Natural approaches in metabolic syndrome management

Unlocking the therapeutic potential of Geraniol: an alternative perspective for metabolic disease management

ETHNOPHARMACOLOGICAL RELEVANCE

Natural substance geraniol has anti-inflammatory and antioxidant qualities. It may be used to treat metabolic diseases such as diabetes, obesity, and cardiovascular illnesses. Innovations in nanoformulations enhance geraniol's absorption, stability, and targeted distribution, augmenting its therapeutic effectiveness and mitigating side effects, despite the limits of traditional treatment.

AIM OF THE REVIEW

The therapeutic potential of geraniol in the management of metabolic disorders such as diabetes, obesity, neuroinflammation, and cardiovascular disease is examined in this review. It highlights the anti-inflammatory, antioxidant, and lipid-lowering qualities of geraniol as well as the potential for nanoformulations to increase bioavailability and therapeutic efficacy.

MATERIALS AND METHODS

A collection of pertinent research articles about the potential of geraniol in metabolic illnesses, including obesity, type 2 diabetes, as well as cardiovascular diseases, was compiled from PubMed, Scopus, and Google Scholar. Terms such as "metabolic syndrome," "antioxidant," "anti-inflammatory," "geraniol," and "nanoformulations" were employed. Google Patents were also examined in order to offer insights into current and upcoming research.

RESULTS

The potential of geraniol to treat metabolic disorders, including obesity, diabetes, hyperlipidemia, and cardiovascular illnesses, is thoroughly reviewed in this article. Recent research has demonstrated the lipid-lowering, antioxidant, and anti-inflammatory properties of geraniol as well as its ability to improve endothelial function and reduce oxidative stress in preclinical animals. The paper delves into the various nanoformulations, including liposomes, nanoparticles, and nanoemulsions, which enhance geraniol's therapeutic efficacy and bioavailability, making it a viable option for managing metabolic syndrome.

CONCLUSION

The antioxidant, anti-inflammatory, and lipid-lowering qualities of geraniol make it a promising treatment for metabolic diseases. Its bioavailability along with therapeutic efficacy are increased by nanoformulations, which makes it a compelling option for the treatment of conditions such as neuroinflammation, diabetes, and obesity.

The Effect of Algae Supplementation on Anthropometric Indices in Adults: A GRADE-Assessed Systematic Review and Meta-Analysis of Randomized Controlled Trials

CONTEXT

Inconsistent results have been reported regarding the effects of different types of algae, such as Spirulina and Chlorella, on anthropometric indices.

OBJECTIVE

To conduct a meta-analysis to assess the efficacy of algae supplementation on anthropometric indices.

DATA SOURCES

A comprehensive systematic search was conducted to find relevant articles published from January 1990 to January 2024.

DATA EXTRACTION

Randomized controlled trials (RCTs) comparing algae supplementation with a placebo or control group were included. The risk of bias and certainty of the evidence were evaluated using the Cochrane risk-of-bias tool and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology, respectively. The random-effects model was used to find the Weighted mean differences (WMDs) for each outcome.

DATA ANALYSIS

Of 9079 distinct articles in the initial screening, 61 clinical trials were included in this meta-analysis. Algae supplementation resulted in lower body mass index (WMD, -0.27 kg/m2 (95% CI, -0.42 to -0.13); GRADE rating, low), body weight (WMD: -0.78 kg [-1.18 to -0.38]; GRADE rating, low), waist circumference (WMD, -0.68 cm [-1.27 to -0.10]; GRADE rating, very low), kilograms of body fat (WMD, -0.65 kg [-1.13 to -0.17]; GRADE rating, low), and body fat percentage (WMD, -0.9% [-1.62 to -0.17]; GRADE rating, very low) compared with placebo or controls. Nevertheless, the statistically significant effects of algae supplementation on hip circumference (WMD, -0.20 cm [-0.73 to 0.32]; GRADE rating, moderate), waist to hip ratio (WMD, -0.01 [-0.01 to 0.00]; GRADE rating, moderate), and lean body mass (WMD, -0.30 kg [-0.62 to 0.02]; GRADE rating, moderate) were not observed.

CONCLUSIONS

Overall, the findings of this meta-analysis indicate supplementation with algae may exert beneficial effects on anthropometric indices. However, due to between-studies heterogeneity and very low to low levels of GRADE for significant outcomes, the results should be interpreted with caution.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO registration no. CRD42024522923.

Metabolic dysfunction-associated fatty liver disease: current therapeutic strategies

The definition of "Metabolic Associated Fatty Liver Disease - MAFLD" has replaced the previous definition of Nonalcoholic Fatty Liver Disease (NAFLD), because cardiometabolic criteria have been added for the prevention of cardiological risk in these patients. This definition leads to an in-depth study of the bidirectional relationships between hepatic steatosis, Type 2 Diabetes Mellitus (T2DM), Cardiovascular Disease (CVD) and/or their complications. Lifestyle modification, which includes correct nutrition combined with regular physical activity, represents the therapeutic cornerstone of MAFLD. When therapy is required, there is not clear accord on how to proceed in an optimal way with nutraceutical or pharmacological therapy. Numerous studies have attempted to identify nutraceuticals with a significant benefit on metabolic alterations and which contribute to the improvement of hepatic steatosis. Several evidences are supporting the use of silymarin, berberine, curcumin, Nigella sativa, Ascophyllum nodosum, and Fucus vesiculosus, vitamin E, coenzyme Q10 and Omega-3. However, more evidence regarding the long-term efficacy and safety of these compounds are required. There is numerous evidence that highlights the use of therapies such as incretins or the use of Proprotein Convertase Subtilisin/Kexin type 9 (PCSK9) inhibitors or other similar therapies which, by assisting existing therapies for pathologies such as diabetes, hypertension, insulin resistance, have given a breakthrough in prevention and the reduction of cardiometabolic risk. This review gave an overview of the current therapeutic strategies that are expected to aid in the treatment and prevention of MAFLD.

The Effects of a Cinchona Supplementation on Satiety, Weight Loss and Body Composition in a Population of Overweight/Obese Adults: A Controlled Randomized Study

Obesity is a risk factor for several diseases present worldwide. Currently, dietary changes and physical activity are considered the most effective treatment to reduce obesity and its associated comorbidities. To promote weight loss, hypocaloric diets can be supported by nutraceuticals. The aim of this study was to evaluate the effects of a hypocaloric diet associated with Cinchona succirubra supplementation on satiety, body weight and body composition in obese subjects. Fifty-nine overweight/obese adults, were recruited, randomized into two groups and treated for 2 months. The first group (32 adults) was treated with a hypocaloric diet plus cinchona supplementation (the T-group); the second one (27 adults) was treated with a hypocaloric diet plus a placebo supplementation (the P-group). Anthropometric-measurements as well as bioimpedance analysis, a Zung test and biochemical parameters were evaluated at baseline and after 60 days. T-group adults showed significant improvement in nutritional status and body composition compared to those at the baseline and in the P-group. Moreover, T-group adults did not show a reduction in Cholecystokinin serum levels compared to those of P-group adults. In conclusion, our data demonstrate that a hypocaloric diet associated with cinchona supplementation is effective in inducing more significant weight loss and the re-establishment of metabolic parameters than those obtained with a hypocaloric diet.

The effects of royal jelly supplementation on anthropometric indices: a GRADE-assessed systematic review and dose-response meta-analysis of randomized controlled trials

Inconsistent data are available about the effect of royal jelly supplementation on anthropometric indices in humans. This systematic review and meta-analysis was done to summarize data from available randomized controlled trials (RCTs) on the effect of royal jelly supplementation on anthropometric indices such as body weight (BW), body mass index (BMI), and fat mass (FM) in adults. We systematically searched Embase, PubMed, Web of Science, and Scopus databases up to March 2023. All RCTs assessing the effect of royal jelly on anthropometric indices were included. Data were pooled using the random-effects method and were expressed as weighted mean difference (WMD) and 95% confidence intervals (CIs). Sensitivity and subgroup analyses were also performed. Out of 1,492 records, 10 studies that enrolled 512 participants were included. There was no significant effect on BW (WMD: -0.29 kg, 95% CI: -1.24, 0.65, p = 0.543), BMI (WMD: 0.11 kg/m2, 95% CI: -0.29, 0.52, p = 0.583), and FM (WMD: 0.02%, 95% CI: -0.41, 0.46, p = 0.84). However, we observed a reduction in BW and BMI following royal jelly intake in subgroup of royal jelly dosage <3,000 mg/day. Although the royal jelly supplementation significantly reduced BW and BMI at the dosages <3,000 mg/day, until additional trials have been conducted to assess the effects on obesity measures, it is best to prescribe royal jelly with caution.

