Dietary Strategies for Metabolic Syndrome: A Comprehensive Review

Knowledge, attitudes, and practices regarding hypertension diet among patients with hypertension

To explore the knowledge, attitudes, and practices (KAP) concerning hypertension diets among hypertensive patients, a cross-sectional survey was conducted across designated institutions in Heilongjiang Province and Jiangsu Province from December 2023 to February 2024. Data on sociodemographic factors and KAP scores were collected via questionnaires. A total of 661 valid responses were obtained, with 33.89% reporting a hypertension duration of 3-10 years. Mean knowledge, attitude, and practice scores were 23.40 ± 4.66, 61.15 ± 8.85, and 20.31 ± 3.37, respectively. Linear regression analysis identified several factors independently associated with practice, including knowledge score, attitude score, urban residence, education level, income, salt consumption, and frequency of consuming vegetables and fruits. Structural equation modeling (SEM) revealed direct and indirect effects of knowledge and attitude on practice. Hypertensive patients demonstrated adequate knowledge, positive attitudes, and proactive practices regarding hypertension diets. Healthcare professionals should focus on reinforcing positive attitudes and knowledge transfer to promote consistent and effective dietary practices for hypertension management.

Dietary therapy to halt the progression of diabetes to diabetic kidney disease

Diabetic Kidney Disease (DKD) is a common and serious complication of diabetes, particularly Type 2 Diabetes Mellitus (T2DM), which significantly contributes to patient morbidity and mortality. The limitations of traditional treatments like ACE inhibitors and ARBs in managing DKD progression highlight the need for innovative therapeutic strategies. This review examines the impact of various dietary patterns, such as the Mediterranean diet, ketogenic diet, intermittent fasting, DASH diet, and vegetarian diet, on the management of DKD. Evidence suggests these diets can halt the progression of DKD, although further research is needed to confirm their long-term effectiveness and safety. Personalized dietary approaches tailored to individual needs may enhance outcomes for DKD patients.

Egg intake in relation to metabolic health status, serum brain derived neurotrophic factor, and adropin levels in Iranian adults

There is conflicting information about the association between egg intake and metabolic health status and no previous information on this association was found in Middle Eastern populations. This research aimed to investigate the relationship between egg consumption and metabolic health status in Iranian adults, focusing on the potential involvement of brain-derived neurotrophic factor (BDNF) and adropin. This cross-sectional study was done on a sample of 527 individuals (45.7% female) aged between 20 and 65 years. Participants were selected using a multistage cluster random-sampling method. Dietary intakes of participants were evaluated using a validated food frequency questionnaire. Blood samples were collected while the individuals were fasting to assess biochemical markers. Metabolic health status of individuals was assessed based on the criteria established by Wildman. Collecting data on covariates was done using pre-tested procedures. Multivariable-adjusted model revealed a statistically significant association between egg consumption and a decreased odds of metabolically unhealthy (MU) status (ORT3 vs. T1 = 0.47; 95%CI 0.24-0.92). Also, each tertile increase in egg consumption was significantly associated with decreased odds of MU status (OR = 0.68; 95%CI 0.49-0.96). This association was especially significant among males rather than females. Elevated high-sensitive C-reactive protein (hs-CRP) levels were substantially reduced among individuals with the highest consumption of egg compared to the lowest intake. Additionally, there was a slight inverse association between egg consumption and high blood pressure. There were no relationships between egg intake and having low BDNF, and adropin levels. Increased consumption of egg was associated with a decreased chance of being metabolically unhealthy in Iranian adults, especially in male participants.

Effects of Liupao Tea with Different Years of Aging on Glycolipid Metabolism, Body Composition, and Gut Microbiota in Adults with Obesity or Overweight: A Randomized, Double-Blind Study

BACKGROUND

Liupao tea (LPT) is a traditionally fermented dark tea from Guangxi, China and the effects of different aging periods of LPT on metabolic health remain inadequately explored.

METHODS

This randomized, double-blind, longitudinal study enrolled 106 adults with obesity or overweight who were assigned to consume LPT of different ages over a 90-day period. Participants were randomly divided into four groups, each consuming LPT that had been aged for 1 year, 4 years, 7 years, or 10 years. The metabolic parameters, body composition, and gut microbiota were assessed at baseline and after the 90-day intervention.

RESULTS

All LPT groups experienced significant reductions in systolic blood pressure (SBP) and diastolic blood pressure (DBP), with the 10-year-aged group showing the most notable SBP decrease (p < 0.001). Total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) levels decreased significantly in the 1-, 4-, and 10-year-aged groups (p < 0.05), while high-density lipoprotein cholesterol (HDL-C) increased in the 7-year-aged group (p < 0.05). Body weight, body fat mass (BFM), body mass index (BMI), waist circumference (WC), body fat percentage (BFP), and visceral fat area (VFA) significantly declined across all groups (p < 0.05). Gut microbiota analysis showed changes in specific genera, though overall diversity remained stable. No significant differences were found in metabolic or microbiota outcomes between the different aged groups.

CONCLUSIONS

LPT consumption effectively improves blood pressure, lipid profiles, and body composition in adults with obesity without adverse liver effects. The aging duration of LPT does not significantly alter these health benefits, challenging the belief that longer-aged LPT is superior.

Impact of 3 G rice on plasma glucose, insulin, and gastrointestinal hormones in patients with obesity or type 2 diabetes: A non-randomized experimental study

OBJECTIVE

To evaluate the effects of a novel grain variety 3 G rice compared to traditional white rice on postprandial glycemia, insulinemia, and gastrointestinal hormones in individuals with obesity and type 2 diabetes (T2D).

METHODS

A non-randomized experimental study was conducted with 20 participants with obesity (without diabetes) and 20 patients with T2D. Each participant consumed meals containing 50 g of carbohydrates from either 3 G rice or white rice. Plasma glucose, insulin, and gastrointestinal hormone levels were measured at baseline and intervals up to 120 min post-consumption.

RESULTS

Among participants with obesity, plasma glucose levels were significantly lower at 90 and 120 after 3 G compared to white rice (0.52 ± 0.04 vs. 2.58 ± 0.37 mmol/L, p < 0.001 at 90 min and 0.06 ± 0.02 vs. 1.47 ± 0.26 mmol/L, p = 0.003 at 120 min). In contrast, plasma insulin levels were markedly higher following 3 G rice consumption at 90-120 min (p = 0.003). Gastrointestinal hormones were significantly elevated after 3 G rice intake compared to white rice, with GLP-1 levels showing sustained increases from 60 to 120 min (p = 0.019). In T2D patients, 3 G rice consumption led to a modest reduction in plasma glucose at 120 min (5.15 ± 0.49 mmol/L for white rice vs. 3.57 ± 0.35 mmol/L for 3 G rice, p = 0.0262) without significant effect on other parameters.

CONCLUSION

3 G rice significantly improved postprandial glycemic control and enhanced gastrointestinal hormone responses in individuals with obesity. These findings highlight the promise of 3 G rice as a dietary intervention for managing postprandial glycemia and insulin sensitivity.

Metabolic syndrome is associated with breast cancer mortality: A systematic review and meta-analysis

BACKGROUND

This systematic review and meta-analysis assesses the association between metabolic syndrome and breast cancer (BC) outcomes in BC survivors.

METHODS

Systematic searches were carried out in PubMed and Embase using variations of the search terms: breast neoplasms (population), metabolic syndrome (exposure), and survival (outcome). Metabolic syndrome was characterized according to the American Heart Association, which includes the presence of three out of five abnormal findings among the risk factors: high blood pressure, high triglycerides, low high-density lipoprotein, high fasting glucose, and central obesity. Data were obtained from observational studies and randomized controlled trials that utilized survival statistics and reported survival ratios to investigate how the presence of metabolic syndrome at the time of BC diagnosis is associated with BC outcomes. Study data were independently extracted by two authors, and effect sizes were pooled using random-effects models.

RESULTS

From the 1019 studies identified in the literature search, 17 were deemed eligible. These encompassed 42,135 BC survivors. The pooled estimates revealed that BC survivors who had metabolic syndrome at the time of their BC diagnosis experienced increased risk of recurrence (HR 1.69, 95% CI: 1.39-2.06), BC mortality (HR 1.83, 95% CI: 1.35-2.49), and shorter disease-free survival (HR 1.57, 95% CI: 1.36-1.81) compared to BC survivors without metabolic syndrome.

CONCLUSIONS

Among BC survivors, metabolic syndrome was associated with inferior BC outcomes. This necessitates the creation of clinical guidelines that include metabolic screening for BC survivors. Further research should identify effective interventions to reduce the prevalence of metabolic syndrome among BC survivors to improve metabolic health and BC outcomes.

When short-chain fatty acids meet type 2 diabetes mellitus: Revealing mechanisms, envisioning therapies

Evidence is accumulating that short-chain fatty acids (SCFAs) produced by the gut microbiota play pivotal roles in host metabolism. They contribute to the metabolic regulation and energy homeostasis of the host not only by preserving intestinal health and serving as energy substrates but also by entering the systemic circulation as signaling molecules, affecting the gut-brain axis and neuroendocrine-immune network. This review critically summarizes the current knowledge regarding the effects of SCFAs in the fine-tuning of the pathogenesis of type 2 diabetes mellitus (T2DM) and insulin resistance, with an emphasis on the complex relationships among diet, microbiota-derived metabolites, T2DM inflammation, glucose metabolism, and the underlying mechanisms involved. We hold an optimistic view that elucidating how diet can influence gut bacterial composition and activity, SCFA production, and metabolic functions in the host will advance our understanding of the mutual interactions of the intestinal microbiota with other metabolically active organs, and may pave the way for harnessing these pathways to develop novel personalized therapeutics for glucometabolic disorders.

