and phosphorus, as well as bioactive substances, i.e., carotenoids, betalains, and phenolic compounds. Of these, the phenolic acids, betalains, and flavonoids are notable in that they are largely responsible for the health-promoting properties of this plant. The purpose of the presented research was to first determine the antioxidant properties and the content of polyphenolic compounds (including individual phenolic acids) in prickly pear fruit, then to produce an innovative gluten-free pasta from rice-field bean flour enriched with various amounts of pear prickly fruit. The content of free phenolic acids, the sum of polyphenols and antioxidant properties of pasta were subsequently determined in the supplemented pasta. Chromatographic analysis (HPLC-ESI-MS/MS) showed a wide variety of phenolic acids. In the fruit sample, 14 acids were detected, whereas in the pasta sample without additives, 9. The dominant acid was isoferulic. The total content of free phenolic acids and the sum of polyphenols increased with increasing content of the functional additive. Moreover, the content of individual acids generally increased as the Opuntia fruit was added. The antioxidant activity was also positively correlated with the addition of fruit, with the content of free phenolic acids and the sum of polyphenols. Our research has shown that our innovative pasta with the addition of prickly fruit can become a source of the free phenolic acids indispensable for human health.