Antihypertensive effects of Nigella sativa supplementation: An updated systematic review and meta-analysis of randomized controlled trials

Clinical studies have suggested that Nigella Sativa (N. sativa) supplementation may effectively reduce blood pressure, but the findings are controversial. Therefore, this study aimed to examine the effects of N. sativa on blood pressure in adults. PubMed, Cochrane Library, Web of Science, Scopus, Embase databases, and Google Scholar were searched till August 2022. To analyze weighted mean differences (WMDs), a random-effects model was utilized. Nonlinear dose-response analysis and a meta-regression were conducted. N. sativa supplementation was effective in reducing both systolic (WMD: -3.06 mmHg; 95% CI: -3.89 to -2.22, p < 0.001; I2  = 84.7%, p < 0.001) and diastolic blood pressure (WMD = -2.69 mmHg; 95% CI: -3.72, -1.66, p < 0.001; I2  = 97.3%, p < 0.001). The current meta-analysis suggests that N. sativa supplementation can improve blood pressure and claims that N. sativa could be used as an effective approach to blood pressure management.

Impact of Ascorbic Acid on Zero-Valent Iron Nanoparticle and UV-B Mediated Stress in the Cyanobacterium, Fremyella diplosiphon

Fremyella diplosiphon is an ideal third-generation biofuel source due to its ability to produce transesterified lipids. While nanofer 25s zero-valent iron nanoparticles (nZVIs) improve lipid production, an imbalance between reactive oxygen species (ROS) and cellular defense can be catastrophic to the organism. In the present study, the effect of ascorbic acid on nZVI and UV-induced stress in F. diplosiphon strain B481-SD was investigated, and lipid profiles in the combination regimen of nZVIs and ascorbic acid compared. Comparison of F. diplosiphon growth in BG11 media amended with 2, 4, 6, 8, and 10 mM ascorbic acid indicated 6 mM to be optimal for the growth of B481-SD. Further, growth in 6 mM ascorbic acid combined with 3.2 mg/L nZVIs was significantly higher when compared to the combination regimen of 12.8 and 51.2 mg/L of nZVIs and 6 mM ascorbic acid. The reversal effect of UV-B radiation for 30 min and 1 h indicated that ascorbic acid restored B481-SD growth. Transesterified lipids characterized by gas chromatography-mass spectrometry indicated C16 hexadecanoate to be the most abundant fatty acid methyl ester in the combination regimen of 6 mM ascorbic acid and 12.8 mg/L nZVI-treated F. diplosiphon. These findings were supported by microscopic observations in which cellular degradation was observed in B481-SD cells treated with 6 mM ascorbic acid and 12.8 mg/L nZVIs. Our results indicate that ascorbic acid counteracts the damaging effect of oxidative stress produced by nZVIs.

Metabolic and vascular effect of a new standardized bergamot phytocomplex: a three-arm, placebocontrolled, double-blind clinical trial

Introduction

In addition to healthy lifestyle and balanced diet, nutraceutical supplementation may be useful to maintain overall metabolic wellness. The aim of the present study was to assess the metabolic and vascular effects of a new, highly standardized bergamot phytocomplex supplement in healthy volunteers with the features of metabolic syndrome.

Material and methods

We carried out a double-blind, randomized, placebo-controlled, three-arm, parallel-group clinical trial in 90 adult subjects (30 per group) treated for 12 weeks with two different dosages of a highly standardized bergamot phytocomplex (Endoberg by AKHYNEX and Kalita by Giellepi) or placebo. Lipid plasma levels, glycemia, plasma hs-CRP, HOMA-IR, body fat, endothelial reactivity and fatty liver index were assessed at baseline, after 6 weeks and at the end of treatment in all subjects.

Results

At the end of treatment, both tested bergamot extract doses were able to significantly improve atherogenic dyslipidemia and insulin sensitivity (p < 0.05) compared to placebo. In the high-dose treated group, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), non high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG) improved versus placebo (p < 0.05) just after 6 weeks of treatment. After 12 weeks of treatment, TC decreased by 13.2 ±2.1%, LDL-C by 17.7 ±3.2%, non-HDL-C by 17.5 ±3.1%, TG by 16.6 ±3.3%, TG/HDL-C by 22.5 ±4.4%, homeostasis insulin resistance index (HOMA-IR) by 12.2 ±2.1%, γ-glutamyl transferase (GGT) by 22.2 ±4.6%, and high-sensitivity C-reactive protein (hs-CRP) by 17.9 ±3.4% versus baseline (p < 0.05) and vs. placebo (p < 0.05). Percentage body fat and endothelial reactivity improved versus baseline, but not versus placebo, in the high-dose treatment only (p < 0.05).

Conclusions

The tested bergamot phytocomplex was able to significantly improve glucose and lipid metabolism, as well as inflammation, and might represent a novel multi-target approach to control metabolic syndrome.

Environmental toxicants and health adversities: A review on interventions of phytochemicals

Toxicity arising from environmental contaminants has attracted global interest in the last few decades, due to the high morbidity and mortality associated with them. Efforts have been made to combat the consequential outcomes of environmental toxicity in humans through traditional remediation techniques and therapeutic measures which have been hampered by one or more limitations. Consequently, this scenario has triggered interest in the medicinal properties of phytochemicals. Thus, this review gives a succinct and in-depth elucidation of the various environmental contaminants and their toxicity effects on humans. It delves into the various classes of phytochemicals and their intervention roles. The study adopted a desk review of existing literatures from scientific reports and peer reviewed articles through triangulation of data sources. "Phytochemicals" are group of secondary metabolites obtained from plants with medicinal properties. These groups of compounds are included but not limited to flavonoids, tannins, saponins, alkaloids, cardenoloids, terpenoids, and phytosteroids. This review corroborates the prophylactic and therapeutics efficacy of these phytochemicals as anti-metastatic, anti-inflammatory, anti-aging, anti-oxidant, anti-microbial and live saving substances with empirical findings from several laboratory, clinical trials and epidemiologic studies. It conclude that given the wide range of medicinal properties of phytochemicals, there is an urgent need for its full optimization in the pharmaceutical industry and future studies should focus on identifying the bioactive molecules in these compounds and its effectiveness against mixer toxicity.

The Mechanism of Kelulut Honey in Reversing Metabolic Changes in Rats Fed with High-Carbohydrate High-Fat Diet

Metabolic syndrome (MetS) is composed of central obesity, hyperglycemia, dyslipidemia and hypertension that increase an individual's tendency to develop type 2 diabetes mellitus and cardiovascular diseases. Kelulut honey (KH) produced by stingless bee species has a rich phenolic profile. Recent studies have demonstrated that KH could suppress components of MetS, but its mechanisms of action are unknown. A total of 18 male Wistar rats were randomly divided into control rats (C group) (n = 6), MetS rats fed with a high carbohydrate high fat (HCHF) diet (HCHF group) (n = 6), and MetS rats fed with HCHF diet and treated with KH (HCHF + KH group) (n = 6). The HCHF + KH group received 1.0 g/kg/day KH via oral gavage from week 9 to 16 after HCHF diet initiation. Compared to the C group, the MetS group experienced a significant increase in body weight, body mass index, systolic (SBP) and diastolic blood pressure (DBP), serum triglyceride (TG) and leptin, as well as the area and perimeter of adipocyte cells at the end of the study. The MetS group also experienced a significant decrease in serum HDL levels versus the C group. KH supplementation reversed the changes in serum TG, HDL, leptin, adiponectin and corticosterone levels, SBP, DBP, as well as adipose tissue 11β-hydroxysteroid dehydrogenase type 1 (11βHSD1) level, area and perimeter at the end of the study. In addition, histological observations also showed that KH administration reduced fat deposition within hepatocytes, and prevented deterioration of pancreatic islet and renal glomerulus. In conclusion, KH is effective in preventing MetS by suppressing leptin, corticosterone and 11βHSD1 levels while elevating adiponectin levels.

A systematic review and meta-analysis of randomized controlled trials investigating the effect of the curcumin and piperine combination on lipid profile in patients with metabolic syndrome and related disorders

Metabolic syndrome is characterized by multiple metabolic disorders. Several studies indicated that curcumin plus piperine could affect lipids profiles in various diseases. The present meta-analysis aims to assess the effect of curcumin plus piperine on lipid profiles in patients with MetS and associated disorders using a systematic review and meta-analysis of randomized controlled trials. Trials were searched by several electronic databases up to May 2022. The Comprehensive Meta-Analysis (CMA) version3 software carried out this systematic review and meta-analysis. Random-effects model and the inverse variance method were used to conduct the meta-analysis. We evaluated the publication bias and heterogeneity of all eligible studies. In addition, subgroup analyses and sensitivity assessments were performed to assess potential sources of heterogeneity. The combined results by the random-effects model demonstrated that curcumin plus piperine significantly decreased total cholesterol and LDL-C in patients suffering from metabolic syndrome. In comparison, the results of the overall effect size did not show any significant change in triglyceride concentrations. Our results were robust in sensitivity analysis and were not dependent on the dose of curcumin, the dose of piperine, and the duration of treatment. Our results showed that co-administration of piperine and curcumin supplementation improves the lipid profile in metabolic syndrome. However, further long-term RCTs are required to ascertain their clinical benefit.