The Role of the Planetary Diet in Managing Metabolic Syndrome and Cardiovascular Disease: A Narrative Review

Introduction: The planetary health diet, introduced by the EAT-Lancet Commission, aims to address global health and sustainability challenges by promoting a plant-based diet with reduced consumption of animal-sourced foods. This diet not only contributes to environmental sustainability but also offers significant health benefits, including prevention and management of abdominal obesity, carbohydrate metabolism disorders, dyslipidemia, and elevated blood pressure. These metabolic disorders are components of metabolic syndrome, a cluster of risk factors for cardiovascular disease. Objectives: This narrative review aims to gather the most recent findings on the impact of the planetary diet on individual components of metabolic syndrome and on the prevention and treatment of cardiovascular disease. Methods: The available research on the topic was identified via searches in PubMed, Scopus, and Google Scholar. Results: Abdominal obesity, a major risk factor for a range of chronic diseases, can be effectively mitigated by adhering to plant-based dietary patterns, which have been shown to reduce waist circumference and improve overall cardiometabolic health. Furthermore, the planetary diet plays a crucial role in reducing the risk of type-2 diabetes and improving glycemic control, with specific dietary components such as whole grains and fiber, demonstrating positive effects on blood glucose levels. This diet is additionally associated with favorable lipid profiles, including lower levels of LDL cholesterol and total cholesterol, which are critical in the prevention of atherosclerosis and cardiovascular diseases. Conclusions: These multiple benefits highlight that the planetary diet may be an effective strategy for managing and preventing metabolic syndrome and cardiovascular disease. However, further research is needed to confirm its long-term efficacy and applicability across diverse populations.

Does supplementation with pine bark extract improve cardiometabolic risk factors? A systematic review and meta-analysis

BACKGROUND

Supplementation with pine bark extract (PBE) may improve risk factors associated with cardiometabolic syndrome (CMS). The effects of PBE supplementation on cardiometabolic risk factors were evaluated in this systematic review and meta-analysis of randomized controlled trials (RCTs).

METHODS

A comprehensive search of various databases was performed to identify relevant RCTs published up to September 2024. A random-effects model was employed for the meta-analysis, which included 27 RCTs with 1,685 participants.

RESULTS

The findings indicated that PBE supplementation significantly reduced systolic blood pressure (SBP) (weighted mean difference (WMD): -2.26 mmHg, 95% confidence interval (CI): -3.73, -0.79; P = 0.003), diastolic blood pressure (DBP) (WMD: -2.62 mmHg, 95% CI: -3.71, -1.53; P < 0.001), fasting blood sugar (FBS) (WMD: -6.25 mg/dL, 95% CI: -9.97, -2.53; P = 0.001), hemoglobin A1c (HbA1c) (WMD: -0.32%, 95% CI: -0.54, -0.11; P = 0.003), body weight (WMD: -1.37 kg, 95% CI: -1.86, -0.88; P < 0.001), and low-density lipoprotein (LDL) cholesterol (WMD: -5.07 mg/dL, 95% CI: -9.21, -0.94; P = 0.016) in the PBE-treated group compared to their untreated counterparts. However, no significant impact of PBE was observed on waist-to-hip ratio (WHR), body mass index (BMI), waist circumference (WC), or serum levels of insulin, high-density lipoprotein (HDL) cholesterol, triglycerides (TG), and total cholesterol (TC).

CONCLUSIONS

Supplementation with PBE may ameliorate specific cardiometabolic risk factors, as indicated by reductions in body weight, DBP, SBP, FBS, LDL, and HbA1c levels. This approach can be regarded as an adjunct therapeutic strategy for CMS management. Further high-quality trials with larger sample sizes and longer durations are required to validate these findings.

Dietary and health risk behaviors for metabolic diseases in different age groups: a cross-sectional study in Chongqing, China

BACKGROUND

The study aimed to investigate the relationship between the frequency of metabolic diseases (MetD) and dietary behaviors as well as health risk behaviors in various age groups.

METHODS

This Cross-Sectional study involved 12,215 participants, and the relationship between MetD and health risk behaviors was discussed using Pearson chi-square tests and unordered binary logistics regression. The Apriori algorithm was used to explore and analyze the combination patterns of health risk behaviors.

RESULTS

Insufficient sleep as a risk factor for MetD (for young adults, odds ratio (OR): 1.31, 95% confidence interval (CI): 1.15, 1.50; for middle-aged adults, OR: 1.15, 95% CI: 1.01, 1.33). For young adults, maladaptive emotion was a risk factor (OR: 1.45; 95% CI: 1.18, 1.80), and their risk of MetD was 1.48 times higher with three health risk behaviors compared with those with no or only one health risk behavior (95% CI: 1.27, 1.72). As for dietary behaviors, meat-based diet, greasy and salty taste preferences were associated with MetD.

CONCLUSIONS

High-risk alcohol consumption is a risk factor for MetD in elderly adults. Insufficient sleep was a common risk factor for MetD in young and middle-aged groups. Young adults may also be affected by maladaptive emotion and the number of risk factors. Poor dietary behaviors such as meat-based diet, greasy and salty dietary taste, may increase risk, particularly among young adults. We should consider interventions systematically and comprehensively targeting modern lifestyles of different key age group populations such as young adults.

The relationship between physical activity level, dietary patterns, and metabolic syndrome: An empirical study in Saudi Arabia

BACKGROUND

Metabolic syndrome, a cluster of conditions increasing the risk of heart disease, stroke, and diabetes, is a growing concern globally. In Saudi Arabia, lifestyle factors such as physical activity and dietary patterns play a significant role in the prevalence of metabolic syndrome.

STUDY PURPOSE

This study aims to explore the relationship between physical activity levels, dietary patterns, and the prevalence of metabolic syndrome among adults in Saudi Arabia.

METHODS

A cross-sectional study was conducted using purposive and convenience sampling techniques. A total of 468 participants completed questionnaires assessing their physical activity levels and dietary patterns. Metabolic syndrome was determined based on clinical measurements of waist circumference, blood pressure, fasting glucose, and lipid levels.

RESULTS

The analysis revealed a significant association between lower physical activity levels and poor dietary patterns with higher prevalence rates of metabolic syndrome. The analysis revealed that participants with low physical activity levels had a higher prevalence of metabolic syndrome (p < 0.01). Similarly, those with unhealthy dietary patterns (high in saturated fats and sugars) showed a metabolic syndrome risk (p < 0.01), compared to those with healthy dietary patterns.

CONCLUSION

The findings underscore the critical role of physical activity and dietary patterns in the development of metabolic syndrome in Saudi Arabia. Public health interventions targeting lifestyle modifications could be essential in mitigating metabolic syndrome and improving overall health.

Healthy lifestyle reduces cardiovascular risk in women with genetic predisposition to hypertensive disorders of pregnancy

The genetic risk for hypertensive disorders of pregnancy is linked with the development of atherosclerotic cardiovascular disease. However, the effects of lifestyle and metabolic syndrome on atherosclerotic cardiovascular disease have not been evaluated. Here, we assess the long-term association between these factors and atherosclerotic cardiovascular disease in women with genetic risk for hypertensive disorders of pregnancy. We evaluate the genetic risk for hypertensive disorders of pregnancy using a genome-wide polygenic risk score derived from a large-scale GWAS. The incidence of atherosclerotic cardiovascular disease is evaluated according to genetic risk, lifestyle, and metabolic syndrome. Individuals with a very high genetic risk for hypertensive disorders of pregnancy have a 53.0% higher chance of developing atherosclerotic cardiovascular disease than those with a low genetic risk. However, the risk of developing atherosclerotic cardiovascular disease is reduced by up to 64.6% through the maintenance of an ideal metabolic syndrome status and a healthy lifestyle in the high genetic risk group (top 20%), and by up to 65.4% in the low genetic risk group (bottom 20%). These findings emphasize that maintaining a healthy lifestyle in women is equally effective at reducing the risk of atherosclerotic cardiovascular disease independent of genetic risk for hypertensive disorders of pregnancy.

[Association between sociodemographic variables, healthy habits and stress with metabolic syndrome. A descriptive, cross-sectional study]

INTRODUCTION

Metabolic syndrome (MS) is a pathological condition that encompasses various cardiometabolic risk factors, such as obesity, dyslipidemia, hyperglycemia, and elevated blood pressure levels. It is considered a multifactorial pathological condition. The aim of this study is to assess how variables such as age, sex, socioeconomic status, tobacco and alcohol consumption, physical activity, adherence to the Mediterranean diet, and stress are associated with the prevalence of MS, determined using two different criteria.

MATERIALS AND METHODS

This is a descriptive, cross-sectional study conducted on 24,224 Spanish workers, evaluating the association between sociodemographic variables, health habits, and stress with MS, determined using two criteria: the National Cholesterol Education Program, Adult Treatment Panel III (NCEP ATP-III), and the International Diabetes Federation (IDF).

RESULTS

All the variables analyzed showed an association with the presence of MS when applying both criteria. Among them, the variables with the strongest association were age: odds ratio 5.55 (95% CI: 4.80-6.30) for MS using the NCEP ATP-III criteria and 6.71 (95% CI: 5.30-8.13) for IDF criteria; and type of job: odds ratio 3.42 (95% CI: 2.95-3.90) for NCEP ATP-III and 3.57 (95% CI: 3.12-4.03) for IDF.

