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Dong YH, Wang ZX, Chen C, Wang PP, Fu X. A review on the hypoglycemic effect, mechanism and application development of natural dietary polysaccharides. Int J Biol Macromol 2023; 253:127267. [PMID: 37820903 DOI: 10.1016/j.ijbiomac.2023.127267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 09/20/2023] [Accepted: 10/03/2023] [Indexed: 10/13/2023]
Abstract
Diabetes mellitus (DM) as one chronic metabolic disease was greatly increased over recent decades. The major agents treating diabetes have noticeable side effects as well as the tolerability problems. The bioactive dietary polysaccharides from abundant natural resources exhibit good hypoglycemic effect with rare adverse effects, which might serve as a candidate to prevent and treat diabetes. However, the correlations between the hypoglycemic mechanism of polysaccharides and their structure were not mentioned in several studies, what's more, most of the current hypoglycemic studies on polysaccharides were based on in vitro and in vivo experiments, and there was a lack of knowledge about the effects in human clinical trials. The aim of this review is to discuss recent literature about the variety of dietary polysaccharides with hypoglycemic activity, as well the mechanism of action and the structure-function relationship are highlighted. Meanwhile, the application of dietary polysaccharides in functional foods and clinical medicine are realized with an in-depth understanding. So as to promote the exploration of dietary polysaccharides in low glycemic healthy foods or clinical medicine to prevent and treat diabetes.
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Affiliation(s)
- Yu-Hao Dong
- SCUT-Zhuhai Institute of Modern Industrial Innovation, School of Food Science and Engineering, South China University of Technology, 381 Wushan Road, Guangzhou 510640, China
| | - Zhen-Xing Wang
- College of life Science, Southwest Forestry University, Kunming 650224, China
| | - Chun Chen
- SCUT-Zhuhai Institute of Modern Industrial Innovation, School of Food Science and Engineering, South China University of Technology, 381 Wushan Road, Guangzhou 510640, China; Guangzhou Inst Modern Ind Technol, Nansha 511458, China; Guangdong Province Key Laboratory for Green Processing of Natural Products and Product Safety, Guangzhou 510640, China; Overseas Expertise Introduction Center for Discipline Innovation of Food Nutrition and Human Health (111 Center), Guangzhou, China.
| | - Ping-Ping Wang
- School of Chemical Engineering and Light Industry, Guangdong University of Technology, Guangzhou 510006, China
| | - Xiong Fu
- SCUT-Zhuhai Institute of Modern Industrial Innovation, School of Food Science and Engineering, South China University of Technology, 381 Wushan Road, Guangzhou 510640, China; Guangzhou Inst Modern Ind Technol, Nansha 511458, China; Guangdong Province Key Laboratory for Green Processing of Natural Products and Product Safety, Guangzhou 510640, China; Overseas Expertise Introduction Center for Discipline Innovation of Food Nutrition and Human Health (111 Center), Guangzhou, China.
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Derosa G, D'Angelo A, Maffioli P. The role of selected nutraceuticals in management of prediabetes and diabetes: An updated review of the literature. Phytother Res 2022; 36:3709-3765. [PMID: 35912631 PMCID: PMC9804244 DOI: 10.1002/ptr.7564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Revised: 07/04/2022] [Accepted: 07/04/2022] [Indexed: 01/05/2023]
Abstract
Dysglycemia is a disease state preceding the onset of diabetes and includes impaired fasting glycemia and impaired glucose tolerance. This review aimed to collect and analyze the literature reporting the results of clinical trials evaluating the effects of selected nutraceuticals on glycemia in humans. The results of the analyzed trials, generally, showed the positive effects of the nutraceuticals studied alone or in association with other supplements on fasting plasma glucose and post-prandial plasma glucose as primary outcomes, and their efficacy in improving insulin resistance as a secondary outcome. Some evidences, obtained from clinical trials, suggest a role for some nutraceuticals, and in particular Berberis, Banaba, Curcumin, and Guar gum, in the management of prediabetes and diabetes. However, contradictory results were found on the hypoglycemic effects of Morus, Ilex paraguariensis, Omega-3, Allium cepa, and Trigonella faenum graecum, whereby rigorous long-term clinical trials are needed to confirm these data. More studies are also needed for Eugenia jambolana, as well as for Ascophyllum nodosum and Fucus vesiculosus which glucose-lowering effects were observed when administered in combination, but not alone. Further trials are also needed for quercetin.
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Affiliation(s)
- Giuseppe Derosa
- Department of Internal Medicine and TherapeuticsUniversity of PaviaPaviaItaly,Centre of Diabetes, Metabolic Diseases, and DyslipidemiasUniversity of PaviaPaviaItaly,Regional Centre for Prevention, Surveillance, Diagnosis and Treatment of Dyslipidemias and AtherosclerosisFondazione IRCCS Policlinico San MatteoPaviaItaly,Italian Nutraceutical Society (SINut)BolognaItaly,Laboratory of Molecular MedicineUniversity of PaviaPaviaItaly
| | - Angela D'Angelo
- Department of Internal Medicine and TherapeuticsUniversity of PaviaPaviaItaly,Laboratory of Molecular MedicineUniversity of PaviaPaviaItaly
| | - Pamela Maffioli
- Centre of Diabetes, Metabolic Diseases, and DyslipidemiasUniversity of PaviaPaviaItaly,Regional Centre for Prevention, Surveillance, Diagnosis and Treatment of Dyslipidemias and AtherosclerosisFondazione IRCCS Policlinico San MatteoPaviaItaly,Italian Nutraceutical Society (SINut)BolognaItaly
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Xiao M, Jia X, Wang N, Kang J, Hu X, Goff HD, Cui SW, Ding H, Guo Q. Therapeutic potential of non-starch polysaccharides on type 2 diabetes: from hypoglycemic mechanism to clinical trials. Crit Rev Food Sci Nutr 2022; 64:1177-1210. [PMID: 36036965 DOI: 10.1080/10408398.2022.2113366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Non-starch polysaccharides (NSPs) have been reported to exert therapeutic potential on managing type 2 diabetes mellitus (T2DM). Various mechanisms have been proposed; however, several studies have not considered the correlations between the anti-T2DM activity of NSPs and their molecular structure. Moreover, the current understanding of the role of NSPs in T2DM treatment is mainly based on in vitro and in vivo data, and more human clinical trials are required to verify the actual efficacy in treating T2DM. The related anti-T2DM mechanisms of NSPs, including regulating insulin action, promoting glucose metabolism and regulating postprandial blood glucose level, anti-inflammatory and regulating gut microbiota (GM), are reviewed. The structure-function relationships are summarized, and the relationships between NSPs structure and anti-T2DM activity from clinical trials are highlighted. The development of anti-T2DM medication or dietary supplements of NSPs could be promoted with an in-depth understanding of the multiple regulatory effects in the treatment/intervention of T2DM.