Comparative effect of a nutraceutical compound based on a flavonoid complex from bergamot on plasma lipids, glucose metabolism, and liver enzymes: a 3-arm, double-blind, placebo-controlled, randomized clinical trial

Introduction

Bergamot and opuntia (prickly pear cladodes) standardized extracts have been demonstrated to have positive metabolic effects in preclinical and clinical models.

Material and methods

The aim of this study was to evaluate the metabolic effect of a combined nutraceutical containing 150 mg of Opuntia ficus Indica extract, 400 mg of plant sterols, 12.5 mg of thiamine, and 200 mg of Brumex® a phytocomplex from bergamot fruit (Citrus bergamia Risso et Poiteau, fructus) standardized 40% in total flavonoids and min 5% in 3-hydroxy-3-methylglutaryl-flavanones. Thus, we carried out a randomized, double-blind, placebo-controlled clinical trial on 75 hypercholesterolaemic subjects randomized to take the active compound (2 tablets per day), placebo (2 tablets per day), or both (1 per product per day).

Results

After 12 weeks of treatment with 1 tablet per day, we observed a significant reduction of a number of metabolic parameters: total cholesterol (TC) (-14.6%), low-density lipoprotein cholesterol (LDL-C) (-19.9%), non-high-density lipoprotein cholesterol (non-HDLC) (-22.1%), triglycerides (TG) (-13.1%), Apolipoprotein B (-16%) (all p < 0.05 both versus baseline and versus placebo), fasting plasma glucose (-5.1%), glutamate oxaloacetate transaminase (-7.8%), glutamate pyruvate transaminase (-7.3%), and γ-glutamyl transferase (-34.4%) (all p < 0.05 versus baseline). High-density lipoprotein cholesterol (HDL-C) was increased 6.9% by the use of 1 tablet per day (p < 0.05 versus baseline). All parameters were reduced to the same extent when taking the full dose (2 tablets), beyond TG.

Conclusions

the tested nutraceutical compound based on a flavonoid complex from bergamot and opuntia showed a short-term positive impact on plasma lipids, fasting plasma glucose, and liver enzyme in overall healthy subjects affected by hypercholesterolaemia with low cardiovascular risk.

Potential Therapeutic Activity of Berberine in Thyroid-Associated Ophthalmopathy: Inhibitory Effects on Tissue Remodeling in Orbital Fibroblasts

Purpose

Berberine (BBR), an alkaloid produced by a traditional Chinese plant, was recently attributed multiple effects on lipometabolism, inflammation, and fibrosis. Thyroid-associated ophthalmopathy (TAO) is highly associated with these pathologic changes. Thus, we aimed to examine the potential therapeutic effect of BBR in an in vitro model of TAO.

Methods

Orbital fibroblasts (OFs) obtained from control donors (n = 6) or patients with TAO (n = 6) were cultured. The CCK-8 assay was conducted for assessing the optimal concentration range. Oil Red O staining, Western blotting, and quantitative RT-PCR (qRT-PCR) were conducted to assess adipogenesis in OFs. RNA sequencing (RNA-seq) was used to screen the key pathways of the antiadipogenic effect mediated by BBR. Along with incremental concentrations of BBR, IL-1β–induced expression of proinflammatory molecules was determined by ELISA and qRT-PCR. In addition, TGF-β–induced hyaluronan (HA) production and fibrosis were evaluated by ELISA, qRT-PCR, and Western blotting.

Results

TAO-OFs, but not control fibroblasts (CON-OFs), were readily differentiated into adipocytes with the commercial medium. Intracellular lipid accumulation was dose-dependently decreased by BBR, and adipogenic markers were also downregulated. Moreover, the PPARγ and AMPK pathways were screened out by RNA-seq and their downstream effectors were suppressed by BBR. Besides, BBR attenuated IL-1β–induced expression of proinflammatory molecules in both TAO-OFs and CON-OFs by blocking nuclear factor–κB signaling. BBR's inhibitory effect on TGF-β–mediated tissue remodeling was also confirmed in OFs.

Conclusions

These findings demonstrate BBR has outstanding capabilities of controlling adipogenesis, inflammation, HA production, and fibrosis in OFs, highlighting its potential therapeutic role in TAO management.

Role of atrial natriuretic peptide receptor in inhibition of laterally spreading tumors via Wnt/β-catenin signaling

Colorectal cancer (CRC) is the third most prevalent malignancy worldwide. Laterally spreading tumors (LSTs), as special manifestations of digestive tract tumors, are often misdiagnosed or undiagnosed due to their unique morphological and pathological features. LST has no protruding lesions and progresses rapidly, and prognoses are consequently poor. LST progression to CRC is complicated. Clinical data indicate that the heart is rarely the site of primary tumorigenesis, and a class of atrial natriuretic peptides (ANPs) secreted by heart tissue play an important role in this phenomenon, which is closely related to the Wnt/β-catenin signaling pathway. However, previous studies focused solely on correlations between the Wnt/β-catenin signaling pathway, downstream gene expression and LST. Thus, correlational studies of ANP/ANP receptor, LST and CRC may be of great help in understanding the occurrence, development and treatment of LST, as well as in establishing specific and sensitive methods for detecting LST.

Efficacy of multi-strain probiotic along with dietary and lifestyle modifications on polycystic ovary syndrome: a randomised, double-blind placebo-controlled study

PURPOSE

Effect of multi-strain probiotic along with dietary and lifestyle modifications in the management of polycystic ovary syndrome (PCOS) has rarely been reported. We thus aimed to investigate the effect of multi-strain probiotic (Lactobacillus acidophilus UBLA-34, L. rhamnosus UBLR-58, L. reuteri UBLRu-87 (each of 2 billion colony forming units (CFU)); L. plantarum UBLP-40, L. casei UBLC-42, L. fermentum UBLF-31, Bifidobacterium bifidum UBBB-55 (each of 1 billion CFU) and fructo-oligosaccharides (100 mg)) and dietary and lifestyle modifications on restoration of menstrual regularity, weight reduction, metabolic and hormonal profile in women with PCOS.

METHODS

A 104 participants (age 18-40 years) were randomly allocated to receive probiotic or placebo capsules for 6 months. Baseline and end line assessment were performed for menstrual cycle regularity, ultrasonography scan for ovaries, total testosterone, dehydroepiandrosterone (DHEAS), insulin, luteinizing hormone/follicle stimulating hormone (LH/FSH) ratio, fasting blood sugar (FBS), homeostatic model assessment-insulin resistance (HOMA-IR), weight reduction, waist-/hip circumference (WC, HC), waist to hip ratio (WHR), and body mass index (BMI). Plasma lipopolysaccharide and effect of intervention on quality of life was investigated. Diet and exercise were controlled during the trial.

RESULTS

Probiotic supplement along with dietary and lifestyle modifications significantly regularised menstrual cycle (p 0.023), improved levels of total testosterone (p 0.043), WC (p 0.030), WHR (p 0.027) and menstrual domain of quality of life (p 0.034) as compared to placebo. No adverse events related to study were reported.

CONCLUSION

Multi-strain probiotic along with dietary and lifestyle modifications were effective in the management of PCOS.

TRIAL REGISTRATION

CTRI: CTRI/2016/07/007086, dated 13 July 2016.

Curcuminoids for Metabolic Syndrome: Meta-Analysis Evidences Toward Personalized Prevention and Treatment Management

The metabolic syndrome (MS) is a multifactorial syndrome associated with a significant economic burden and healthcare costs. MS management often requires multiple treatments (polydrug) to ameliorate conditions such as diabetes mellitus, insulin resistance, obesity, cardiovascular diseases, hypertension, and non-alcoholic fatty liver disease (NAFLD). However, various therapeutics and possible drug-drug interactions may also increase the risk of MS by altering lipid and glucose metabolism and promoting weight gain. In addition, the medications cause side effects such as nausea, flatulence, bloating, insomnia, restlessness, asthenia, palpitations, cardiac arrhythmias, dizziness, and blurred vision. Therefore, is important to identify and develop new safe and effective agents based on a multi-target approach to treat and manage MS. Natural products, such as curcumin, have multi-modalities to simultaneously target several factors involved in the development of MS. This review discusses the recent preclinical and clinical findings, and up-to-date meta-analysis from Randomized Controlled Trials regarding the effects of curcumin on MS, as well as the metabonomics and a pharma-metabolomics outlook considering curcumin metabolites, the gut microbiome, and environment for a complementary personalized prevention and treatment for MS management.