CONCLUSIONS

The profile of an individual at higher risk of developing MS under both criteria would be an older male, manual laborer, smoker, habitual alcohol consumer, sedentary, with low adherence to the Mediterranean diet, and experiencing high levels of stress.

Association between Healthy Eating Index 2015 and metabolic syndrome among US cancer survivors: evidence from NHANES 2005-2016

Our study examined the relationship between diet quality and the prevalence of metabolic syndrome (MetS) among 1779 U.S. cancer survivors using data from the National Health and Nutrition Examination Survey (NHANES, 2005-2016). Diet quality was assessed using the Healthy Eating Index 2015 (HEI-2015). Higher HEI-2015 scores were linked to significantly lower MetS prevalence (OR: 0.51, 95% CI: 0.32-0.80). Specifically, a higher intake of seafood and plant proteins, and fatty acids, coupled with a reduced intake of added sugars, was associated with decreased odds of MetS prevalence (OR: 0.93; 95% CI, 0.86-0.99) in cancer survivors. Additionally, a better diet quality was linked to lower prevalence of high waist circumference, elevated triglycerides, reduced high-density lipoprotein (HDL) cholesterol and high fasting glucose levels (OR, 0.44; 95% CI, 0.27-0.72). These results suggest that adopting healthy dietary habits may prevent MetS in cancer survivors.

Recompensation in MASLD-related cirrhosis via metabolic bariatric surgery

The prognosis of patients with decompensated cirrhosis is poor, with significantly increased liver-related mortality rates. With the rising tide of decompensated cirrhosis associated with metabolic dysfunction-associated steatotic liver disease (MASLD), the role of metabolic bariatric surgery (MBS) in achieving hepatic recompensation is garnering increasing attention. However, the complexity of preoperative assessment, the risk of postoperative disease recurrence, and the potential for patients to experience surgical complications of the MBS present challenges. In this opinion article we analyze the potential of MBS to induce recompensation in MASLD-related cirrhosis, discuss the mechanisms by which MBS may affect recompensation, and compare the characteristics of different MBS procedures; we highlight the therapeutic potential of MBS in MASLD-related cirrhosis recompensation and advocate for research in this complex area.

Dietary calcium intake in relation to metabolic syndrome in adults: A systematic review and dose-response meta-analysis of epidemiological studies with GRADE assessment

Numerous studies have examined the relationship of calcium intake and metabolic syndrome (MetS) in adults in previous decades; but the results were inconsistent across different societies. This systematic review and dose-response meta-analysis assessed the relation between calcium consumption and MetS in adults. We did a systematic search of all articles published up to July 2023 in Scopus, PubMed/Medline, ISI Web of Science electronic databases, and Google Scholar. Observational studies investigated the association between dietary calcium (Ca) intake and MetS in adults were eligible to be included. For computing the estimates, a random effects model was applied. Combining 24 effect size from 17 investigations (15 cross-sectional and two cohort studies) with 74,720 participants and 18,200 cases showed that highest versus lowest level of dietary Ca intake was related to 23% significant decreased odds of MetS (OR = 0.77; 95% CI: 0.66, 0.89). Linear dose-response analysis of estimates from 12 investigations showed that each 100 mg/day increment in dietary Ca intake was associated with 3% marginally significant decreased odds in MetS (OR = 0.97; 95%CI: 0.93, 1.01). In nonlinear dose-response analysis of 12 studies with 67,896 participants, a significant association between dietary calcium intake and MetS was found (Pnonlinearity <0.001); such that 500 mg/day dietary calcium intake was related to maximum decrease in odds of MetS. According to this meta-analysis, the likelihood of MetS was significantly lower in adults with higher level of dietary calcium intake. Further large-scale prospective cohort investigations are needed to obtain stronger and more accurate results.

Nanotechnology and Artificial Intelligence in Dyslipidemia Management-Cardiovascular Disease: Advances, Challenges, and Future Perspectives

This narrative review explores emerging technologies in dyslipidemia management, focusing on nanotechnology and artificial intelligence (AI). It examines the current treatment recommendations and contrasts them with the future prospects enabled by these innovations. Nanotechnology shows significant potential in enhancing drug delivery systems, enabling more targeted and efficient lipid-lowering therapies. In parallel, AI offers advancements in diagnostics, cardiovascular risk prediction, and personalized treatment strategies. AI-based decision support systems and machine learning algorithms are particularly promising for analyzing large datasets and delivering evidence-based recommendations. Together, these technologies hold the potential to revolutionize dyslipidemia management, improving outcomes and optimizing patient care. In addition, this review covers key topics such as cardiovascular disease biomarkers and risk factors, providing insights into the current methods for assessing cardiovascular risk. It also discusses the current understanding of dyslipidemia, including pathophysiology and clinical management. Together, these insights and technologies hold the potential to revolutionize dyslipidemia management, improving outcomes and optimizing patient care.

Associations between accurate measures of adiposity and fitness, blood proteins, and insulin sensitivity among South Asians and Europeans

Objective

South Asians (SAs) may possess a unique predisposition to insulin resistance (IR). We explored this possibility by investigating the relationship between 'gold standard' measures of adiposity, fitness, selected proteomic biomarkers, and insulin sensitivity among a cohort of SAs and Europeans (EURs).

Methods

A total of 46 SAs and 41 EURs completed 'conventional' (lifestyle questionnaires, standard physical exam) as well as 'gold standard' (dual energy X-ray absorptiometry scan, cardiopulmonary exercise test, and insulin suppression test) assessments of adiposity, fitness, and insulin sensitivity. In a subset of 28 SAs and 36 EURs, we also measured the blood-levels of eleven IR-related proteins. We conducted Spearman correlation to identify correlates of steady-state plasma glucose (SSPG) derived from the insulin suppression test, followed by multivariable linear regression analyses of SSPG, adjusting for age, sex and ancestral group.

Results

Sixteen of 30 measures significantly associated with SSPG, including one conventional and eight gold standard measures of adiposity, one conventional and one gold standard measure of fitness, and five proteins. Multivariable regressions revealed that gold standard measures and plasma proteins attenuated ancestral group differences in IR, suggesting their potential utility in assessing IR, especially among SAs.

Conclusion

Ancestral group differences in IR may be explained by accurate measures of adiposity and fitness, with specific proteins possibly serving as useful surrogates for these measures, particularly for SAs.

Plasma Lipid Profile Among Perimenopausal Latvian Women in Relation to Dietary Habits

Background/Objectives: Hormonal changes throughout a woman's life cycle significantly affect serum lipid levels. Alterations in the serum lipid profile can increase the risk of cardiovascular diseases (CVDs). Additionally, nutrition and dietary habits are crucial for managing dyslipidemia. The current study evaluated the association between dietary habits and plasma lipid profiles among perimenopausal women in Latvia. Methods: The randomized clinical trial involved perimenopausal women (n = 61) aged 49 ± 3 years with moderately high low-density lipoprotein cholesterol (LDL-C) levels of 3.61 ± 0.30 mmol L-1. A series of questionnaires were completed, including a questionnaire on the subject's demographic, anthropometric, lifestyle, health, physical activity, and dietary factors, a 24 h food diary, a 72 h food diary, and a food-frequency questionnaire (FFQ). Blood testing was conducted for all participants, which included total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), alanine aminotransferase (ALAT), and glucose level analyses. Results: The consumption of refined sugar, honey, syrup, and jam demonstrated a strong positive association with higher levels of remnant cholesterol (β = 0.462, p ≤ 0.05) and non-high-density lipoprotein cholesterol (non-HDL-C) (β = 0.395, p ≤ 0.05). Similarly, the consumption of fruit juices is associated with increased LDL-C (β = 0.303, p ≤ 0.05) and non-HDL-C (β = 0.285, p ≤ 0.05). Conversely, higher meat and poultry consumption negatively correlates with TC levels (β = -0.290, p ≤ 0.05). Conclusions: This underscores the need for further examination to understand the impact of dietary habits on lipid profile.

Diet Quality, Metabolic Syndrome, and Nativity Status: Elucidating Metabolic Advantage and Disadvantage Among Non-US-Native and US-Native Populations Using NHANES Data (2013-2018)

BACKGROUND/OBJECTIVES

Nutrient-poor diet quality is a major driver of the global burden of metabolic syndrome (MetS). The US ranks among the lowest in diet quality and has the highest rate of immigration, which may present unique challenges for non-US-native populations who experience changes in access to health-promoting resources. This study examined associations among MetS, nativity status, diet quality, and interaction effects of race-ethnicity among Hispanic, Asian, Black, and White US-native and non-US-native adults.

METHODS

We examined data from 5482 adult participants (≥20 years of age) in the National Health and Nutrition Examination Survey (2013-2018). MetS (per the ATP III panel guidelines) was assessed continuously (MetS z-score) and dichotomously. Dietary recalls were used to compute HEI-2015 scores. Nativity status and sociodemographic variables were assessed. Age-adjusted and multivariate-adjusted logistic regressions were conducted to examine the associations between nativity status and MetS and interaction effects by race-ethnicity.

RESULTS

Non-US-native participants displayed more guideline-adherent diet quality (55.23% vs. 49.38%, p < 0.001) compared to their US-native counterparts-even when stratified by racial-ethnic groups. US-native participants had larger waist circumferences and elevated triglyceride levels. Non-US-native Black Americans had a 60% lower risk of having MetS even after adjusting for diet quality (OR: 0.39, 95% CI: 0.17, 0.88) compared to their US-native counterparts. For MetS components, non-US-native Asian participants reported a lower risk for dyslipidemia, while non-US-native multiracial participants had higher triglycerides.