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Affiliation(s)
- Meng Xiao
- State Key Laboratory of Food Nutrition and Safety, College of Food Science and Engineering, Tianjin University of Science and Technology, Tianjin, China
| | - Xing Jia
- State Key Laboratory of Food Nutrition and Safety, College of Food Science and Engineering, Tianjin University of Science and Technology, Tianjin, China
| | - Nifei Wang
- State Key Laboratory of Food Nutrition and Safety, College of Food Science and Engineering, Tianjin University of Science and Technology, Tianjin, China
| | - Ji Kang
- State Key Laboratory of Food Nutrition and Safety, College of Food Science and Engineering, Tianjin University of Science and Technology, Tianjin, China
| | - Xinzhong Hu
- College of Food Engineering & Nutrition Science, Shaanxi Normal University, Shaanxi, China
| | | | - Steve W Cui
- Guelph Research and Development Centre, AAFC, Guelph, Ontario, Canada
| | | | - Qingbin Guo
- State Key Laboratory of Food Nutrition and Safety, College of Food Science and Engineering, Tianjin University of Science and Technology, Tianjin, China
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Jovanovski E, Nguyen M, Kurahashi Y, Komishon A, Li D, Hoang Vi Thanh H, Khayyat R, Jenkins AL, Khan TA, Zurbau A, Sievenpiper J, Vuksan V. Are all fibres created equal with respect to lipid lowering? Comparing the effect of viscous dietary fibre to non-viscous fibre from cereal sources: a systematic review and meta-analysis of randomised controlled trials. Br J Nutr 2022; 129:1-13. [PMID: 35929339 DOI: 10.1017/s0007114522002355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Although compelling evidence from observational studies supports a positive association between consumption of cereal fibre and CVD risk reduction, randomised controlled trials (RCT) often target viscous fibre type as the prospective contributor to lipid lowering to reduce CVD risk. The objective of our study is to compare the lipids-lowering effects of viscous dietary fibre to non-viscous, cereal-type fibre in clinical studies. RCT that evaluated the effect of viscous dietary fibre compared with non-viscous, cereal fibre on LDL cholesterol and alternative lipid markers, with a duration of ≥ 3 weeks, in adults with or without hypercholesterolaemia were included. Medline, EMBASE, CINAHL and the Cochrane Central Register were searched through October 19, 2021. Data were extracted and assessed by two independent reviewers. The generic inverse variance method with random effects model was utilised to pool the data which were expressed as mean differences (MD) with 95 % CI. Eighty-nine trials met eligibility criteria (n 4755). MD for the effect of viscous dietary fibre compared with non-viscous cereal fibre were LDL cholesterol (MD = -0·26 mmol/l; 95 % CI: -0·30, -0·22 mmol/l; P < 0·01), non-HDL cholesterol (MD = -0·33 mmol/l; 95 % CI: -0·39, -0·28 mmol/l; P < 0·01) and Apo-B (MD = -0·04 g/l; 95 % CI: -0·06, -0·03 g/l; P < 0·01). Viscous dietary fibre reduces LDL cholesterol and alternative lipid markers relative to the fibre from cereal sources, hence may be a preferred type of fibre-based dietary intervention targeting CVD risk reduction.