The role of Pycnogenol in the control of inflammation and oxidative stress in chronic diseases: Molecular aspects

The prevalence of chronic diseases has increased significantly with the rising trend of sedentary lifestyles, reduced physical activity, and dietary modifications in recent decades. Inflammation and oxidative stress play a key role in the pathophysiology of several chronic diseases, such as type II diabetes, cardiovascular diseases, and hepatic conditions. Therefore, reducing inflammation and oxidative stress may be beneficial in the prevention and treatment of various chronic disorders. Since chronic diseases are not completely curable, various methods have been proposed for their control. Complementary therapies and the use of natural antioxidant and antiinflammatory compounds are among these novel approaches. Pycnogenol (PYC) is a natural compound that could control inflammation and oxidative stress. Furthermore, some previous studies have shown that PYC could effectively reduce inflammation through signaling the downstream of insulin receptors, inhibiting the phosphorylation of the serine residues of insulin receptor substrate-1, reducing pro-inflammatory cytokines and oxidative stress indices through the stimulation of antioxidant pathways, increasing free radical scavenging activities, preventing lipid peroxidation, and protecting the erythrocytes in glucose-6-phosphate dehydrogenase-deficient individuals, although these effects have not been fully proved. The present study aimed to comprehensively review the evidence concerning the positive physiological and pharmacological properties of PYC, with an emphasis on the therapeutic potential of this natural component for enhancing human health.

Relationship between Dietary Behaviors and Physical Activity and the Components of Metabolic Syndrome: A Case-Control Study

Poor diet and low physical activity play an important role in the etiopathogenesis of metabolic syndrome. The aim of this study was to analyze the association between nutrient intake, groups of food products and physical exercise undertaken and the components of metabolic syndrome (MS). The study included 330 patients with MS, and the control group comprised of 270 subjects without MS. The food intake was assessed using 24-h dietary recall, and a 13-item Food Frequency Questionnaire. To assess nutrition knowledge, a Beliefs and Eating Habits Questionnaire was used. The level of physical activity was assessed using the International Physical Activity Questionnaire. Three patterns of behavior were identified: Prudent-Active, Western-Sedentary, and NotPrudent-notWestern-lowActive. In the Prudent-Active group, as compared to the NotPrudent-notWestern-lowActive subjects, the risk of central obesity, hypertension, hypertriglyceridemia, low HDL cholesterol and hyperglycemia occurrence was lower. There was also a lower proportion of patients with MS. As compared to the NotPrudent-notWestern-lowActive subjects, in the Prudent-Active group there was more than a two times higher chance of subjects with a high level of nutrition knowledge. Western diets have been proven to exert a detrimental effect on the components of MS. When designing intervention programs, education of patients with MS on dietary habits and physical activity should be considered.

In vitro antiaging activity of polyphenol rich Polyalthia longifolia (Annonaceae) leaf extract in Saccharomyces cerevisiae BY611 yeast cells

ETHNOPHARMACOLOGICAL RELEVANCE

Polyalthia longifolia var. angustifolia Thw. (Annonaceae) is commonly used in traditional medicine as a tonic for rejuvenation and exhibiting good antioxidant activities.

AIM OF THE STUDY

To evaluate P. longifolia methanolic leaf extract (PLME) antiaging activity at 1 mg/mL in Saccharomyces cerevisiae BY611 yeast.

MATERIALS AND METHODS

The antiaging effect of PLME was studied via replicative lifespan assay, antioxidative stress assays, reactive oxygen species (ROS) determination, reduced glutathione (GSH) determination, superoxide dismutase (SOD) and Sirtuin 1 (SIRT1) genes regulation studies and SOD and SIRT1 proteins activities.

RESULTS

The PLME treatment increased the growth and prolonged the lifespan of the yeast significantly (p < 0.05) compared to the untreated yeast group. Besides, the PLME also protected the yeast from oxidative stress induced by 4-mM-H₂O₂ via decreasing (p < 0.05) the ROS from 143.207 to 127.223. The antioxidative action of PLME was proved by spot assay. Phloxine B staining was further confirmed the PLME antioxidative action of PLME, where more whitish-pink live yeast cells were observed. In addition, the PLME also enhanced GSH content significantly (p < 0.05) in yeast treated with PLME from 16.81 to 25.31 μmol. Furthermore, PLME increased the SOD and SIRT1 genes expression significantly (p < 0.05) with ΔCt values of 1.11 and 1.15, respectively. The significantly (p < 0.05) elevated SOD and SIRT1 protein activities were recorded as 51.54 U/mg Prot and 1716 ng/mL, respectively.

CONCLUSIONS

PLME exhibited good antiaging activities in S. cerevisiae, by modulating oxidative stress, enhancing GSH content, and increasing SOD and SIRT1 genes expression.

Transcriptome and metabolome changes induced by bitter melon (Momordica charantia)- intake in a high-fat diet induced obesity model

Background and aim

Metabolic syndrome (MetS) is a complex disease of physiological imbalances interrelated to abnormal metabolic conditions, such as abdominal obesity, type II diabetes, dyslipidemia and hypertension. In the present pilot study, we investigated the nutraceutical bitter melon (Momordica charantia L) -intake induced transcriptome and metabolome changes and the converging metabolic signaling networks underpinning its inhibitory effects against MetS-associated risk factors.

Experimental procedure

Metabolic effects of lyophilized bitter melon juice (BMJ) extract (oral gavage 200 mg/kg/body weight-daily for 40 days) intake were evaluated in diet-induced obese C57BL/6J male mice [fed-high fat diet (HFD), 60 kcal% fat]. Changes in a) serum levels of biochemical parameters, b) gene expression in the hepatic transcriptome (microarray analysis using Affymetrix Mouse Exon 1.0 ST arrays), and c) metabolite abundance levels in lipid-phase plasma [liquid chromatography mass spectrometry (LC-MS)-based metabolomics] after BMJ intervention were assessed.

Results and conclusion

BMJ-mediated changes showed a positive trend towards enhanced glucose homeostasis, vitamin D metabolism and suppression of glycerophospholipid metabolism. In the liver, nuclear peroxisome proliferator-activated receptor (PPAR) and circadian rhythm signaling, as well as bile acid biosynthesis and glycogen metabolism targets were modulated by BMJ (p < 0.05). Thus, our in-depth transcriptomics and metabolomics analysis suggests that BMJ-intake lowers susceptibility to the onset of high-fat diet associated MetS risk factors partly through modulation of PPAR signaling and its downstream targets in circadian rhythm processes to prevent excessive lipogenesis, maintain glucose homeostasis and modify immune responses signaling.

Effects of turmeric (Curcuma longa) and its constituent (curcumin) on the metabolic syndrome: An updated review

Metabolic syndrome (MS) involves people with the following risk factors: obesity, hypertension, high glucose level and hyperlipidemia. It can increase the risk of heart disease, stroke and type 2 diabetes mellitus. The prevalence of MS in the world's adult population is about 20%-25%. Today, there is much care to use medicinal plants. Turmeric (Curcuma longa) as well as curcumin which is derived from the rhizome of the plant, has been shown beneficial effects on different components of MS. Thus, the purpose of this manuscript was to introduce different in vitro, in vivo and human studies regarding the effect of turmeric and its constituent on MS. Moreover, different mechanisms of action by which this plant overcomes MS have been introduced. Based on studies, turmeric and its bioactive component, curcumin, due to their anti-inflammatory and antioxidant properties, have antidiabetic effects through increasing insulin release, antihyperlipidemic effects by increasing fatty acid uptake, anti-obesity effects by decreasing lipogenesis, and antihypertensive effects by increasing nitric oxide. According to several in vivo, in vitro and human studies, it can be concluded that turmeric or curcumin has important values as a complementary therapy in MS. However, more clinical trials should be done to confirm these effects.

Effect of Anti-Obesity and Antioxidant Activity through the Additional Consumption of Peel from ‘Fuji’ Pre-Washed Apple

There is limited information on the health effects of apple peel taken from ‘Fuji’ (Malus pumila Mill) apples washed with ozonated water. To clarify the health-promoting effects of peel, the triterpenoids (ursolic acid and oleanolic acid) were quantified with gas chromatograph–mass spectrometry. Anti-obesity effects of apple peel extract on the 3T3-L1 pre-adipocyte cell were compared with apple flesh, whole apple, and ursolic acid. The peel extract treatment with 3.30 ± 1.05 μM of ursolic acid significantly suppressed (p < 0.05) the lipid accumulation compared with the content in flesh, and a similar level was reached in the 5 μM ursolic acid positive control group. In the peel extract and ursolic acid treatment groups, the C16:0 concentration was significantly inhibited (p < 0.05), implying the anti-obesity effect of ursolic acid on the 3T3-L1 cell. Moreover, apple peel contributed 41% of the total flavonoids content and 31% of the phenolic contents of the whole apple, but only accounted for less than 10% of the whole apple (weight basis). This study’s results offer basic data on pre-washed apple as a health functional food, offering information about the health benefits of apple peel, calculated based on the partial ratio in the whole apple.

