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Huang H, Liao D, He B, Zhou G, Cui Y. Effects of Citrus Flavanone Hesperidin Extracts or Purified Hesperidin Consumption on Risk Factors for Cardiovascular Disease: Evidence From an Updated Meta-analysis of Randomized Controlled Trials. Curr Dev Nutr 2024; 8:102055. [PMID: 39279783 PMCID: PMC11399677 DOI: 10.1016/j.cdnut.2023.102055] [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: 10/06/2023] [Revised: 11/21/2023] [Accepted: 12/04/2023] [Indexed: 09/18/2024] Open
Abstract
Background Cardiovascular disease (CVD) is a serious public health problem worldwide. The role of citrus flavanone hesperidin consumption on cardiovascular disease risk factors (CVDRFs) has been examined in many clinical trials, but conflicting results have been found. Objectives This study aimed to systematically evaluate the effects of hesperidin extracts or purified hesperidin on CVDRFs in humans with an updated meta-analysis of randomized controlled trials. Methods According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines, we systematically screened and searched electronic databases from their establishment to March 2023. Reference lists and previous reviews were also searched. Intervention trials assessing hesperidin consumption on CVD outcomes were included for pooling. To assess the quality of the included articles, the tool of Cochrane risk-of-bias tool was applied. We synthesized the effect sizes with 95% CIs and weighted mean difference (WMD). The I 2 index was used to evaluate the between-study heterogeneity. To explore the heterogeneity source, we used meta-regression and subgroup analysis. Publication bias and sensitivity analysis were also performed. We used the Grading of Recommendations Assessment, Development, and Evaluation approach to evaluate the evidence quality. Results We included 12 trials with 589 participants. We found evident effects of hesperidin on low-density lipoprotein cholesterol (WMD: -0.22 mmol/L; 95% CI: -0.33, -0.11 mmol/L), total cholesterol (WMD: -0.20 mmol/L; 95% CI: -0.31, -0.08 mmol/L), fasting blood glucose (WMD: -0.15 mg/dL; 95% CI: -0.29, -0.02 mg/dL), quantitative insulin-sensitivity check index (WMD 0.06, 95% CI 0.01 to 0.10), intercellular adhesion molecule 1 (WMD: -13.60 ng/mL; 95% CI: -23.72, -3.48 ng/mL), vascular cell adhesion molecule 1 (WMD: -15.60 ng/mL; 95% CI: -30.13, -1.06 ng/mL), and C-reactive protein (WMD: -0.56 mg/L; 95% CI: -1.11, -0.01 mg/L), whereas no effects were found for other CVDRFs. Conclusions Our current findings demonstrate that hesperidin might be advantageous in improving numerous CVDRFs in humans, such as blood lipid concentrations, blood glucose control, and management of inflammatory indicators.
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Affiliation(s)
- Haohai Huang
- Clinical Translational Medical Center, The Affiliated Dongguan Songshan Lake Central Hospital, Guangdong Medical University, Dongguan, Guangdong, China
- Department of Clinical Pharmacy, The Affiliated Dongguan Songshan Lake Central Hospital, Guangdong Medical University, Dongguan, Guangdong, China
| | - Dan Liao
- Department of Gynaecology, The Affiliated Dongguan Songshan Lake Central Hospital, Guangdong Medical University, Dongguan, Guangdong, China
| | - Bin He
- Clinical Translational Medical Center, The Affiliated Dongguan Songshan Lake Central Hospital, Guangdong Medical University, Dongguan, Guangdong, China
| | - Guanghui Zhou
- Department of Rehabilitation Medicine, The Affiliated Dongguan Songshan Lake Central Hospital, Guangdong Medical University, Dongguan, Guangdong, China
| | - Yejia Cui
- Department of Clinical Laboratory, The Affiliated Dongguan Songshan Lake Central Hospital, Guangdong Medical University, Dongguan, Guangdong, China
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Narra F, Piragine E, Benedetti G, Ceccanti C, Florio M, Spezzini J, Troisi F, Giovannoni R, Martelli A, Guidi L. Impact of thermal processing on polyphenols, carotenoids, glucosinolates, and ascorbic acid in fruit and vegetables and their cardiovascular benefits. Compr Rev Food Sci Food Saf 2024:e13426. [PMID: 39169551 DOI: 10.1111/1541-4337.13426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 06/19/2024] [Accepted: 07/28/2024] [Indexed: 08/23/2024]
Abstract
Bioactive compounds in fruit and vegetables have a positive impact on human health by reducing oxidative stress, inflammation, and the risk of chronic diseases such as cancer, cardiovascular (CV) diseases, and metabolic disorders. However, some fruit and vegetables must be heated before consumption and thermal processes can modify the amount of nutraceuticals, that is, polyphenols, carotenoids, glucosinolates, and ascorbic acid, that can increase or decrease in relation to different factors such as type of processing, temperature, and time but also the plant part (e.g., flower, leaf, tuber, and root) utilized as food. Another important aspect is related to the bioaccessibility and bioavailability of nutraceuticals. Indeed, the key stage of nutraceutical bioefficiency is oral bioavailability, which involves the release of nutraceuticals from fruit and vegetables in gastrointestinal fluids, the solubilization of nutraceuticals and their interaction with other components of gastrointestinal fluids, the absorption of nutraceuticals by the epithelial layer, and the chemical and biochemical transformations into epithelial cells. Several studies have shown that thermal processing can enhance the absorption of nutraceuticals from fruit and vegetable. Once absorbed, they reach the blood vessels and promote multiple biological effects (e.g., antioxidant, anti-inflammatory, antihypertensive, vasoprotective, and cardioprotective). In this review, we described the impact of different thermal processes (such as boiling, steaming and superheated steaming, blanching, and microwaving) on the retention/degradation of bioactive compounds and their health-promoting effects after the intake. We then summarized the impact of heating on the absorption of nutraceuticals and the biological effects promoted by natural compounds in the CV system to provide a comprehensive overview of the potential impact of thermal processing on the CV benefits of fruit and vegetables.
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Affiliation(s)
- Federica Narra
- Department of Agriculture, Food and Environment, University of Pisa, Pisa, Italy
| | - Eugenia Piragine
- Interdepartmental Research Center Nutrafood "Nutraceuticals and Food for Health", University of Pisa, Pisa, Italy
- Department of Pharmacy, University of Pisa, Pisa, Italy
| | | | - Costanza Ceccanti
- Department of Agriculture, Food and Environment, University of Pisa, Pisa, Italy
- Interdepartmental Research Center Nutrafood "Nutraceuticals and Food for Health", University of Pisa, Pisa, Italy
| | - Marta Florio
- Department of Agriculture, Food and Environment, University of Pisa, Pisa, Italy
| | | | | | - Roberto Giovannoni
- Interdepartmental Research Center Nutrafood "Nutraceuticals and Food for Health", University of Pisa, Pisa, Italy
- Department of Biology, University of Pisa, Pisa, Italy
| | - Alma Martelli
- Interdepartmental Research Center Nutrafood "Nutraceuticals and Food for Health", University of Pisa, Pisa, Italy
- Department of Pharmacy, University of Pisa, Pisa, Italy
| | - Lucia Guidi
- Department of Agriculture, Food and Environment, University of Pisa, Pisa, Italy
- Interdepartmental Research Center Nutrafood "Nutraceuticals and Food for Health", University of Pisa, Pisa, Italy
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Heidari Z, Farahmandpour F, Bazyar H, Pashayee-Khamene F. Effects of Hesperidin Supplementation on Cardiometabolic Markers: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Nutr Rev 2024:nuae084. [PMID: 39038797 DOI: 10.1093/nutrit/nuae084] [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: 07/24/2024] Open
Abstract
CONTEXT Hesperidin is a naturally occurring bioactive compound that may influence cardiometabolic markers, but the existing evidence is inconclusive. OBJECTIVE This study aims to further investigate the effects of hesperidin supplementation on cardiometabolic markers in adults. DATA SOURCES A comprehensive search was conducted up to August 2023, utilizing relevant key words in databases such as PubMed, Scopus, Embase, and the Cochrane Central Register of Controlled Trials, focusing on randomized controlled trials (RCTs). DATA EXTRACTION RCTs that examined the impact of hesperidin on fasting blood sugar (FBS), insulin, quantitative insulin-sensitivity check index (QUICKI), homeostatic model assessment of insulin resistance (HOMA-IR), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglyceride (TG), systolic blood pressure (SBP), diastolic blood pressure (DBP), tumor necrosis factor-alpha (TNF-α), and high-sensitivity C-reactive protein (hs-CRP) were selected independently by 2 authors. The GRADE assessment was used to ascertain the certainty of the evidence. Results were pooled using a random-effects model as weighted mean differences and 95% CIs. DATA ANALYSIS The results of this study demonstrate that hesperidin supplementation had a significant impact on reducing FBS, TG, TC, LDL-C, SBP, and TNF-α. However, there was no significant effect observed on insulin, HOMA-IR, QUICKI, HDL-C, DBP, and hs-CRP. The study's subgroup analyses also revealed that interventions lasting more than 12 weeks were effective in reducing FBS, TG, TC, and LDL-C. Moreover, hesperidin dosage exceeding 500 mg/day showed significance in reducing FBS, TC, and LDL-C levels. CONCLUSION In conclusion, this research suggests that hesperidin can be consumed as an effective dietary approach to enhance cardiometabolic markers. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42022325775.
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Affiliation(s)
- Zeinab Heidari
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, 6135715794, Iran
| | - Fatemeh Farahmandpour
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, 6135715794, Iran
| | - Hadi Bazyar
- Department of Public Health, Sirjan School of Medical Sciences, Sirjan, 7816916338, Iran
- Student Research Committee, Sirjan School of Medical Sciences, Sirjan, 7816916338, Iran
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Gao H, Chen F, Wang S. Hesperidin reduces systolic blood pressure in diabetic patients and has no effect on blood pressure in healthy individuals: A systematic review and meta-analysis. Phytother Res 2024; 38:3706-3719. [PMID: 38772688 DOI: 10.1002/ptr.8231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 04/19/2024] [Accepted: 04/20/2024] [Indexed: 05/23/2024]
Abstract
In recent years, there have been a number of studies where hesperidin was administered to modify arterial blood pressure, but the conclusions of each study are contradictory. In order to investigate the effect of hesperidin on blood pressure, we searched the CNKI, Wanfang Database, the VIP database, Sinomed database, Pubmed, Embase and The Cochrane Library databases, and searched the literature on hesperidin and blood pressure published in Chinese and English journals, mainly focusing on patients' systolic blood pressure and diastolic blood pressure. The search time frame was from the inception of the databases until December 2023. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to assess the overall quality and used Cohen's kappa coefficient (κ) to measure agreement. We did preliminary screening of the retrieved literature through Notexpress, 14 articles with a total of 656 patients were included. Cochrance data conversion tool was used for data conversion, and RevMan 5.3 was used for meta-analysis, and finally Stata was used to make the Egger's test for the included study. The results of total population blood pressure showed that hesperidin had no antihypertensive effect on the population, but the conclusions changed when the population was divided into groups. The results of different populations showed that hesperidin had no effect on systolic blood pressure (weighted mean difference [WMD] = -0.50, 95% CI: -3.25 ~ 2.26, Z = 0.35, p = 0.72) and diastolic blood pressure (WMD = -0.51, 95% CI: -2.53 ~ 1.51, Z = 0.50, p = 0.62) in healthy individuals. However, hesperidin reduced systolic blood pressure in patients with type 2 diabetes (WMD = -4.32, 95% CI: - 7.77 ~ - 0.87, Z = 2.45, p = 0.01), and had a tendency to reduce diastolic blood pressure in diabetic patients (WMD = -3.72, 95% CI: -7.63 ~ 0.18, Z = 1.87, p = 0.06). The results in patients with type 2 diabetes needed to be further supported by future research focusing on individuals with diabetes.
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Affiliation(s)
- Haifeng Gao
- School of Pharmaceutical Sciences, Liaocheng University, Liaocheng, Shandong, China
| | - Fang Chen
- School of Pharmaceutical Sciences, Liaocheng University, Liaocheng, Shandong, China
| | - Shuo Wang
- School of Pharmaceutical Sciences, Liaocheng University, Liaocheng, Shandong, China
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Jalili F, Moradi S, Talebi S, Mehrabani S, Ghoreishy SM, Wong A, Jalalvand AR, Kermani MAH, Jalili C, Jalili F. The effects of citrus flavonoids supplementation on endothelial function: A systematic review and dose-response meta-analysis of randomized clinical trials. Phytother Res 2024; 38:2847-2859. [PMID: 38561995 DOI: 10.1002/ptr.8190] [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: 09/02/2023] [Revised: 01/25/2024] [Accepted: 03/03/2024] [Indexed: 04/04/2024]
Abstract
The present systematic review and dose-response meta-analysis was conducted to synthesize existing data from randomized clinical trials (RCTs) concerning the impact of citrus flavonoids supplementation (CFS) on endothelial function. Relevant RCTs were identified through comprehensive searches of the PubMed, ISI Web of Science, and Scopus databases up to May 30, 2023. Weighted mean differences and their corresponding 95% confidence intervals (CI) were pooled utilizing a random-effects model. A total of eight eligible RCTs, comprising 596 participants, were included in the analysis. The pooled data demonstrated a statistically significant augmentation in flow-mediated vasodilation (FMD) (2.75%; 95% CI: 1.29, 4.20; I2 = 87.3%; p < 0.001) associated with CFS compared to the placebo group. Furthermore, the linear dose-response analysis indicated that each increment of 200 mg/d in CFS led to an increase of 1.09% in FMD (95% CI: 0.70, 1.48; I2 = 94.5%; p < 0.001). The findings from the nonlinear dose-response analysis also revealed a linear relationship between CFS and FMD (Pnon-linearity = 0.903, Pdose-response <0.001). Our findings suggest that CFS enhances endothelial function. However, more extensive RTCs encompassing longer intervention durations and different populations are warranted to establish more precise conclusions.
