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Advances in Nutrition (Bethesda, Md.) May 2019There is insufficient evidence on the role of functional fortified dairy products in improving health and in preventing risk factors associated with noncommunicable... (Meta-Analysis)
Meta-Analysis
There is insufficient evidence on the role of functional fortified dairy products in improving health and in preventing risk factors associated with noncommunicable chronic diseases. This systematic review was conducted to summarize effects of the consumption of fortified dairy products on biomarkers of cardiometabolic risk. MEDLINE and SCOPUS databases were used to perform searches to include studies published up to 30 April 2018. Randomized clinical trials with human subjects consuming dairy products fortified with phytosterols, FAs, vitamins or minerals and relating this consumption with cardiometabolic health were included in this review. Risk of bias assessment according to Cochrane guidelines was performed to determine the quality of the trials. Forty-one studies were finally selected for this synthesis; the selected studies tested dairy products fortified with the following nutrients and bioactive components: phytosterols (n = 31), FAs (n = 8), and vitamin D (n = 2). We found that the consumption of phytosterol-fortified dairy, led to an overall LDL cholesterol reduction of -0.36 (-0.41, -0.31) mmol/L, P < 0.001; this decrease was mainly related to the dosage. Likewise, consumption of ω-3 FA-fortified dairy products resulted in a plasma LDL cholesterol reduction of -0.18 (-0.27, -0.09) mmol/L as well as a decrease of -0.18 (-0.32, -0.05) mmol/L in triacylglycerols (TG). Performing meta-analyses of the consumption of dairy products fortified with vitamin D or FAs other than ω-3 FAs and biomarkers of cardiometabolic risk was not possible because of the few available publications. Our results indicate that consumption of dairy products fortified with phytosterols and ω-3 FAs can lead to a reduction of LDL cholesterol and consumption of fortified dairy products fortified with ω-3 FAs can reduce TG concentration. However, more studies with homogeneous designs are needed to determine the advantages of using dairy products as fortification vehicles to prevent cardiometabolic risk.
Topics: Adult; Animals; Cardiovascular Diseases; Dairy Products; Diet; Fatty Acids, Omega-3; Feeding Behavior; Female; Food, Fortified; Humans; Lipids; Male; Middle Aged; Milk; Phytosterols; Vitamin D; Vitamins; Young Adult
PubMed: 31089744
DOI: 10.1093/advances/nmz001 -
Osteoarthritis and Cartilage Jan 2011The aim of this first global systematic review on selected nutraceuticals was to synthesize and evaluate scientific relevant data available in the literature. Evidences... (Review)
Review
OBJECTIVES
The aim of this first global systematic review on selected nutraceuticals was to synthesize and evaluate scientific relevant data available in the literature. Evidences that can support health, physiological or functional benefit on osteoarthritis (OA) were gathered and the level of evidence relative to each of these ingredients was highlighted.
METHODOLOGY
Relevant scientific data (positive or not) regarding OA were searched for five groups of compounds (avocado/soybean unsaponifiables (ASU), n-3 polyunsaturated fatty acids, collagen hydrosylates (CHs), vitamin D, polyphenols) within preclinical (in vitro and in vivo), epidemiological, and clinical studies. The following criteria were evaluated to assess the methodology quality of each study: (1) study question; (2) study population; (3) primary endpoint; (4) study design (randomization, control, blinding, duration of follow up); (5) data analysis and interpretation. A scientific consensus was determined for all studied nutraceuticals to evaluate their efficacy in OA.
RESULTS
The studied compounds demonstrated different potencies in preclinical studies. Most of them have demonstrated anti-catabolic and anti-inflammatory effects by various inhibitory activities on different mediators. Vitamin D showed a pro-catabolic effect in vitro and the polyphenol, Genistein, had only anti-inflammatory potency. The evaluation of the clinical data showed that ASU was the only one of the studied ingredients to present a good evidence of efficacy, but the efficient formulation was considered as a drug in some countries. Pycnogenol showed moderate evidence of efficacy, and vitamin D and collagen hydrolysate demonstrated a suggestive evidence of efficacy, whereas curcumin, epigallocatechin-3-gallate (EGCG) and resveratrol had only preclinical evidence of efficacy due to the lack of clinical data. The literature gathered for n-3 PUFA, nobiletin and genistein was insufficient to conclude for their efficacy in OA.
CONCLUSION
Additional data are needed for most of the studied nutraceuticals. Studies of good quality are needed to draw solid conclusions regarding their efficacy but nutraceuticals could represent good alternates for OA management. Their use should be driven by any recommendations.