Phytonutrients of Bitter Apricot Seeds Modulate Human Lipid Profile and LDL Subfractions in Adults with Elevated Cholesterol Levels

The objective of the present study was to evaluate the effect of short-term consumption of bitter apricot seeds phytonutrients on cardiovascular risk factors with a special focus on LDL cholesterol subfractions using the Lipoprint system. A group of 34 adult volunteers (21 female/13 male) consumed 60 mg kg⁻¹ of body weight of bitter apricot seeds daily for 42 days. Subjects were divided into two groups: one with normal cholesterol levels (NTC) and one with elevated total cholesterol levels (ETC). Blood serum levels of total cholesterol (T-C), low-density cholesterol (LDL-C), high-density cholesterol (HDL-C), and triglycerides (TG) did not change significantly (p > 0.05) in NTC group. However, there were significant decreasing of T-C (p ˂ 0.05) and LDL-C (p < 0.01) in ETC group. The LDL₁, LDL₂, and atherogenic LDL₃₋₇ subfractions progressively decreased after 42 days of apricot seeds consumption in ETC group (p < 0.05). Apricot seeds consumption was associated with a significant increase in the mean LDL particle size especially in ETC group (p ˂ 0.01). The results of the present study support the hypothesis that daily consumption of bitter apricot seeds for 42 days positively modified the lipoprotein profile in the group with elevated total cholesterol.

Potential roles of Garcinia family as antimetabolic syndrome

The incidence rate is directly proportional to the incidence of obesity or overweight and Type 2 diabetes mellitus. Garcinia is a plant that has been proven empirically, preclinically, and clinically to have activities for the avoidance and treatment of metabolic syndrome and on the pathogenesis and pathophysiology caused by the disease. The aim of this study is to create a discussion and summarize information regarding the activity or usefulness of the Garcinia plant. This review article was based on the published journals obtained from Google Scholar, Scopus, and PubMed databases using the keywords Garcinia obesity, Garcinia overweight, and Garcinia metabolic syndrome. Garcinia had many activities related to metabolic syndrome because it was able to reduce body fat mass, blood sugar level, body weight, total cholesterol, and triglyceride level. These activities were mediated by numerous apparatuses of feat together with a reserve of fatty acid synthase, α-amylase, α-glucosidase, and several other enzymes and pathways associated with the metabolic syndrome. Garcinia plant was able to be used as a candidate for a new herbal that had a good effect in treating metabolic syndrome in future.

Fibroblast growth factor 21 levels and liver inflammatory biomarkers in obese subjects after weight loss

INTRODUCTION

Previous studies have hypothesized fibroblast growth factor 21 (FGF-21) as a potential biomarker of the inflammation associated with liver diseases, which is also receiving considerable attention for its potential application concerning the management of obesity and co-morbidities. This study aimed to analyze the response of FGF-21 after a weight loss intervention and the relationships with other putative inflammatory liver biomarkers.

MATERIAL AND METHODS

Sixty-six obese participants from the RESMENA study were evaluated at baseline and following a 6-month energy restriction treatment. Anthropometric, body composition by DXA, routine laboratory measurements, which included transaminases and γ-glutamyl transferase (GGT) were analyzed by standardized methods. Moreover, FGF-21, M30 fragment (M30) and plasminogen activator inhibitor-1 (PAI-I) were analyzed as recognized liver inflammatory related biomarkers with specific ELISA kits.

RESULTS

Most measurements related to hepatic damage, inflammation and adiposity status improved at the end of the 6-month nutritional intervention. In addition, ΔFGF-21 shifts showed statistical relationships with changes in ΔM30, ΔGGT and ΔPAI. The reduction of M30 showed significant associations with changes in transaminases. Furthermore, PAI-I changes were associated with ΔM30 and ΔGGT regardless of weight loss. A linear regression model was set up to assess the influence of ΔPAI-I and ΔM30 on the variability of ΔFGF-21 (23.8%) adjusted by weight loss.

CONCLUSIONS

These results demonstrated interactions of some liver inflammatory mediators, specifically M30 and PAI-I with FGF-21. Thus, more investigation about FGF-21 is required given that this protein could be a biomarker of the obesity-inflammation-liver process.

Association of Age of Metabolic Syndrome Onset With Cardiovascular Diseases: The Kailuan Study

BACKGROUND

Metabolic syndrome (MetS) is associated with an increased risk of incident cardiovascular diseases (CVD), but the association between the new-onset MetS at different ages and the CVD risk remain unclear.

METHODS

This was a prospective study comprising a total of 72,986 participants without MetS and CVD who participated in the Kailuan study baseline survey (July 2006 to October 2007). All participants received the biennial follow-up visit until December 31, 2019. In addition, 26,411 patients with new-onset MetS were identified from follow-up, and one control participant was randomly selected for each of them as a match for age ( ± 1 year) and sex. In the end, a total of 25,125 case-control pairs were involved. Moreover, the Cox proportional hazard model was established to calculate the hazard ratios (HR) for incident CVD across the onset age groups.

RESULTS

According to the median follow-up for 8.47 years, 2,319 cases of incident CVD occurred. As MetS onset age increased, CVD hazards gradually decreased after adjusting for potential confounders. Compared with non-MetS controls, the HR and the 95% confidence interval (CI) for CVD were 1.84 (1.31-2.57) in the MetS onset age <45 years group, 1.67 (1.42-1.95) for the 45-54 years group, 1.36 (1.18-1.58) for the 55-64 years group, and 1.28 (1.10-1.50) for the ≥65 years group, respectively (p for interaction = 0.03).

CONCLUSIONS

The relative risks of CVD differed across MetS onset age groups, and the associations was more intense in the MetS onset group at a younger age.

Omega-6 fatty acids and the risk of cardiovascular disease: insights from a systematic review and meta-analysis of randomized controlled trials and a Mendelian randomization study

INTRODUCTION

Omega-6 polyunsaturated fatty acids (PUFAs) represent almost 15% of the total energy intake in Western countries. Their effects on the cardiovascular (CV) risk factors are still controversial. Thus, we performed a systematic review and meta-analysis of randomized control trials (RCTs) as well as a Mendelian randomization (MR) analysis to evaluate the links and possible causality between supplementation or serum levels of omega-6 PUFA, CV disease (CVD) and cardiometabolic risk factors.

MATERIAL AND METHODS

Selected databases were searched until September 2019 to identify prospective studies investigating the effects of omega-6 PUFA supplementation on CVD events/mortality. Random-effects model meta-analysis was performed for quantitative data synthesis. Trial sequential analysis (TSA) was used to evaluate the optimal sample size to detect a 20% reduction in outcomes after administration of omega-6 PUFAs. The inverse variance weighted (IVW) method, weighted median-based method, MR-Egger and MR-Pleiotropy RESidual Sum and Outlier (PRESSO) were applied for MR.

RESULTS

The pooled estimate risk ratio (RR) of omega-6 PUFA supplementation was 0.94 for any CVD event (95% CI: 0.77-1.15, I ² = 66.2%), 1.06 for CVD death (95% CI: 0.73-1.55, I ² = 66.2%), 0.84 for coronary heart disease (CHD) events (95% CI: 0.61-1.16, I ² = 79.4%), 0.87 for myocardial infarction (MI) (95% CI: 0.74-1.01, I ² = 2.3%) and 1.36 for stroke (95% CI: 0.45-4.07, I ² = 55.3%). In contrast, MR showed that individuals with higher serum omega-6 acid - adrenic acid (AA) levels had a greater risk for CHD events (IVW β = 0.526), MI (IVW β = 0.606) and large artery stroke (IVW β = 1.694), as well as increased levels of fasting blood glucose (FBG) (IVW β = 0.417), low-density lipoprotein cholesterol (LDL-C) (IVW β = 0.806), high-density lipoprotein cholesterol (HDL-C) (IVW β = 0.820), and lower levels of triglycerides (TG) (IVW β = -1.064) and total cholesterol (TC) (IVW β = -1.064).

CONCLUSIONS

Omega-6 PUFA supplementation did not affect the risk for CVD morbidity and mortality. Additionally, based on MR analysis we found that higher AA levels might even significantly increase the risk of CHD, MI and large artery stroke, as well as the levels of FBG and LDL-C, whereas they were negatively associated with TC and TG. Since a considerable chance of heterogeneity was observed for some of the results, further research is needed to elucidate the effects of omega-6 PUFAs on cardiometabolic outcomes.

Effects of Salvia hispanica L. (chia) seed on blood coagulation, endothelial dysfunction and liver fibrosis in an experimental model of Metabolic Syndrome

The aim of this study was to analyze blood coagulation, endothelial dysfunction and liver fibrosis in an experimental model of Metabolic Syndrome (MS) induced by chronic administration of a sucrose-rich diet (SRD) and to evaluate the effects of chia seed as a therapeutic strategy. Male Wistar rats were fed with a reference diet (RD) - 6 months - or a SRD - 3 months. Then, the last group was randomly divided into two subgroups. One subgroup continued receiving the SRD for up to 6 months and the other was fed with a SRD where whole chia seed was incorporated as the source of dietary fat for the next 3 months (SRD + CHIA). Results showed that rats fed a SRD for a long period of time develop dyslipidemia, visceral adiposity, insulin resistance, and a hypercoagulable and hypofibrinolytic basal state. Hepatic VCAM-1 (main adhesion molecules involved in endothelial dysfunction) expression was significantly increased. In addition, the SRD group presented hepatic steatosis, a significant increase in interstitial collagen deposition and hydroxyproline content. Liver TGF-β1 (a key cytokine involved in fibrogenesis) levels increased and a negative correlation with PPARα protein mass levels was found. The administration of chia seed for 3 months reversed dyslipidemia, visceral adiposity and insulin resistance. Platelet count, coagulation parameters and plasma fibrinogen levels were normalized. In the liver tissue, VCAM-1 expression, steatosis, interstitial collagen deposition and the hydroxyproline content decreased. TGF-β1 expression was decreased and this was associated with an increase in the PPARα protein levels. The present study showed new aspects in the progression from liver steatosis to fibrosis in dyslipidemic insulin-resistant rats chronically fed a sucrose-rich diet. Chia seed supplementation could be used as a functional food and a potential dietary strategy to prevent or ameliorate disorders related to atherothrombotic cardiovascular events and NASH.

