Dietary Strategies for Metabolic Syndrome: A Comprehensive Review

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.

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.

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.

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.

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.

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.

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.

Effectiveness of Prebiotics and Mediterranean and Plant-Based Diet on Gut Microbiota and Glycemic Control in Patients with Prediabetes or Type 2 Diabetes: A Systematic Review and Meta-Analysis

BACKGROUND

A high-calorie diet results in the development of prediabetes (PD) or type 2 diabetes mellitus (T2DM). This diet has been reported to cause changes in microbial composition, concentration levels of glycemic parameters, and immune cells or inflammatory cytokines. This systematic review and meta-analysis aimed to evaluate the effects of prebiotics, as well as Mediterranean and plant-based dietary interventions, on gut microbiota composition and glucose homeostasis in individuals with PD or T2D.

METHODS

This systematic review and meta-analysis was developed according to the 2020 PRISMA guidelines and checklist. PubMed, EBSCOhost and Google Scholar were the three databases that were used to search for electronically published studies. Data extraction was conducted and examined by the reviewers and all the eligible studies were selected. To test for the quality and biases of the included studies, the Downs and Black checklist was used, followed by the use of Review Manager 5.4. A forest plot was used for meta-analysis and sensitivity analysis. The strength of the evidence was assessed using the Grading of Recommendation Assessment, Development and Evaluation approach.

RESULTS

Overall, eight studies met the inclusion criteria: seven focused on patients with T2D, and one focused on patients with PD. The prebiotic dietary intervention did not have a statistically significant effect on glycemic control, including fasting blood glucose (FBG) and glycated hemoglobin (HbA1c). However, one study investigating the Mediterranean diet reported a significant effect on glycemic control. Both prebiotic and Mediterranean dietary interventions were found to beneficially influence gut microbial composition in the intervention groups compared to the placebo groups. No studies assessed the impact of a plant-based diet on microbial composition and glucose parameters.

CONCLUSIONS

This review indicated that dietary intervention with a prebiotic or Mediterranean diet shows to beneficially improve the gut microbiota composition of Firmicutes, Bacteroidetes and Bifidobacteria in patients with PD or T2D. However, their beneficial effects on FBG and HbA1c were less clear and uncertain due to limited reports, particularly regarding the Mediterranean dietary intervention.

Influence of dietary cholesterol on metabolic syndrome risk in middle-aged Korean adults: using the Korean Genome and Epidemiology Study (KoGES)

BACKGROUND

The association between dietary cholesterol and metabolic diseases remains controversial. However, the majority of studies focus on egg intake, and there is a limitation in the availability of prospective cohort studies. Our study examined the association between dietary cholesterol and the incidence risk of metabolic syndrome (MetS) in middle aged adults using large prospective cohort study in Republic of Korea.

METHODS

The Health Examinees cohort from the Korean Genome and Epidemiology Study was used from baseline to follow-up. Dietary cholesterol intake was assessed by the validated semi-quantitative food frequency questionnaire. Participants were classified as quintile groups according to adjusted dietary cholesterol for total energy intake. MetS was defined as more than 3 of the 5 components of MetS. Hazard ratio (HR) and 95% confidence intervals (CI) for MetS were evaluated by multivariable cox regression analyses.

RESULTS

Of the total 40,578 participants, metabolic syndrome developed in 4,172 (10.28%) individuals during an average follow-up period of approximately 4.76 years. Dietary cholesterol did not exhibit a significant association with the risk of MetS after adjusting for potential confounding factors, but a trend was observed indicating an increased risk with higher intake (p for trend = 0.044). Among the components of MetS, the incidence risk of high waist circumference (HR: 1.164, 95% CI: 1.049-1.290), high blood pressure (HR: 1.188, 95% CI: 1.075-1.313), high serum triglyceride (HR: 1.132, 95% CI: 1.044-1.227) and high fasting blood glucose (HR: 1.217, 95% CI: 1.132-1.308) in the group that consumed the highest dietary cholesterol intake was increased compared with the group that consumed the lowest dietary cholesterol intake. Dose-response relationship suggested a positive linear association between dietary cholesterol intake and the risk of high waist circumference (p-linearity = 0.004), blood pressure (p-linearity = 0.012), and triglycerides (p-linearity = 0.005).

CONCLUSION

This study suggests a positive association between dietary cholesterol intake and the risk of MetS and its components (abdominal obesity, hypertension, hypertriglyceridemia, and hyperglycemia) in middle-aged Korean adults.