CONCLUSIONS

Non-US-native groups display better diet quality compared to their US-native counterparts. However, the findings suggest that diet quality alone does not account for nativity-related cardiometabolic disparities, particularly in US-native Black Americans, thus necessitating interventions targeting the social determinants of health.

Metabolic syndrome index measurement tool (MSI): scale development, reliability and validity study

AIM

Identifying the risks of metabolic syndrome (MetS) can lead to early targeted interventions and thus contribute to improved quality of life by reducing the risk of developing MetS, diabetes or heart disease in the future. We aimed to develop a valid and reliable measurement tool to measure the MetS risk of the population.

MATERIALS AND METHODS

In the methodological study, an item pool was created by reviewing the literature. Pre-application was performed after the weighting of the items whose content validity was ensured by taking expert opinions. Data were collected from 43 patients with MetS from a state hospital affiliated to the Ministry of Health and 405 individuals without MetS from the community, from a total of 448 individuals using the Individual Information Form, Finnish Diabetes Risk Scale (FINDRISC) and Metabolic Syndrome Index (MSI). The data obtained were evaluated using SPSS 22.0 and MedCalc 19.1 statistical programmes. Scale discrimination was analyzed by independent samples t-test between the upper and lower 27% groups. The cut-off point of the scale score in predicting the diagnosis of MetS was tested by ROC analysis. Correlation analysis was performed with the parallel form for criterion validity.

RESULTS

As a result of the ROC analysis, a perfectly compatible scale with a sensitivity of 100%, a specificity of 85.43% and a cut-off score of 48 was obtained. When the correlation analyses between MSI and FINDRISC scores were examined for criterion validity, a positive moderate (r = 0.632, p < 0.001) correlation was found between FINDRISC and MSI. When the discrimination of the scale was analysed, it was found that there was a significant difference between the lower 27% and upper 27% groups (p < 0.05) and it was revealed that the MSI made sensitive measurements to discriminate.

CONCLUSIONS

The MSI scale is a valid and reliable tool for early detection of MetS risk.

Common Dietary Patterns Among Female Employees Participating in the Persian Cohort Study (Mashhad) and Their Relationship With Metabolic Syndrome

Background

The protective effect of a healthy diet against chronic diseases has been confirmed in several primary studies. This study identifies the dominant food patterns using factor analysis and determining its relationship with metabolic syndrome in female employees participating in the Persian cohort study.

Methods

Female participants with metabolic syndrome (based on the National Cholesterol Education Program (NCEP ATP III) were studied using a cross-sectional design. Demographic, clinical and anthropometric information of the subjects were analyzed after checking the inclusion and exclusion criteria. Also, dietary intake based on the food frequency questionnaire (FFQ) was extracted from the participants' records.

Results

Waist circumference and HDL were significantly correlated with the healthy food pattern (p < 0.05). In the unadjusted model, a significant relationship was observed between healthy food patterns and low HDL (p = 0.035, OR = 0.674, 95% CI for OR: 0.467-0.973). After adjusting for confounding factors, a significant relationship was observed between low HDL and the third and fourth quartiles of healthy food pattern (p < 0.001, OR = 420, 95% CI for OR: 0.257-0.684, and p < 0.001, OR = 0.294, 95% CI for OR: 0.148-0.585, respectively), indicating that being in the third and fourth quartiles of dietary health was associated with 58% and 70.6% decreased risk of low HDL, respectively.

Conclusions

The results indicated that only healthy dietary patterns could have a preventive role against low HDL criterion of the metabolic syndrome among women.

Predicting dyslipidemia in Chinese elderly adults using dietary behaviours and machine learning algorithms

OBJECTIVES

We aimed to predict dyslipidemia risk in elderly Chinese adults using machine learning and dietary analysis for public health.

STUDY DESIGN

This cross-sectional study includes 13,668 Chinese adults aged 65 or older from the 2018 Chinese Longitudinal Healthy Longevity Survey.

METHODS

Dyslipidemia prediction was carried out using a variety of machine learning algorithms, including Support Vector Machine (SVM), Extreme Gradient Boosting (XGBoost), Random Forest (RF), Gaussian Naive Bayes (GNB), Gradient Boosting Machine (GBM), Adaptive Boosting Classifier (AdaBoost), Light Gradient Boosting Machine (LGBM), and K-Nearest Neighbour (KNN), as well as conventional logistic regression (LR).

RESULTS

The prevalence of dyslipidemia among eligible participants was 5.4 %. LGBM performed best in predicting dyslipidemia, followed by LR, XGBoost, SVM, GBM, AdaBoost, RF, GNB, and KNN (all AUC > 0.70). Frequency of nut product consumption, childhood water source, and housing types were key predictors for dyslipidemia.

CONCLUSIONS

Machine learning algorithms that integrated dietary behaviours accurately predicted dyslipidemia in elderly Chinese adults. Our research identified novel predictors such as the frequency of nut product consumption, the main source of drinking water during childhood, and housing types, which could potentially prevent and control dyslipidemia in elderly adults.

Probiotics: A Potential Strategy for Preventing and Managing Cardiovascular Disease

Probiotics are gaining recognition as a viable strategy for mitigating cardiovascular risk factors. Specifically, recent studies highlight their potential benefits in managing cholesterol levels, blood pressure, and inflammation, which are critical components in the prevention of cardiovascular diseases (CVD). This comprehensive review aims to elucidate the impact of probiotic consumption on major cardiovascular risk factors, including individuals with hypertension, type II diabetes mellitus, metabolic syndrome, hypercholesterolemia, and in secondary prevention in coronary artery disease. Scientific evidence based on human studies suggests that probiotic consumption is associated with positive effects on anthropometric measures, inflammation markers, blood pressure, glucose metabolism markers, lipid profiles, and endothelial function. However, these findings should be interpreted pragmatically and acknowledge the significant variability in results. This variability may be attributed to factors such as probiotic composition (single strain or multiple strains), the characteristics of the delivery matrix (food, capsules, and sachets), the duration of the intervention, the dosage regimen, and baseline health profiles of the participants. Incorporating probiotics as part of a comprehensive and healthy lifestyle approach can be considered a feasible strategy for both the prevention and management of CVD. However, further research is needed on factors influencing the effect of probiotics, such as: (i) optimal probiotic strain(s), (ii) appropriate dosage, (iii) duration of treatment, (iv) optimal delivery vehicle, and (v) sex-specific differences.

Body Mass Index mediates the associations between dietary approaches to stop hypertension and obstructive sleep apnea among U.S. adults

Background

The Dietary Approaches to Stop Hypertension (DASH) are associated with reduced cardiovascular, diabetes risk, but the effect on obstructive sleep apnea (OSA) is uncertain.

Methods

This study used data from the National Health and Nutrition Examination Survey (NHANES). DASH score was assessed through 24-h dietary recall interviews, and OSA diagnosis in individuals was based on predefined criteria. Logistic regression analysis was used to assess the association between DASH and OSA. Restricted cubic spline (RCS) analysis was used to investigate the dose-response relationship between DASH score and OSA risk. And comprehensive subgroup and mediation analyses were performed.

Results

Among the 14,978 participants, 27.01% had OSA. DASH scores had a negative association with the risk of OSA (OR = 0.91, 95%CI: 0.88-0.95, p < 0.01). Next, we divided DASH scores into quintiles groups. In comparison to the reference group Q1, groups Q5 had adjusted OR values of 0.63 (95%CI: 0.52-0.76, p < 0.01). Subgroup analyses revealed that this association was consistent across different groups. Further mediation analyses showed that the associations of DASH with OSA risk parallelly mediated by the above Body Mass Index (BMI) 33.4%,95%CI (20.6-46.2%) (all p < 0.05). The restricted cubic spline (RCS) analysis indicated a significant dose-response relationship between DASH diet and OSA risk.

Conclusion

These findings suggested that DASH decreased OSA risk, which was possibly and partly mediated by BMI.

Nutrition information and the menopause: An online survey of perimenopausal and menopausal women

OBJECTIVE

This study aimed to explore where perimenopausal and menopausal women get their nutrition information from, and how reliable they perceive these sources to be.

STUDY DESIGN

This was a cross-sectional study that used an online survey to collect data about nutrition information seeking habits. The survey was generated using the Qualtrics software and promoted via social media. The convenience sample included women over the age of 40 years living in the UK. Main outcome measures: Quantitative data.

RESULTS

Two hundred and sixty-nine responses were analysed. The majority of respondents were over the age of 50, and from a white British background. Online sources were most commonly used by women to access nutrition information, namely official websites such as the British Menopause Society (BMS) and National Health Service (NHS) websites. The majority of participants believed that these, along with research papers, were the most reliable sources. However, receiving nutrition information from healthcare professionals was most likely to cause women to change their behaviour towards nutrition. The majority of women were interested in receiving targeted menopausal nutrition information, and this would ideally be from official websites or their healthcare professionals.

CONCLUSIONS

Findings from this study suggest that women predominantly rely on online sources for information about nutrition, perceiving official websites as reliable sources. There is a demand among women for tailored nutritional guidance during the menopausal transition, emphasising the importance of providing accessible and targeted resources to support women's health needs during this life stage.