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Affiliation(s)
- Elena Jovanovski
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Unity Health, Toronto, ON, Canada
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Michelle Nguyen
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Unity Health, Toronto, ON, Canada
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Yui Kurahashi
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Allison Komishon
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Unity Health, Toronto, ON, Canada
| | - Dandan Li
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Unity Health, Toronto, ON, Canada
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Ho Hoang Vi Thanh
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Unity Health, Toronto, ON, Canada
| | - Rana Khayyat
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Unity Health, Toronto, ON, Canada
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Alexandra Louisa Jenkins
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Unity Health, Toronto, ON, Canada
| | - Tauseef Ahmad Khan
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Toronto 3D Knowledge Synthesis and Clinical Trials Unit, St. Michael's Hospital, Toronto, Canada
| | - Andreea Zurbau
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Unity Health, Toronto, ON, Canada
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Toronto 3D Knowledge Synthesis and Clinical Trials Unit, St. Michael's Hospital, Toronto, Canada
| | - John Sievenpiper
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Unity Health, Toronto, ON, Canada
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Toronto 3D Knowledge Synthesis and Clinical Trials Unit, St. Michael's Hospital, Toronto, Canada
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
- Division of Endocrinology and Metabolism, St. Michael's Hospital, Toronto, ON, Canada
- Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ONCanada
| | - Vladimir Vuksan
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Unity Health, Toronto, ON, Canada
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
- Division of Endocrinology and Metabolism, St. Michael's Hospital, Toronto, ON, Canada
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Micronutrient status of individuals with overweight and obesity following 3 months' supplementation with PolyGlycopleX (PGX®) or psyllium: a randomized controlled trial. BMC Nutr 2022; 8:42. [PMID: 35505399 PMCID: PMC9063372 DOI: 10.1186/s40795-022-00534-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 04/08/2022] [Indexed: 11/17/2022] Open
Abstract
Background Safe and effective weight control strategies are needed to curtail the current obesity epidemic worldwide. Increasing dietary fibre has shown positive results with weight loss as well as in the reduction of metabolic syndrome risk factors. However, fibre can act as an inhibitor to the bioavailability of micronutrients in the gastrointestinal tract. While there is a substantial amount of scientific research into psyllium fibre, PolyGlycopleX (PGX®) is a novel fibre and as yet the effects of PGX® on micronutrient status is not well researched. Aim To determine whether 3-months’ supplementation with 15 g of psyllium or PGX® fibre daily affects micronutrient status of overweight and obese adults. Methods Overweight and obese individuals with a BMI between 25–40 kg/m2 and aged between 18 and 65 years, but otherwise healthy, were instructed to consume a 5 g sachet of psyllium, PGX® fibre or a rice flour placebo three times a day for 52 weeks as part of a larger long-term study. Blood sample data for the first 3 months were analysed for associations between serum micronutrient levels and psyllium fibre and/or PGX® supplements. Results No significant differences between fibre supplement groups and micronutrient status were found after 3 months at p > 0.05. Dietary intake of vitamin C was significantly lower for PGX® at 3 months compared to baseline and compared to control (p < 0.05). Folate was significantly lower in the control group after 3 months (p < 0.05). In the psyllium group, folate, sodium, zinc and magnesium intake decreased after 3 months (p < 0.05). A limitation of dietary intake data (tertiary measure) is the potential for inaccurate self-reporting, although reduced nutrient intake could be due to the satiating effect of dietary fibre. Conclusions There were no significant between group differences in serum micronutrient concentrations after a 3-month psyllium fibre or PGX® supplementation intervention of 15 g per day. Fibre supplementation is unlikely to compromise the nutritional status of overweight and obese individuals in the short term. Further research is recommended to monitor micronutrient status over a longer period or with a higher fibre dosage. Supplementary Information The online version contains supplementary material available at 10.1186/s40795-022-00534-7.
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Luna-Castillo KP, Olivares-Ochoa XC, Hernández-Ruiz RG, Llamas-Covarrubias IM, Rodríguez-Reyes SC, Betancourt-Núñez A, Vizmanos B, Martínez-López E, Muñoz-Valle JF, Márquez-Sandoval F, López-Quintero A. The Effect of Dietary Interventions on Hypertriglyceridemia: From Public Health to Molecular Nutrition Evidence. Nutrients 2022; 14:nu14051104. [PMID: 35268076 PMCID: PMC8912493 DOI: 10.3390/nu14051104] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 02/26/2022] [Accepted: 03/03/2022] [Indexed: 11/16/2022] Open
Abstract
Approximately 25–50% of the population worldwide exhibits serum triglycerides (TG) (≥150 mg/dL) which are associated with an increased level of highly atherogenic remnant-like particles, non-alcoholic fatty liver disease, and pancreatitis risk. High serum TG levels could be related to cardiovascular disease, which is the most prevalent cause of mortality in Western countries. The etiology of hypertriglyceridemia (HTG) is multifactorial and can be classified as primary and secondary causes. Among the primary causes are genetic disorders. On the other hand, secondary causes of HTG comprise lifestyle factors, medical conditions, and drugs. Among lifestyle changes, adequate diets and nutrition are the initial steps to treat and prevent serum lipid alterations. Dietary intervention for HTG is recommended in order to modify the amount of macronutrients. Macronutrient distribution changes such as fat or protein, low-carbohydrate diets, and caloric restriction seem to be effective strategies in reducing TG levels. Particularly, the Mediterranean diet is the dietary pattern with the most consistent evidence for efficacy in HTG while the use of omega-3 supplements consumption is the dietary component with the highest number of randomized clinical trials (RCT) carried out with effective results on reducing TG. The aim of this review was to provide a better comprehension between human nutrition and lipid metabolism.
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Affiliation(s)
- Karla Paulina Luna-Castillo
- Doctorado en Ciencias de la Nutrición Traslacional, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Guadalajara 44340, Jalisco, Mexico; (K.P.L.-C.); (X.C.O.-O.); (R.G.H.-R.); (I.M.L.-C.); (S.C.R.-R.); (A.B.-N.); (B.V.); (E.M.-L.); (J.F.M.-V.)
| | - Xochitl Citlalli Olivares-Ochoa
- Doctorado en Ciencias de la Nutrición Traslacional, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Guadalajara 44340, Jalisco, Mexico; (K.P.L.-C.); (X.C.O.-O.); (R.G.H.-R.); (I.M.L.-C.); (S.C.R.-R.); (A.B.-N.); (B.V.); (E.M.-L.); (J.F.M.-V.)
| | - Rocío Guadalupe Hernández-Ruiz
- Doctorado en Ciencias de la Nutrición Traslacional, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Guadalajara 44340, Jalisco, Mexico; (K.P.L.-C.); (X.C.O.-O.); (R.G.H.-R.); (I.M.L.-C.); (S.C.R.-R.); (A.B.-N.); (B.V.); (E.M.-L.); (J.F.M.-V.)
| | - Iris Monserrat Llamas-Covarrubias
- Doctorado en Ciencias de la Nutrición Traslacional, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Guadalajara 44340, Jalisco, Mexico; (K.P.L.-C.); (X.C.O.-O.); (R.G.H.-R.); (I.M.L.-C.); (S.C.R.-R.); (A.B.-N.); (B.V.); (E.M.-L.); (J.F.M.-V.)