Efficacy of Cuminum Cyminum supplementation on lipid profile and anthropometric parameters: A systematic review and meta-analysis of randomized controlled clinical trials

We aimed to evaluate the effect of Cuminum Cyminum (CC) supplementation on lipid profile and selected anthropometric parameters. PubMed, Scopus, Web of Science, and Embase databases were systematically searched until May 2021. The random-effect model was used to study the effect sizes. The sources of heterogeneity were assessed using subgroup analysis and meta-regression. Publication bias was studied by funnel plots. The GRADE approach was used to assess the overall quality of the evidence.The data from our eight included studies have indicated that CC supplementation can lower body mass index (BMI) (WMD = -0.88 kg/m² ; 95%CI: -1.58, -0.18; p = .023) and total cholesterol (TC) (WMD = -3.96 mg/dl; 95%CI: -6.51, -1.04; p=.008). Also, after adjusting for publication bias, CC was shown to be effective in improving waist circumference (WC), high-density lipoprotein (HDL-C), and triglycerides (TG) levels. Although, the current evidence has not shown that CC supplementation can affect low-density lipoprotein (LDL-C), our subgroup analysis has indicated that CC supplementation with supplementation length of more than 8 weeks is associated with beneficial effects on LDL-C.While CC might be a suitable choice in managing BMI and TC, further high-quality studies are needed to confirm its efficacy in the clinical setting.

The current use and evolving landscape of nutraceuticals

The nutraceutical market is currently a high-impact multi-billion-dollar industry, and it is anticipated to grow rapidly over the next decade. Nutraceuticals comprise diverse food-derived product categories that have become widespread due to increased consumer awareness of potential health benefits and the need for improved wellness. This targeted review is designed to identify the current global trends, market opportunities, and regulations that drive the nutraceutical industry. Safety and efficacy concerns are also explored with a view to highlighting areas that necessitate further research and oversight. Key drivers of the nutraceutical market include aging populations, consumer awareness, consumer lifestyle, increasing cost of healthcare, and marketing channels. Although some nutraceuticals hold promising preventive and therapeutic opportunities, there is a lack of a universal definition and regulatory framework among countries. Moreover, there is a lack of adequate evidence for their efficacy, safety, and effectiveness, which was even further highlighted during the ongoing coronavirus pandemic. Future prospective epidemiological studies can delineate the health impact of nutraceuticals and help set the scientific basis and rationale foundation for clinical trials, reducing the time and cost of trials themselves. Together, an understanding of the key drivers of the nutraceutical market alongside a consistent and well-defined regulatory framework will provide further opportunities for growth, expansion, and segmentation of nutraceuticals applications.

Effects of Essential Oils and Selected Compounds from Lamiaceae Family as Adjutants on the Treatment of Subjects with Periodontitis and Cardiovascular Risk

Essential oils from different plant species were found to contain different compounds exhibiting anti-inflammatory effects with the potential to be a valid alternative to conventional chemotherapy that is limited in long-term use due to its serious side effects. Generally, the first mechanism by which an organism counteracts injurious stimuli is inflammation, which is considered a part of the innate immune system. Periodontitis is an infectious and inflammatory disease caused by a dysbiosis in the subgingival microbiome that triggers an exacerbated immune response of the host. The immune–inflammatory component leads to the destruction of gingival and alveolar bone tissue. The main anti-inflammation strategies negatively modulate the inflammatory pathways and the involvement of inflammatory mediators by interfering with the gene’s expression or on the activity of some enzymes and so affecting the release of proinflammatory cytokines. These effects are a possible target from an effective and safe approach, suing plant-derived anti-inflammatory agents. The aim of the present review is to summarize the current evidence about the effects of essentials oils from derived from plants of the Lamiaceae family as complementary agents for the treatment of subjects with periodontitis and their possible effect on the cardiovascular risk of these patients.

Antidiabetic effects of the ethanolic extract of Allium saralicum R.M. Fritsch on streptozotocin-induced diabetes in a mice model

Medicinal plants can protect different organs against diabetes-induced oxidative stress due to their antioxidant compounds. The present study was designed to investigate the potential of Allium saralicum R.M. Fritsch (A. saralicum) ethanolic extract to alleviate the adverse effects of streptozotocin (STZ)-induced diabetes in male BALB/c mice. Seventy male mice were randomly divided into seven groups (n = 10). Diabetes was experimentally induced by STZ (60 mg/kg bw). A. saralicum ethanolic extract with doses 5, 20, 80, and 320 mg/kg was administrated for 20 consecutive days in diabetic animals. Based on the obtained results, the untreated diabetic mice showed high blood glucose level, cholesterol, low-density lipoprotein (LDL), white blood cells count (WBC), and platelets, as well as liver enzymes, urea, and creatinine. Administration of different doses of A. saralicum extract significantly reduced blood glucose level similar to glibenclamide. Also, the levels of catalase and superoxide dismutase enzymes restored toward normal level. All hepatic and renal function parameters as well as hematological parameters were improved following treatment with A. saralicum extract particularly at high doses. Histopathological studies showed a decrease in hepatic, renal, and pancreatic damage after treatment with A. saralicum extract. The results of the present work indicate that A. saralicum ethanolic extract can attenuate diabetic hepato-renal, pancreatic, and hematological damages.

Dietary Supplements-For Whom? The Current State of Knowledge about the Health Effects of Selected Supplement Use

Dietary supplements are products containing nutrients sold in various medicinal forms, and their widespread use may stem from the conviction that a preparation that looks like a drug must have therapeutic properties. The aim of this scoping review is to present what is known about the effects of using selected dietary supplements in the context of chronic diseases, as well as the risks associated with their use. The literature shows that the taking of vitamin and mineral supplements by healthy people neither lowers their risk of cardiovascular diseases nor prevents the development of malignancies. Many scientific societies recognize that omega-3 fatty acids lower blood triglycerides, but whether taking them prevents heart disease is less clear-cut. Taking weight loss supplements is not an effective method of fighting obesity. Often, some supplements are increasingly sold illegally, which is then also associated with the higher risk that they may be adulterated with banned substances, thus making them even more dangerous and potentially life-threatening. Supplements are necessary in cases of nutrient deficiency; however, even though prescription is not required, their use should be recommended and monitored by a physician.

No additional effects of ursolic acid supplementation associated with combined exercise program on metabolic syndrome of postmenopausal women: A double-blind, randomized, placebo-controlled trial

BACKGROUND & AIMS

Ursolic acid (UA) supplementation may have therapeutic effects on metabolic syndrome (MetS). Therefore, this study aimed to investigate the effects of UA supplementation associated with a combined exercise program on MetS components in postmenopausal women.

METHODS

Twenty-six women (61 ± 7 years) were randomized into two groups: UA (n = 13) and placebo (PLA, n = 13). Both groups followed a combined exercise program for 8 weeks (twice a week; ~60 min at moderate intensity) associated with either UA (450 mg/day) or placebo supplementation. Before and post-intervention, waist circumference (primary outcome), resting blood pressure, fasting blood analyses, body composition and physical function (secondary outcomes) were evaluated.

RESULTS

Greater changes in the absolute (mean difference: 1.8 kgf, 95% CI 0.3, 3.2) and relative (0.03 kgf/kg, 95% CI 0.01, 0.05) handgrip strength was observed for the UA group compared with PLA. However, no significant effects between groups were observed for waist circumference and other secondary outcomes. Furthermore, remission of MetS (according to the NCEP ATP III criteria) occurred in 38.5% of the participants in both groups.

CONCLUSIONS

The UA supplementation did not promote additional MetS profile improvement after 8 weeks of free-living intervention. However, our data indicated that UA resulted in a higher response on handgrip strength than did placebo in postmenopausal women, but further long-term studies are needed.

TRIAL REGISTRATION

Brazilian Registry of Clinical Trials (ensaiosclinicos.gov.br): number RBR-276rrt.