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Affiliation(s)
- Farnaz Jalili
- University of Adelaide Faculty of Medicine, Adelide, Australia
| | - Sajjad Moradi
- Department of Nutrition and Food Sciences, Research Center for Evidence-Based Health Management, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Sepide Talebi
- Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Sanaz Mehrabani
- Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Seyed Mojtaba Ghoreishy
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
- Student Research Committee, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Alexei Wong
- Department of Health and Human Performance, Marymount University, School of Health Sciences, Arlington, Virginia, USA
| | - Ali R Jalalvand
- Research Center of Oils and Fats, Research Institute for Health Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohammad Ali Hojjati Kermani
- Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Cyrus Jalili
- Medical Biology Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Faramarz Jalili
- School of Health Administration, Dalhousie University, Halifax, Canada
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6
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Shylaja H, Viswanatha GL, Sunil V, Hussain SM, Farhana SA. Effect of hesperidin on blood pressure and lipid profile: A systematic review and meta-analysis of randomized controlled trials. Phytother Res 2024; 38:2560-2571. [PMID: 38462779 DOI: 10.1002/ptr.8174] [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: 07/05/2023] [Revised: 02/08/2024] [Accepted: 02/13/2024] [Indexed: 03/12/2024]
Abstract
The cardioprotective activity of hesperidin has been well demonstrated in several clinical studies. Also, there is a meta-analysis published on this topic in 2019. However, considering the recently published clinical studies, there is a scope for performing a systematic review and meta-analysis of hesperidin to determine its beneficial effect in alleviating alterations in cardiovascular parameters. In this study, the literature search was performed using online databases such as PubMed and Google Scholar till April 2023 involving randomized controlled studies conducted on hesperidin against various cardiovascular disorders including metabolic disorders in healthy/diseased individuals compared to the placebo/control. Based on the inclusion and exclusion criteria, nine clinical studies involving 2414 subjects were included. The meta-analysis revealed that hesperidin has significantly reduced the low-density lipoprotein (LDL) (IV: -0.55 (-0.94 to -0.16) at 95% CI, p = 0.005, I2 = 70%), total cholesterol (TC) (IV: -61 (-0.82 to -0.41) at 95% CI, p < 0.00001, I2 = 69%), and triglycerides (TG) (IV: -0.21 (-0.40 to -0.02) at 95% CI, p = 0.03, I2 = 12%). However, there were no statistically significant changes in the systolic blood pressure (IV: -0.29 (-2.21 to 1.63) at 95% CI, p = 0.77, I2 = 60%), diastolic blood pressure (IV: 0.79 (-0.74 to 2.31) at 95% CI, p = 0.31, I2 = 49%), and high-density lipoprotein (IV: 0.04 (-0.25 to 0.34) at 95% CI, p = 0.78, I2 = 56%) in the hesperidin treatment compared to the placebo/control. In conclusion, the outcomes of this meta-analysis suggest that hesperidin administration could benefit patients with CVD by reducing LDL, TC, and TG. Further high-quality studies are needed to firmly establish the clinical efficacy of hesperidin for its benefits in treating cardiovascular conditions.
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Affiliation(s)
| | | | | | - Shalam M Hussain
- Department of Clinical Pharmacy, Al-Rayan College of Health Sciences and Nursing, Madinah, Saudi Arabia
| | - Syeda Ayesha Farhana
- Department of Pharmaceutics, College of Pharmacy, Qassim University, Buraidah, Al Qassim, Saudi Arabia
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Liao G, Liu W, Dai Y, Shi X, Liu Y, Li D, Xu T. Beneficial effects of flavonoids on animal models of atherosclerosis: A systematic review and meta-analysis. iScience 2023; 26:108337. [PMID: 38026172 PMCID: PMC10665821 DOI: 10.1016/j.isci.2023.108337] [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: 05/23/2023] [Revised: 09/07/2023] [Accepted: 10/23/2023] [Indexed: 12/01/2023] Open
Abstract
Atherosclerosis is the main cause of cardiovascular diseases that seriously endanger human health. The existing treatment drugs are effective, but they have some side effects. Accumulating evidence suggests that flavonoids have attracted wide attention due to their multiple cardioprotective effects and fewer side effects. PubMed, Web of Science database, Embase, and Cochrane Library were searched for studies evaluating the effects of flavonoids against atherosclerosis. 119 studies published from August 1954 to April 2023 were included. Random-effects models were performed for synthesis. Compared with the control group, flavonoids significantly reduced longitudinal and cross-sectional plaque area. The findings indicated that flavonoids significantly reduced the concentrations of serum TC, TG, and LDL-C and increased serum HDL-C concentrations. Besides, flavonoids reduced the levels of circulating pro-inflammatory factors, including TNF-α, IL-1β, and IL-6, and increased the serum IL-10 level. This study provides evidence for the potential cardiovascular benefits of flavonoids.
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Affiliation(s)
- Gege Liao
- Institute of Cardiovascular Disease Research, Xuzhou Medical University, Xuzhou, China
| | - Wanlu Liu
- Institute of Cardiovascular Disease Research, Xuzhou Medical University, Xuzhou, China
| | - Yiming Dai
- Institute of Cardiovascular Disease Research, Xuzhou Medical University, Xuzhou, China
| | - Xiangxiang Shi
- Department of Cardiology, the Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Yang Liu
- Institute of Cardiovascular Disease Research, Xuzhou Medical University, Xuzhou, China
| | - Dongye Li
- Institute of Cardiovascular Disease Research, Xuzhou Medical University, Xuzhou, China
| | - Tongda Xu
- Department of Cardiology, the Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
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Ebrahimi F, Ghazimoradi MM, Fatima G, Bahramsoltani R. Citrus flavonoids and adhesion molecules: Potential role in the management of atherosclerosis. Heliyon 2023; 9:e21849. [PMID: 38028000 PMCID: PMC10663934 DOI: 10.1016/j.heliyon.2023.e21849] [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: 06/09/2023] [Revised: 10/27/2023] [Accepted: 10/30/2023] [Indexed: 12/01/2023] Open
Abstract
Atherosclerosis as a chronic inflammatory disorder is accompanied with oxidative stress which causes a high morbidity and mortality. Adhesion molecules, including intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), P-selectin, and E-selectin, are amongst the most important contributors in atherosclerosis. In such cases, dietary interventions with functional foods containing natural antioxidant and anti-inflammatory constituents are of a great interest. Citrus fruits are rich sources of flavonoids as natural pigments with potent antioxidant and anti-inflammatory activities. This study aims to review current evidence regarding the role of citrus flavonoids in the management of atherosclerosis with a focus on their effect on adhesion molecules. Electronic databases including PubMed, Scopus, and Web of Science were searched with the names of adhesion molecules and flavonoids from inception until January 2023. The included articles highly support the beneficial effects of citrus flavonoids in preclinical models of atherosclerosis. Quercetin, naringin and naringenin, hesperidin and hesperetin, nobiletin, rutin, luteolin, apigenin, and kaempferol are the most common flavonoids in citrus fruits which could modulate adhesion molecules including ICAM-1, VCAM-1, E-selectin, and P-selectin. Additionally, markers of chronic inflammation such as interleukins, tumor necrosis factor-α, nuclear factor-κB, and nitric oxide signaling, as well as oxidative stress markers like superoxide dismutase and glutathione were all normalized upon administration of citrus flavonoids. Conclusively, this review confirms the modulatory role of flavonoids on adhesion molecules in atherosclerosis based on the preclinical evaluations. Thus, citrus fruits can be further studied in atherosclerotic patients regarding their activity in reducing adhesion molecules.
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Affiliation(s)
- Farnaz Ebrahimi
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy and Pharmaceutical Sciences, Isfahan, Iran
- PhytoPharmacology Interest Group (PPIG), Universal Scientific Education and Research Network (USERN), Isfahan, Iran
| | | | - Ghizal Fatima
- Era's Lucknow Medical College and Hospital, Era University, Lucknow, India
| | - Roodabeh Bahramsoltani
- Department of Traditional Pharmacy, School of Persian Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Booyani Z, Aryaeian N, Omidi N, Khorasanian AS, Hoseini AF, Nejatian M, Jazayeri S, Morvaridi M. Hesperidin reduces serum levels of triglyceride after coronary artery bypass graft surgery. Food Sci Nutr 2023; 11:7145-7154. [PMID: 37970430 PMCID: PMC10630806 DOI: 10.1002/fsn3.3639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 07/28/2023] [Accepted: 08/04/2023] [Indexed: 11/17/2023] Open
Abstract
Hesperidin, as an antioxidant and anti-inflammatory agent, has beneficial effects on cardiovascular diseases. This study aimed to determine the effects of hesperidin supplementation on inflammation, oxidative stress, and lipid profile in depressed coronary artery bypass graft surgery (CABG) patients. Eighty patients after coronary artery bypass graft surgery participated in this clinical trial and were randomly divided into two groups. The intervention group received 200 mg/d pure hesperidin supplement and the second group received placebo for 12 weeks. Both groups continued their usual diet. Serum concentrations of inflammatory and stress oxidative markers (hs-CRP, P-selectin, and ox-LDL) were measured and compared at baseline and the end of the intervention. The changes in serum levels of triglyceride were significantly different between the two groups (p < .05). HDL-c significantly increased in groups but the differences between the two groups were not statistically significant (p > .05). Hesperidin did not affect FBS, other lipid parameters, hs-CRP, P-selectin, and OX-LDL (p > .05). SBP and DBP differences were not statistically significant (p > .05). After 12 weeks of intervention, hesperidin reduced serum levels of triglyceride in depressed post-CABG patients.
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Affiliation(s)
- Zahra Booyani
- Department of Nutrition, School of Public HealthIran University of Medical SciencesTehranIran
| | - Naheed Aryaeian
- Department of Nutrition, School of Public HealthIran University of Medical SciencesTehranIran
| | - Negar Omidi
- Cardiac Primary Prevention Research Centre, Cardiovascular Disesae Research InstituteTehran University of Medical SciencesTehranIran
| | - Atie Sadat Khorasanian
- Department of Nutrition, School of Public HealthIran University of Medical SciencesTehranIran
| | - Agha Fatemeh Hoseini
- Department of Biostatistics, School of HealthIran University of Medical SciencesTehranIran
| | - Mostafa Nejatian
- Department of Cardiac Rehabilitation, Tehran Heart CenterTehran University of Medical SciencesTehranIran
| | - Shima Jazayeri
- Department of Nutrition, School of Public HealthIran University of Medical SciencesTehranIran
| | - Mehrnaz Morvaridi
- Department of Nutrition, School of Public HealthIran University of Medical SciencesTehranIran
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Khorasanian AS, Fateh ST, Gholami F, Rasaei N, Gerami H, Khayyatzadeh SS, Shiraseb F, Asbaghi O. The effects of hesperidin supplementation on cardiovascular risk factors in adults: a systematic review and dose-response meta-analysis. Front Nutr 2023; 10:1177708. [PMID: 37502716 PMCID: PMC10369082 DOI: 10.3389/fnut.2023.1177708] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 06/13/2023] [Indexed: 07/29/2023] Open
Abstract
Hesperidin is a naturally occurring bioactive compound that may have an impact on cardiovascular disease risks, but the evidence is not conclusive. To investigate further, this study aimed to explore the effects of hesperidin supplementation on cardiovascular risk factors in adults. A comprehensive search was conducted up to August 2022 using relevant keywords in databases such as Scopus, PubMed, Embase, Cochrane Library, and ISI Web of Science for all randomized controlled trials (RCTs). The results showed that hesperidin supplementation had a significant effect on reducing serum triglyceride (TG), total cholesterol (TC), low-density cholesterol (LDL), tumor necrosis factor-alpha (TNF-α), and systolic blood pressure (SBP), whereas weight was increased. However, no significant effect was observed on high-density cholesterol (HDL), waist circumference (WC), fasting blood glucose (FBG), insulin, homeostatic model assessment for insulin resistance (HOMA-IR), C-reactive protein (CRP), interleukin-6 (IL-6), body mass index (BMI), and diastolic blood pressure (DBP). The study also found that an effective dosage of hesperidin supplementation was around 1,000 mg/d, and a more effective duration of supplementation was more than eight weeks to decrease insulin levels. Furthermore, the duration of intervention of more than six weeks was effective in decreasing FBG levels.
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Affiliation(s)
- Atie Sadat Khorasanian
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | | | - Fatemeh Gholami
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Niloufar Rasaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Hadis Gerami
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sayyed Saeid Khayyatzadeh
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Nutrition, Faculty of Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Farideh Shiraseb
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Omid Asbaghi
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Student Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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11
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Chen Q, Hu K, Shi J, Li H, Li W. Hesperidin inhibits methylation and autophagy in LPS and high glucose-induced human villous trophoblasts. Biochem Biophys Res Commun 2023; 671:278-285. [PMID: 37311265 DOI: 10.1016/j.bbrc.2023.05.117] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 05/23/2023] [Accepted: 05/28/2023] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Gestational diabetes mellitus (GDM) is the first occurrence of diabetes due to abnormal maternal sugar metabolism after pregnancy, which may lead to adverse pregnancy outcomes. Hesperidin is known to decrease in the cord blood of GDM with obesity, but its role is unknown. This study aims to explore the potential function of hesperidin in GDM with obesity to develop new therapeutic ideas. METHODS Peripheral blood and placental tissues from GDM and GDM with obesity patients were collected to isolate human villous trophoblasts and detection. Bioinformatics was used to analyze the differential methylation genes between GDM and GDM with obesity. Immunofluorescence was applied for the detection of CK7 expression. Cells vitality was detected by CCK8 and transwell. Molecular docking was applied to predict the binding of hesperidin and ATG7 protein. Inflammation and m6A levels was analyzed by ELISA. ATG7, LC3, TLR4 and P62 proteins was analyzed by Western blot. RESULTS The methylation of ATG7 gene was up-regulated in GDM with obesity compared with GDM. The m6A and autophagy proteins levels in GDM with obesity were higher than that in GDM. LPS with 2.5-25 mM glucose induced the increase of autophagy proteins, inflammation and m6A levels in human villous trophoblasts. Hesperidin formed hydrogen bonds and hydrophobic interactions with ATG7 proteins. Hesperidin (0.25 μM) inhibited the autophagy proteins and m6A level in LPS and 25 mM glucose-induced human villous trophoblasts. DISCUSSION GDM with obesity followed the increase of autophagy proteins and m6A levels. Hesperidin inhibited the autophagy proteins and m6A level in LPS and glucose-induced human villous trophoblasts.