Raman Spectroscopic Analysis of Steviol Glycosides: Spectral Database and Quality Control Algorithms

Besides all sharing an extraordinary high (i.e., up to ~450 times) sweetening power as compared to sucrose and while presenting strong similarities in their molecular structures, molecules belonging to the family of diterpene glycosides (i.e., the secondary metabolites of Stevia rebaudiana) differ in specific structural details that strongly impact on their levels of sweetness and bitter aftertaste. Given the nutritional and pharmacological benefits of steviol secondary metabolites as natural dietetic and anti-diabetic remedies, extraction and purification of steviol glycosides from plant material are nowadays widely spread among many countries. However, an unpleasant bitter aftertaste, which is linked to a genetic variation in human bitter taste receptors, hampers the full exploitation of such benefits and calls for a prompt improvement in organoleptic property control of stevia products. A deeper understanding of the molecular structure of different steviol glycosides and the consequent development of promptly measurable criteria for the organoleptic performance of their mixtures will support processing optimization and control of taste profiles within desired yields. The present research aimed at establishing Raman spectroscopic algorithms for quantitative characterizations of raw stevia-based sweetener products. First, a series of twelve high-purity diterpene glycosides were analyzed by high spectrally resolved Raman spectroscopy and their spectra analyzed in order to establish a complete Raman library of molecular structures. Then, quantitative spectroscopic parameters were built up and applied to characterize the organoleptic property of five different commercially available samples including the recently developed Rebaudioside M isoform. Raman spectroscopy was confirmed as a versatile analytical technique that could be used for quantitative quality control tasks on the production line and for prompt in situ characterizations of purchased products.

Association of Dietary Patterns with Metabolic Syndrome among Middle-Aged Adults in Shiraz, Iran: Shiraz Heart Study (SHS)

Introduction

Metabolic syndrome (MetS) is a noncommunicable disease with a high burden, including the development of type 2 diabetes mellitus, cardiovascular events, and death. It is characterized by abdominal obesity, elevated blood pressure, increased fasting plasma glucose levels, hypertriglyceridemia, and reduced levels of high-density lipoprotein (HDL) cholesterol. MetS is preventable by modifying lifestyle and dietary patterns, which are major contributing factors. This research aimed to investigate the dietary patterns of the Shiraz Heart Study (SHS) and their associations with the occurrence of MetS and its components among middle-aged residents of Shiraz.

Methods

Based on data from the Shiraz Heart Study (SHS), a prospective cohort study, the nutritional status of 1,675 participants was assessed using a food frequency questionnaire (FFQ). Three food patterns were extracted from the analysis named as vegan, western, and carbohydrate. Subjects were categorized into three levels for three major dietary patterns: low, moderate, and high, based on their adherence to each pattern. After adjusting the effect of co-founder variables, the relationship between dietary patterns, and the risk of developing MetS was analyzed.

Results

Of the 1,675 participants, 728 (43.5%) of them were male. The prevalence of MetS was 47.2%. Multivariate logistic regression analysis showed that high adherence to the vegan pattern was negatively associated with the occurrence of MetS (P value <0.001), while low adherence to the western pattern was also negatively associated (P value <0.05).

Conclusion

Healthier diets, such as vegan diets, are significantly related to lower rates of MetS among the 40-70-year-old people in Shiraz, Iran.

Comparison of Incidence of Metabolic Syndrome and Five Obesity- and Lipid-Linked Indicators for Predicting Metabolic Syndrome Among Normal-Weight and Overweight Adults

Purpose

Metabolic syndrome (MetS) is an increasingly prevalent issue in China's public health landscape. Few studies have investigated the metabolic syndrome (MetS) in overweight people. We proposed to analyze and contrast the occurrence of MetS in normal-weight and overweight individuals and identify potential indicators for forecasting MetS in adults in Zhejiang Province.

Methods

This cohort study included 359 adults aged 40-65 years and followed up for five years in Zhejiang Province. The study assessed the predictive capabilities of five indicators linked to obesity and lipid levels, namely body mass index (BMI), waist-to-height ratio (WHtR), triglyceride-glucose index (TyGi), and their combined indices (TyG-BMI, TyG-WHtR). The evaluation was done employing the area under the Receiver Operating Characteristic (ROC) Curve (AUC). DeLong test was applied to compare area under different ROC curves.We evaluated the relationships between five variables and MetS using multivariate logistic regression.