Leptin and TGF-β1 Downregulate PREP1 Expression in Human Adipose-Derived Mesenchymal Stem Cells and Mature Adipocytes

Adipose tissue is widely recognized as an extremely active endocrine organ producing adipokines as leptin that bridge metabolism and the immune system. Pre-B-cell leukemia homeobox (Pbx)-regulating protein-1 (PREP1) is a ubiquitous homeodomain transcription factor involved in the adipogenic differentiation and insulin-sensitivity processes. Leptin, as pleiotropic adipokine, and TGF-β, known to be expressed by primary pre-adipocytes [adipose-derived stem cells (ASCs)] and mature differentiated adipocytes, modulate inflammatory responses. We aimed to assess for the first time if leptin and TGF-β interfere with PREP1 expression in both ASCs and mature differentiated adipocytes. Human ASCs were isolated from subcutaneous adipose liposuction and, after expansion, fully differentiated to mature adipocytes. In both ASCs and adipocytes, leptin and TGF-β1 significantly decreased the expression of PREP1, alone and following concurrent Toll-like receptor 4 (TLR4) activation. Moreover, in adipocytes, but not in ASCs, leptin increased TLR4 and IL-33 expression, whereas TGF-β1 enhanced TLR4 and IL-6 expression. Taken together, we provide evidence for a direct regulation of PREP1 by leptin and TGF-β1 in ASCs and mature adipocytes. The effects of leptin and TGF-β1 on immune receptors and cytokines, however, are limited to mature adipocytes, suggesting that modulating immune responses depends on the differentiation of ASCs. Further studies are needed to fully understand the regulation of PREP1 expression and its potential for the development of new therapeutic approaches in obesity-related diseases.

The effect of apple cider vinegar on lipid profiles and glycemic parameters: a systematic review and meta-analysis of randomized clinical trials

Background

Elevated lipid profiles and impaired glucose homeostasis are risk factors for several cardiovascular diseases (CVDs), which, subsequently, represent a leading cause of early mortality, worldwide. The aim of the current study was to conduct a systematic review and meta-analysis of the effect of apple cider vinegar (ACV) on lipid profiles and glycemic parameters in adults.

Methods

A systematic search was conducted in electronic databases, including Medline, Scopus, Cochrane Library, and Web of Knowledge, from database inception to January 2020. All clinical trials which investigated the effect of ACV on lipid profiles and glycemic indicators were included. Studies were excluded if ACV was used in combination with other interventions or when the duration of intervention was < 2 weeks. To account for between-study heterogeneity, we performed meta-analysis using a random-effects model.

Results

Overall, nine studies, including 10 study arms, were included in this meta-analysis. We found that ACV consumption significantly decreased serum total cholesterol (− 6.06 mg/dL; 95% CI: − 10.95, − 1.17; I²: 39%), fasting plasma glucose (− 7.97 mg/dL; 95% CI: − 13.74, − 2.21; I²: 75%), and HbA1C concentrations (− 0.50; 95% CI: − 0.90, − 0.09; I²: 91%). No significant effect of ACV consumption was found on serum LDL-C, HDL-C, fasting insulin concentrations, or HOMA-IR. The stratified analysis revealed a significant reduction of serum TC and TG in a subgroup of patients with type 2 diabetes, those who took ≤15 mL/day of ACV, and those who consumed ACV for > 8-weeks, respectively. Furthermore, ACV consumption significantly decreased FPG levels in a subgroup of studies that administered ACV for > 8-weeks. Further, ACV intake appeared to elicit an increase in FPG and HDL-C concentrations in apparently healthy participants.

Conclusion

We found a significant favorable effect of ACV consumption on FPG and blood lipid levels.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12906-021-03351-w.

Regulation of Apolipoprotein B by Natural Products and Nutraceuticals: A Comprehensive Review

Cardiovascular Disease (CVD) is the most important and the number one cause of mortality in both developing and industrialized nations. The co-morbidities associated with CVD are observed from infancy to old age. Apolipoprotein B100 (Apo B) is the primary apolipoprotein and structural protein of all major atherogenic particles derived from the liver including Very-Low- Density Lipoproteins (VLDL), Intermediate-density Lipoprotein (IDL), and Low-density Lipoprotein (LDL) particles. It has been suggested that measurement of the Apo B concentration is a superior and more reliable index for the prediction of CVD risk than is the measurement of LDL-C. Nutraceuticals and medicinal plants have attracted significant attention as it pertains to the treatment of non-communicable diseases, particularly CVD, diabetes mellitus, hypertension, and Nonalcoholic Fatty Liver Disease (NAFLD). The effect of nutraceuticals and herbal products on CVD, as well as some of its risk factors such as dyslipidemia, have been investigated previously. However, to the best of our knowledge, the effect of these natural products, including herbal supplements and functional foods (e.g. fruits and vegetables as either dry materials, or their extracts) on Apo B has not yet been investigated. Therefore, the primary objective of this paper was to review the effect of bioactive natural compounds on plasma Apo B concentrations. It is concluded that, in general, medicinal plants and nutraceuticals can be used as complementary medicine to reduce plasma Apo B levels in a safe, accessible, and inexpensive manner in an attempt to prevent and treat CVD.

Novel Therapeutical Approaches to Managing Atherosclerotic Risk

Atherosclerosis is a multifactorial vascular disease that leads to inflammation and stiffening of the arteries and decreases their elasticity due to the accumulation of calcium, small dense Low Density Lipoproteins (sdLDL), inflammatory cells, and fibrotic material. A review of studies pertaining to cardiometabolic risk factors, lipids alterations, hypolipidemic agents, nutraceuticals, hypoglycaemic drugs, atherosclerosis, endothelial dysfunction, and inflammation was performed. There are several therapeutic strategies including Proprotein Convertase Subtilisin/Kexin 9 (PCSK9) inhibitors, inclisiran, bempedoic acid, Glucagon-Like Peptide-1 Receptor agonists (GLP-1 RAs), and nutraceuticals that promise improvement in the atheromatous plaque from a molecular point of view, because have actions on the exposure of the LDL-Receptor (LDL-R), on endothelial dysfunction, activation of macrophages, on lipid oxidation, formations on foam cells, and deposition extracellular lipids. Atheroma plaque reduction both as a result of LDL-Cholesterol (LDL-C) intensive lowering and reducing inflammation and other residual risk factors is an integral part of the management of atherosclerotic disease, and the use of valid therapeutic alternatives appear to be appealing avenues to solving the problem.

Novel molecular markers of cardiovascular disease risk in type 2 diabetes mellitus

Diabetes represents the leading risk factor for the development of cardiovascular disease (CVD). Chronic hyperglycemia and/or acute post-prandial changes in blood glucose determine an increase in reactive oxygen species (ROS), which play a fundamental role in endothelial dysfunction and in the nuclear transport of pro-atherogenic transcription factors that activate the "inflammasome". In addition, the glycemic alteration favors the formation and stabilization of atherosclerotic plaque through the mechanism of non-enzymatic glycation of different molecules, with the establishment of the so-called "advanced glycosylation end products" (AGE). Laboratory information provided by the level of biomarkers could make a quantitative and qualitative contribution to the clinical process of screening, prediction, prevention, diagnosis, prognosis and monitoring of cardiovascular (CV) risk linked to diabetes. This review describes the importance of specific biomarkers, with particular focus on novel ones, for stratifying and management of diabetes CV risk.

The beneficial effects of cinnamon among patients with metabolic diseases: A systematic review and dose-response meta-analysis of randomized-controlled trials

This systematic review and meta-analysis aims to summarize and conclude the clinical evidence regarding the use of cinnamon among patients with metabolic diseases. A comprehensive literature search without any limitation on language was conducted using the following bibliographical databases: ISI Web of Science, Embase, Scopus, PubMed, and Google Scholar. Search was conducted up to 23 January 2020. A total of 35 clinical trials were included for final analysis. Pooling of results showed a significant reducing effect of cinnamon on total cholesterol (TC) (weighted mean difference (WMD) = -11.67 mg/dL; P = 0.010), triglyceride (TG) (WMD = -16.27 mg/dL; P < 0.001), low density lipoprotein-cholesterol (LDL-C) (WMD = -6.36 mg/dL; P < 0.001), serum glucose (WMD = -11.39 mg/dL; P < 0.001), serum insulin (WMD = -1.27 μIU/mL; P = 0.028), and waist circumstance (WC) (WMD = -1.68 cm; P = 0.016). These lowering effects on TG, TC, LDL-C, and serum glucose levels were robust in studies that used cinnamon supplementation dose ≤1.5 g. Also, our findings of the present meta-analysis showed that cinnamon supplementation could have favorable effects on high density lipoprotein-cholesterol (HDL-C, WMD = 1.35; P = 0.038) as well as systolic (WMD = -3.95 mmHg; P = 0.018) and diastolic (WMD = -3.36; P = 0.001) blood pressure among patients with metabolic diseases. The present meta-analysis suggests that cinnamon might exert beneficial effects on various cardiometabolic risk factors among patients with metabolic diseases.