Metabolic syndrome therapy in pediatric age - between classic and modern. From diets to pipeline drugs

The metabolic syndrome, made up of the sum of the entities that define it (obesity, hypertension, dyslipidemias and non-alcoholic hepatic steatosis) has gained an important place in the research of the last decades. This aspect is mainly due to the complexity of management in pediatric practice. The main directions in his approach therefore bring together the concern of counteracting the noise or systemic, of the multiple intercurrents at the physiopathological level, as well as the negative imprint exerted on the quality of life. Its appearance and evolution are currently controversial topics, but the influence of genetic predisposition and lifestyle (diet, physical activity, psychological balance) are certainties. Considering the escalation of the incident at the global level, it is self-evident that it is necessary to know the pathogenesis and practice countermeasures for prophylactic or therapeutic purposes. The present work aims to summarize general aspects related to the metabolic syndrome encountered in pediatric age, with an emphasis on complementary therapeutic perspectives and their effectiveness, by analyzing the latest data from the specialized literature, accessed with the help of international databases (e.g., PubMed, Web of Science, Scopus, Embase, Google Scholar).

Healthy Lifestyle Changes Improve Cortisol Levels and Liver Steatosis in MASLD Patients: Results from a Randomized Clinical Trial

Background: Steatotic liver disease associated with metabolic dysfunction (MASLD) affects up to about 30% of the general adult population and is closely related to obesity and the metabolic syndrome. Cortisol, a stress-related hormone contributing to hepatic fat accumulation and insulin resistance, also promotes progression of the disease. The study aims to investigate the impact of lifestyle modifications on cortisol levels and hepatic steatosis in patients with MASLD. Methods: In a 16-week three-arm randomized trial, 42 patients were randomly assigned to three groups who received dietary advice (CG), dietary advice combined with aerobic exercise (AE + DA), or dietary advice with high-intensity interval training (HIIT + DA). Before the start, after 2 months of intervention, and at the end of the project, medical evaluations, routine biochemical assessments, and psychological questionnaires were analyzed. At baseline and at the end of 4 months, hepatic steatosis was evaluated by Fibroscan®. Results: In the study population, severe hepatic steatosis (74%) and obesity (98%) were prevalent at the beginning of the study. A statistically significant (p-value = 0.001) reduction in circulating cortisol levels was observed over time in the two groups doing exercise, especially in HIIT + DA (p-value = 0.006). Hepatic steatosis, assessed by Fibroscan®, disappeared in 10 participants (CAP value < 248, p-value = 0.003). CAP values and waist circumference decreased in all groups, statistically significantly in the AE + DA group (p-value = 0.005; p-value = 0.04, respectively). Conclusions: The study emphasizes the benefits of combining diet and exercise in managing MASLD. HIIT + DA significantly decreased cortisol levels, while AE + DA was the most potent intervention for reducing hepatic steatosis.

Changes in the triglyceride-glucose-body mass index estimate the risk of hypertension among the middle-aged and older population: a prospective nationwide cohort study in China in the framework of predictive, preventive, and personalized medicine

Background

Hypertension is a major modifiable cause of cardiovascular diseases and premature death worldwide. The triglyceride-glucose-body mass index (TyG-BMI), as a novel indicator, has been proposed for assessing hypertension risk. Nevertheless, a paucity of studies has explored the predictive potential of dynamic TyG-BMI for hypertension. The purpose of this study was to investigate whether cumulative TyG-BMI could better predict hypertension incidence and explore the interplay between TyG and BMI in hypertension development. From the perspective of predictive, preventive, and personalized medicine (PPPM/3PM), we assumed that dynamic monitoring of TyG-BMI level and joint assessment of TyG and BMI provide novel insights for individual risk assessment, targeted prevention, and personalized intervention of cardiovascular diseases.

Methods

Using data from the China Health and Retirement Longitudinal Study (CHARLS), a nationwide cohort conducted between 2011 and 2018, the changes in TyG-BMI between 2012 and 2015 were categorized into four groups by K-means clustering analysis. Cumulative TyG-BMI was also divided into four levels based on quartile cutoffs. Logistic regression and restricted cubic spline analyses were performed to examine the associations of different TyG-BMI classes with hypertension. Mediating and interactive analyses were utilized to discern the mutual effects between TyG and BMI in hypertension development.

Results

A total of 2891 participants were enrolled, among whom 386 (13.4%) developed hypertension during a median 36.5-month follow-up period. Logistic regression analysis revealed that, compared to participants with persistently low TyG‑BMI, an increased risk of hypertension was observed among those with a moderate (odds ratio (OR) = 1.60, 95% confidence interval (CI) 1.15 to 2.22), a higher (OR = 1.93, 95% CI 1.28 to 2.89), and the highest TyG‑BMI (OR = 2.33, 95% CI 1.35 to 4.03). A positive linear association of cumulative TyG-BMI with hypertension was discovered (P for non-linear = 0.343). Furthermore, TyG partially mediated the relationship between BMI and hypertension, accounting for 13.18% of the total effect. The joint effect of BMI and TyG was positively affiliated to hypertension development.

Conclusions

This study demonstrated a significant positive association between dynamic TyG-BMI and hypertension among the Chinese middle-aged and older population. In the context of PPPM/3PM, long-term monitoring of TyG-BMI could assist in identifying individuals at high risk of hypertension, strengthening primary prevention efforts and facilitating prompt intervention strategies. In addition, this study revealed the mutual effect of TyG and BMI on hypertension development, which provides a novel approach for mitigating the risk of cardiovascular diseases via addressing metabolic disorders, thereby enhancing effective prevention and targeted intervention.

Supplementary Information

The online version contains supplementary material available at 10.1007/s13167-024-00380-6.

Diet Quality Scores, Obesity and Metabolic Syndrome in Children and Adolescents: A Systematic Review and Meta-Analysis

PURPOSE OF REVIEW

We aimed to examine the relationship between various diet quality scores and obesity and Metabolic Syndrome (MetS) in children and adolescents.

RECENT FINDINGS

Obesity and MetS, which increase the risk of type 2 diabetes and cardiovascular disease from childhood through adolescence, have been associated with adherence to various diet quality scores. A systematic search was performed in PubMed/Medline, Scopus, SciELO, Embase, and Cochrane, covering the period until March 2024. Two researchers evaluated 3,519 studies according to the inclusion criteria. Finally, 73 articles that analysed the relationship between diet quality scores and obesity and MetS were included, and 6 of them were included in a meta-analysis. Children younger than 12 years old showed statistically significant differences indicating a higher Mediterranean diet (MD) score adherence compared to those with a low score adherence for BMI (MD = 0.33 kg/m2, 95% CI: 0.01, 0.64) and WC values (MD = 1.21 cm, 95% CI: 0.50, 1.93). Additionally, in the meta-regression analysis, boys showed stronger associations for BMI, z-score BMI and WC (β = 19.82, 95% CI: 17.62, 22.03, β = 0.64, 95% CI: 0.33, 0.96 and β = 67.03, 95% CI: 57.29, 76.77, respectively). Studies in this review suggest an association between high adherence to different diet quality scores and low BMI. Meta-analysis assessing the association between adherence to the MD and BMI, and WC, showed a protective effect of the MD pattern against obesity outcomes. This systematic review and meta-analyses provided evidence on the effect of the diet quality on obesity and MetS in children and adolescents.

Effect of anthocyanins on metabolic syndrome through interacting with gut microbiota

Metabolic syndrome, as a complex pathological condition, is caused by a series of pathogenic factors and has become a global public health challenge. Anthocyanins, a natural water-soluble flavonoid pigment, have attracted much attention due to their antioxidant, anti-inflammatory, and anticancer biological activities. After ingestion, a majority of anthocyanins is not directly absorbed but rather reaches the colon. Hence, the exertion of their biological benefits is closely intertwined with the role played by gut microbiota. In this review, we introduce the pathogenesis and intervention methods of metabolic syndrome, as well as the interaction between anthocyanins and gut microbiota. We also discuss the therapeutic potential of anthocyanins through gut microbiota in addressing a range of metabolic syndrome conditions, including obesity, type 2 diabetes mellitus, cardiovascular diseases, non-alcoholic fatty liver disease, inflammatory bowel disease, polycystic ovary syndrome, osteoporosis, and cancer.

Prevalence, Risk Factors, and Clinical Management of Disease-Related Malnutrition in Hospitalized Patients: A Descriptive Analysis Using GLIM and SGA Criteria

OBJECTIVES

This study aimed to assess the prevalence and risk factors associated with disease-related malnutrition (DRM) in hospitalized patients using the Subjective Global Assessment (SGA) and Global Leadership Initiative on Malnutrition (GLIM) criteria. Additionally, we sought to identify key determinants of moderate and severe malnutrition.

METHODS

A retrospective analysis was conducted on 1036 adult patients hospitalized in a tertiary care hospital between August 2019 and November 2020. Nutritional status was evaluated using both the SGA and GLIM criteria. Data on demographic characteristics, comorbidities, dietary intake, and gastrointestinal symptoms were collected. Logistic regression models were employed to identify risk factors for DRM, and multivariate analysis was used to determine independent predictors.