- Instituto de Nutrigenética y Nutrigenómica Traslacional, CUCS, UdeG, Guadalajara 44340, Jalisco, Mexico
| | - Saraí Citlalic Rodríguez-Reyes
- Doctorado en Ciencias de la Nutrición Traslacional, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Guadalajara 44340, Jalisco, Mexico; (K.P.L.-C.); (X.C.O.-O.); (R.G.H.-R.); (I.M.L.-C.); (S.C.R.-R.); (A.B.-N.); (B.V.); (E.M.-L.); (J.F.M.-V.)
- Instituto de Nutrigenética y Nutrigenómica Traslacional, CUCS, UdeG, Guadalajara 44340, Jalisco, Mexico
| | - Alejandra Betancourt-Núñez
- Doctorado en Ciencias de la Nutrición Traslacional, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Guadalajara 44340, Jalisco, Mexico; (K.P.L.-C.); (X.C.O.-O.); (R.G.H.-R.); (I.M.L.-C.); (S.C.R.-R.); (A.B.-N.); (B.V.); (E.M.-L.); (J.F.M.-V.)
| | - Barbara Vizmanos
- Doctorado en Ciencias de la Nutrición Traslacional, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Guadalajara 44340, Jalisco, Mexico; (K.P.L.-C.); (X.C.O.-O.); (R.G.H.-R.); (I.M.L.-C.); (S.C.R.-R.); (A.B.-N.); (B.V.); (E.M.-L.); (J.F.M.-V.)
- Instituto de Nutrigenética y Nutrigenómica Traslacional, CUCS, UdeG, Guadalajara 44340, Jalisco, Mexico
| | - Erika Martínez-López
- Doctorado en Ciencias de la Nutrición Traslacional, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Guadalajara 44340, Jalisco, Mexico; (K.P.L.-C.); (X.C.O.-O.); (R.G.H.-R.); (I.M.L.-C.); (S.C.R.-R.); (A.B.-N.); (B.V.); (E.M.-L.); (J.F.M.-V.)
- Instituto de Nutrigenética y Nutrigenómica Traslacional, CUCS, UdeG, Guadalajara 44340, Jalisco, Mexico
| | - José Francisco Muñoz-Valle
- Doctorado en Ciencias de la Nutrición Traslacional, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Guadalajara 44340, Jalisco, Mexico; (K.P.L.-C.); (X.C.O.-O.); (R.G.H.-R.); (I.M.L.-C.); (S.C.R.-R.); (A.B.-N.); (B.V.); (E.M.-L.); (J.F.M.-V.)
- Instituto de Investigación en Ciencias Biomédicas, CUCS, UdeG, Guadalajara 44340, Jalisco, Mexico
| | - Fabiola Márquez-Sandoval
- Doctorado en Ciencias de la Nutrición Traslacional, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Guadalajara 44340, Jalisco, Mexico; (K.P.L.-C.); (X.C.O.-O.); (R.G.H.-R.); (I.M.L.-C.); (S.C.R.-R.); (A.B.-N.); (B.V.); (E.M.-L.); (J.F.M.-V.)
- Instituto de Nutrigenética y Nutrigenómica Traslacional, CUCS, UdeG, Guadalajara 44340, Jalisco, Mexico
- Correspondence: (F.M.-S.); (A.L.-Q.); Tel.: +52-(33)1058-5200 (ext. 33644 or 33704) (F.M.-S.)
| | - Andres López-Quintero
- Doctorado en Ciencias de la Nutrición Traslacional, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Guadalajara 44340, Jalisco, Mexico; (K.P.L.-C.); (X.C.O.-O.); (R.G.H.-R.); (I.M.L.-C.); (S.C.R.-R.); (A.B.-N.); (B.V.); (E.M.-L.); (J.F.M.-V.)
- Instituto de Nutrigenética y Nutrigenómica Traslacional, CUCS, UdeG, Guadalajara 44340, Jalisco, Mexico
- Correspondence: (F.M.-S.); (A.L.-Q.); Tel.: +52-(33)1058-5200 (ext. 33644 or 33704) (F.M.-S.)
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Zhang S, Hu J, Sun Y, Tan H, Yin J, Geng F, Nie S. Review of structure and bioactivity of the Plantago (Plantaginaceae) polysaccharides. Food Chem X 2021; 12:100158. [PMID: 34825168 PMCID: PMC8604743 DOI: 10.1016/j.fochx.2021.100158] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/02/2021] [Accepted: 11/11/2021] [Indexed: 01/06/2023] Open
Abstract
Plantago (Plantaginaceae) is an herbal plant, which is used in folk medicine, functional food, and dietary supplement products. Recent pharmacological and phytochemical studies have shown that polysaccharides isolated from Plantago have multiple medicinal and nutritional benefits, including improve intestinal health, hypoglycemic effect, immunomodulatory effect, etc. These health and pharmacological benefits are of great interest to the public, academia, and biotechnology industries. This paper provides an overview of recent advances in the physicochemical, structural features, and biological effects of Plantago polysaccharides and highlights the similarities and differences of the polysaccharides from different species and in different parts, including leaves, seeds, and husks. The scientific support for its use as a prebiotic is also addressed. The purpose of this review is to provide background as well as useful and up-to-date information for future research and applications of these polysaccharides.