The association between serum uric acid and features of metabolic disturbances in young adults

INTRODUCTION

The increase in the number of people affected by different metabolic disturbances, especially among young people, is alarming. It seems worthwhile to reappraise the usefulness of commonly used laboratory parameters potentially associated with metabolic and metabolically obese normal weight syndrome. Serum uric acid may be considered as an indicator and/or a predictor of metabolic disorders. We evaluated serum uric acid concentration in relation to metabolic syndrome, as well as metabolically obese normal weight features, and examined its usefulness in improving metabolic and metabolically obese normal weight syndrome diagnosis in young people.

MATERIAL AND METHODS

In 349 apparently healthy people, aged 18-31, features of metabolic and metabolically obese normal weight syndrome and serum uric acid concentration were examined under fasting conditions.

RESULTS

Prevalence of metabolic syndrome increased in uric acid quartiles, while the percentage of metabolically obese normal weight syndrome was at a similar level in all uric acid quartiles. A relationship between uric acid concentration and features of metabolic disorders in quartile and correlation analysis was revealed. Data mining techniques did not indicate the usefulness of uric acid for distinguishing people with metabolic syndrome from those with metabolically obese normal weight syndrome.

CONCLUSIONS

We confirmed that in young people an increase in uric acid levels is more closely related to metabolic syndrome features than insulin resistance. Serum uric acid concentration could not be recommended as an independent, strong marker of metabolic or metabolically obese normal weight syndrome occurrence in young people, but finding its elevated concentration should be an indicator for screening for other disturbances associated with metabolic syndrome.

The effect of camelina oil (α-linolenic acid) and canola oil (oleic acid) on lipid profile, blood pressure, and anthropometric parameters in postmenopausal women

INTRODUCTION

Cold-pressed camelina oil (Camelina sativa) is rich in polyunsaturated fatty acids and may have a beneficial effect on the reduction of cardiovascular risk.

MATERIAL AND METHODS

In this study, we investigated the parameters contributing to the development of cardiovascular diseases, such as dietary intake, nutritional status, blood pressure, and lipid profile. Sixty postmenopausal women with dyslipidaemia were randomly assigned to two oil groups: camelina oil and canola oil. The subjects consumed daily 30 g of the test oils for 6 weeks. Before and after dietary intervention, the assessment of nutrition (4-day dietary recall), anthropometric parameters, lipid profile, and blood pressure were evaluated.

RESULTS

During the dietary intervention, decreased low-density lipoprotein cholesterol concentration in both groups (15 mg/dl (0.4 mmol/l) reduction in the camelina oil group and 11 mg/dl (0.3 mmol/l) reduction in the canola oil group) was observed. In this study a decrease of waist circumference (approx. 1 cm) in the two groups was observed. In the group of women consuming camelina oil, a significant decrease of waist-to-hip ratio was seen. In the other anthropometric parameters no statistically significant changes were observed (body weight, body fat mass). After the intervention, no significant decreases in systolic and diastolic blood pressure were noticed.

CONCLUSIONS

The camelina and canola oil intake contributed to reduction of the consumption of saturated fatty acids in the diet, had a positive influence on the lipid profile parameters, and decreased the waist circumference, which may reduce the risk of cardiovascular disease.

Association between metabolic syndrome and psoriasis: a meta-analysis of observational studies with non-psoriasis control groups

INTRODUCTION

Psoriasis is a highly prevalent condition that affects the quality of life of affected individuals. Several studies have indicated an association between psoriasis and metabolic syndrome (MS). However, the results were inconsistent. The objective of this study was to evaluate the relationship between psoriasis and MS.

MATERIAL AND METHODS

Electronic databases (PubMed, EBSCO, Elsevier, Springer, Wiley, and Cochrane) were searched systematically for published studies up to November 2, 2018. Odds ratio (OR) and 95% confidence interval (CI) were used to evaluate the association between psoriasis and MS. The heterogeneity of the study was estimated with the I² statistic and analyzed by meta-regression and subgroup analyses.

RESULTS

Twenty-two studies with a total of 137,053 participants were included in this meta-analysis. Psoriasis was associated with MS and the combined OR (95% CI) was 2.02 (1.67-2.43). The results showed high heterogeneity (I ² = 83.60%, p < 0.001) and no publication bias among the included studies (p = 0.119). The source of controls may have influenced the heterogeneity according to the meta-regression. There was no heterogeneity in studies with matched non-psoriasis control groups according to the subgroup analysis.

CONCLUSIONS

Psoriasis was associated with MS. The source of the control group was an influencing factor on heterogeneity in this study. Treating for MS in patients with psoriasis might improve psoriasis and reduce the risk of cardiovascular disease.

Bioactive Compounds for the Management of Hypertriglyceridemia: Evidence From Clinical Trials and Putative Action Targets

Hypertriglyceridemia refers to the presence of elevated concentrations of triglycerides (TG) in the bloodstream (TG >200 mg/dL). This lipid alteration is known to be associated with an increased risk of atherosclerosis, contributing overall to the onset of atherosclerotic cardiovascular disease (CVD). Guidelines for the management of hypertriglyceridemia are based on both lifestyle intervention and pharmacological treatment, but poor adherence, medication-related costs and side effects can limit the success of these interventions. For this reason, the search for natural alternative approaches to reduce plasma TG levels currently represents a hot research field. This review article summarizes the most relevant clinical trials reporting the TG-reducing effect of different food-derived bioactive compounds. Furthermore, based on the evidence obtained from in vitro studies, we provide a description and classification of putative targets of action through which several bioactive compounds can exert a TG-lowering effect. Future research may lead to investigations of the efficacy of novel nutraceutical formulations consisting in a combination of bioactive compounds which contribute to the management of plasma TG levels through different action targets.

Hepatoprotective and anti-inflammatory effects of a standardized pomegranate (Punica granatum) fruit extract in high fat diet-induced obese C57BL/6 mice

Diets rich in fats are linked to elevated systemic inflammation, which augments the progression of inflammatory-related disorders including non-alcoholic fatty liver disease (NAFLD) and neurodegenerative diseases. A phenolic-enriched pomegranate fruit extract (PE) was investigated for its hepatoprotective and anti-inflammatory effects in male C57BL/6 mice fed either a high-fat diet or a standard rodent diet with or without 1% of PE for 12 weeks. Mouse livers and hippocampi were evaluated for the expression of genes associated with NAFLD and inflammation by multiplexed gene analysis. PE alleviated diet-induced fatty liver and suppressed hepatic lipid regulating genes including Cd36, Fas, Acot2 and Slc27a1. In addition, PE suppressed gene expression of pro-inflammatory cytokines including Il-1α, Il-7, Il-11, Ifnα, Tnfα and Lepr in the hippocampi. Our findings support the protective effects of PE against high-fat diet-induced hepatic and neurological disease.

Therapeutic application of nutraceuticals in diabetic nephropathy: Current evidence and future implications

Diabetes mellitus (DM) is a common metabolic disease which may cause several complications, such as diabetic nephropathy (DN). The routine medical treatments used for DM are not effective enough and have many undesirable side effects. Moreover, the global increased prevalence of DM makes researchers try to explore potential complementary or alternative treatments. Nutraceuticals, as natural products with pharmaceutical agents, have a wide range of therapeutic properties in various pathologic conditions such as DN. However, the exact underlying mechanisms have not been fully understood. The purpose of this review is to summarize recent findings on the effect of nutraceuticals on DN.

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

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

Daily Use of Extra Virgin Olive Oil with High Oleocanthal Concentration Reduced Body Weight, Waist Circumference, Alanine Transaminase, Inflammatory Cytokines and Hepatic Steatosis in Subjects with the Metabolic Syndrome: A 2-Month Intervention Study

Extra virgin olive oil (EVOO) intake is associated with reduced cardiovascular risk, and its phenolic compound oleocanthal (OC) has anti-oxidant and anti-inflammatory properties. The cardiometabolic effects of EVOO with a high OC concentration have not been fully elucidated. We administered EVOO with a high OC concentration daily to 23 subjects with the metabolic syndrome (MetS) and hepatic steatosis (15 men and 8 women, age: 60 ± 11 years) for 2 months. Anthropometric data, metabolic parameters, hepatic steatosis (by fatty liver index, FLI), abdominal fat distribution (by ultrasound), and pro- and anti-inflammatory cytokines were assessed before and after the intervention. EVOO supplementation was associated with a reduction in body weight, waist circumference, body mass index (BMI), alanine transaminase and FLI, as well as interleukin (IL)-6, IL-17A, tumor necrosis factor-α and IL-1B, while IL-10 increased. Maximum subcutaneous fat thickness (SFT max) also increased, with a concomitant decrease in the ratio of visceral fat layer thickness/SFT max. Correlation analysis revealed positive associations between changes in body weight and BMI and those in SFT max, along with an inverse association between changes in IL-6 and those in SFT max. In conclusion, ingestion of EVOO with a high OC concentration had beneficial effects on metabolic parameters, inflammatory cytokines and abdominal fat distribution in MetS subjects with hepatic steatosis, a category of patients at high cardiometabolic risk.