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Affiliation(s)
- Qiuling Chen
- Department of Obstetrics, Changsha Hospital for Maternal & Child Health Care Affiliated to Hunan Normal University, Changsha, 41700, Hunan, China
| | - Ke Hu
- Department of Obstetrics, Changsha Hospital for Maternal & Child Health Care Affiliated to Hunan Normal University, Changsha, 41700, Hunan, China
| | - Jun Shi
- Department of Obstetrics, Changsha Hospital for Maternal & Child Health Care Affiliated to Hunan Normal University, Changsha, 41700, Hunan, China
| | - Hua Li
- Department of Obstetrics, Changsha Hospital for Maternal & Child Health Care Affiliated to Hunan Normal University, Changsha, 41700, Hunan, China
| | - Wenxia Li
- Department of Obstetrics, Changsha Hospital for Maternal & Child Health Care Affiliated to Hunan Normal University, Changsha, 41700, Hunan, China.
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Polyphenols: a route from bioavailability to bioactivity addressing potential health benefits to tackle human chronic diseases. Arch Toxicol 2023; 97:3-38. [PMID: 36260104 DOI: 10.1007/s00204-022-03391-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 09/26/2022] [Indexed: 02/07/2023]
Abstract
Chronic pathologies or non-communicable diseases (NCDs) include cardiovascular diseases, metabolic syndrome, neurological diseases, respiratory disorders and cancer. They are the leading global cause of human mortality and morbidity. Given their chronic nature, NCDs represent a growing social and economic burden, hence urging the need for ameliorating the existing preventive strategies, and for finding novel tackling therapies. NCDs are highly correlated with unhealthy lifestyle habits (such as high-fat and high-glucose diet, or sedentary life). In general, lifestyle approaches that might improve these habits, including dietary consumption of fresh vegetables, fruits and fibers, may contrast NCD symptoms and prolong life expectancy of affected people. Polyphenols (PPLs) are plant-derived molecules with demonstrated biological activities in humans, which include: radical scavenging and anti-oxidant activities, capability to modulate inflammation, as well as human enzymes, and even to bind nuclear receptors. For these reasons, PPLs are currently tested, both preclinically and clinically, as dietary adjuvants for the prevention and treatment of NCDs. In this review, we describe the human metabolism and bioactivity of PPLs. Also, we report what is currently known about PPLs interaction with gastro-intestinal enzymes and gut microbiota, which allows their biotransformation in many different metabolites with several biological functions. The systemic bioactivity of PPLs and the newly available PPL-delivery nanosystems are also described in detail. Finally, the up-to-date clinical studies assessing both safety and efficacy of dietary PPLs in individuals with different NCDs are hereby reported. Overall, the clinical results support the notion that PPLs from fruits, vegetables, but also from leaves or seeds extracts, are safe and show significant positive results in ameliorating symptoms and improving the whole quality of life of people with NCDs.
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Amorphous Solid Dispersion of Hesperidin with Polymer Excipients for Enhanced Apparent Solubility as a More Effective Approach to the Treatment of Civilization Diseases. Int J Mol Sci 2022; 23:ijms232315198. [PMID: 36499518 PMCID: PMC9740072 DOI: 10.3390/ijms232315198] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 11/26/2022] [Accepted: 11/30/2022] [Indexed: 12/11/2022] Open
Abstract
The present study reports amorphous solid dispersions (ASDs) of hesperidin (Hes) prepared by ball milling to improve its solubility and apparent solubility over the unmodified compound. The carriers were Soluplus® (Sol), alginate sodium (SA), and hydroxypropylmethylcellulose (HPMC). XRPD analysis confirmed full amorphization of all binary systems in 1:5 w/w ratio. One glass transition (Tg) observed in DSC thermograms of hesperidin:Soluplus® (Hes:Sol) and hesperidin:HPMC (Hes:HPMC) 1:5 w/w systems confirmed complete miscibility. The mathematical model (Gordon-Taylor equation) indicates that the obtained amorphous systems are characterized by weak interactions. The FT-IR results confirmed that hydrogen bonds are responsible for stabilizing the amorphous state of Hes. Stability studies indicate that the strength of these bonds is insufficient to maintain the amorphous state of Hes under stress conditions (25 °C and 60 °C 76.4% RH). HPLC analysis suggested that the absence of degradation products indicates safe hesperidin delivery systems. The solubility and apparent solubility were increased in all media (water, phosphate buffer pH 6.8 and HCl (0.1 N)) compared to the pure compound. Our study showed that all obtained ASDs are promising systems for Hes delivery, wherein Hes:Sol 1:5 w/w has the best solubility (about 300-fold in each media) and apparent solubility (about 70% in phosphate buffer pH 6.8 and 63% in HCl).
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Fewkes JJ, Kellow NJ, Cowan SF, Williamson G, Dordevic AL. A single, high-fat meal adversely affects postprandial endothelial function: a systematic review and meta-analysis. Am J Clin Nutr 2022; 116:699-729. [PMID: 35665799 PMCID: PMC9437993 DOI: 10.1093/ajcn/nqac153] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 05/29/2022] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Endothelial dysfunction is a predictive risk factor for the development of atherosclerosis and is assessed by flow-mediated dilation (FMD). Although it is known that NO-dependent endothelial dysfunction occurs after consuming a high-fat meal, the magnitude of the effect and the factors that affect the response are unquantified. OBJECTIVES We conducted a systematic review and meta-analysis exploring the quantitative effects of a single high-fat meal on endothelial function and determined the factors that modify the FMD response. METHODS Six databases were systematically searched for original research published up to January 2022. Eligible studies measured fasting and postprandial FMD following consumption of a high-fat meal. Meta-regression was used to analyze the effect of moderator variables. RESULTS There were 131 studies included, of which 90 were suitable for quantitative meta-analysis. A high-fat meal challenge transiently caused endothelial dysfunction, decreasing postprandial FMD at 2 hours [-1.02 percentage points (pp); 95% CI: -1.34 to -0.70 pp; P < 0.01; I2 = 93.3%], 3 hours [-1.04 pp; 95% CI: -1.48 to -0.59 pp; P < 0.001; I2 = 84.5%], and 4 hours [-1.19 pp; 95% CI: -1.53 to -0.84 pp; P < 0.01; I2 = 94.6%]. Younger, healthy-weight participants exhibited a greater postprandial reduction in the FMD percentage change than older, heavier, at-risk groups after a high-fat meal ( P < 0.05). The percentage of fat in the meals was inversely associated with the magnitude of postprandial changes in FMD at 3 hours (P < 0.01). CONCLUSIONS A single, high-fat meal adversely impacts endothelial function, with the magnitude of the impact on postprandial FMD moderated by the fasting FMD, participant age, BMI, and fat content of the meal. Recommendations are made to standardize the design of future postprandial FMD studies and optimize interpretation of results, as high-fat meals are commonly used in clinical studies as a challenge to assess endothelial function and therapeutics. This trial was registered at PROSPERO as CRD42020187244.
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Affiliation(s)
- Juanita J Fewkes
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Faculty of Medicine Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
- Victorian Heart Institute, Monash University, Clayton, Victoria, Australia
| | - Nicole J Kellow
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Faculty of Medicine Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
- Centre for Innate Immunity and Infectious Diseases, Hudson Institute of Medical Research, Clayton, Victoria, Australia
| | - Stephanie F Cowan
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Faculty of Medicine Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Gary Williamson
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Faculty of Medicine Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
- Victorian Heart Institute, Monash University, Clayton, Victoria, Australia
| | - Aimee L Dordevic
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Faculty of Medicine Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
- Victorian Heart Institute, Monash University, Clayton, Victoria, Australia
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15
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Osama H, Hamed EO, Mahmoud MA, Abdelrahim MEA. The Effect of Hesperidin and Diosmin Individually or in Combination on Metabolic Profile and Neuropathy among Diabetic Patients with Metabolic Syndrome: A Randomized Controlled Trial. J Diet Suppl 2022; 20:749-762. [PMID: 35946912 DOI: 10.1080/19390211.2022.2107138] [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: 10/15/2022]
Abstract
Current evidence supports the association of metabolic syndrome (MetS) with neuropathy. Limited data are available on proper strategies to control metabolic disorders and neuropathy among patients with type2 diabetes mellitus (T2DM). We aimed to determine hesperidin and diosmin efficacy individually and in combination among T2DM patients with neuropathy and meet MetS criteria. In this parallel-group designed trial, 129 T2DM patients with MetS and neuropathy were recruited and randomized to receive their oral hypoglycemics with either hesperidin (1g/day), or diosmin (1g/day), or combination of both or oral hypoglycemics without intervention for 12 weeks. Diabetic neuropathy was evaluated using Michigan Neuropathy Screening Instrument (MNSI) at baseline and after trial. Anthropometric parameters, blood glucose and lipid profile were also assessed before and after the intervention using paired student t-test within groups. The trial is registered at clinicaltrials.gov as NCT05243238. By completion of the trial duration, both hesperidin and diosmin groups showed significant reduction in blood glucose, triglycerides (TGs) and low density lipoprotein (LDL) from baseline (p<0.05). However, the magnitude of improvement in metabolic components significantly increased with hesperidin and diosmin combination. Although MNSI scores improved significantly in both groups, the reduction was more significant with the combination of hesperidin and diosmin. Moreover, the change in MNSI score was significantly correlated with the improvement in metabolic profile components including LDL, TGs and fasting blood glucose. Oral supplementation of hesperidin and diosmin was associated with improvement in metabolic syndrome and diabetic neuropathy and the combination of both was superior in efficacy.
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Affiliation(s)
- Hasnaa Osama
- Clinical Pharmacy Department, Faculty of Pharmacy, Beni-Suef University, Beni-Suef, Egypt
| | - Ehdaa O Hamed
- Department of Chemistry, Toxicology And Nutritional Deficiency, Toxicology Unit, Animal Health Research Institute (AHRI), Agricultural Research Center (ARC), El-Fayoum Governorate Laboratory, Cairo, Egypt
| | | | - Mohamed E A Abdelrahim
- Clinical Pharmacy Department, Faculty of Pharmacy, Beni-Suef University, Beni-Suef, Egypt
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Effects of the Treatment with Flavonoids on Metabolic Syndrome Components in Humans: A Systematic Review Focusing on Mechanisms of Action. Int J Mol Sci 2022; 23:ijms23158344. [PMID: 35955475 PMCID: PMC9369232 DOI: 10.3390/ijms23158344] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 07/24/2022] [Accepted: 07/26/2022] [Indexed: 02/04/2023] Open
Abstract
Diets high in bioactive compounds, such as polyphenols, have been used to mitigate metabolic syndrome (MetS). Polyphenols are a large group of naturally occurring bioactive compounds, classified into two main classes: non-flavonoids and flavonoids. Flavonoids are distributed in foods, such as fruits, vegetables, tea, red wine, and cocoa. Studies have already demonstrated the benefits of flavonoids on the cardiovascular and nervous systems, as well as cancer cells. The present review summarizes the results of clinical studies that evaluated the effects of flavonoids on the components of the MetS and associated complications when offered as supplements over the long term. The results show that flavonoids can significantly modulate several metabolic parameters, such as lipid profile, blood pressure, and blood glucose. Only theaflavin and catechin were unable to affect metabolic parameters. Moreover, only body weight and body mass index were unaltered. Thus, the evidence presented in this systematic review offers bases in support of a flavonoid supplementation, held for at least 3 weeks, as a strategy to improve several metabolic parameters and, consequently, reduce the risk of diseases associated with MetS. This fact becomes stronger due to the rare side effects reported with flavonoids.
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Imperatrice M, Cuijpers I, Troost FJ, Sthijns MMJPE. Hesperidin Functions as an Ergogenic Aid by Increasing Endothelial Function and Decreasing Exercise-Induced Oxidative Stress and Inflammation, Thereby Contributing to Improved Exercise Performance. Nutrients 2022; 14:nu14142955. [PMID: 35889917 PMCID: PMC9316530 DOI: 10.3390/nu14142955] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 07/12/2022] [Accepted: 07/15/2022] [Indexed: 02/06/2023] Open
Abstract
The regulation of blood flow to peripheral muscles is crucial for proper skeletal muscle functioning and exercise performance. During exercise, increased mitochondrial oxidative phosphorylation leads to increased electron leakage and consequently induces an increase in ROS formation, contributing to DNA, lipid, and protein damage. Moreover, exercise may increase blood- and intramuscular inflammatory factors leading to a deterioration in endurance performance. The aim of this review is to investigate the potential mechanisms through which the polyphenol hesperidin could lead to enhanced exercise performance, namely improved endothelial function, reduced exercise-induced oxidative stress, and inflammation. We selected in vivo RCTs, animal studies, and in vitro studies in which hesperidin, its aglycone form hesperetin, hesperetin-metabolites, or orange juice are supplemented at any dosage and where the parameters related to endothelial function, oxidative stress, and/or inflammation have been measured. The results collected in this review show that hesperidin improves endothelial function (via increased NO availability), inhibits ROS production, decreases production and plasma levels of pro-inflammatory markers, and improves anaerobic exercise outcomes (e.g., power, speed, energy). For elite and recreational athletes, hesperidin could be used as an ergogenic aid to enhance muscle recovery between training sessions, optimize oxygen and nutrient supplies to the muscles, and improve anaerobic performance.
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Affiliation(s)
- Maria Imperatrice
- BioActor BV, Gaetano Martinolaan 50, 6229 GS Maastricht, The Netherlands
- Correspondence: (M.I.); (I.C.)
| | - Iris Cuijpers
- Food Innovation and Health, Department of Human Biology, Maastricht University, 6200 MD Maastricht, The Netherlands; (F.J.T.); (M.M.J.P.E.S.)
- Correspondence: (M.I.); (I.C.)
| | - Freddy J. Troost
- Food Innovation and Health, Department of Human Biology, Maastricht University, 6200 MD Maastricht, The Netherlands; (F.J.T.); (M.M.J.P.E.S.)
| | - Mireille M. J. P. E. Sthijns
- Food Innovation and Health, Department of Human Biology, Maastricht University, 6200 MD Maastricht, The Netherlands; (F.J.T.); (M.M.J.P.E.S.)