RESULTS

The prevalence of DRM was 63.3% according to GLIM and 64.8% according to SGA. Moderate malnutrition was observed in 22.6% of patients, while 40.7% were classified as having severe malnutrition, and severe weight loss was noted in 34.5% of the subjects. The key risk factors for DRM included male sex (OR 1.67, p < 0.0001), non-oncological gastrointestinal conditions (OR 1.48, p = 0.041), infectious diseases (OR 1.66, p = 0.007), inadequate ingestion (OR 5.13, p < 0.0001), and the presence of gastrointestinal symptoms (OR 3.06, p < 0.0001). Individualized diets were found to have a protective effect, while central parenteral nutrition significantly reduced the risk of severe DRM (OR 0.610, p = 0.014). In the final adjusted model, sex (p < 0.0001), ingestion (p < 0.0001), and gastrointestinal symptoms (p < 0.0001) emerged as the most significant independent predictors of DRM.

CONCLUSIONS

The high prevalence of DRM in hospitalized patients emphasizes the importance of routine nutritional screening and personalized interventions. Proactive management of key risk factors such as inadequate intake and gastrointestinal symptoms is crucial to mitigating malnutrition and improving patient outcomes.

Metabolic syndrome in association with novel dietary index, metabolic parameters, nesfatin-1 and omentin-1

BACKGROUND

Metabolic syndrome is a prevalent and common health problem and numerous studies have revealed the role of diet and lifestyle change in prevention of metabolic syndrome. However, the novel dietary index, cardioprotective index (CPI) and its association with metabolic syndrome is not investigated yet. In the current study, we evaluated the association between metabolic syndrome and its components, CPI, Nesfatin-1 and Omentin-1in a cross-sectional study.

METHODS

Three hundred forty eight overweight and obese individuals with metabolic syndrome were recruited. Subjects underwent anthropometric and laboratory assays including metabolic markers, Nesfatin-1 and Omentin-1 with commercial kits.

RESULTS

Those at the first tertile of CPI had lower high density lipoprotein concentrations (HDL) and higher low density lipoprotein concentrations (LDL), triglyceride (TG), systolic and diastolic blood pressures (SBP, DBP) levels compared with those at the highest tertiles (P < 0.05). After adjustment for the confounding effects of age, sex, body mass index, physical activity and total calorie intake, LDL lost its significance across CPI tertiles. Moreover, serum total cholesterol, insulin and insulin resistance were not significant across CPI tertiles neither in crude nor in adjusted models (P > 0.05). Additionally, being at the third tertile of CPI was accompanied with significantly higher Nesfatin-1 and Omentin-1 levels compared with lowest tertiels (P < 0.05) in crude and confounder - adjusted models.

CONCLUSIONS

To our findings, CPI was in positive relationship with metabolic parameters, blood pressure, Nesfatin-1 and Omentin-1 levels in metabolic syndrome. Further future studies will help to elaborate the causality.

CLINICAL TRIAL NUMBER

Not applicable.

Decoding senescence of aging single cells at the nexus of biomaterials, microfluidics, and spatial omics

Aging has profound effects on the body, most notably an increase in the prevalence of several diseases. An important aging hallmark is the presence of senescent cells that no longer multiply nor die off properly. Another characteristic is an altered immune system that fails to properly self-surveil. In this multi-player aging process, cellular senescence induces a change in the secretory phenotype, known as senescence-associated secretory phenotype (SASP), of many cells with the intention of recruiting immune cells to accelerate the clearance of these damaged senescent cells. However, the SASP phenotype results in inducing secondary senescence of nearby cells, resulting in those cells becoming senescent, and improper immune activation resulting in a state of chronic inflammation, called inflammaging, in many diseases. Senescence in immune cells, termed immunosenescence, results in further dysregulation of the immune system. An interdisciplinary approach is needed to physiologically assess aging changes of the immune system at the cellular and tissue level. Thus, the intersection of biomaterials, microfluidics, and spatial omics has great potential to collectively model aging and immunosenescence. Each of these approaches mimics unique aspects of the body undergoes as a part of aging. This perspective highlights the key aspects of how biomaterials provide non-cellular cues to cell aging, microfluidics recapitulate flow-induced and multi-cellular dynamics, and spatial omics analyses dissect the coordination of several biomarkers of senescence as a function of cell interactions in distinct tissue environments. An overview of how senescence and immune dysregulation play a role in organ aging, cancer, wound healing, Alzheimer's, and osteoporosis is included. To illuminate the societal impact of aging, an increasing trend in anti-senescence and anti-aging interventions, including pharmacological interventions, medical procedures, and lifestyle changes is discussed, including further context of senescence.

Advances in plant-derived extracellular vesicles: isolation, composition, and biological functions

Plant-derived extracellular vesicles (PDEVs) are nanoscale vesicles released from plant cells into the extracellular space. While similar in structure and function to mammalian-derived EVs, PDEVs are unique due to their origin and the specific metabolites they carry. PDEVs have gained significant attention in recent years, with numerous reports isolating different PDEVs from various plants, each exhibiting diverse biological functions. However, the field is still in its early stages, and many issues need further exploration. To better develop and utilize PDEVs, it is essential to have a comprehensive understanding of their characteristics. This review provides an overview of recent advances in PDEV research. It focuses on the methods and techniques for isolating and purifying PDEVs, comparing their respective advantages, limitations, and application scenarios. Furthermore, we discuss the latest discoveries regarding the composition of PDEVs, including lipids, proteins, nucleic acids, and various plant metabolites. Additionally, we detail advanced studies on the multiple biological functions of PDEVs. Our goal is to advance our understanding of PDEVs and encourage further exploration in PDEV-based science and technology, offering insights into their potential applications for human health.

Impact of gut microbiota on metabolic syndrome and its comprising traits: a two-sample mendelian randomization study

BACKGROUND

The prevalence of metabolic syndrome is on the rise globally. Understanding the etiology and discovering potential treatment target have become a priority. Observational data have linked gut microbiota with metabolic syndrome and its comprising traits. However, whether these relations underlie causal effects remains unclear.

METHODS

Using Inver Variance Weighted (IVW) as primary analysis method, we performed two-sample Mendelian Randomization (MR) analyses to explore the causal relationship between gut microbiota and metabolic syndrome with its comprising traits. Methods including MR-Egger regression, MR Pleiotropy RESidual Sum and Outlier (MR-PRESSO), Weighted Mode, and Weighted Median were chosen for additional MR analysis to test the robustness of MR results. Cochran's IVW Q test and leave-one-out IVW analysis tested the heterogeneity among instrumental variables (IVs). Steiger filtering was utilized to exclude all IVs with reverse causality. Genome-wide association study (GWAS) data used in this study were all from the largest respective GWAS studies available.

RESULTS

Out of 1172 tests, a total of 16 associations with evidence of causality were identified after sensitivity analyses, but only 3 remained after multiple testing correction. Class Melainabacteria (β = 0.02, adjusted P = 0.01) with affiliated order Gastranaerophilales (β = 0.02, adjusted P = 1.20*10- 3) and genus Eubacterium hallii (β = 0.03, adjusted P = 0.03) showed a positive effect on abdominal obesity. All effect sizes were small (abs(β) < 0.1). All causal relationships identified were unidirectional.

CONCLUSIONS

Given the study's limitations, we found little evidence supporting a large causal effect, i.e. absolute effect size > 0.1, of gut microbial taxa abundance on metabolic syndrome and its comprising traits. This study also suggests that previously reported associations between gut microbiota and metabolic syndrome with its comprising traits may not necessarily lead to causal relations.

CLINICAL TRIAL NUMBER

Not applicable.

Lactobacillus plantarum and Bifidobacterium longum Alleviate High-Fat Diet-Induced Obesity and Depression/Cognitive Impairment-like Behavior in Mice by Upregulating AMPK Activation and Downregulating Adipogenesis and Gut Dysbiosis

Background/Objective: Long-term intake of a high-fat diet (HFD) leads to obesity and gut dysbiosis. AMP-activated protein kinase (AMPK) is a key regulator of energy metabolism. Herein, we investigated the impacts of Lactobacillus (Lactiplantibacillus) plantarum P111 and Bifidobacterium longum P121, which suppressed dexamethasone-induced adipogenesis in 3T3 L1 cells and increased lipopolysaccharide-suppressed AMPK activation in HepG2 cells, on HFD-induced obesity, liver steatosis, gut inflammation and dysbiosis, and depression/cognitive impairment (DCi)-like behavior in mice. Methods: Obesity is induced in mice by feeding with HFD. Biomarker levels were measured using immunoblotting, enzyme-linked immunosorbent assay, and immunofluorescence staining. Results: Orally administered P111, P121, or their mix LpBl decreased HFD-induced body weight gain, epididymal fat pad weight, and triglyceride (TG), total cholesterol (TC), and lipopolysaccharide levels in the blood. Additionally, they downregulated HFD-increased NF-κB activation and TNF-α expression in the liver and colon, while HFD-decreased AMPK activation was upregulated. They also suppressed HFD-induced DCi-like behavior and hippocampal NF-κB activation, NF-κB-positive cell population, and IL-1β and TNF-α levels, while increasing the hippocampal BDNF-positive cell population and BDNF level. The combination of P111 and P122 (LpBl) also improved body weight gain, liver steatosis, and DCi-like behavior. LpBl also mitigated HFD-induced gut dysbiosis: it decreased Desulfovibrionaceae, Helicobacteriaceae, Coriobacteriaceae, and Streptococcaceae populations and lipopolysaccharide production, which were positively correlated with TNF-α expression; and increased Akkermansiaceae, Bifidobacteriaceae, and Prevotellaceae populations, which were positively correlated with the BDNF expression. Conclusions: P111 and/or P121 downregulated adipogenesis, gut dysbiosis, and NF-κB activation and upregulatde AMPK activation, leading to the alleviation of obesity, liver steatosis, and DCi.