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Affiliation(s)
- Shanshan Zhang
- State Key Laboratory of Food Science and Technology, China-Canada Joint Lab of Food Science and Technology (Nanchang), Nanchang University, Nanchang 330047, China
| | - Jielun Hu
- State Key Laboratory of Food Science and Technology, China-Canada Joint Lab of Food Science and Technology (Nanchang), Nanchang University, Nanchang 330047, China
| | - Yonggan Sun
- State Key Laboratory of Food Science and Technology, China-Canada Joint Lab of Food Science and Technology (Nanchang), Nanchang University, Nanchang 330047, China
| | - Huizi Tan
- State Key Laboratory of Food Science and Technology, China-Canada Joint Lab of Food Science and Technology (Nanchang), Nanchang University, Nanchang 330047, China
| | - Junyi Yin
- State Key Laboratory of Food Science and Technology, China-Canada Joint Lab of Food Science and Technology (Nanchang), Nanchang University, Nanchang 330047, China
| | - Fang Geng
- Key Laboratory of Coarse Cereal Processing (Ministry of Agriculture and Rural Affairs), School of Food and Biological Engineering, Chengdu University, Chengdu 610106, China
| | - Shaoping Nie
- State Key Laboratory of Food Science and Technology, China-Canada Joint Lab of Food Science and Technology (Nanchang), Nanchang University, Nanchang 330047, China
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Polysaccharide Structures and Their Hypocholesterolemic Potential. Molecules 2021; 26:molecules26154559. [PMID: 34361718 PMCID: PMC8348680 DOI: 10.3390/molecules26154559] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 07/23/2021] [Accepted: 07/24/2021] [Indexed: 12/12/2022] Open
Abstract
Several classes of polysaccharides have been described to have hypocholesterolemic potential, namely cholesterol bioaccessibility and bioavailability. This review will highlight the main mechanisms by which polysaccharides are known to affect cholesterol homeostasis at the intestine, namely the effect (i) of polysaccharide viscosity and its influence on cholesterol bioaccessibility; (ii) on bile salt sequestration and its dependence on the structural diversity of polysaccharides; (iii) of bio-transformations of polysaccharides and bile salts by the gut microbiota. Different quantitative structure–hypocholesterolemic activity relationships have been explored depending on the mechanism involved, and these were based on polysaccharide physicochemical properties, such as sugar composition and ramification degree, linkage type, size/molecular weight, and charge. The information gathered will support the rationalization of polysaccharides’ effect on cholesterol homeostasis and highlight predictive rules towards the development of customized hypocholesterolemic functional food.
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Deehan EC, Colin-Ramirez E, Triador L, Madsen KL, Prado CM, Field CJ, Ball GDC, Tan Q, Orsso C, Dinu I, Pakseresht M, Rubin D, Sharma AM, Tun H, Walter J, Newgard CB, Freemark M, Wine E, Haqq AM. Efficacy of metformin and fermentable fiber combination therapy in adolescents with severe obesity and insulin resistance: study protocol for a double-blind randomized controlled trial. Trials 2021; 22:148. [PMID: 33596993 PMCID: PMC7890810 DOI: 10.1186/s13063-021-05060-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 01/20/2021] [Indexed: 02/08/2023] Open
Abstract
Background Accumulating evidence suggests that the metabolic effects of metformin and fermentable fibers are mediated, in part, through diverging or overlapping effects on the composition and metabolic functions of the gut microbiome. Pre-clinical animal models have established that the addition of fiber to metformin monotherapy improves glucose tolerance. However, possible synergistic effects of combination therapy (metformin plus fiber) have not been investigated in humans. Moreover, the underlying mechanisms of synergy have yet to be elucidated. The aim of this study is to compare in adolescents with obesity the metabolic effects of metformin and fermentable fibers in combination with those of metformin or fiber alone. We will also determine if therapeutic responses correlate with compositional and functional features of the gut microbiome. Methods This is a parallel three-armed, double-blinded, randomized controlled trial. Adolescents (aged 12–18 years) with obesity, insulin resistance (IR), and a family history of type 2 diabetes mellitus (T2DM) will receive either metformin (850 mg p.o. twice/day), fermentable fibers (35 g/day), or a combination of metformin plus fiber for 12 months. Participants will be seen at baseline, 3, 6, and 12 months, with a phone follow-up at 1 and 9 months. Primary and secondary outcomes will be assessed at baseline, 6, and 12 months. The primary outcome is change in IR estimated by homeostatic model assessment of IR; key secondary outcomes include changes in the Matsuda index, oral disposition index, body mass index z-score, and fat mass to fat-free mass ratio. To gain mechanistic insight, endpoints that reflect host-microbiota interactions will also be assessed: obesity-related immune, metabolic, and satiety markers; humoral metabolites; and fecal microbiota composition, short-chain fatty acids, and bile acids. Discussion This study will compare the potential metabolic benefits of fiber with those of metformin in adolescents with obesity, determine if metformin and fiber act synergistically to improve IR, and elucidate whether the metabolic benefits of metformin and fiber associate with changes in fecal microbiota composition and the output of health-related metabolites. This study will provide insight into the potential role of the gut microbiome as a target for enhancing the therapeutic efficacy of emerging treatments for T2DM prevention. Trial registration ClinicalTrials.gov NCT04578652. Registered on 8 October 2020. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-021-05060-8.