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Yao J, Zhang Y, Zhao J, Wang XZ, Lin YP, Sun L, Lu QY, Fan GJ. Efficacy of flavonoids-containing supplements on insulin resistance and associated metabolic risk factors in overweight and obese subjects: a systematic review and meta-analysis of 25 randomized controlled trials. Front Endocrinol (Lausanne) 2022; 13:917692. [PMID: 35937836 PMCID: PMC9355558 DOI: 10.3389/fendo.2022.917692] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 07/04/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Obesity is becoming a global epidemic. Flavonoids, with anti-inflammatory and antioxidative functions, are proposed to treat insulin resistance (IR) in obese subjects. We aimed to evaluate the effectiveness and safety of flavonoids-containing supplements on IR and associated metabolic risk factors in overweight and obese participants. METHODS Randomized controlled trials (RCTs) involving flavonoids-containing supplements used to treat overweight and obese subjects with results of IR, other associated metabolic risk factors, and adverse effects published were retrieved from 5 electronic databases from the year of inception to January 2, 2022. RESULTS Twenty-five RCTs (n = 1950) were included. Pooled results demonstrated that HOMA-IR in the group receiving flavonoids-containing supplements significantly decreased versus the control group (WMD = -0.132, 95% CI: -0.236 to -0.027, p = 0.013). Subgroup analyses showed that HOMA-IR in the subgroup receiving flavonoid-containing mixtures significantly decreased (WMD = -0.25, 95% CI: -0.43 to -0.06, p = 0.008), whereas such result was not found in the singly-used flavonoids subgroup (WMD = -0.08, 95% CI: -0.20 to 0.05, p = 0.240). In addition, QUICKI in the experimental group had an increasing trend compared to that in the control group (WMD = 0.01, 95% CI: -0.00 to 0.02, p = 0.065). For secondary outcomes, FBG, FBI, TC, TG, SBP, weight, BMI, and WHR in the group receiving flavonoids-containing supplements dropped significantly compared to those in the controls (WMD = -0.05, 95% CI: -0.08 to -0.02, p = 0.002; WMD = -0.58, 95% CI: -1.04 to -0.12, p = 0.014; WMD = -0.04, 95% CI: -0.06 to -0.03, p < 0.001; WMD = -0.04, 95% CI: -0.05 to -0.03, p < 0.001; WMD = -2.01, 95% CI: -3.17 to -0.86, p = 0.001; WMD = -0.29, 95% CI: -0.49 to -0.09, p = 0.004; WMD = -0.10 95% CI: -0.17 to -0.04, p = 0.003; WMD = -0.10, 95% CI: -0.01 to -0.00, p = 0.015; respectively). Adverse reactions did not differ between the group receiving flavonoids-containing supplements and the control group (RR = 0.97, 95% CI: 0.62 to 1.52, p = 0.905). CONCLUSION This study showed that flavonoids-containing supplements may be efficacious and safe in improving IR and associated metabolic risk factors in overweight and obese participants. Nevertheless, doubt over the findings remains because limited RCTs per type of flavonoids-containing supplement were investigated, and many of the RCTs had a small sample size. Therefore, the findings must be validated in future research. SYSTEMATIC REVIEW REGISTRATION https://inplasy.com/inplasy-2022-2-0011/, identifier INPLASY202220011.
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Affiliation(s)
- Jia Yao
- School of Second Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Endocrinology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Endocrinology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Yuan Zhang
- School of Second Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Endocrinology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Endocrinology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Jia Zhao
- School of Second Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xian-Zhe Wang
- School of Second Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yu-Ping Lin
- Department of Endocrinology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Lu Sun
- Department of Endocrinology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Qi-Yun Lu
- Department of Endocrinology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Guan-Jie Fan
- Department of Endocrinology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
- *Correspondence: Guan-Jie Fan,
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Li L, Jin N, Ji K, He Y, Li H, Liu X. Does chronic consumption of orange juice improve cardiovascular risk factors in overweight and obese adults? A systematic review and meta-analysis of randomized controlled trials. Food Funct 2022; 13:11945-11953. [DOI: 10.1039/d2fo02195a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This is the first meta-analysis that investigates the effects of chronic consumption of orange juice on cardiovascular risk factors in overweight and obese adults, demonstrating beneficial effects on blood pressure and HDL-C.
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Affiliation(s)
- Lu Li
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, Beijing Engineering and Technology Research Center of Food Additives, National Soybean Processing Industry Technology Innovation Center, School of Food and Health, Beijing Technology and Business University, Beijing, China
| | - Nini Jin
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, Beijing Engineering and Technology Research Center of Food Additives, National Soybean Processing Industry Technology Innovation Center, School of Food and Health, Beijing Technology and Business University, Beijing, China
| | - Kexin Ji
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, Beijing Engineering and Technology Research Center of Food Additives, National Soybean Processing Industry Technology Innovation Center, School of Food and Health, Beijing Technology and Business University, Beijing, China
| | - Yueyue He
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, Beijing Engineering and Technology Research Center of Food Additives, National Soybean Processing Industry Technology Innovation Center, School of Food and Health, Beijing Technology and Business University, Beijing, China
| | - He Li
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, Beijing Engineering and Technology Research Center of Food Additives, National Soybean Processing Industry Technology Innovation Center, School of Food and Health, Beijing Technology and Business University, Beijing, China
| | - Xinqi Liu
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, Beijing Engineering and Technology Research Center of Food Additives, National Soybean Processing Industry Technology Innovation Center, School of Food and Health, Beijing Technology and Business University, Beijing, China
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20
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Pla-Pagà L, Valls RM, Pedret A, Calderón-Pérez L, Llauradó E, Companys J, Domenech-Coca C, Canela N, Del Bas JM, Caimari A, Puiggròs F, Mi C, Arola L, Solà R. Effect of the consumption of hesperidin in orange juice on the transcriptomic profile of subjects with elevated blood pressure and stage 1 hypertension: A randomized controlled trial (CITRUS study). Clin Nutr 2021; 40:5812-5822. [PMID: 34800819 DOI: 10.1016/j.clnu.2021.10.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 09/21/2021] [Accepted: 10/14/2021] [Indexed: 12/19/2022]
Abstract
SCOPE Hesperidin exerts cardiovascular beneficial effects, but its mechanisms of action remain undefined. In a previous study we demonstrated that a single dose and a 12-week treatment of hesperidin decreased systolic blood pressure. The aim of this study was to ascertain the action mechanisms of hesperidin consumption in subjects with elevated blood pressure or with stage 1 hypertension, by determining their transcriptomic profile after a single dose or a 12-week treatment. METHODS AND RESULTS For transcriptomic analysis, peripheral blood mononuclear cells were obtained from 37 subjects with elevated blood pressure and stage 1 hypertension from CITRUS study who were randomized to receive for 12 weeks: control drink (CD; n = 11), OJ (containing 345 mg of hesperidin; n = 15) or EOJ (containing 600 mg of hesperidin; n = 11). Before starting the 12-weeks treatment, a single dose study with a 6 h of follow-up in each group was performed. After the single dose consumption, EOJ versus OJ, downregulated DHRS9 gene which is related with insulin resistance. Compared to CD, 12-week treatment of EOJ downregulated 6 proinflammatory genes while after OJ consumption only 1 proinflammatory gene was downregulated. Moreover, 12-week treatment of EOJ versus OJ, downregulated acute coronary syndrome gene related (SELENBP1). CONCLUSION A single dose consumption of EOJ could protect from insulin resistance. Moreover, EOJ decrease the expression of proinflammatory genes after 12-week treatment providing a possible mechanism of action on inflammation pathway.
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Affiliation(s)
- Laura Pla-Pagà
- Eurecat, Centre Tecnològic de Catalunya, Unitat de Nutrició i Salut, Reus, Spain; Universitat Rovira i Virgili, Facultat de Medicina i Ciències de la Salut, Functional Nutrition, Oxidation and Cardiovascular Disease Group (NFOC-Salut), Reus, Spain
| | - Rosa M Valls
- Eurecat, Centre Tecnològic de Catalunya, Unitat de Nutrició i Salut, Reus, Spain; Universitat Rovira i Virgili, Facultat de Medicina i Ciències de la Salut, Functional Nutrition, Oxidation and Cardiovascular Disease Group (NFOC-Salut), Reus, Spain.
| | - Anna Pedret
- Eurecat, Centre Tecnològic de Catalunya, Unitat de Nutrició i Salut, Reus, Spain; Universitat Rovira i Virgili, Facultat de Medicina i Ciències de la Salut, Functional Nutrition, Oxidation and Cardiovascular Disease Group (NFOC-Salut), Reus, Spain.
| | - Lorena Calderón-Pérez
- Eurecat, Centre Tecnològic de Catalunya, Unitat de Nutrició i Salut, Reus, Spain; Universitat Rovira i Virgili, Facultat de Medicina i Ciències de la Salut, Functional Nutrition, Oxidation and Cardiovascular Disease Group (NFOC-Salut), Reus, Spain
| | - Elisabet Llauradó
- Universitat Rovira i Virgili, Facultat de Medicina i Ciències de la Salut, Functional Nutrition, Oxidation and Cardiovascular Disease Group (NFOC-Salut), Reus, Spain
| | - Judit Companys
- Eurecat, Centre Tecnològic de Catalunya, Unitat de Nutrició i Salut, Reus, Spain; Universitat Rovira i Virgili, Facultat de Medicina i Ciències de la Salut, Functional Nutrition, Oxidation and Cardiovascular Disease Group (NFOC-Salut), Reus, Spain
| | | | - Nuria Canela
- Eurecat, Centre Tecnològic de Catalunya, Centre for Omic Sciences, Joint Unit Universitat Rovira i Virgili-EURECAT, Reus, Spain
| | - Josep M Del Bas
- Eurecat, Centre Tecnològic de Catalunya, Unitat de Nutrició i Salut, Reus, Spain
| | - Antoni Caimari
- Eurecat, Centre Tecnològic de Catalunya, Unitat de Nutrició i Salut, Reus, Spain
| | - Francesc Puiggròs
- Eurecat, Centre Tecnològic de Catalunya, Centre for Omic Sciences, Joint Unit Universitat Rovira i Virgili-EURECAT, Reus, Spain
| | - Covas Mi
- Nutritional Projects Assessment (Nuproas.es), Barcelona, Spain
| | - Lluís Arola
- Eurecat, Centre Tecnològic de Catalunya, Centre for Omic Sciences, Joint Unit Universitat Rovira i Virgili-EURECAT, Reus, Spain
| | - Rosa Solà
- Universitat Rovira i Virgili, Facultat de Medicina i Ciències de la Salut, Functional Nutrition, Oxidation and Cardiovascular Disease Group (NFOC-Salut), Reus, Spain; Hospital Universitari Sant Joan de Reus, Reus, Spain
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21
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Agrawal PK, Agrawal C, Blunden G. Pharmacological Significance of Hesperidin and Hesperetin, Two Citrus Flavonoids, as Promising Antiviral Compounds for Prophylaxis Against and Combating COVID-19. Nat Prod Commun 2021. [DOI: 10.1177/1934578x211042540] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Hesperidin and hesperetin are flavonoids that are abundantly present as constituents of citrus fruits. These compounds have attracted attention as several computational methods, mostly docking studies, have shown that hesperidin may bind to multiple regions of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (spike protein, angiotensin-converting enzyme 2, and proteases). Hesperidin has a low binding energy, both with the SARS-CoV-2 “spike” protein responsible for internalization, and also with the “PLpro” and “Mpro” responsible for transforming the early proteins of the virus into the complex responsible for viral replication. This suggests that these flavonoids could act as prophylactic agents by blocking several mechanisms of viral infection and replication, and thus helping the host cell to resist viral attack.
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Affiliation(s)
| | | | - Gerald Blunden
- School of Pharmacy & Biomedical Sciences, University of Portsmouth, Portsmouth, UK
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22
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Valls RM, Pedret A, Calderón-Pérez L, Llauradó E, Pla-Pagà L, Companys J, Moragas A, Martín-Luján F, Ortega Y, Giralt M, Rubió L, Canela N, Puiggrós F, Caimari A, Del Bas JM, Arola L, Solà R. Hesperidin in orange juice improves human endothelial function in subjects with elevated blood pressure and stage 1 hypertension: A randomized, controlled trial (Citrus study). J Funct Foods 2021. [DOI: 10.1016/j.jff.2021.104646] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
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23
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Visvanathan R, Williamson G. Effect of citrus fruit and juice consumption on risk of developing type 2 diabetes: Evidence on polyphenols from epidemiological and intervention studies. Trends Food Sci Technol 2021. [DOI: 10.1016/j.tifs.2021.06.038] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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24
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Cannataro R, Fazio A, La Torre C, Caroleo MC, Cione E. Polyphenols in the Mediterranean Diet: From Dietary Sources to microRNA Modulation. Antioxidants (Basel) 2021; 10:328. [PMID: 33672251 PMCID: PMC7926722 DOI: 10.3390/antiox10020328] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 02/14/2021] [Accepted: 02/16/2021] [Indexed: 02/05/2023] Open
Abstract
It is now well established that polyphenols are a class of natural substance that offers numerous health benefits; they are present in all plants in very different quantities and types. On the other hand, their bioavailability, and efficacy is are not always well proven. Therefore, this work aims to discuss some types of polyphenols belonging to Mediterranean foods. We chose six polyphenols-(1) Naringenin, (2) Apigenin, (3) Kaempferol, (4) Hesperidin, (5) Ellagic Acid and (6) Oleuropein-present in Mediterranean foods, describing dietary source and their chemistry, as well as their pharmacokinetic profile and their use as nutraceuticals/supplements, in addition to the relevant element of their capability in modulating microRNAs expression profile.
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Affiliation(s)
- Roberto Cannataro
- Department of Pharmacy, Health and Nutritional Sciences, Department of Excellence 2018-2022, University of Calabria, Edificio Polifunzionale, 87036 Rende (CS), Italy; (R.C.); (A.F.); (C.L.T.); (E.C.)
- GalaScreen Laboratories, Department of Pharmacy, Health and Nutrition Sciences, University of Calabria, 87036 Rende (CS), Italy
| | - Alessia Fazio
- Department of Pharmacy, Health and Nutritional Sciences, Department of Excellence 2018-2022, University of Calabria, Edificio Polifunzionale, 87036 Rende (CS), Italy; (R.C.); (A.F.); (C.L.T.); (E.C.)
| | - Chiara La Torre
- Department of Pharmacy, Health and Nutritional Sciences, Department of Excellence 2018-2022, University of Calabria, Edificio Polifunzionale, 87036 Rende (CS), Italy; (R.C.); (A.F.); (C.L.T.); (E.C.)
- GalaScreen Laboratories, Department of Pharmacy, Health and Nutrition Sciences, University of Calabria, 87036 Rende (CS), Italy
| | - Maria Cristina Caroleo
- Department of Pharmacy, Health and Nutritional Sciences, Department of Excellence 2018-2022, University of Calabria, Edificio Polifunzionale, 87036 Rende (CS), Italy; (R.C.); (A.F.); (C.L.T.); (E.C.)