Results

In normal-weight individuals, the five-year cumulative incidence of MetS was 21.85%, but in overweight people, it was 60.33%. After adjusting for confounding factors, BMI, WHtR, TyGi, TyG-BMI, and TyG-WHtR were independently linked to MetS in normal-weight individuals, while BMI, TyGi, TyG-BMI, and TyG-WHtR were independently linked to MetS in overweight individuals. In normal-weight individuals, the WHtR (AUC=0.738 and optimal threshold value =0.469) and TyG-WHtR (AUC=0.731 and optimal threshold value =4.121) had the larger AUC, which was significantly greater than that of the different three indicators. The TyG-BMI (AUC=0.769 and optimal threshold value = 211.099) was the best predictor of MetS in overweight individuals.

Conclusion

The five-year cumulative incidence of MetS in overweight people was approximately triple that of normal-weight people in Zhejiang Province. In the overweight population, the TyG-BMI performed better than the other indices in predicting MetS. WHtR and TyG-WHtR outperformed BMI, TyGi, and TyG-BMI in anticipating MetS in a normal-weight population.

Dietary and Lifestyle Insulinemic Potential Indices and Risk Factors of Metabolic Syndrome Among Overweight and Obese Individuals: A Cross-Sectional Study

Background

As a worldwide pandemic, metabolic syndrome (MetS) is related with high disease burden. The emergence of multiple chronic diseases can be attributed to unfavorable dietary and lifestyle choices made by individuals, with hyperinsulinemia and insulin resistance as the underlying causes. Current study sought to assess the relationship between the Empirical Dietary Index for Hyperinsulinemia (EDIH) and the Empirical Lifestyle Index for Hyperinsulinemia (ELIH) and MetS risk factors.

Methods

This cross-sectional study involved 339 individuals between the ages of 20 and 50, who were either obese or overweight, and were recruited from Tabriz, Iran. In this study, a validated semi-quantitative Food Frequency Questionnaire (FFQ) with 168 questions was used to assess individuals' food consumption. Blood tests were performed to assess total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), triglyceride (TG) levels, as well as blood glucose and insulin levels.

Results

After multivariable adjustment, among tertiles of EDIH, systolic blood pressure (SBP) and TG were significantly different. Also, SBP, diastolic blood pressure (DBP), and HDL-C significantly differed across tertiles of ELIH. In multivariate-adjusted models, individuals classified in the highest tertile of EDIH demonstrated elevated ORs in relation to FBG levels [OR: 1.035 (1.004-1.068; P < .05)], and the second tertile of ELIH was inversely associated with SBP [OR: 0.966 (0.935-0.999; P < .05)], DBP [OR: 0.972 (0.948-0.997; P < .05)], TG in the model I [OR: 0.991 (0.983-0.999; P < .05)], and model II [OR: 0.991 (0.983-0.999; P < .05)].

Conclusion

Considering the findings of our study, higher insulinemic dietary potential, indicated by EDIH, can be related to higher odds of FBG and decreased odds of TG as risk factors of MetS. Furthermore, our findings suggest that individuals with a higher ELIH may potentially exhibit lower SBP and DBP levels. Nevertheless, further experimental and long-term investigations are necessary to fully comprehend this association.

Development and Evaluation of Solidified Supersaturated SNEDDS Loaded with Triple Combination Therapy for Metabolic Syndrome

The present study aimed to develop and optimize solidified supersaturated self-nanoemulsifying drug delivery systems (SNEDDS) for the combined administration of antihypertensive, antihyperglycemic, and antihyperlipidemic drugs to enhance their solubility and dissolution during the treatment of metabolic syndrome. Various SNEDDS formulations were prepared and subjected to pharmaceutical assessment. The solubility of candesartan (CC), glibenclamide (GB), and rosuvastatin (RC) in SNEDDS and supersaturated SNEDDS formulations was evaluated. The optimized formulation was solidified using Syloid adsorbent at different ratios. Pharmaceutical characterization of the formulations included particle size, zeta potential, in-vitro dissolution, PXRD, FTIR, and SEM analysis. The prepared optimized formulation (F6) was able to form homogeneous nanoemulsion droplets without phase separation, which is composed of Tween 20: PEG-400: Capmul MCM (4: 3: 3). It was mixed with 5% PVP-K30 to prepare a supersaturated liquid SNEDDS formulation (F9). In addition, it was found that the addition of PVP-K30 significantly increased solubility CC and GB from 20.46 ± 0.48 and 6.73 ± 0.05 to 27.67 ± 1.72 and 9.45 ± 0.32 mg/g, respectively. In-vitro dissolution study revealed that liquid and solid SNEDD formulations remarkably improved the dissolution rates of CC, GB, and RC compared to pure drugs. XRPD and FTIR analysis revealed that all drugs present in an amorphous state within prepared solidified supersaturated SNEDDS formulation. SEM images showed that liquid SNEDDS formulation was successfully adsorbed on the surface of Syloid. Overall, optimized F9 and solidified supersaturated SNEDDS formulations showed superior performance in enhancing drug solubility and dissolution rate. The present study revealed that the proposed triple combination therapy of metabolic syndrome holds a promising strategy during the treatment of metabolic syndrome. Further in-vivo studies are required to evaluate the therapeutic efficacy of prepared solidified supersaturated SNEDDS formulation.