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Affiliation(s)
- Edward C Deehan
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, T6G 2E1, AB, Canada
| | | | - Lucila Triador
- Department of Pediatrics, University of Alberta, Edmonton, T6G 2E1, AB, Canada
| | - Karen L Madsen
- Department of Medicine, University of Alberta, Edmonton, T6G 2C2, AB, Canada
| | - Carla M Prado
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, T6G 2E1, AB, Canada
| | - Catherine J Field
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, T6G 2E1, AB, Canada
| | - Geoff D C Ball
- Department of Pediatrics, University of Alberta, Edmonton, T6G 2E1, AB, Canada
| | - Qiming Tan
- Department of Pediatrics, University of Alberta, Edmonton, T6G 2E1, AB, Canada
| | - Camila Orsso
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, T6G 2E1, AB, Canada
| | - Irina Dinu
- School of Public Health, University of Alberta, Edmonton, T6G 1C9, AB, Canada
| | - Mohammadreza Pakseresht
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, T6G 2E1, AB, Canada
| | - Daniela Rubin
- California State University Fullerton, Fullerton, USA
| | - Arya M Sharma
- Department of Medicine, University of Alberta, Edmonton, T6G 2C2, AB, Canada
| | - Hein Tun
- University of Hong Kong School of Public Health, Hong Kong, China
| | - Jens Walter
- DNational University of Ireland University College Cork, University College Cork, Cork, Ireland
| | | | - Michael Freemark
- Duke University Medical Center, Duke University Hospital, Durham, NC, USA
| | - Eytan Wine
- Department of Pediatrics and Physiology, University of Alberta, Edmonton, T6G 1C9, BA, Canada
| | - Andrea M Haqq
- Department of Pediatrics, University of Alberta, Edmonton, T6G 2E1, AB, Canada.
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10
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Schiano E, Annunziata G, Ciampaglia R, Iannuzzo F, Maisto M, Tenore GC, Novellino E. Bioactive Compounds for the Management of Hypertriglyceridemia: Evidence From Clinical Trials and Putative Action Targets. Front Nutr 2020; 7:586178. [PMID: 33330588 PMCID: PMC7734325 DOI: 10.3389/fnut.2020.586178] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 10/26/2020] [Indexed: 01/22/2023] Open
Abstract
Hypertriglyceridemia refers to the presence of elevated concentrations of triglycerides (TG) in the bloodstream (TG >200 mg/dL). This lipid alteration is known to be associated with an increased risk of atherosclerosis, contributing overall to the onset of atherosclerotic cardiovascular disease (CVD). Guidelines for the management of hypertriglyceridemia are based on both lifestyle intervention and pharmacological treatment, but poor adherence, medication-related costs and side effects can limit the success of these interventions. For this reason, the search for natural alternative approaches to reduce plasma TG levels currently represents a hot research field. This review article summarizes the most relevant clinical trials reporting the TG-reducing effect of different food-derived bioactive compounds. Furthermore, based on the evidence obtained from in vitro studies, we provide a description and classification of putative targets of action through which several bioactive compounds can exert a TG-lowering effect. Future research may lead to investigations of the efficacy of novel nutraceutical formulations consisting in a combination of bioactive compounds which contribute to the management of plasma TG levels through different action targets.
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Affiliation(s)
| | | | | | - Fortuna Iannuzzo
- Department of Pharmacy, University of Naples Federico II, Naples, Italy
| | - Maria Maisto
- Department of Pharmacy, University of Naples Federico II, Naples, Italy
| | - Gian Carlo Tenore
- Department of Pharmacy, University of Naples Federico II, Naples, Italy
| | - Ettore Novellino
- Department of Pharmacy, University of Naples Federico II, Naples, Italy
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11
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McKay J, Ho S, Jane M, Pal S. Overweight & obese Australian adults and micronutrient deficiency. BMC Nutr 2020; 6:12. [PMID: 32377370 PMCID: PMC7193396 DOI: 10.1186/s40795-020-00336-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 02/17/2020] [Indexed: 12/15/2022] Open
Abstract
Background Micronutrients have been implicated as an important factor in regulating various metabolic processes and thus playing a role in the aetiology of obesity. Many studies have been conducted worldwide that clearly show a direct link between obesity and micronutrient deficiencies. The aim of this study was to assess the nutritional status of overweight and obese Australian adults to see if there were any associations between BMI and serum micronutrient levels. Methods Baseline serum micronutrient data of overweight and obese individuals with a body mass index (BMI) between 25 and 40 kg/m2 and aged between 18 and 65 years was compared to the clinical micronutrient reference ranges for associations between BMI and micronutrient status. Results There were significant negative associations between BMI and serum vitamin D (p = 0.044), folate (p = 0.025), magnesium (p = 0.010) and potassium (p = 0.023). Conclusions Overweight and obesity appears to impact on the bioavailability and utilisation of micronutrients with absorption, excretion, storage/distribution (fat sequestering, tissue dispersion), metabolism (catabolic losses, possibly oxidative), increased physiologic requirements, and lower absolute total dietary intake being the current theory for observed differences. While vitamins D, folate, magnesium and potassium showed a negative relationship to BMI, other micronutrients did not. This may be explained by the fortification of certain processed foods, or the possibility of overweight and obese people eating more to satisfy their nutritional requirements.