- GalaScreen Laboratories, Department of Pharmacy, Health and Nutrition Sciences, University of Calabria, 87036 Rende (CS), Italy
| | - Erika Cione
- Department of Pharmacy, Health and Nutritional Sciences, Department of Excellence 2018-2022, University of Calabria, Edificio Polifunzionale, 87036 Rende (CS), Italy; (R.C.); (A.F.); (C.L.T.); (E.C.)
- GalaScreen Laboratories, Department of Pharmacy, Health and Nutrition Sciences, University of Calabria, 87036 Rende (CS), Italy
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25
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Salehi B, Cruz-Martins N, Butnariu M, Sarac I, Bagiu IC, Ezzat SM, Wang J, Koay A, Sheridan H, Adetunji CO, Semwal P, Schoebitz M, Martorell M, Sharifi-Rad J. Hesperetin's health potential: moving from preclinical to clinical evidence and bioavailability issues, to upcoming strategies to overcome current limitations. Crit Rev Food Sci Nutr 2021; 62:4449-4464. [PMID: 33491467 DOI: 10.1080/10408398.2021.1875979] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Flavonoids are common in the plant kingdom and many of them have shown a wide spectrum of bioactive properties. Hesperetin (Hst), the aglycone form of hesperidin, is a great example, and is the most abundant flavonoid found in Citrus plants. This review aims to provide an overview on the in vitro, in vivo and clinical studies reporting the Hst pharmacological effects and to discuss the bioavailability-related issues. Preclinical studies have shown promising effects on cancer, cardiovascular diseases, carbohydrate dysregulation, bone health, and other pathologies. Clinical studies have supported the Hst promissory effects as cardioprotective and neuroprotective agent. However, further well-designed clinical trials are needed to address the other Hst effects observed in preclinical trials, as well as to a more in-depth understanding of its safety profile.
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Affiliation(s)
- Bahare Salehi
- Medical Ethics and Law Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Natália Cruz-Martins
- Faculty of Medicine, University of Porto, Alameda Professor Hernâni Monteiro, Porto, Portugal.,Institute for Research and Innovation in Health (i3S), University of Porto, Porto, Portugal.,Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Portugal
| | - Monica Butnariu
- Banat's University of Agricultural Sciences and Veterinary Medicine "King Michael I of Romania" from Timisoara, Timisoara, Romania
| | - Ioan Sarac
- Banat's University of Agricultural Sciences and Veterinary Medicine "King Michael I of Romania" from Timisoara, Timisoara, Romania
| | - Iulia-Cristina Bagiu
- Timisoara, Discipline of Microbiology, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - Shahira M Ezzat
- Pharmacognosy Department, Faculty of Pharmacy, Cairo University, Cairo, Egypt.,Department of Pharmacognosy, Faculty of Pharmacy, October University for Modern Sciences and Arts (MSA), Giza, Egypt
| | - Jinfan Wang
- Trinity College Dublin. NatPro (Natural Products Research Centre), School of Pharmacy and Pharmaceutical Science, Dublin, Ireland
| | - Aaron Koay
- Trinity College Dublin. NatPro (Natural Products Research Centre), School of Pharmacy and Pharmaceutical Science, Dublin, Ireland
| | - Helen Sheridan
- Trinity College Dublin. NatPro (Natural Products Research Centre), School of Pharmacy and Pharmaceutical Science, Dublin, Ireland
| | - Charles Oluwaseun Adetunji
- Applied Microbiology, Biotechnology and Nanotechnology Laboratory, Department of Microbiology, Edo University Iyamho, Auchi, Edo State, Nigeria
| | - Prabhakar Semwal
- Department of Biotechnology, Graphic Era University, Dehradun, Uttarakhand, India.,Uttarakhand State Council for Science and Technology, Dehradun, Uttarakhand, India
| | - Mauricio Schoebitz
- Departamento de Suelos y Recursos Naturales, Facultad de Agronomía, Universidad de Concepción, Concepción, Chile
| | - Miquel Martorell
- Department of Nutrition and Dietetics, Faculty of Pharmacy, and Centre for Healthy Living, University of Concepción, Concepción, Chile.,Unidad de Desarrollo Tecnológico, Universidad de Concepción UDT, Concepcion, Chile
| | - Javad Sharifi-Rad
- Phytochemistry Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Facultad de Medicina, Universidad del Azuay, Cuenca, Ecuador
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26
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Wang Y, Liu XJ, Chen JB, Cao JP, Li X, Sun CD. Citrus flavonoids and their antioxidant evaluation. Crit Rev Food Sci Nutr 2021; 62:3833-3854. [PMID: 33435726 DOI: 10.1080/10408398.2020.1870035] [Citation(s) in RCA: 72] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The antioxidant ability is the link and bridge connecting a variety of biological activities. Citrus flavonoids play an essential role in regulating oxidative stress and are an important source of daily intake of antioxidant supplements. Many studies have shown that citrus flavonoids promote health through antioxidation. In this review, the biosynthesis, composition and distribution of citrus flavonoids were concluded. The detection methods of antioxidant capacity of citrus flavonoids were divided into four categories: chemical, cellular, animal and clinical antioxidant capacity evaluation systems. The modeling methods, applicable scenarios, and their relative merits were compared based on these four systems. The antioxidant functions of citrus flavonoids under different evaluation systems were also discussed, especially the regulation of the Nrf2-antioxidases pathway. Some shortcomings in the current research were pointed out, and some suggestions for progress were put forward.
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Affiliation(s)
- Yue Wang
- Laboratory of Fruit Quality Biology/The State Agriculture Ministry Laboratory of Horticultural Plant Growth, Development and Quality Improvement, Zhejiang University, Hangzhou, China
| | - Xiao-Juan Liu
- Laboratory of Fruit Quality Biology/The State Agriculture Ministry Laboratory of Horticultural Plant Growth, Development and Quality Improvement, Zhejiang University, Hangzhou, China
| | - Jie-Biao Chen
- Laboratory of Fruit Quality Biology/The State Agriculture Ministry Laboratory of Horticultural Plant Growth, Development and Quality Improvement, Zhejiang University, Hangzhou, China
| | - Jin-Ping Cao
- Laboratory of Fruit Quality Biology/The State Agriculture Ministry Laboratory of Horticultural Plant Growth, Development and Quality Improvement, Zhejiang University, Hangzhou, China
| | - Xian Li
- Laboratory of Fruit Quality Biology/The State Agriculture Ministry Laboratory of Horticultural Plant Growth, Development and Quality Improvement, Zhejiang University, Hangzhou, China
| | - Chong-De Sun
- Laboratory of Fruit Quality Biology/The State Agriculture Ministry Laboratory of Horticultural Plant Growth, Development and Quality Improvement, Zhejiang University, Hangzhou, China
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27
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Yari Z, Naser-Nakhaee Z, Karimi‐Shahrbabak E, Cheraghpour M, Hedayati M, Mohaghegh SM, Ommi S, Hekmatdoost A. Combination therapy of flaxseed and hesperidin enhances the effectiveness of lifestyle modification in cardiovascular risk control in prediabetes: a randomized controlled trial. Diabetol Metab Syndr 2021; 13:3. [PMID: 33402222 PMCID: PMC7786892 DOI: 10.1186/s13098-020-00619-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 12/17/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Regarding the increasing prevalence of cardiometabolic abnormalities, and its association with non-communicable chronic diseases, providing preventive and therapeutic strategies is a priority. A randomized placebo-controlled study was conducted to assess the effects of combination therapy of milled brown flaxseed and hesperidin during lifestyle intervention on controlling cardiovascular risk in prediabetes. METHODS A total of forty-eight subjects were randomly assigned to receive lifestyle intervention plus combination therapy of brown flaxseed (30 g milled) and hesperidin (two 500 mg capsules) or lifestyle modification alone for 12 weeks. Changes from baseline in anthropometric measures, lipid profile and atherogenic indices, glucose homeostasis parameters, and inflammatory biomarkers was assessed as a primary end point. RESULTS Anthropometric data comparison between the two groups showed a significant reduction in weight (p = 0.048). Waist circumference reduction was about twice that of the control group (- 6.75 cm vs - 3.57 cm), but this difference was not statistically significant. Comparison of blood pressure changes throughout the study indicated a greater reduction in blood pressure in the intervention group rather than control group (- 5.66 vs. - 1.56 mmHg, P = 0.049). Improvements of lipid profile and atherogenic indices, glucose homeostasis parameters, and inflammatory biomarkers in flaxseed-hesperidin group was significantly more than the control group after 12 weeks of intervention (p < 0.05). CONCLUSION Our results indicate that co-administration of flaxseed and hesperidin as an adjunct to lifestyle modification program is more effective than lifestyle modification alone in the metabolic abnormalities remission of prediabetic patients. TRIAL REGISTRATION The trial was registered with ClinicalTrials.gov, number NCT03737422. Registered 11 November 2018. Retrospectively registered, https://clinicaltrials.gov/ct2/results?cond=&term=NCT03737422&cntry=&state=&city=&dist= .
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Affiliation(s)
- Zahra Yari
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology, Research Institute Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Naser-Nakhaee
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology, Research Institute Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Makan Cheraghpour
- Cancer Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mehdi Hedayati
- Cellular and Molecular Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyede Marjan Mohaghegh
- Diabetes Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Shahrzad Ommi
- Department of Dietetics and Nutrition, Florida International University, Miami, FL USA
| | - Azita Hekmatdoost
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology, Research Institute Shahid Beheshti University of Medical Sciences, Tehran, Iran
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28
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van Iersel LE, Stevens YR, Conchillo JM, Troost FJ. The effect of citrus flavonoid extract supplementation on anaerobic capacity in moderately trained athletes: a randomized controlled trial. J Int Soc Sports Nutr 2021; 18:2. [PMID: 33407631 PMCID: PMC7789554 DOI: 10.1186/s12970-020-00399-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 12/07/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Nutritional supplementation is commonly used by athletes to improve their exercise performance. Previous studies demonstrated that citrus flavonoid extract (CFE) supplementation may be an effective strategy to improve exercise performance in male athletes. Yet, no conclusive research has been performed to investigate the effect of chronic CFE supplementation on high-intensity exercise performance under anaerobic conditions. Therefore, the aim of the study was to assess whether CFE supplementation in daily dosages of 400 and 500 mg for a period of 4 and 8 weeks improves anaerobic exercise capacity. METHODS A randomized, double-blind, placebo controlled, parallel clinical study was conducted in 92 moderately trained healthy men and women. Subjects were randomized to receive 400 mg of CFE (n = 30), 500 mg of CFE (n = 31) or placebo (n = 31) daily, for 8 consecutive weeks. The Wingate anaerobic test was used to assess anaerobic exercise capacity and power output at baseline, after 4 weeks and after 8 weeks. RESULTS After 4 weeks supplementation, average power output significantly increased in the 400 mg group (Estimated difference [ED] = 38.2 W [18.0, 58.3]; p < 0.001; effect size [ES] = 0.27) and in the 500 mg group (ED = 21.2 W [0.91, 41.4]; p = 0.041; ES = 0.15) compared to placebo. The 5 s peak power output was also increased in the 400 mg group (ED = 53.6 [9.96, 97.2]; p = 0.017; ES = 0.25) after 4 weeks compared to placebo. After 8 weeks of supplementation, average power output was significantly improved in the group receiving 400 mg of CFE (ED = 31.6 [8.33, 54.8]; p = 0.008; ES = 0.22) compared to placebo. CONCLUSION These results demonstrate that CFE supplementation improved anaerobic capacity and peak power during high intensity exercise in moderately trained individuals. Further research is needed to identify the underlying mechanisms that are affected by CFE supplementation. TRIAL REGISTRATION ClinicalTrials.gov ( NCT03044444 ). Registered 7 February 2017.
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Affiliation(s)
- Lieke E van Iersel
- BioActor BV, Gaetano Martinolaan 85, 6229 GS, Maastricht, The Netherlands
| | - Yala R Stevens
- BioActor BV, Gaetano Martinolaan 85, 6229 GS, Maastricht, The Netherlands. .,Division Gastroenterology-Hepatology, Department of Internal Medicine, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
| | - Jose M Conchillo
- Division Gastroenterology-Hepatology, Department of Internal Medicine, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
| | - Freddy J Troost
- Division Gastroenterology-Hepatology, Department of Internal Medicine, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.,Department of Food Innovation and Health, Centre for Healthy Eating and Food Innovation, Maastricht University, 5911 BV, Venlo, The Netherlands
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29
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Di Pietro N, Baldassarre MPA, Cichelli A, Pandolfi A, Formoso G, Pipino C. Role of Polyphenols and Carotenoids in Endothelial Dysfunction: An Overview from Classic to Innovative Biomarkers. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2020; 2020:6381380. [PMID: 33133348 PMCID: PMC7593735 DOI: 10.1155/2020/6381380] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 08/26/2020] [Accepted: 10/05/2020] [Indexed: 12/14/2022]
Abstract
Nowadays, the dramatically increased prevalence of metabolic diseases, such as obesity and diabetes mellitus and their related complications, including endothelial dysfunction and cardiovascular disease, represents one of the leading causes of death worldwide. Dietary nutrients together with healthy lifestyles have a crucial role in the endothelium health-promoting effects. From a growing body of evidence, active natural compounds from food, including polyphenols and carotenoids, have attracted particular attention as a complementary therapy on atherosclerosis and cardiovascular disease, as well as preventive approaches through the attenuation of inflammation and oxidative stress. They mainly act as radical scavengers by promoting a variety of biological mechanisms, such as improvements in endothelial function, blood pressure, platelet activity, and insulin sensitivity, and by modulating various known biomarkers. The present review highlights the role of polyphenols and carotenoids in early endothelial dysfunction with attention to their beneficial effect in modulating both classical and recent technologically generated emerging biomarkers. These, alone or in combination, can play an important role in the prediction, diagnosis, and evolution of cardiovascular disease. However, a main challenge is to speed up early and prompt new interventions in order to prevent or slow down disease progression, even with an adequate intake of bioactive compounds. Hence, there is an urgent need of new more validated, appropriate, and reliable diagnostic and therapeutic biomarkers useful to diagnose endothelial dysfunction at an earlier stage.