Sex-specific dietary patterns and their association with metabolic syndrome: Insights from a cross-sectional analysis

AIMS

This study aims to identify a posteriori dietary patterns with a sex approach and to evaluate their association with metabolic syndrome criteria.

METHODS

Cross-sectional study conducted in 6821 men and women between 55 and 75 years of age. Forty-two food groups were analyzed from dietary information collected with food frequency questionnaires, using principal component analysis and cluster analysis and then information from both statistical methods was compared. Prevalences were calculated foreach cluster group, based on the number and types of metabolic syndrome criteria they met.

RESULTS

Following principal component analysis, two dietary patterns labeled "healthy" and "unhealthy" were identified in both men and women, due to the presence of foods that are considered more or less healthy. These same dietary patterns were found in cluster analysis plus an "intermediate" cluster consisting of both healthy and unhealthy foods. The presence of metabolic syndrome is related to the "healthy" dietary pattern in women and to the "unhealthy" dietary pattern in men. Comparison of the two statistical approaches showed a high level of correlation between them (weighted Kappa = 0.703 in women and weighted Kappa = 0.691 in men).

CONCLUSIONS

Adherence to both healthy and unhealthy dietary pattern appears to be related to the development of MS. The differences found by sex make it necessary to develop interventions with a sex-specific approach.

Stachydrine, a pyrrole alkaloid with promising therapeutic potential against metabolic syndrome and associated organ dysfunction

Metabolic syndrome is a multifaceted condition marked by interconnected risk factors, significantly increasing the risk of serious diseases like cardiovascular disease, type 2 diabetes, and stroke. Effective management often demands new medications due to complexity of the conditions and limitations of current treatments. Natural compounds are increasingly recognized in drug discovery due to their vast chemical diversity, commercial availability, low cost, and minimal side effects. One such compound is stachydrine (STA), also known as proline betaine or N-dimethyl proline. This simple pyrrole alkaloid is a major constituent of the genus Leonurus and the family Lamiaceae, and it shows promise due to its potential therapeutic properties. A comprehensive review of the literature, sourced from databases such as PubMed, Scopus, SciFinder, and Google Scholar, has provided extensive information on the sources, chemistry, biosynthesis, derivatives, molecular targets, biological activities, bioavailability, and toxicity of STA. This review highlights numerous in vitro and in vivo studies that demonstrate the effectiveness of STA in various therapeutic areas, including anti-obesity, neuroprotective, nephroprotective, and cardiovascular protection, among others. The wide range of biological activities of STA is attributed to its influence on multiple molecular targets and signaling pathways, such as ACE/AngII/AT1R-TGFβ1, NF-κB, JAK/STAT, AKT/ERK, AMPK/CAMKKβ/LKB1, CaMKII/PLN, etc. which are critical in the development and progression of metabolic syndrome. Additionally, this review addresses limitations related to the pharmacokinetics and bioavailability of STA. Overall, the findings underscore the potential of STA as a therapeutic agent for metabolic syndrome and related disorders, suggesting that further clinical investigation is warranted to fully understand and utilize its benefits.

Buddleoside-rich Chrysanthemum indicum L. extract modulates macrophage-mediated inflammation to prevent metabolic syndrome induced by unhealthy diet

BACKGROUND

Metabolic syndrome (MetS) is a precursor to the development of many diseases (atherosclerosis, diabetes, etc.). It is marked by disruptions in glucose and lipid metabolism, along with hypertension. Numerous types of risk factors contribute to the development of the MetS, inflammation and insulin resistance are present throughout the metabolic abnormalities. Chrysanthemum indicum L. is a traditional Chinese plant used for both tea and medicine, known for its high content of total flavonoids, which are important secondary metabolites. Our research led to the extraction of a Buddleoside-Rich Chrysanthemum indicum L. extract (BUDE) which has demonstrated anti-inflammatory properties. Nonetheless, the specific role and mechanism of BUDE in preventing MetS remain unclear.