Topics: Collagen; Fatty Acids; Flavonoids; Food, Organic; Humans; Nutrition Therapy; Osteoarthritis; Phenols; Phytosterols; Polyphenols; Vitamin D
PubMed: 21035558
DOI: 10.1016/j.joca.2010.10.017 -
Journal of Ethnopharmacology Jan 2021Blepharis is an Afro-Asiatic genus belonging to the family Acanthaceae. It comprises about 126 species that occur in arid and semi-arid habitats. Some species of...
ETHNOPHARMACOLOGICAL RELEVANCE
Blepharis is an Afro-Asiatic genus belonging to the family Acanthaceae. It comprises about 126 species that occur in arid and semi-arid habitats. Some species of Blepharis are used in traditional medicines in different countries mainly for their anti-inflammatory, wound healing activities along with treatment of gastrointestinal disorders and bone fractures.
AIM OF THE REVIEW
The present review aims to collate and analyze the available data and information on distribution, traditional uses, chemical constituents and pharmacological activities of Blepharis.
METHODS
Scientific information of genus Blepharis was retrieved from the online bibliographic databases such as MEDLINE/PubMed, SciFinder, Web of Science and Google Scholar and secondary resources including books and proceedings.
RESULTS
Seven species of Blepharis were found to be reported frequently as useful in folklore in African and Asian countries. B. maderaspatensis was found to be widely used in Indian traditional medicines whereas the B. ciliaris and B. edulis were common in folklore of Egypt, Jordan, and Arabia. Active phytochemicals of Blepharis are flavonoids from B. ciliaris, alkaloids from B. sindica, phenolic acid derivatives, and phytosterols, and derivatives of hydroxamic acids from B. edulis resulted in possessing diverse biological properties such as anti-microbial, anti-inflammatory, and anti-cancer.
CONCLUSIONS
Various species of Blepharis were found to be used in traditional medicine systems in African and Asian countries. Few of these species were studied for their bioactive chemical constituents however the activity guided isolation studies are not performed. Similarly, detailed pharmacological studies in animal models to explore their mechanism of action are also not reported. Future studies should focus on these aspects related to the medicinally used species of Blepharis. The detailed and comprehensive comparative analysis presented here gives valuable information of the currently used Blepharis species and pave the way to investigate other useful species of Blepharis pertaining to ethnobotany, phytochemistry and discovery of new drugs.
Topics: Acanthaceae; Animals; Ethnobotany; Ethnopharmacology; Humans; Medicine, Traditional; Phytochemicals; Phytotherapy; Plant Preparations
PubMed: 32798615
DOI: 10.1016/j.jep.2020.113255 -
BJU International Jun 1999To conduct a systematic review of the evidence for the efficacy of beta-sitosterol in men with symptomatic benign prostatic hyperplasia (BPH). (Review)
Review
OBJECTIVES
To conduct a systematic review of the evidence for the efficacy of beta-sitosterol in men with symptomatic benign prostatic hyperplasia (BPH).
METHODS
Studies were identified through Medlinetrade mark (1966-98), EMBASEtrade mark, Phytodok, the Cochrane Library, bibliographies of identified trials and review articles, and contact with study authors and pharmaceutical companies. Randomized trials were included if: men had symptomatic BPH; plant extract preparations contained beta-sitosterols; a control group received placebo or a pharmacological therapy; and treatment duration was >/=30 days. Study characteristics, demographic information, enrolment criteria and outcomes were extracted.
RESULTS
Four trials comprising a total of 519 men met the inclusion criteria. All were double-blind and lasted 4-26 weeks. Three studies used nonglucosidic beta-sitosterols and one used a preparation that contained only beta-sitosterol-beta-d-glucoside. Compared with placebo, beta-sitosterol improved urinary symptom scores and flow measures. For the two studies reporting the International Prostate Symptom Score (IPSS), the weighted mean difference (WMD) against placebo was -4.9 IPSS points (95% confidence interval, CI,-6.3 to-3.5). The WMD for peak urinary flow rate was 3.91 mL/s (95% CI 0.91 to 6.90, four studies) and for residual volume the WMD was -28.62 mL (95% CI-41.42 to-15.83, four studies). beta-sitosterol did not reduce prostate size. The trial using pure beta-sitosterol-beta-d-glucoside (WA184) showed no improvement in urinary flow measures. Withdrawal rates for men assigned to beta-sitosterol and placebo were 7.8% and 8.0% (not significant), respectively.
CONCLUSION
beta-sitosterol improves urological symptoms and flow measures. However, the existing studies are limited by short treatment duration and lack of standardized beta-sitosterol preparations. Their long-term effectiveness, safety and ability to prevent the complications of BPH are unknown.