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Affiliation(s)
- Natalia Di Pietro
- Department of Medical, Oral and Biotechnological Sciences, University G. d'Annunzio of Chieti-Pescara, 66100 Chieti, Italy
- Center for Advanced Studies and Technology-CAST (ex CeSI-MeT), University G. d'Annunzio of Chieti-Pescara, 66100 Chieti, Italy
| | - Maria Pompea Antonia Baldassarre
- Center for Advanced Studies and Technology-CAST (ex CeSI-MeT), University G. d'Annunzio of Chieti-Pescara, 66100 Chieti, Italy
- Department of Medicine and Aging Sciences, University G. d'Annunzio of Chieti-Pescara, 66100 Chieti, Italy
| | - Angelo Cichelli
- Department of Medical, Oral and Biotechnological Sciences, University G. d'Annunzio of Chieti-Pescara, 66100 Chieti, Italy
| | - Assunta Pandolfi
- Department of Medical, Oral and Biotechnological Sciences, University G. d'Annunzio of Chieti-Pescara, 66100 Chieti, Italy
- Center for Advanced Studies and Technology-CAST (ex CeSI-MeT), University G. d'Annunzio of Chieti-Pescara, 66100 Chieti, Italy
| | - Gloria Formoso
- Center for Advanced Studies and Technology-CAST (ex CeSI-MeT), University G. d'Annunzio of Chieti-Pescara, 66100 Chieti, Italy
- Department of Medicine and Aging Sciences, University G. d'Annunzio of Chieti-Pescara, 66100 Chieti, Italy
| | - Caterina Pipino
- Department of Medical, Oral and Biotechnological Sciences, University G. d'Annunzio of Chieti-Pescara, 66100 Chieti, Italy
- Center for Advanced Studies and Technology-CAST (ex CeSI-MeT), University G. d'Annunzio of Chieti-Pescara, 66100 Chieti, Italy
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30
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Valls RM, Pedret A, Calderón-Pérez L, Llauradó E, Pla-Pagà L, Companys J, Moragas A, Martín-Luján F, Ortega Y, Giralt M, Romeu M, Rubió L, Mayneris-Perxachs J, Canela N, Puiggrós F, Caimari A, Del Bas JM, Arola L, Solà R. Effects of hesperidin in orange juice on blood and pulse pressures in mildly hypertensive individuals: a randomized controlled trial (Citrus study). Eur J Nutr 2020; 60:1277-1288. [PMID: 32661681 PMCID: PMC7987641 DOI: 10.1007/s00394-020-02279-0] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 05/11/2020] [Indexed: 12/25/2022]
Abstract
Purpose To assess the sustained and acute effects, as well as the influence of sustained consumption on the acute effects, of orange juice (OJ) with a natural hesperidin content and hesperidin-enriched OJ (EOJ) on blood (BP) and pulse (PP) pressures in pre- and stage-1 hypertensive individuals. Methods In a randomized, parallel, double-blind, placebo-controlled trial, participants (n = 159) received 500 mL/day of control drink, OJ, or EOJ for 12 weeks. Two dose–response studies were performed at baseline and after 12 weeks. Results A single EOJ dose (500 mL) reduced systolic BP (SBP) and PP, with greater changes after sustained treatment where a decrease in diastolic BP (DBP) also occurred (P < 0.05). SBP and PP decreased in a dose-dependent manner relative to the hesperidin content of the beverages throughout the 12 weeks (P < 0.05). OJ and EOJ decreased homocysteine levels at 12 weeks versus the control drink (P < 0.05). After 12 weeks of EOJ consumption, four genes related to hypertension (PTX3, NLRP3, NPSR1 and NAMPT) were differentially expressed in peripheral blood mononuclear cells (P < 0.05). Conclusion Hesperidin in OJ reduces SBP and PP after sustained consumption, and after a single dose, the chronic consumption of EOJ enhances its postprandial effect. Decreases in systemic and transcriptomic biomarkers were concomitant with BP and PP changes. EOJ could be a useful co-adjuvant tool for BP and PP management in pre- and stage-1 hypertensive individuals. Electronic supplementary material The online version of this article (10.1007/s00394-020-02279-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Rosa M Valls
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Universitat Rovira i Virgili, Facultat de Medicina i Ciències de La Salut, Reus, Spain
- Eurecat, Centre Tecnològic de Catalunya, Unitat de Nutrició i Salut, Av. de La Universitat, 1, 43204, Reus, Spain
| | - Anna Pedret
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Universitat Rovira i Virgili, Facultat de Medicina i Ciències de La Salut, Reus, Spain.
- Eurecat, Centre Tecnològic de Catalunya, Unitat de Nutrició i Salut, Av. de La Universitat, 1, 43204, Reus, Spain.
| | - Lorena Calderón-Pérez
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Universitat Rovira i Virgili, Facultat de Medicina i Ciències de La Salut, Reus, Spain
- Eurecat, Centre Tecnològic de Catalunya, Unitat de Nutrició i Salut, Av. de La Universitat, 1, 43204, Reus, Spain
| | - Elisabet Llauradó
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Universitat Rovira i Virgili, Facultat de Medicina i Ciències de La Salut, Reus, Spain
- Eurecat, Centre Tecnològic de Catalunya, Unitat de Nutrició i Salut, Av. de La Universitat, 1, 43204, Reus, Spain
| | - Laura Pla-Pagà
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Universitat Rovira i Virgili, Facultat de Medicina i Ciències de La Salut, Reus, Spain
- Eurecat, Centre Tecnològic de Catalunya, Unitat de Nutrició i Salut, Av. de La Universitat, 1, 43204, Reus, Spain
| | - Judit Companys
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Universitat Rovira i Virgili, Facultat de Medicina i Ciències de La Salut, Reus, Spain
- Eurecat, Centre Tecnològic de Catalunya, Unitat de Nutrició i Salut, Av. de La Universitat, 1, 43204, Reus, Spain
| | - Ana Moragas
- Departament de Medicina i Cirurgia, Universitat Rovira i Virgili, Reus, Spain
- Institut Universitari d'Investigació en Atenció Primària-IDIAP Jordi Gol, Tarragona, Spain
- Primary Care Centre Jaume I, Institut Català de la Salut, Tarragona, Spain
| | - Francisco Martín-Luján
- Departament de Medicina i Cirurgia, Universitat Rovira i Virgili, Reus, Spain
- Institut Universitari d'Investigació en Atenció Primària-IDIAP Jordi Gol, Tarragona, Spain
- Primary Care Centre El Morell, Institut Català de la Salut, Tarragona, Spain
| | - Yolanda Ortega
- Institut Universitari d'Investigació en Atenció Primària-IDIAP Jordi Gol, Tarragona, Spain
- Primary Care Centre Jaume I, Institut Català de la Salut, Tarragona, Spain
- Primary Care Centre Salou, Institut Català de la Salut, Tarragona, Spain
| | - Montse Giralt
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Universitat Rovira i Virgili, Facultat de Medicina i Ciències de La Salut, Reus, Spain
| | - Marta Romeu
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Universitat Rovira i Virgili, Facultat de Medicina i Ciències de La Salut, Reus, Spain
| | - Laura Rubió
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Universitat Rovira i Virgili, Facultat de Medicina i Ciències de La Salut, Reus, Spain
- Food Technology Department, XaRTA-TPV, Agrotecnio Center, Escola Tècnica Superior d'Enginyeria Agrària, University of Lleida, Av/ Alcalde Rovira Roure 191, 25198, Lleida, Spain
| | - Jordi Mayneris-Perxachs
- Eurecat, Centre Tecnològic de Catalunya, Unitat de Nutrició i Salut, Av. de La Universitat, 1, 43204, Reus, Spain
- Eurecat, Centre Tecnològic de Catalunya, Centre for Omic Sciences, Reus, Spain
| | - Núria Canela
- Eurecat, Centre Tecnològic de Catalunya, Centre for Omic Sciences, Reus, Spain
| | - Francesc Puiggrós
- Eurecat, Centre Tecnològic de Catalunya, Unitat de Nutrició i Salut, Av. de La Universitat, 1, 43204, Reus, Spain
| | - Antoni Caimari
- Eurecat, Centre Tecnològic de Catalunya, Unitat de Nutrició i Salut, Av. de La Universitat, 1, 43204, Reus, Spain
| | - Josep M Del Bas
- Eurecat, Centre Tecnològic de Catalunya, Unitat de Nutrició i Salut, Av. de La Universitat, 1, 43204, Reus, Spain
| | - Lluís Arola
- Eurecat, Centre Tecnològic de Catalunya, Unitat de Nutrició i Salut, Av. de La Universitat, 1, 43204, Reus, Spain
- Departament de Bioquímica i Biotecnologia, Grup de Recerca en Nutrigenòmica, Universitat Rovira i Virgili, Tarragona, Spain
| | - Rosa Solà
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Universitat Rovira i Virgili, Facultat de Medicina i Ciències de La Salut, Reus, Spain
- Eurecat, Centre Tecnològic de Catalunya, Unitat de Nutrició i Salut, Av. de La Universitat, 1, 43204, Reus, Spain
- Hospital Universitari Sant Joan de Reus, Reus, Spain
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Yari Z, Cheraghpour M, Alavian SM, Hedayati M, Eini-Zinab H, Hekmatdoost A. The efficacy of flaxseed and hesperidin on non-alcoholic fatty liver disease: an open-labeled randomized controlled trial. Eur J Clin Nutr 2020; 75:99-111. [PMID: 32647367 DOI: 10.1038/s41430-020-0679-3] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 05/31/2020] [Accepted: 06/29/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND/OBJECTIVES Non-alcoholic fatty liver disease (NAFLD) is growing in prevalence globally and no definitive evidence for any approved pharmacological approaches for patients with NAFLD has been found yet. This study was aimed to assess the clinical effects of flaxseed and hesperidin in patients with NAFLD. SUBJECTS/METHODS In this randomized, controlled, clinical trial, one hundred eligible patients with NAFLD were enrolled and randomly assigned to four dietary intervention groups including lifestyle modification program (control), lifestyle modification program with 30 g whole flaxseed powder, lifestyle modification program with 1 g hesperidin supplementation, and lifestyle modification program with combination of 30 g flaxseed and 1 g hesperidin (flax-hes) for 12 weeks. The changes in anthropometric parameters, metabolic profiles of glucose and lipids, inflammatory biomarkers and hepatic steatosis and fibrosis were evaluated. RESULTS After the 12-week dietary interventions, significant reductions in body mass index, glucose hemostasis parameters and hepatic steatosis were observed in all groups. Repeated measures analysis of variance revealed a significant effect for time relative to almost all paraclinical parameters. Post hoc analysis with Bonferroni correction revealed that the three intervention groups experienced significant decreases in plasma levels of alanine aminotransferase, indices of insulin resistance and insulin sensitivity, fasting glucose and fatty liver index compared to control (p < 0.008). CONCLUSIONS In conclusion, our study confirmed that hesperidin and flaxseed supplementation improved glucose and lipid metabolism, while reduced inflammation and hepatic steatosis (controlled attenuation parameter) in NAFLD patients. The synergistic effects of their combination were observed on plasma glucose concentration and HOMA-IR.
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Affiliation(s)
- Zahra Yari
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Makan Cheraghpour
- Cancer Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | | | - Mehdi Hedayati
- Cellular and Molecular Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hassan Eini-Zinab
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute; and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Azita Hekmatdoost
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Mas-Capdevila A, Teichenne J, Domenech-Coca C, Caimari A, Del Bas JM, Escoté X, Crescenti A. Effect of Hesperidin on Cardiovascular Disease Risk Factors: The Role of Intestinal Microbiota on Hesperidin Bioavailability. Nutrients 2020; 12:E1488. [PMID: 32443766 PMCID: PMC7284956 DOI: 10.3390/nu12051488] [Citation(s) in RCA: 84] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 05/07/2020] [Accepted: 05/18/2020] [Indexed: 12/12/2022] Open
Abstract
Recently, hesperidin, a flavonone mainly present in citrus fruits, has emerged as a new potential therapeutic agent able to modulate several cardiovascular diseases (CVDs) risk factors. Animal and in vitro studies demonstrate beneficial effects of hesperidin and its derived compounds on CVD risk factors. Thus, hesperidin has shown glucose-lowering and anti-inflammatory properties in diabetic models, dyslipidemia-, atherosclerosis-, and obesity-preventing effects in CVDs and obese models, and antihypertensive and antioxidant effects in hypertensive models. However, there is still controversy about whether hesperidin could contribute to ameliorate glucose homeostasis, lipid profile, adiposity, and blood pressure in humans, as evidenced by several clinical trials reporting no effects of treatments with this flavanone or with orange juice on these cardiovascular parameters. In this review, we focus on hesperidin's beneficial effects on CVD risk factors, paying special attention to the high interindividual variability in response to hesperidin-based acute and chronic interventions, which can be partly attributed to differences in gut microbiota. Based on the current evidence, we suggest that some of hesperidin's contradictory effects in human trials are partly due to the interindividual hesperidin variability in its bioavailability, which in turn is highly dependent on the α-rhamnosidase activity and gut microbiota composition.
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Affiliation(s)
- Anna Mas-Capdevila
- Eurecat, Technology Centre of Catalunya, Nutrition and Health Unit, 43204 Reus, Spain; (A.M.-C.); (J.T.); (C.D.-C.); (A.C.); (J.M.D.B.)
- Department of Biochemistry and Biotechnology, Universitat Rovira i Virgili, Campus Sescelades, 43007 Tarragona, Spain
| | - Joan Teichenne
- Eurecat, Technology Centre of Catalunya, Nutrition and Health Unit, 43204 Reus, Spain; (A.M.-C.); (J.T.); (C.D.-C.); (A.C.); (J.M.D.B.)
| | - Cristina Domenech-Coca
- Eurecat, Technology Centre of Catalunya, Nutrition and Health Unit, 43204 Reus, Spain; (A.M.-C.); (J.T.); (C.D.-C.); (A.C.); (J.M.D.B.)
| | - Antoni Caimari
- Eurecat, Technology Centre of Catalunya, Nutrition and Health Unit, 43204 Reus, Spain; (A.M.-C.); (J.T.); (C.D.-C.); (A.C.); (J.M.D.B.)