METHODS

The study initially evaluated the role of BUDE in preventing MetS. Subsequently, it investigated the anti-inflammatory properties of BUDE in the liver and pancreas in response to unhealthy diets. It then examined the level of insulin resistance and pancreatic β-cell function induced by inflammation. Additionally, an lipopolysaccharide (LPS)-induced macrophage inflammation model was used to further investigate the ameliorative effects of BUDE in inflammation.

RESULTS

BUDE has hypotensive, hypoglycemic and hypolipidemic effects. It can also resolve the imbalance between macrophage subpopulations, impede the triggering of the NF-κB signaling pathway, reduce the secretion of inflammatory mediators, ameliorate insulin resistance, and safeguard organs such as the liver and pancreas from inflammatory damage. These effects collectively contribute to preventing the development of MetS.

DISCUSSION

BUDE has the ability to modulate macrophage-mediated inflammation, leading to improved insulin resistance. Additionally, it delivers antihypertensive, hypoglycemic, and hypolipidemic effects, offering a potential for preventing MetS.

Agave-Laurate-Bioconjugated Fructans Decrease Hyperinsulinemia and Insulin Resistance, Whilst Increasing IL-10 in Rats with Metabolic Syndrome Induced by a High-Fat Diet

Metabolic syndrome (MetS) comprises a cluster of metabolic risk factors, which include obesity, hypertriglyceridemia, high blood pressure, and insulin resistance. The purpose of this study was to evaluate the effects of laurate-bioconjugated fructans on pro- and anti-inflammatory cytokines in Wistar rats with MetS induced by a high-fat diet. Laurate-bioconjugated fructans were synthesized with agave fructans, immobilized lipase B, and vinyl laureate as the acylant. Groups were fed a standard diet (NORMAL), a high-fat diet (HFD), or a high-fat diet plus laurate-bioconjugated fructans (FL PREV) for 9 weeks. A fourth group received a high-fat diet for 6 weeks, followed by simultaneous exposure to a high-fat diet and laurate-bioconjugated fructans for 3 additional weeks (FL REV). The dose of laurate-bioconjugated fructans was 130 mg/kg. Laurate-bioconjugated fructans reduced food and energy intake, body weight, body mass index, abdominal circumference, adipose tissue, adipocyte area, serum triglycerides, insulin, insulin resistance, and C-reactive protein but they increased IL-10 protein serum levels and mRNA expression. The impact of laurate-bioconjugated fructans on zoometric and metabolic parameters supports their potential as therapeutic agents to improve obesity, obesity comorbidities, insulin resistance, type 2 diabetes mellitus, and MetS.

The effect of PAP on UACR and metabolic indexes in patients with MS and OSAHS

PURPOSE

To investigate the effects of positive airway pressure (PAP) device on urinary albumin to creatinine ratio (UACR) and metabolic indexes in patients with metabolic syndrome (MS) and obstructive sleep apnea-hypopnea syndrome (OSAHS).

METHODS

This study is a retrospective cohort study. Grouped according to whether to use PAP treatment, there were 25 cases in the PAP group and 44 cases in the no OSAHS treatment group. The PAP group received positive airway pressure device and routine treatment of MS. The no OSAHS treatment group received routine treatment of OSAHS and MS. The treatment period is 3 months.

RESULTS

1. The PAP group demonstrated significant reductions in Body Mass Index (BMI), Waist circumference (WC), Neck circumference (NC), Visceral fat area (VFA), Fasting C peptide (FCP), high-sensitivity C-reactive protein (hs-CRP), and UACR compared to the no OSAHS treatment group, with significant differences (P all <0.05). Among them, the UACR in the PAP group decreased significantly (from 86.05(52.55,131.61)mg/g to 16.76(8.70,25.12)mg/g, P<0.001). 2. Linear regression analysis using the decrease in UACR values as the dependent variable demonstrated a positive linear relationship with the decrease in BMI, VFA, fasting insulin (FINS), and homeostasis model assessment of insulin resistance (HOMA-IR). Furthermore, multiple linear regression analysis indicated that the decrease in VFA (B=0.537 [95% confidence interval, 0.084 to 0.989]; P = 0.021) and HOMA-IR (B=1.000 [95% confidence interval, 0.082 to 1.917]; P = 0.033) values independently correlated with decrease in UACR values.