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Affiliation(s)
- Jenny McKay
- School of Public Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia
| | - Suleen Ho
- School of Public Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia
| | - Monica Jane
- School of Public Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia
| | - Sebely Pal
- School of Public Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia
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12
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Armet AM, Deehan EC, Thöne JV, Hewko SJ, Walter J. The Effect of Isolated and Synthetic Dietary Fibers on Markers of Metabolic Diseases in Human Intervention Studies: A Systematic Review. Adv Nutr 2020; 11:420-438. [PMID: 31342059 PMCID: PMC7442353 DOI: 10.1093/advances/nmz074] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 05/22/2019] [Accepted: 06/14/2019] [Indexed: 12/25/2022] Open
Abstract
Observational studies provide strong evidence for the health benefits of dietary fiber (DF) intake; however, human intervention studies that supplement isolated and synthetic DFs have shown inconsistent results. Therefore, we conducted a systematic review to summarize the effects of DF supplementation on immunometabolic disease markers in intervention studies in healthy adults, and considered the role of DF dose, DF physicochemical properties, intervention duration, and the placebo used. Five databases were searched for studies published from 1990 to 2018 that assessed the effect of DF on immunometabolic markers. Eligible studies were those that supplemented isolated or synthetic DFs for ≥2 wk and reported baseline data to assess the effect of the placebo. In total, 77 publications were included. DF supplementation reduced total cholesterol (TC), LDL cholesterol, HOMA-IR, and insulin AUC in 36-49% of interventions. In contrast, <20% of the interventions reduced C-reactive protein (CRP), IL-6, glucose, glucose AUC, insulin, HDL cholesterol, and triglycerides. A higher proportion of interventions showed an effect if they used higher DF doses for CRP, TC, and LDL cholesterol (40-63%), viscous and mixed plant cell wall DFs for TC and LDL cholesterol (>50%), and longer intervention durations for CRP and glucose (50%). Half of the placebo-controlled studies used digestible carbohydrates as the placebo, which confounded findings for IL-6, glucose AUC, and insulin AUC. In conclusion, interventions with isolated and synthetic DFs resulted mainly in improved cholesterol concentrations and an attenuation of insulin resistance, whereas markers of dysglycemia and inflammation were largely unaffected. Although more research is needed to make reliable recommendations, a more targeted supplementation of DF with specific physicochemical properties at higher doses and for longer durations shows promise in enhancing several of its health effects.
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Affiliation(s)
- Anissa M Armet
- Department of Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Edward C Deehan
- Department of Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada,Address correspondence to ECD (e-mail: )
| | - Julia V Thöne
- Department of Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada,Medical Department, Justus-Liebig University Giessen, Giessen, Germany
| | - Sarah J Hewko
- Department of Applied Human Sciences, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
| | - Jens Walter
- Department of Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada,Department of Biological Sciences, University of Alberta, Edmonton, Alberta, Canada,Address correspondence to JW (e-mail: )
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13
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Psyllium (Plantago ovata Forsk): From evidence of health benefits to its food application. Trends Food Sci Technol 2020. [DOI: 10.1016/j.tifs.2019.12.006] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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14
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Solah VA, Kerr DA, Irawati D, Hunt W, Meng X, Gahler RJ, Fenton HK, Johnson SK, James AP, Wood S. Effect of PolyGlycopleX (PGX) Consumption on Blood Lipid Profiles in Healthy, Low CVD Risk Overweight Adults. Nutrients 2019; 11:E717. [PMID: 30934797 PMCID: PMC6520870 DOI: 10.3390/nu11040717] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 03/22/2019] [Accepted: 03/26/2019] [Indexed: 11/21/2022] Open
Abstract
Raised blood lipid levels are associated with a risk of a cardiovascular disease (CVD). Moderate reductions in several CVD factors such as total, low-density lipoprotein (LDL) cholesterol and non-high-density lipoprotein (non-HDL) cholesterol concentrations may be more effective in reducing overall risk than a major reduction in just one. A blind, randomised controlled trial was conducted with 120 healthy overweight (BMI 25⁻30) adults aged 25⁻70 years who were non-smokers, not diabetic and of low risk of cardiovascular disease, as assessed by the Framingham risk equation. Participants consumed 4.5 g PolyGlycopleX (PGX) as softgel capsules (PGXS) or 5 g PGX granules (PGXG) or 5 g rice flour (RF) with meals three times a day for 12 weeks. Total, LDL and non-HDL cholesterol were all significantly reduced (-6%, -5% and -3.5%, respectively) post the PGX granule treatment; however, PGX in softgel capsule form did not affect blood lipid profiles. Daily consumption of PGX granules in overweight low CVD risk adults produced lipid changes indicating a CVD preventative benefit.
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Affiliation(s)
- Vicky A Solah
- School of Molecular and Life Sciences, Faculty of Science and Engineering, Curtin University, Perth, WA 6845, Australia.
| | - Deborah A Kerr
- School of Public Health, Faculty of Health Sciences, Curtin University, Perth, WA 6845, Australia.
| | - Deasy Irawati
- School of Public Health, Faculty of Health Sciences, Curtin University, Perth, WA 6845, Australia.
- Faculty of Medicine, Mataram University, West Nusa Tenggara 83125, Indonesia.
| | - Wendy Hunt
- School of Public Health, Faculty of Health Sciences, Curtin University, Perth, WA 6845, Australia.
- Australian Export Grains Innovation Centre, South Perth, WA 6151, Australia.
| | - Xingqiong Meng
- Flinders Centre for Epidemiology and Biostatistics, College of Medicine and Public Health, Flinders University, Adelaide, SA 5001, Australia.
| | | | - Haelee K Fenton
- School of Molecular and Life Sciences, Faculty of Science and Engineering, Curtin University, Perth, WA 6845, Australia.
| | - Stuart K Johnson
- School of Molecular and Life Sciences, Faculty of Science and Engineering, Curtin University, Perth, WA 6845, Australia.
| | - Anthony P James
- School of Public Health, Faculty of Health Sciences, Curtin University, Perth, WA 6845, Australia.
- Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Perth, WA 6845, Australia.
| | - Simon Wood
- School of Public Health, Faculty of Health Sciences, Curtin University, Perth, WA 6845, Australia.
- InovoBiologic Inc., Calgary, AB Y2N4Y7, Canada.
- Food, Nutrition and Health Program, University of British Columbia, Vancouver, BC V6T1Z4, Canada.
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15
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Yao F, Yang G, Xian Y, Wang G, Zheng Z, Jin Z, Xie Y, Wang W, Gu J, Lin R. The protective effect of hydroxytyrosol acetate against inflammation of vascular endothelial cells partly through the SIRT6-mediated PKM2 signaling pathway. Food Funct 2019; 10:5789-5803. [DOI: 10.1039/c9fo00586b] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
HT-AC had anti-inflammatory effect in hypercholesterolemic mice and TNF-stimulated HUVECs. HT-AC inhibited the inflammatory response partly through the TNFRSF1A/SIRT6/PKM2-mediated signaling pathway.