- Eurecat, Technology Centre of Catalunya, Biotechnology Area and Technological Unit of Nutrition and Health, 43204 Reus, Spain
| | - Josep M Del Bas
- Eurecat, Technology Centre of Catalunya, Nutrition and Health Unit, 43204 Reus, Spain; (A.M.-C.); (J.T.); (C.D.-C.); (A.C.); (J.M.D.B.)
| | - Xavier Escoté
- Eurecat, Technology Centre of Catalunya, Nutrition and Health Unit, 43204 Reus, Spain; (A.M.-C.); (J.T.); (C.D.-C.); (A.C.); (J.M.D.B.)
- Department of Biochemistry and Biotechnology, Universitat Rovira i Virgili, Campus Sescelades, 43007 Tarragona, Spain
| | - Anna Crescenti
- Eurecat, Technology Centre of Catalunya, Nutrition and Health Unit, 43204 Reus, Spain; (A.M.-C.); (J.T.); (C.D.-C.); (A.C.); (J.M.D.B.)
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Metabolomics Elucidates Dose-Dependent Molecular Beneficial Effects of Hesperidin Supplementation in Rats Fed an Obesogenic Diet. Antioxidants (Basel) 2020; 9:antiox9010079. [PMID: 31963315 PMCID: PMC7023145 DOI: 10.3390/antiox9010079] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 01/07/2020] [Accepted: 01/14/2020] [Indexed: 02/07/2023] Open
Abstract
Metabolic syndrome (MetS) is a global epidemic concern. Polyphenols are proposed as good candidates for its prevention, although their mechanisms are not fully understood. The gut microbiota seems to play a key role in polyphenol beneficial effects. Here, we assessed the effects of the citrus polyphenol hesperidin combining an untargeted metabolomics approach, which has an inherent potential to elucidate the host-microbiome interplay, with extensive anthropometric and biochemical characterizations and integrating metabolomics results with our previous 16S rRNA bacterial sequencing data. The rats were fed either a standard or an obesogenic cafeteria diet (CAF) for 17 weeks. After nine weeks, rats were supplemented with vehicle; low- (H1), or high- (H2) hesperidin doses. CAF animals developed MetS features. Hesperidin supplementation in CAF rats decreased the total cholesterol, LDL-C, and free fatty acids. The highest hesperidin dose also ameliorated blood pressure, insulin sensitivity, and decreased markers of arterial stiffness and inflammation. Metabolomics revealed an improvement of the lipidomic profile, decreases in circulating amino acids, and lower excretions of inflammation- and oxidative stress-related metabolites. Bacteroidaceae increases in the CAF-H2 group paralleled higher excretions of microbial-derived metabolites. Overall, our results provide detailed insights into the molecular effects of hesperidin on MetS and suggest that it is a promising prebiotic for the treatment of MetS and related conditions.
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Shams-Rad S, Mohammadi M, Ramezani-Jolfaie N, Zarei S, Mohsenpour M, Salehi-Abargouei A. Hesperidin supplementation has no effect on blood glucose control: A systematic review and meta-analysis of randomized controlled clinical trials. Br J Clin Pharmacol 2019; 86:13-22. [PMID: 31489695 DOI: 10.1111/bcp.14120] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 08/03/2019] [Accepted: 08/18/2019] [Indexed: 12/25/2022] Open
Abstract
AIMS To the best of our knowledge, no study has tried to quantitatively summarize the published evidence regarding the effect of hesperidin supplementation on blood glucose control. The present systematic review and meta-analysis of randomized controlled trials aimed to determine the effectiveness of hesperidin supplementation in improving blood glucose control in adults. METHODS Electronic databases including PubMed, ISI Web of Science, Scopus, and Google Scholar were searched up to February 2019. The risk of bias in individual studies was assessed using the Cochrane collaboration's tool. The overall estimates and their 95% confidence intervals (CIs) were calculated using a random-effects model. RESULTS Six trials with 318 participants were reviewed in the present systematic review. The results showed that hesperidin had no significant effect on serum fasting blood glucose (weighted mean difference [WMD] = -1.10 mg/dL, 95% CI: -3.79, 1.57), plasma insulin (WMD = -0.01 μU/mL, 95% CI: -1.20, 1.19), glycated haemoglobin A1c (WMD = -0.04%, 95% CI: -0.14, 0.04), homeostasis model assessment for insulin resistance (WMD = 0.117, 95% CI: -0.06, 0.29) and quantitative insulin sensitivity check index (WMD = 0.135; 95% CI: -0.13, 0.39), with no significant between-study heterogeneity. Subgroup analyses also indicated that the effects were not different based on the studies' design and duration, or the health status of the participants. CONCLUSION Although several animal studies have proposed that hesperidin supplementation might improve blood glucose control, the present study could not confirm this benefit in humans.
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Affiliation(s)
- Shamim Shams-Rad
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Mohammadi
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Nahid Ramezani-Jolfaie
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Sadegh Zarei
- Department of Clinical Biochemistry, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Mohammadali Mohsenpour
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Amin Salehi-Abargouei
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Hesperidin reduces adverse symptomatic intracerebral hemorrhage by promoting TGF-β1 for treating ischemic stroke using tissue plasminogen activator. Neurol Sci 2019; 41:139-147. [PMID: 31478148 DOI: 10.1007/s10072-019-04054-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 08/22/2019] [Indexed: 10/26/2022]
Abstract
Treatment with recombinant tissue plasminogen activator (rt-PA) is the most effective therapeutic option against brain ischemic stroke at the present time. However, elevated incidence of symptomatic intracerebral hemorrhage (SIH) greatly hinders ideal treatment outcome of rt-PA. We sought to assess the impacts of hesperidin on SIH following rt-PA therapies. Patients with ischemic stroke were assigned into two groups in a random fashion, to receive either rt-PA + placebo (Pc) or rt-PA + hesperidin. Treatment outcome was evaluated 24 h after the initial reperfusion using the transcranial Doppler ultrasonography (TCD) and the NIH Stroke Scale (NIHSS). Further, serum concentrations of transforming growth factor (TGF)-β1, matrix metalloproteinase (MMP)-2, and MMP-9 were examined. Following the initial administration, stroke patients continued to receive either daily Pc or daily hesperidin, and the treatment outcome after 7 days was examined using the TCD, NIHSS, Glasgow Outcome Scale (GOS), and the Modified Rankin Scale (MRS). Combined treatment of rt-PA with hesperidin yielded significant improvement of outcomes, as revealed by better TCD and NIHSS scores as well as decreased SIH incidences, which could be attributable to elevation of TGF-β1 and reduction in serum levels of both MMP-2 and MMP-9 caused by hesperidin. Follow-up hesperidin treatment for 7 consecutive days also markedly enhanced the recovery of stroke patients, as indicated by TCD, MRS, GOS, and NIHSS. Findings of the present study strongly suggested potential clinical application of hesperidin supplement in rt-PA therapies to reduce SIH and thereby improve the treatment outcomes of rt-PA in patients with ischemic stroke.
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Zhou Z, Kandhare AD, Kandhare AA, Bodhankar SL. Hesperidin ameliorates bleomycin-induced experimental pulmonary fibrosis via inhibition of TGF-beta1/Smad3/AMPK and IkappaBalpha/NF-kappaB pathways. EXCLI JOURNAL 2019; 18:723-745. [PMID: 31611754 PMCID: PMC6785776 DOI: 10.17179/excli2019-1094] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 08/26/2019] [Indexed: 12/12/2022]
Abstract
Bleomycin (BLM) is a chemotherapeutic agent which is associated with Idiopathic pulmonary fibrosis (IPF) due to its chronic administration. Hesperidin, a bioflavonoid has been reported to possess antioxidant, anti-inflammatory, wound healing, and antiapoptotic potential. To evaluate the therapeutic potential of hesperidin against BLM-induced pulmonary fibrosis and decipher its possible mechanism of action. Intraperitoneal administration of BLM (6 IU/kg) caused induction of IPF in Sprague-Dawley rats. Rats were treated with hesperidin (25, 50, and 100 mg/kg, p.o.) for 28 days, followed by estimation of various parameters in bronchoalveolar lavage fluid (BALF) and lung. Hesperidin (50 and 100 mg/kg) administration significantly ameliorated (p < 0.05) alterations induced by BLM in lung index, percent oxygen saturation, serum ALP and LDH levels, BALF differential cell count, and lung function test. Elevated levels of oxido-nitrosative stress, hydroxyproline, and myeloperoxidase levels in BALF and lung were significantly decreased by hesperidin on day 14. Hesperidin significantly inhibited BLM-induced down-regulated lung Nrf2 and HO-1 as well as up-regulated TNF-α, IL-1β, IL-6, collagen-1, TGF-β, and Smad-3 mRNA expressions. Western blot analysis showed that alteration in lung NF-κB, IκBα, AMPK, and PP2C-α protein expressions were ameliorated by hesperidin on day 28. Furthermore, BLM induced histological and ultrastructural aberrations in the lung which were attenuated by hesperidin treatment. Hesperidin alleviates BLM-induced IPF via inhibition of TGF-β1/Smad3/AMPK and IκBα/NF-κB pathways which in turn ameliorate the modulation of oxido-inflammatory markers (Nrf2 and HO-1) and pro-inflammatory markers (TNF-α, IL-1β, and IL-6) to reduce collagen deposition during pulmonary fibrosis. See also Figure 1(Fig. 1).
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Affiliation(s)
- Zheng Zhou
- Department of Respiratory Medicine, the Second Affiliated Hospital of Zhengzhou University, Zhengzhou City, Henan Province, 450014, China
| | - Amit D Kandhare
- Department of Pharmacology, Center for Advanced Research in Pharmaceutical Sciences, Bharati Vidyapeeth Deemed University, Poona College of Pharmacy, Pune-411 038, India
| | - Anwesha A Kandhare
- Department of Pharmacology, Center for Advanced Research in Pharmaceutical Sciences, Bharati Vidyapeeth Deemed University, Poona College of Pharmacy, Pune-411 038, India
| | - Subhash L Bodhankar
- Department of Pharmacology, Center for Advanced Research in Pharmaceutical Sciences, Bharati Vidyapeeth Deemed University, Poona College of Pharmacy, Pune-411 038, India
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The Postprandial Appearance of Features of Cardiometabolic Risk: Acute Induction and Prevention by Nutrients and Other Dietary Substances. Nutrients 2019; 11:nu11091963. [PMID: 31438565 PMCID: PMC6770341 DOI: 10.3390/nu11091963] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Revised: 08/18/2019] [Accepted: 08/19/2019] [Indexed: 12/11/2022] Open
Abstract
The purpose of this review is to provide an overview of diets, food, and food components that affect postprandial inflammation, endothelial function, and oxidative stress, which are related to cardiometabolic risk. A high-energy meal, rich in saturated fat and sugars, induces the transient appearance of a series of metabolic, signaling and physiological dysregulations or dysfunctions, including oxidative stress, low-grade inflammation, and endothelial dysfunction, which are directly related to the amplitude of postprandial plasma triglycerides and glucose. Low-grade inflammation and endothelial dysfunction are also known to cluster together with insulin resistance, a third risk factor for cardiovascular diseases (CVD) and type-II diabetes, thus making a considerable contribution to cardiometabolic risk. Because of the marked relevance of the postprandial model to nutritional pathophysiology, many studies have investigated whether adding various nutrients and other substances to such a challenge meal might mitigate the onset of these adverse effects. Some foods (e.g., nuts, berries, and citrus), nutrients (e.g., l-arginine), and other substances (various polyphenols) have been widely studied. Reports of favorable effects in the postprandial state have concerned plasma markers for systemic or vascular pro-inflammatory conditions, the activation of inflammatory pathways in plasma monocytes, vascular endothelial function (mostly assessed using physiological criteria), and postprandial oxidative stress. Although the literature is fragmented, this topic warrants further study using multiple endpoints and markers to investigate whether the interesting candidates identified might prevent or limit the postprandial appearance of critical features of cardiometabolic risk.
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Martínez-Noguera FJ, Marín-Pagán C, Carlos-Vivas J, Rubio-Arias JA, Alcaraz PE. Acute Effects of Hesperidin in Oxidant/Antioxidant State Markers and Performance in Amateur Cyclists. Nutrients 2019; 11:nu11081898. [PMID: 31416212 PMCID: PMC6723516 DOI: 10.3390/nu11081898] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 08/07/2019] [Accepted: 08/13/2019] [Indexed: 12/19/2022] Open
Abstract
Human and animal studies have shown that Hesperidin has the ability to modulate antioxidant and inflammatory state and to improve aerobic performance. The main objective of this study was to assess whether the acute intake of 500 mg of 2S-Hesperidin (Cardiose®) improves antioxidant status, metabolism, and athletic performance, during and after a rectangular test (aerobic and anaerobic effort). For this, a crossover design was used in 15 cyclists (>1 year of training), with one week of washout between placebo and Cardiose® supplementation. After the intervention, significant differences in average power (+2.27%, p = 0.023), maximum speed (+3.23%, p = 0.043) and total energy (∑ 4 sprint test) (+2.64%, p = 0.028) between Cardiose® and placebo were found in the best data of the repeated sprint test. Small changes were also observed in the activity of catalase, superoxide dismutase, reduced glutathione concentration and oxidized/reduced glutathione (GSSG/GSH) ratio, as well as the lipoperoxidation products (thiobarbituric acid reactive substances; TBARS), at different points of the rectangular test, although not significant. Our findings showed improvements in anaerobic performance after Cardiose® intake, but not in placebo, suggesting the potential benefits of using Cardiose® in sports with a high anaerobic component.
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Affiliation(s)
| | - Cristian Marín-Pagán
- Research Center for High Performance Sport, Catholic University of Murcia, 30107 Murcia, Spain.
| | - Jorge Carlos-Vivas
- Research Center for High Performance Sport, Catholic University of Murcia, 30107 Murcia, Spain
| | | | - Pedro E Alcaraz
- Faculty of Sport, Research Center for High Performance Sport, Catholic University of Murcia Catholic University of Murcia, 30107 Murcia, Spain
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Pla-Pagà L, Companys J, Calderón-Pérez L, Llauradó E, Solà R, Valls RM, Pedret A. Effects of hesperidin consumption on cardiovascular risk biomarkers: a systematic review of animal studies and human randomized clinical trials. Nutr Rev 2019; 77:845-864. [DOI: 10.1093/nutrit/nuz036] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Abstract
Context
The cardioprotective effects of the flavonoid hesperidin, which is present in citrus products, are controversial and unclear. This systematic review was conducted in accordance with the PRISMA 2015 guidelines.