CONCLUSIONS

PAP treatment can reduce UACR in patients with MS and OSAHS, and has the effect of improving metabolic disorders. The decrease of UACR in patients may be related to the decrease of visceral fat and the improvement of insulin resistance.

The effect of microbiome-modulating therapeutics on glucose homeostasis in metabolic syndrome: A systematic review, meta-analysis, and meta-regression of clinical trials

BACKGROUND

Metabolic syndrome (MetS) is a chronic disorder featuring overweight/obesity, high blood pressure, and dysfunction of lipid and carbohydrate metabolism. Microbiome-modulating probiotics, prebiotics, synbiotics and fecal microbiota transplant (FMT) are promising adjunct therapies for improving parameters of glucose homeostasis and insulinemia.

METHODS

We conducted a comprehensive systematic review, meta-analyses, and meta-regressions to investigate the effect of the abovementioned microbiome therapies on various biomarkers after screening clinical trials published through April 2023. We pooled data using random effects meta-analyses, reporting them as mean differences (MDs) with 95 % confidence intervals (CIs), and conducting univariate linear model meta-regressions.

RESULTS

Data from 21 trial comparisons across 19 studies (n = 911) revealed that, compared to placebo/control, microbiome-modulating therapies were associated with statistically significant changes in fasting plasma glucose (MD: 4.03 mg/dL [95%CI: 6.93; -1.13]; p effect = 0.006, I2 = 89.8 %), and fasting insulin (MD: 2.56 μU/mL [95%CI: 4.28; -0.84]; p effect = 0.004, I2 = 87.9 %), but not insulin resistance or sensitivity indices and HbA1c. Age, baseline BMI, baseline biomarker value, pro/synbiotic dosage, trial duration, nutraceutical type, and WHO region were factors affecting the efficacy of these interventions at producing changes in biomarkers, signaling the potential role of personalized precision medicine adjunct therapy for deranged glucose homeostasis in patients with MetS. Nevertheless, presence of heterogeneity calls for further investigation before their clinical application.

CONCLUSIONS

Probiotics, prebiotics, synbiotics and FMT supplementation improved fasting glucose and insulin in patients with MetS. Further large-scale and high-quality trials are required before potential clinical applications.

Examination of eating competence in a geo-diverse sample with metabolic syndrome

Eating competence (EatC) is an intra-individual approach to eating attitudes and behaviors associated with greater well-being. EatC research has not included persons with confirmed metabolic syndrome (MetS). Therefore, EatC of persons with MetS was explored to identify unique associations and inform implementation of MetS lifestyle interventions using baseline data from a multisite, randomized trial of a 2-year lifestyle intervention with MetS. EatC, measured with the Satter Eating Competence Inventory 2.0 (ecSI 2.0™), was examined for relationships with bioclinical measures (e.g., blood pressure, lipids), medication use, BMI, waist circumference, fruit/vegetable intake, and psychosocial factors, (e.g., stress, mindfulness). Data were collected in person and video call by trained research personnel. EatC was examined as a continuous score and as a categorical variable with ecSI 2.0™ scores ≥ 32 considered eating competent. Participants (n = 618) were predominantly female (76%), White (74%), college educated (60%). Mean age was 55.5 ± 11 y. Mean ecSI 2.0™ was 29.9 ± 7.4 and 42% were eating competent. EatC was greater for males, persons who were older and food secure. Competent eaters (vs. non-eating competent) had lower waist circumference (112.7 ± 12.5 cm vs.116.8 ± 16.0 cm; P < 0.001) and BMI (35.0 ± 6.1 vs. 37.5 ± 7.3; P < 0.001). Serum triglycerides, HDL-cholesterol, fasting blood glucose, HbA1c, and blood pressure did not differ by EatC status. Compared to non-eating competent persons, competent eaters perceived less stress, were more mindful, indicated better physical function, and more habitual vegetable intake (all P < 0.001) and sensory awareness (P < 0.05). EatC in MetS paralleled the non-MetS profile. EatC was associated with a healthier psychosocial profile, waist circumference and BMI. Findings support further research to examine the mediational or moderating influence of EatC in the treatment of MetS.