Medical Comorbidities, Nutritional Markers, and Cardiovascular Risk Markers in Youth With ARFID

OBJECTIVE

Avoidant/restrictive food intake disorder (ARFID) is common among populations with nutrition-related medical conditions. Less is known about the medical comorbidity/complication frequencies in youth with ARFID. We evaluated the medical comorbidities and metabolic/nutritional markers among female and male youth with full/subthreshold ARFID across the weight spectrum compared with healthy controls (HC).

METHOD

In youth with full/subthreshold ARFID (n = 100; 49% female) and HC (n = 58; 78% female), we assessed self-reported medical comorbidities via clinician interview and explored abnormalities in metabolic (lipid panel and high-sensitive C-reactive protein [hs-CRP]) and nutritional (25[OH] vitamin D, vitamin B12, and folate) markers.

RESULTS

Youth with ARFID, compared with HC, were over 10 times as likely to have self-reported gastrointestinal conditions (37% vs. 3%; OR = 21.2; 95% CI = 6.2-112.1) and over two times as likely to have self-reported immune-mediated conditions (42% vs. 24%; OR = 2.3; 95% CI = 1.1-4.9). ARFID, compared with HC, had a four to five times higher frequency of elevated triglycerides (28% vs. 12%; OR = 4.0; 95% CI = 1.7-10.5) and hs-CRP (17% vs. 4%; OR = 5.0; 95% CI = 1.4-27.0) levels.

DISCUSSION

Self-reported gastrointestinal and certain immune comorbidities were common in ARFID, suggestive of possible bidirectional risk/maintenance factors. Elevated cardiovascular risk markers in ARFID may be a consequence of limited dietary variety marked by high carbohydrate and sugar intake.

Tea (Camellia sinensis L.) flower polysaccharide attenuates metabolic syndrome in high-fat diet induced mice in association with modulation of gut microbiota

There is a growing body of evidence suggesting that dietary polysaccharides play a crucial role in preventing metabolic syndrome (MetS) through their interaction with gut microbes. Tea (Camellia sinensis L.) flower polysacchride (TFPS) is a novel functional compound known for its diverse beneficial effects in both vivo and vitro. To further investigate the effects of TFPS on MetS and gut microbiota, and the possible association between gut microbiota and their activities, this study was carried out on mice that were fed a high-fat diet (HFD) and given oral TFPS at a dose of 400 and 800 mg/kg·body weight (BW)/d, respectively. TFPS treatment significantly mitigated HFD-induced MetS, evidenced by reductions in body weight, fat accumulation, plasma levels of total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and pro-inflammatory cytokines tumor necrosis factor α (TNF-α), interleukin 6 (IL-6), and IL-1β, along with an increase in plasma IL-10 levels. Furthermore, TFPS induced alterations in the diversity and composition of HFD-induced gut microbiota. Specifically, TFPS influenced the relative abundance of 11 genera, including Lactobacillus and Lactococcus, which showed strong correlations with metabolic improvements and likely contributed to the amelioration of MetS. In conclusion, TFPS exhibits promising prebiotic properties in preventing MetS and regulating gut microbiota.

The effect of different dietary restriction on weight management and metabolic parameters in people with type 2 diabetes mellitus: a network meta-analysis of randomized controlled trials

BACKGROUND

Type 2 diabetes mellitus (T2DM) is a globally prevalent chronic condition. Individuals with T2DM are at increased risk of developing complications associated with both macrovascular and microvascular pathologies. These comorbidities reduce patient quality of life and increase mortality. Dietary restriction is a principal therapeutic approach for managing T2DM. This study assessed the effects of various dietary regimens on body weight and metabolic profiles in T2DM patients, aiming to determine the most beneficial interventions for enhancing clinical outcomes and overall well-being.

METHODS

We conducted a literature search in PubMed, Embase, and Web of Science from 2003 to April 15, 2024. The risk of bias was assessed via the Revised Cochrane risk-of-bias tool for randomized trials (RoB2). The certainty of the evidence was appraised via the confidence in network meta-analysis (CINeMA) framework. Intermittent fasting (IF) was directly compared with continuous energy restriction (CER) via Review Manager 5.4. Network meta-analysis was statistically assessed via R Studio 4.3.3 and STATA 14.0.

RESULTS

Eighteen studies involving 1,658 participants were included. The network meta-analysis indicated that intermittent energy restriction, the twice-per-week fasting, time-restricted eating, fasting-mimicking diets (FMD), and CER interventions were more effective than conventional diets. Direct comparisons revealed that IF was as effective as CER for reducing glycated haemoglobin A1c, body weight, and body mass index. The results of the cumulative ranking analysis demonstrated that FMD had the greatest combined intervention effect, followed by TRE in terms of overall effectiveness.

CONCLUSIONS

Both IF and CER exert positive influences on weight control and metabolic profile enhancement in individuals with T2DM, with FMD as part of IF demonstrating the greatest impact. To substantiate these findings, more rigorous randomized controlled trials that directly compare the effects of the different IF regimens with one another and with the CER regimen are needed.

Targeting lncRNA MALAT1: A Promising Approach to Overcome Metabolic Syndrome

Metabolic syndrome (MetS) is a collection of metabolic abnormalities including insulin resistance, atherogenic dyslipidemia, central obesity, and hypertension. Recently, long noncoding RNAs (lncRNAs) have emerged as pivotal regulators of metabolic balance, influencing the genes associated with MetS. Although the prevalence of insulin resistance is rising, leading to an increased risk of type 2 diabetes mellitus (T2DM) and its vascular complications, there is still a notable gap in understanding the role of lncRNAs in the context of clinical diabetes. Among lncRNAs, lung adenocarcinoma metastasis-associated transcript 1 (MALAT1) has been identified as a significant regulator of metabolism-related disorders, including T2DM and cardiovascular disease (CVD). This review explores the mechanism of lncRNA MALAT1 and suggests that targeting it could offer a promising strategy to combat MetS, thereby enhancing the prognosis of MetS.

Modulation of the gut microbiota by dietary intervention with Acanthocereus tetragonus improves the health status of Wistar rats with metabolic syndrome

The gastrointestinal tract is an ecosystem with heterogeneous patterns, distributions, and environments, resulting in different microbial compositions in each gut segment. The relationship between diet and microbiota determines this heterogeneity. Consumption of diets high in fat and carbohydrates (HLHC) is associated with gut dysbiosis, low microbial diversity, and metabolic syndrome (MetS). Functional fiber consumption improves the profile and diversity of the gut microbiota (GM); it stimulates the production of short-chain fatty acids (SCFAs), which act as signaling molecules that maintain the gut barrier integrity and induce hormone synthesis that regulates satiety and glucose metabolism, reducing some MetS parameters. The effect of a dietary intervention with Acanthocereus tetragonus (At), a cactus rich in fiber, antioxidants, amino acids, and minerals traditionally consumed by the Mexican population, is reported here. For this purpose, Wistar rats were randomly divided into three study groups: a control (C) group, a MetS group, and an At-supplemented group. In the MetS and At groups, an HLHC was administered for 12 weeks, inducing MetS. After 18 weeks, stool samples were collected for microbiota sequencing. HLHC administration favored Firmicutes and decreased the abundance of Bacteriodetes at the phylum level in the MetS group. At the genus level, the dietary intervention with At increased the presence of Roseburia, Ruminococcus, Blautia, Bacteroides, and Christensenella, reflecting the effect of A. tetragonus consumption on GM. At diet administration reduced body weight; the plasma glucose, insulin, and lipid levels; and insulin resistance.

Link Between Metabolic Syndrome, Blood Lipid Markers, Dietary Lipids, and Survival in Women with Early-Stage Breast Cancer

BACKGROUND/OBJECTIVES

Nearly 10% of cancers could be prevented through dietary changes. In addition, breast cancer (BC) is the most common cancer in women worldwide. Inadequate diet may lead to several metabolic abnormalities, including metabolic syndrome (MS). The goal of our study is to evaluate the link between survival after BC and MS, as well as diet lipids and circulating lipids.

METHODS

This study was performed in an early-stage BC cohort (n = 73): MS, dietary lipids, and circulating biological parameters, including leucocyte expression in cholesterol carriers (ATP-binding cassette transporter ABCA1, ABCG1), were determined before any medication intervention. The data of each patient were analyzed using univariate logistic regression and are expressed by HR, 95%CI [5th-95th]. All these parameters were explored with survival parameters using Cox regression analyses.

RESULTS

Overall survival (OS) and invasive disease-free survival (iDFS) were significantly longer for the women without metabolic syndrome with HR 4.7 [1.11-19.92] and p = 0.036, and 3.58 [1.23-10.44] and p = 0.019, respectively. The expression of ABCG1 in peripheral leucocytes, an ATP-binding cassette transporter involved in cholesterol and phospholipid trafficking, is significantly associated with iDFS (1.38 [1.1-1.9], p = 0.0048). MS is associated with more pejorative survival parameters in early-stage breast cancer. Paraoxonase (or PON) activities differ according to PON gene polymorphism, but also diet. A link between PON activities and survival parameters was suggested and needs to be clarified.

CONCLUSIONS

This study emphasizes the link between survival parameters of early-stage breast cancer, metabolic syndrome, and some parameters related to lipid metabolism.