Objective
To evaluate the current evidence from animal and human clinical studies and thus determine whether the consumption of hesperidin exerts beneficial effects on cardiovascular risk factors.
Data sources
PICOS (Population, Intervention, Comparison, Outcome, and Study Design) criteria defined the research question. Searches of the PubMed and Cochrane Plus databases were conducted and studies that met the inclusion criteria and were published in English in the last 15 years were included.
Data extraction
The first author, year of publication, study design, characteristics of animals and humans, intervention groups, dose of hesperidin, route of administration, duration of the intervention, cardiovascular risk biomarkers assessed, and results observed were extracted from the included articles.
Results
A total of 12 animal studies and 11 randomized clinical trials met the inclusion criteria. In the animal studies, the glucose, total and LDL cholesterol, and triglyceride levels decreased with chronic flavonoid consumption. In the human studies, endothelial function improved with flavonoid consumption, whereas no conclusive results were observed for the other biomarkers.
Conclusions
Animal studies have revealed that hesperidin and hesperetin consumption reduces glucose levels and various lipid profile parameters. However, a definitive conclusion cannot be drawn from the existing human clinical trials. Further research is needed to confirm whether the findings observed in animal models can also be observed in humans.
Systematic Review Registration
Prospero registration number CRD42018088942.
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Affiliation(s)
- L Pla-Pagà
- Eurecat, Centre Tecnològic de Catalunya, Unitat de Nutrició i Salut, Reus, Spain
- Universitat Rovira i Virgili, Facultat de Medicina i Ciències de la Salut, Functional Nutrition, Oxidation and Cardiovascular Disease Group (NFOC-SALUT), Reus, Spain
- Hospital Universitari Sant Joan, Reus, Spain
| | - J Companys
- Eurecat, Centre Tecnològic de Catalunya, Unitat de Nutrició i Salut, Reus, Spain
- Universitat Rovira i Virgili, Facultat de Medicina i Ciències de la Salut, Functional Nutrition, Oxidation and Cardiovascular Disease Group (NFOC-SALUT), Reus, Spain
| | - L Calderón-Pérez
- Eurecat, Centre Tecnològic de Catalunya, Unitat de Nutrició i Salut, Reus, Spain
- Universitat Rovira i Virgili, Facultat de Medicina i Ciències de la Salut, Functional Nutrition, Oxidation and Cardiovascular Disease Group (NFOC-SALUT), Reus, Spain
| | - E Llauradó
- Eurecat, Centre Tecnològic de Catalunya, Unitat de Nutrició i Salut, Reus, Spain
- Universitat Rovira i Virgili, Facultat de Medicina i Ciències de la Salut, Functional Nutrition, Oxidation and Cardiovascular Disease Group (NFOC-SALUT), Reus, Spain
| | - R Solà
- Eurecat, Centre Tecnològic de Catalunya, Unitat de Nutrició i Salut, Reus, Spain
- Universitat Rovira i Virgili, Facultat de Medicina i Ciències de la Salut, Functional Nutrition, Oxidation and Cardiovascular Disease Group (NFOC-SALUT), Reus, Spain
- Hospital Universitari Sant Joan, Reus, Spain
| | - R M Valls
- Eurecat, Centre Tecnològic de Catalunya, Unitat de Nutrició i Salut, Reus, Spain
- Universitat Rovira i Virgili, Facultat de Medicina i Ciències de la Salut, Functional Nutrition, Oxidation and Cardiovascular Disease Group (NFOC-SALUT), Reus, Spain
| | - A Pedret
- Eurecat, Centre Tecnològic de Catalunya, Unitat de Nutrició i Salut, Reus, Spain
- Universitat Rovira i Virgili, Facultat de Medicina i Ciències de la Salut, Functional Nutrition, Oxidation and Cardiovascular Disease Group (NFOC-SALUT), Reus, Spain
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Ruiz-León AM, Lapuente M, Estruch R, Casas R. Clinical Advances in Immunonutrition and Atherosclerosis: A Review. Front Immunol 2019; 10:837. [PMID: 31068933 PMCID: PMC6491827 DOI: 10.3389/fimmu.2019.00837] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 04/01/2019] [Indexed: 12/11/2022] Open
Abstract
Atherosclerosis is a chronic low-grade inflammatory disease that affects large and medium-sized arteries and is considered to be a major underlying cause of cardiovascular disease (CVD). The high risk of mortality by atherosclerosis has led to the development of new strategies for disease prevention and management, including immunonutrition. Plant-based dietary patterns, functional foods, dietary supplements, and bioactive compounds such as the Mediterranean Diet, berries, polyunsaturated fatty acids, ω-3 and ω-6, vitamins E, A, C, and D, coenzyme Q10, as well as phytochemicals including isoflavones, stilbenes, and sterols have been associated with improvement in atheroma plaque at an inflammatory level. However, many of these correlations have been obtained in vitro and in experimental animals' models. On one hand, the present review focuses on the evidence obtained from epidemiological, dietary intervention and supplementation studies in humans supporting the role of immunonutrient supplementation and its effect on anti-inflammatory response in atherosclerotic disease. On the other hand, this review also analyzes the possible molecular mechanisms underlying the protective action of these supplements, which may lead a novel therapeutic approach to prevent or attenuate diet-related disease, such as atherosclerosis.
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Affiliation(s)
- Ana María Ruiz-León
- Department of Internal Medicine, Hospital Clinic, University of Barcelona, Barcelona, Spain.,Mediterranean Diet Foundation, Barcelona, Spain
| | - María Lapuente
- Department of Internal Medicine, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Ramon Estruch
- Department of Internal Medicine, Hospital Clinic, University of Barcelona, Barcelona, Spain.,CIBER 06/03: Fisiopatología de la Obesidad y la Nutrición, Instituto de Salud Carlos III, Madrid, Spain
| | - Rosa Casas
- Department of Internal Medicine, Hospital Clinic, University of Barcelona, Barcelona, Spain.,CIBER 06/03: Fisiopatología de la Obesidad y la Nutrición, Instituto de Salud Carlos III, Madrid, Spain
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Lorzadeh E, Ramezani-Jolfaie N, Mohammadi M, Khoshbakht Y, Salehi-Abargouei A. The effect of hesperidin supplementation on inflammatory markers in human adults: A systematic review and meta-analysis of randomized controlled clinical trials. Chem Biol Interact 2019; 307:8-15. [PMID: 30991044 DOI: 10.1016/j.cbi.2019.04.016] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Revised: 03/30/2019] [Accepted: 04/12/2019] [Indexed: 02/05/2023]
Abstract
BACKGROUND Hesperidin (a flavanone found in citrus fruits) supplementation is suggested to inversely affect inflammation; however, clinical trials have led to inconsistent results. OBJECTIVE To examine the effect of hesperidin supplementation on inflammatory markers using systematic review and meta-analysis of randomized controlled clinical trials (RCTs). PATIENT AND METHODS Online databases including PubMed, Scopus, ISI Web of Science, and Google Scholar were searched up to December 2018. A random-effects model was used to compare the mean changes in the inflammatory markers between hesperidin supplemented and control subjects. RESULTS Six eligible RCTs with 296 participants were included in the systematic review. The meta-analysis revealed that hesperidin significantly reduces Vascular Cell Adhesion Molecule 1 (VCAM-1) levels [weighted mean difference (WMD) = -22.81 ng/L, P = 0.041, n = 3]. No considerable changes was observed for serum C-reactive protein (CRP) levels (WMD = -0.69 mg/L, P = 0.079, n = 5); the subgroup analysis showed a significant reduction in studies with a parallel design (WMD = -0.72 mg/L, P = 0.024, n = 3), and studies with more than 4 weeks of follow-up (WMD = -0.76 mg/L, P = 0.020, n = 2). Hesperidin supplementation had no signification effect on circulating E-selectin, interleukin 6, and Intercellular Adhesion Molecule 1 (ICAM-1) levels. CONCLUSION The present study suggests that although hesperidin supplementation significantly improves VCAM-1 levels; however, other inflammatory markers might not be affected. Further high-quality systematic reviews exploring the effect of hesperidin particularly on VCAM-1, ICAM-1, E-selectin, and interleukin 6 are still needed to confirm these results.
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Affiliation(s)
- Elnaz Lorzadeh
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran; Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Nahid Ramezani-Jolfaie
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran; Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Mohammadi
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran; Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Yadollah Khoshbakht
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran; Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Amin Salehi-Abargouei
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran; Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
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Cuevas S, Villar VAM, Jose PA. Genetic polymorphisms associated with reactive oxygen species and blood pressure regulation. THE PHARMACOGENOMICS JOURNAL 2019; 19:315-336. [PMID: 30723314 PMCID: PMC6650341 DOI: 10.1038/s41397-019-0082-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 10/19/2018] [Accepted: 12/21/2018] [Indexed: 02/08/2023]
Abstract
Hypertension is the most prevalent cause of cardiovascular disease and kidney failure, but only about 50% of patients achieve adequate blood pressure control, in part, due to inter-individual genetic variations in the response to antihypertensive medication. Significant strides have been made toward the understanding of the role of reactive oxygen species (ROS) in the regulation of the cardiovascular system. However, the role of ROS in human hypertension is still unclear. Polymorphisms of some genes involved in the regulation of ROS production are associated with hypertension, suggesting their potential influence on blood pressure control and response to antihypertensive medication. This review provides an update on the genes associated with the regulation of ROS production in hypertension and discusses the controversies on the use of antioxidants in the treatment of hypertension, including the antioxidant effects of antihypertensive drugs.
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Affiliation(s)
- Santiago Cuevas
- Center for Translational Science, Children's National Health System, 111 Michigan Avenue, NW, Washington, DC, 20010, USA.
| | - Van Anthony M Villar
- Department of Medicine, Division of Renal Diseases and Hypertension, The George Washington University School of Medicine and Health Sciences, Walter G. Ross Hall, Suite 738, 2300 I Street, NW, Washington, DC, 20052, USA
| | - Pedro A Jose
- Department of Medicine, Division of Renal Diseases and Hypertension, The George Washington University School of Medicine and Health Sciences, Walter G. Ross Hall, Suite 738, 2300 I Street, NW, Washington, DC, 20052, USA
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43
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Mohammadi M, Ramezani-Jolfaie N, Lorzadeh E, Khoshbakht Y, Salehi-Abargouei A. Hesperidin, a major flavonoid in orange juice, might not affect lipid profile and blood pressure: A systematic review and meta-analysis of randomized controlled clinical trials. Phytother Res 2019; 33:534-545. [PMID: 30632207 DOI: 10.1002/ptr.6264] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 11/23/2018] [Accepted: 11/28/2018] [Indexed: 12/19/2022]
Abstract
Previous studies have led to conflicting results regarding the effect of hesperidin supplementation on cardiometabolic markers. This study aimed to evaluate the efficacy of hesperidin supplementation on lipid profile and blood pressure through a systematic review and meta-analysis of randomized controlled trials (RCTs). PubMed, Web of Science, Scopus, and Google Scholar, as well as the reference lists of the identified relevant RCTs, were searched up to May 2018. Effect sizes were pooled by using the random effects model. Ten RCTs (577 participants) were eligible to be included in the systematic review. The meta-analysis revealed that hesperidin supplementation had no effect on serum total cholesterol (weighted mean difference [WMD] = -1.04 mg/dl; 95% confidence interval [CI]: -5.65, 3.57), low-density lipoprotein cholesterol (WMD = -1.96 mg/dl; 95% CI [-7.56, 3.64]), high-density lipoprotein cholesterol (WMD = 0.16 mg/dl; 95% CI [-1.94, 2.28]), and triglyceride (WMD = 0.69 mg/dl; 95% CI [-5.91, 7.30]), with no significant between-study heterogeneity. Hesperidin supplement also had no effect on systolic (WMD = -0.85 mmHg; 95% CI [-3.07, 1.36]) and diastolic blood pressure (WMD = -0.48 mmHg; 95% CI [-2.39, 1.42]). Hesperidin supplementation might not improve lipid profile and blood pressure. Future well-designed trials are still needed to confirm these results.
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Affiliation(s)
- Mohammad Mohammadi
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Nahid Ramezani-Jolfaie
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Elnaz Lorzadeh
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Yadollah Khoshbakht
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Amin Salehi-Abargouei
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Sánchez M, Romero M, Gómez-Guzmán M, Tamargo J, Pérez-Vizcaino F, Duarte J. Cardiovascular Effects of Flavonoids. Curr Med Chem 2019; 26:6991-7034. [DOI: 10.2174/0929867326666181220094721] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 10/29/2018] [Accepted: 10/29/2018] [Indexed: 02/07/2023]
Abstract
:
Cardiovascular Disease (CVD) is the major cause of death worldwide, especially in Western
society. Flavonoids are a large group of polyphenolic compounds widely distributed in plants, present
in a considerable amount in fruit and vegetable. Several epidemiological studies found an inverse association
between flavonoids intake and mortality by CVD. The antioxidant effect of flavonoids was
considered the main mechanism of action of flavonoids and other polyphenols. In recent years, the role
of modulation of signaling pathways by direct interaction of flavonoids with multiple protein targets,
namely kinases, has been increasingly recognized and involved in their cardiovascular protective effect.
There are strong evidence, in in vitro and animal experimental models, that some flavonoids induce
vasodilator effects, improve endothelial dysfunction and insulin resistance, exert platelet antiaggregant
and atheroprotective effects, and reduce blood pressure. Despite interacting with multiple targets, flavonoids
are surprisingly safe. This article reviews the recent evidence about cardiovascular effects that
support a beneficial role of flavonoids on CVD and the potential molecular targets involved.
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Affiliation(s)
- Manuel Sánchez
- Department of Pharmacology, School of Pharmacy, University of Granada, and Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain
| | - Miguel Romero
- Department of Pharmacology, School of Pharmacy, University of Granada, and Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain
| | - Manuel Gómez-Guzmán
- Department of Pharmacology, School of Pharmacy, University of Granada, and Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain
| | - Juan Tamargo
- Department of Pharmacology, School of Medicine, Complutense University of Madrid and Instituto de Investigación Sanitaria Gregorio Marañón (IISGM), Madrid, Spain
| | - Francisco Pérez-Vizcaino
- Department of Pharmacology, School of Medicine, Complutense University of Madrid and Instituto de Investigación Sanitaria Gregorio Marañón (IISGM), Madrid, Spain
| | - Juan Duarte
- Department of Pharmacology, School of Pharmacy, University of Granada, and Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain
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