Efficacy and Tolerability of a Food Supplement Based on Zea mays L., Gymnema sylvestre (Retz.) R.br.ex Sm, Zinc and Chromium for the Maintenance of Normal Carbohydrate Metabolism: A Monocentric, Randomized, Double-Blind, Placebo-Controlled Clinical Trial

A study on 81 individuals (18-75 years old) with mildly impaired fasting blood glucose (FBG) concentrations (98-125 mg/dL) was undertaken to investigate the tolerability of a food supplement (FS) based on Zea mays and Gymnema sylvestre extracts, zinc, and chromium and its efficacy on glucose and lipid metabolism. The subjects were randomized into three groups (27 in each group) and supplemented with one or two tablet(s)/day of FS (groups 1 and 2, respectively), or two tablets/day of placebo (group 3). Blood sampling was carried out at baseline (t0) and after a 3-month treatment (t1), and biochemical parameters associated with glucose and lipid metabolism and kidney and liver toxicity were evaluated. Compared to the placebo, FBG and glycated haemoglobin (HbA1c) were significantly (p < 0.001) reduced in group 1 subjects. In contrast, at the doses of one and two tablet(s)/day, the FS exerted no effect on the other parameters examined. We conclude that in subjects with slightly impaired FBG, ingestion of a FS based on Z. mays and G. sylvestre extracts, zinc, and chromium over 3 months lowers FBG and modulates glucose homeostasis by improving glucose metabolism. These beneficial effects occur in the absence of biochemical evidence of kidney and liver toxicity.

Current advances in cancer energy metabolism under dietary restriction: a mini review

The manipulation of the energy or source of food for cancer cells has attracted significant attention in oncology research. Metabolic reprogramming of the immune system allows for a deeper understanding of cancer cell mechanisms, thereby impeding their progression. A more targeted approach is the restriction of cancer cells through dietary restriction (CR), which deprives cancer cells of the preferred energy sources within the tumor microenvironment, thereby enhancing immune cell efficacy. Although there is a plethora of CR strategies that can be employed to impede cancer progression, there is currently no comprehensive review that delineates the specific dietary restrictions that target the diverse metabolic pathways of cancer cells. This mini-review introduces amino acids as anti-cancer agents and discusses the role of dietary interventions in cancer prevention and treatment. It highlights the potential of a ketogenic diet as a therapeutic approach for cancer, elucidating its distinct mechanisms of action in tumor progression. Additionally, the potential of plant-based diets as anti-cancer agents and the role of polyphenols and vitamins in anti-cancer therapy were also discussed, along with some prospective interventions for CR as anti-tumor progression.

Biomarkers of food intake and their relevance to metabolic syndrome

Metabolic syndrome (MetS) constitutes a prevalent risk factor associated with non communicable diseases such as cardiovascular disease and type 2 diabetes. A major factor impacting the etiology of MetS is diet. Dietary patterns and several individual food constituents have been related to the risk of developing MetS or have been proposed as adjuvant treatment. However, traditional methods of dietary assessment such as 24 h recalls rely greatly on intensive user-interaction and are subject to bias. Hence, more objective methods are required for unbiased dietary assessment and efficient prevention. While it is accepted that some dietary-derived constituents in blood plasma are indicators for certain dietary patterns, these may be too unstable (such as vitamin C as a marker for fruits/vegetables) or too broad (e.g. polyphenols for plant-based diets) or reflect too short-term intake only to allow for strong associations with prolonged intake of individual food groups. In the present manuscript, commonly employed biomarkers of intake including those related to specific food items (e.g. genistein for soybean or astaxanthin and EPA for fish intake) and novel emerging ones (e.g. stable isotopes for meat intake or microRNA for plant foods) are emphasized and their suitability as biomarker for food intake discussed. Promising alternatives to plasma measures (e.g. ethyl glucuronide in hair for ethanol intake) are also emphasized. As many biomarkers (i.e. secondary plant metabolites) are not limited to dietary assessment but are also capable of regulating e.g. anti-inflammatory and antioxidant pathways, special attention will be given to biomarkers presenting a double function to assess both dietary patterns and MetS risk.