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Affiliation(s)
- Feng Yao
- Department of Pharmacology
- Xi'an Jiaotong University Health Science Center
- Xi'an 710061
- China
| | - Guangde Yang
- School of Pharmacy
- Xi'an Jiaotong University Health Science Center
- Xi'an 710061
- China
| | - Yushan Xian
- Department of Pharmacology
- Xi'an Jiaotong University Health Science Center
- Xi'an 710061
- China
| | - Guan Wang
- Department of Pharmacology
- Xi'an Jiaotong University Health Science Center
- Xi'an 710061
- China
| | - Zihan Zheng
- Department of Pharmacology
- Xi'an Jiaotong University Health Science Center
- Xi'an 710061
- China
| | - Zhen Jin
- Department of Pharmacology
- Xi'an Jiaotong University Health Science Center
- Xi'an 710061
- China
| | - Yundong Xie
- College of Pharmacy
- Shaanxi University of Chinese Medicine
- Xianyang 712000
- China
| | - Weirong Wang
- Department of Medical Experiment Animal Science
- Xi'an Jiaotong University Health Science Center
- Xi'an 710061
- China
| | - Jianli Gu
- Xi'an Jiaotong University Health Science Center
- Xi'an 710061
- China
- Xi'an NO.3 hospital
- Xi'an 710018
| | - Rong Lin
- Department of Pharmacology
- Xi'an Jiaotong University Health Science Center
- Xi'an 710061
- China
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16
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Jane M, McKay J, Pal S. Effects of daily consumption of psyllium, oat bran and polyGlycopleX on obesity-related disease risk factors: A critical review. Nutrition 2019; 57:84-91. [DOI: 10.1016/j.nut.2018.05.036] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 05/24/2018] [Accepted: 05/26/2018] [Indexed: 01/08/2023]
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17
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Jovanovski E, Yashpal S, Komishon A, Zurbau A, Blanco Mejia S, Ho HVT, Li D, Sievenpiper J, Duvnjak L, Vuksan V. Effect of psyllium (Plantago ovata) fiber on LDL cholesterol and alternative lipid targets, non-HDL cholesterol and apolipoprotein B: a systematic review and meta-analysis of randomized controlled trials. Am J Clin Nutr 2018; 108:922-932. [PMID: 30239559 DOI: 10.1093/ajcn/nqy115] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 05/07/2018] [Indexed: 11/14/2022] Open
Abstract
Background Studies have identified viscous dietary fiber as potentially attenuating cholesterol, including psyllium, which reduces LDL cholesterol and thus may complement cardiovascular disease (CVD) treatment. Objectives The aims of this study were to update evidence on the effect of psyllium on LDL cholesterol and to provide an assessment of its impact on alternate markers: non-HDL cholesterol and apolipoprotein B (apoB). Design Medline, EMBASE, CINAHL, and the Cochrane Central Register of Controlled Trials were searched through 3 October 2017. Independent reviewers extracted relevant data and assessed risk of bias. We included randomized controlled trials with a duration of ≥3 wk that assessed the effect of psyllium on blood lipids in individuals with or without hypercholesterolemia. Data were pooled by using the generic inverse variance method with random-effects models and expressed as mean differences (MDs) with 95% CIs. Heterogeneity was assessed by Cochran's Q statistic and quantified by the I2 statistic. Overall quality of the evidence was assessed by using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach. Results We included 28 trials in our analysis (n = 1924). Supplementation of a median dose of ∼10.2 g psyllium significantly reduced LDL cholesterol (MD = -0.33 mmol/L; 95% CI: -0.38, -0.27 mmol/L; P < 0.00001), non-HDL cholesterol (MD = -0.39 mmol/L; 95% CI: -0.50, -0.27 mmol/L; P < 0.00001), and apoB (MD = -0.05 g/L; 95% CI: -0.08, -0.03 g/L; P < 0.0001). Effect estimates for LDL cholesterol and non-HDL cholesterol were graded as moderate quality on the basis of downgrades for inconsistency and graded as high quality for apoB. Conclusion Psyllium fiber effectively improves conventional and alternative lipids markers, potentially delaying the process of atherosclerosis-associated CVD risk in those with or without hypercholesterolemia. This trial is registered at www.clinicaltrials.gov as NCT03346733.
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Affiliation(s)
- Elena Jovanovski
- Clinical Nutrition and Risk Factor Modification Center.,Departments of Nutritional Sciences
| | - Shahen Yashpal
- Clinical Nutrition and Risk Factor Modification Center.,Departments of Nutritional Sciences
| | | | - Andreea Zurbau
- Clinical Nutrition and Risk Factor Modification Center.,Departments of Nutritional Sciences
| | - Sonia Blanco Mejia
- Clinical Nutrition and Risk Factor Modification Center.,Toronto 3D Knowledge Synthesis and Clinical Trials Unit.,Departments of Nutritional Sciences
| | | | - Dandan Li
- Clinical Nutrition and Risk Factor Modification Center.,Departments of Nutritional Sciences
| | - John Sievenpiper
- Clinical Nutrition and Risk Factor Modification Center.,Toronto 3D Knowledge Synthesis and Clinical Trials Unit.,Departments of Nutritional Sciences
| | - Lea Duvnjak
- Clinic for Diabetes, Endocrinology, and Metabolic Diseases Vuk Vrhovac, University Hospital Merkur, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Vladimir Vuksan
- Clinical Nutrition and Risk Factor Modification Center.,Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.,Departments of Nutritional Sciences.,Medicine, University of Toronto, Toronto, Ontario, Canada
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