Plant-Based Dietary Protein Is Associated with Lower Metabolic Syndrome Risk in Division III Female Athletes: A Pilot Study

BACKGROUND

College athletes are often overlooked for metabolic syndrome (MetS), as their increased physical activity is assumed to reduce their disease risk. However, energy or macronutrient imbalance has been shown to increase risk independent of activity. The purpose of this investigation was to assess the current dietary habits of Division III female athletes and determine their associations with body composition and MetS. Secondly, we sought to determine whether dietary intake and dietary protein source (i.e., animal- and plant-based, ABP and PBP) and quality were associated with MetS, as estimated by the Simple Method for Quantifying Metabolic Syndrome (siMS) score and the siMS risk score, and whether protein pacing was associated with body composition in Division III female athletes.

METHODS

Stepwise linear regression determined whether age (years), body mass (kg), body mass index (BMI; kg/m2), ABP (g/d), PBP (g/d), ABP:PBP, ratio of high-quality to low-quality ABP (ABP QR), relative energy intake (kcal/kg/d), and relative protein, carbohydrate, and fat intake (g/kg/d) were predictors of siMS score and siMS risk score.

RESULTS

Twenty-five athletes (19.6 ± 1.3 years; 65.9 ± 7.0 kg; 23.5 ± 2.0 kg/m2; ABP 71.7 ± 28.2 g/d; PBP 30.0 ± 12.2 g/d) were included in the analyses. An inverse relationship was observed between PBP and the siMS score (F1, 22 = 5.498, p = 0.028) and siMS risk score (F1, 22 = 7.614, p = 0.011). The models explained 20% and 26% of the variance in siMS score and siMS risk score, respectively.

CONCLUSIONS

PBP was associated with lower MetS risk in Division III female athletes, while ABP, regardless of quality, was unrelated. These associations were independent of physical activity in this cohort of Division III female athletes.

Effects of dietary habits and catheterization type on breast cancer-related lymphedema: a retrospective cohort study

BACKGROUND

Understanding the factors that contribute to variability in breast cancer-related lymphedema (BCRL) is an important first step in developing targeted interventions to improve quality of life in breast cancer patients. Although previous research studies have has identified many risk factors for BCRL, dietary habits and catheterization type have rarely been studied until the present.

AIM

This study aims to explore the effects of nursing factors such as dietary habits and catheterization type on breast cancer-related lymphedema (BCRL).

METHODS

This retrospective cohort study included 1,476 breast cancer patients who underwent surgery between January 1, 2012, and September 1, 2020. Lymphedema was assessed with a validated self-report questionnaire. All research data were obtained from medical records and a follow-up database. Multivariate Cox regression was conducted to explore the effects of dietary habits and catheterization type on BCRL.

RESULTS

The results showed an increased risk for BCRL among breast cancer patients who followed a high-fat diet prehospitalization (HR = 2.47; 95% CI = 1.55-3.94; P < 0.001), indwelling totally implantable venous access ports (TIVAPs) compared with indwelling needles (HR = 0.56; 95% CI = 0.35-0.90;P = 0.017) or indwelling peripherally inserted central catheters (PICCs) (HR = 0.69; 95% CI = 0.45-1.05; P = 0.086).

CONCLUSION

High-fat diet pre-hospitalization was an independent risk factor for lymphedema. The TIVAPs did not exert a protective effect on lymphedema compared with the PICC and indwelling needle. This study finding offers new insights to develop targeted interventions to decrease the incidence of lymphedema.

Association between the Korean Healthy Diet Score and Metabolic Syndrome: Effectiveness and Optimal Cutoff of the Korean Healthy Diet Score

OBJECTIVES

Although the prevalence of metabolic syndrome has increased among Koreans, the specific health benefits of the Korean Healthy Diet score remain unexplored. This study aimed to evaluate the association between the Korean Healthy Diet score and metabolic syndrome and to identify the optimal cutoff of the Korean Healthy Diet score for reducing metabolic syndrome prevalence.

METHODS

This cross-sectional study used data from 11,403 participants of the seventh and eighth Korea National Health and Nutrition Examination Survey. The Korean Healthy Diet score was calculated based on adherence to 13 dietary components. A logistic regression analysis was used to determine the association between the Korean Healthy Diet score and metabolic syndrome, as well as to identify the optimal cutoff values for the Korean Healthy Diet score.

RESULTS

The average Korean Healthy Diet score was significantly lower in participants with metabolic syndrome than in those without metabolic syndrome (5.03 vs. 5.14, p = 0.016). A one-point increase in the Korean Healthy Diet score was associated with a reduction in metabolic syndrome prevalence (odds ratio: 0.95, 95% confidence interval: 0.91-0.98). The optimal cutoff for the Korean Healthy Diet score was identified as >7 points, particularly showing significantly decreased prevalence of hypertriglyceridemia and low high-density lipoprotein cholesterol.

CONCLUSIONS

The Korean Healthy Diet score was inversely associated with metabolic syndrome prevalence, and the identified optimal cutoff values can serve as a practical tool for public health interventions aimed at reducing the risk of metabolic syndrome.

Dietary patterns according to gender and ethnicity associated with metabolic syndrome: a systematic review and meta-analysis

The objective of this systematic review (SR) with meta-analysis (MA) was to identify the dietary patterns of the population, regarding ethnicity and gender, and their association with the metabolic syndrome and its risk factors (MetS-RF). The literature search was performed using Medline, Scopus, Ebsco, SciELO, and BVS databases. Studies with adult participants that identified dietary patterns associated with MetS-RF were included. Pooled odds ratio (OR) and 95%CI were calculated using a random-effect, generic inverse variance method. Statistical heterogeneity and publication bias were explored. The dietary patterns were classified as healthy or unhealthy. Studies were categorized into three groups: Women (all ethnicities), Afro-descendant (men and women), and General Population (both genders and ethnicity). Among the articles found (n=8,496), 22 integrated the SR and 11 the MA. The adherence to the healthy dietary pattern was negatively associated (protective factor) with MetS-RF only in the General Population (OR=0.77; 95%CI: 0.61-0.98). Nevertheless, the unhealthy dietary pattern was associated with the higher prevalence of MetS-RF in all analyzed groups. It was concluded that an unhealthy eating pattern increases the chances of SM-RF in adults, regardless of gender and ethnicity.

Another piece of puzzle for the human microbiome: the gut virome under dietary modulation

The virome is the most abundant and highly variable microbial consortium in the gut. Because of difficulties in isolating and culturing gut viruses and the lack of reference genomes, the virome has remained a relatively elusive aspect of the human microbiome. In recent years, studies on the virome have accumulated growing evidence showing that the virome is diet-modulated and widely involved in regulating health. Here, we review the responses of the gut virome to dietary intake and the potential health implications, presenting changes in the gut viral community and preferences of viral members to particular diets. We further discuss how viral-bacterial interactions and phage lifestyle shifts shape the gut microbiota. We also discuss the specific functions conferred by diet on the gut virome and bacterial community in the context of horizontal gene transfer, as well as the import of new viral members along with the diet. Collating these studies will expand our understanding of the dietary regulation of the gut virome and inspire dietary interventions and health maintenance strategies targeting the gut microbiota.

Skin carotenoid scores and metabolic syndrome in a general Japanese population: the Hisayama study

BACKGROUND

Higher vegetable intake is being promoted as an initiative to prevent lifestyle-related diseases. Carotenoids are yellow or red pigment components and are widely present in vegetables. Since ingested carotenoids accumulate in the skin, skin carotenoid levels are a quantitative indicator of vegetable intake. Recently, noninvasive optical sensors for assessing skin carotenoid levels were developed. We here examined the association between skin carotenoid scores measured using optical sensors and the presence of metabolic syndrome.

METHODS

A total of 1618 individuals (604 men and 1014 women) aged ≥ 40 years (mean age 63.1 years) participated in the study. Skin carotenoid scores were determined using a noninvasive optical sensor based on multiple spatially resolved reflectance spectroscopy. Metabolic syndrome was defined based on the Joint Scientific Statement criteria developed by six international scientific societies. Multivariable-adjusted logistic regression models were used.

RESULTS

The prevalence of metabolic syndrome was 31.3% (n = 506). A remarkably strong association was found between higher skin carotenoid scores and lower prevalence of metabolic syndrome after adjusting for confounders. The multivariable-adjusted odds ratio for the presence of metabolic syndrome in individuals with the highest quartile of skin carotenoid scores was 0.39 (95% confidence interval, 0.28-0.55) compared to those with the lowest quartile.

CONCLUSIONS

Our findings suggest that higher skin carotenoid scores measured by non-invasive optimal sensors are significantly associated with a lower likelihood of having metabolic syndrome in the general Japanese population.

The therapeutic effect and possible mechanisms of alginate oligosaccharide on metabolic syndrome by regulating gut microbiota

Metabolic syndrome (MetS) is a disease condition incorporating the abnormal accumulation of various metabolic components, including overweight or abdominal obesity, insulin resistance and abnormal glucose tolerance, hypertension, atherosclerosis, or dyslipidemia. It has been proved that the gut microbiota and microbial-derived products play an important role in regulating lipid metabolism and thus the onset and development of MetS. Previous studies have demonstrated that oligosaccharides with prebiotic effects, such as chitosan oligosaccharides, can regulate the structure of the microbial community and its derived products to control weight and reduce MetS associated with obesity. Alginate oligosaccharides (AOS), natural products extracted from degraded alginate salts with high solubility and extensive biological activity, have also been found to modulate gut microbiota. This review aims to summarize experimental evidence on the positive effects of AOS on different types of MetS while providing insights into mechanisms through which AOS regulates gut microbiota for preventing and treating MetS.