Management of Metabolic-Associated Fatty Liver Disease/Metabolic Dysfunction-Associated Steatotic Liver Disease: From Medication Therapy to Nutritional Interventions

Non-alcoholic fatty liver disease (NAFLD) is a common long-lasting liver disease that affects millions of people around the world. It is best identified with a hepatic fat build-up that ultimately leads to inflammation and damage. The classification and nomenclature of NAFLD have long been a controversial topic, until 2020 when a group of international experts recommended substituting NAFLD with MAFLD (metabolic dysfunction-associated FLD). MAFLD was then terminologically complemented in 2023 by altering it to MASLD, i.e., metabolic dysfunction-associated steatotic liver disease (MASLD). Both the MAFLD and the MASLD terminologies comprise the metabolic element of the disorder, as they offer diagnostic benchmarks that are embedded in the metabolic risk factors that underlie the disease. MASLD (as a multisystemic disease) provides a comprehensive definition that includes a larger population of patients who are at risk of liver morbidity and mortality, as well as adverse cardiovascular and diabetes outcomes. MASLD highlights metabolic risks in lean or normal weight individuals, a factor that has not been accentuated or discussed in previous guidelines. Novel antihyperglycemic agents, anti-hyperlipidemic drugs, lifestyle modifications, nutritional interventions, and exercise therapies have not been extensively studied in MAFLD and MASLD. Nutrition plays a vital role in managing both conditions, where centralizing on a diet rich in whole vegetables, fruits, foods, healthy fats, lean proteins, and specific nutrients (e.g., omega-3 fatty acids and fibers) can improve insulin resistance and reduce inflammation. Thus, it is essential to understand the role of nutrition in managing these conditions and to work with patients to develop an individualized plan for optimal health. This review discusses prevention strategies for NAFLD/MAFLD/MASLD management, with particular attention to nutrition and lifestyle correction.

Walnut supplementation increases levels of UCP1 and CD36 in brown adipose tissue independently of diet type

Dietary interventions that modulate the brown adipose tissue (BAT) thermogenic activity could represent a promising therapy for metabolic disorders. In order to examine if dietary walnuts intake regulates the expression of BAT thermogenic markers levels in healthy and metabolically challenged (fructose fed) animals, rats were initially divided into the control and fructose-fed groups. After nine weeks, these groups were subdivided into the one kept on the original regimens and the other supplemented with walnuts. High-fructose diet resulted in an increased relative BAT mass and no change in UCP1 content, while the walnut supplementation increased the amount of UCP1 in BAT, but did not affect 5-HT, NA, DHPG content and DHPG/NA ratio regardless of the diet. Moreover, the CD36 levels were increased following the walnut consumption, unlike FATP1, GLUT1, GLUT4, and glycogen content which remained unchanged. Additionally, the BAT levels of activated IR and Akt were not affected by walnut consumption, while ERK signaling was decreased. Overall, we found that walnut consumption increased UCP1 and CD36 content in the BAT of both control and metabolically challenged rats, suggesting that FFAs represent the BAT preferred substrate under the previously described circumstances. This further implies that incorporating walnuts into the everyday diet may help to alleviate some symptoms of the metabolic disorder.

Efficacy of tryushnadya churna in metabolic syndrome with obesity - A randomized double blind controlled clinical trial

BACKGROUND

Metabolic syndrome (MetS) with obesity has significant mortality and morbidity. Integrative Ayurveda management is explored for it's possible effect.

AIM

To evaluate the effect of Tryushnadi churna in the management of Metabolic syndrome with obesity.

METHODS

Study is a Randomized, Controlled, double blind, parallel group comparative clinical trial. 48 participants meeting the National Cholesterol Education Programme Adult Treatment panel 3 diagnostic criteria were recruited in the study. They were divided in two 2 groups. Placebo group were administered with Placebo 1 gm twice a day, Ayurveda diet and yoga. Tryushnadi Group were intervened with Tryushnadi churna 1 gm twice a day, Ayurveda diet and yoga. Interventions were for 90 days. Assessments criteria included Weight, BMI,Waist circumference (WC), Waist hip ratio, Skin fold thickness (SFT), Body fat, blood pressure, WHO-QOL BREF scale, Clinical Global Impression Scale (CGI)- Severity, Global improvement and Efficacy index, Fasting blood sugar (FBS) were assessed on every 30th day. Other blood parameters like Glycated haemoglobin (HbA1c), Triglycerides, High density lipoproteins (HDL), Low density lipoproteins (LDL), Total cholesterol (TC) were evaluated at pre and post study.

RESULTS

Between groups comparison showed, Tryushnadi group had significant improvements in BMI, Weight, WHOQOL-Bref and had large effect size. Both the groups showed improvement in WC, body fat, SFT, CGI severity, CGI efficacy index and improvement in quality of life in within group assessment.

CONCLUSION

Study showed that Tryushnadi churna was effective in management of MetS with Obesity. Integrated management of Ayurveda medicine, Ayurveda diet and yoga had beneficial effect.