Topics: Adult; Aged; Aged, 80 and over; Humans; Male; Middle Aged; Prostatic Hyperplasia; Randomized Controlled Trials as Topic; Sitosterols; Treatment Outcome; Urination; Urination Disorders
PubMed: 10368239
DOI: 10.1046/j.1464-410x.1999.00026.x -
Nutrients Jan 2019Non-cholesterol sterols are validated biomarkers for intestinal cholesterol absorption and endogenous cholesterol synthesis. However, their use in metabolic disturbances...
Non-cholesterol sterols are validated biomarkers for intestinal cholesterol absorption and endogenous cholesterol synthesis. However, their use in metabolic disturbances has not been systematically explored. Therefore, we conducted a systematic review to provide an overview of non-cholesterol sterols as markers for cholesterol metabolism in different metabolic disorders. Potentially relevant studies were retrieved by a systematic search of three databases in July 2018 and ninety-four human studies were included. Cholesterol-standardized levels of campesterol, sitosterol and cholestanol were collected to reflect cholesterol absorption and those of lathosterol and desmosterol to reflect cholesterol synthesis. Their use as biomarkers was examined in the following metabolic disorders: overweight/obesity ( = 16), diabetes mellitus ( = 15), metabolic syndrome ( = 5), hyperlipidemia ( = 11), cardiovascular disease ( = 17), and diseases related to intestine ( = 16), liver ( = 22) or kidney ( = 2). In general, markers for cholesterol absorption and synthesis displayed reciprocal patterns, showing that cholesterol metabolism is tightly regulated by the interplay of intestinal absorption and endogenous synthesis. Distinctive patterns for cholesterol absorption or cholesterol synthesis could be identified, suggesting that metabolic disorders can be classified as 'cholesterol absorbers or cholesterol synthesizers'. Future studies should be performed to confirm or refute these findings and to examine whether this information can be used for targeted (dietary) interventions.
Topics: Biomarkers; Cardiovascular Diseases; Cholesterol; Desmosterol; Diabetes Mellitus; Humans; Intestinal Absorption; Intestinal Diseases; Kidney Diseases; Liver Diseases; Metabolic Diseases; Obesity; Overweight; Phytosterols; Sitosterols; Sterols
PubMed: 30634478
DOI: 10.3390/nu11010124 -
The Cochrane Database of Systematic... Jul 2013Patients undergoing vascular surgery are a high-risk population with widespread atherosclerosis, an adverse cardiovascular risk profile and often multiple... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Patients undergoing vascular surgery are a high-risk population with widespread atherosclerosis, an adverse cardiovascular risk profile and often multiple co-morbidities. Postoperative cardiovascular complications, including myocardial infarct (MI), are common. Statins are the medical treatment of choice to reduce high cholesterol levels. Evidence is accumulating that patients taking statins at the time of surgery are protected against a range of perioperative complications, but the specific benefits for patients undergoing noncardiac vascular surgery are not clear.
OBJECTIVES
We examined whether short-term statin therapy, commenced before or on the day of noncardiac vascular surgery and continuing for at least 48 hours afterwards, improves patient outcomes including the risk of complications, pain, quality of life and length of hospital stay. We also examined whether the effect of statin therapy on these outcomes changes depending on the dose of statin received.
SEARCH METHODS
We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2012, Issue 7), MEDLINE via Ovid SP (1966 to August 2012), EMBASE via Ovid SP (1966 to August 2012), CINAHL via EBSCO host (1966 to August 2012) and ISI Web of Science (1946 to July 2012) without any language restriction. We used a combination of free text search and controlled vocabulary search. The results were limited to randomized controlled clinical trials (RCTs). We conducted forwards and backwards citation of key articles and searched two clinical trial Websites for ongoing trials (www.clinicaltrials.gov and http://www.controlled-trials.com).
SELECTION CRITERIA
We included RCTs that had compared short-term statin therapy, either commenced de novo or with existing users randomly assigned to different dosages, in adult participants undergoing elective and emergency noncardiac arterial surgery, including both open and endovascular procedures. We defined short-term as commencing before or on the day of surgery and continuing for at least 48 hours afterwards.
DATA COLLECTION AND ANALYSIS
Two authors independently assessed trial quality and extracted data, including information on adverse events. We contacted study authors for additional information. We performed separate analyses for the comparisons of statin with placebo/no treatment and between different doses of statin. We presented results as pooled risk ratios (RRs) with 95% confidence intervals (CIs) based on random-effects models (inverse variance method). We employed the Chi(2) test and calculated the I(2) statistic to investigate study heterogeneity.
MAIN RESULTS
We identified six eligible studies in total. The six Included studies were generally of high quality, but the largest eligible study was excluded because of concerns about its validity. Study populations were statin naive, which led to a considerable loss of eligible participants.Five RCTs compared statin use with placebo or standard care. We pooled results from three studies, with a total of 178 participants, for mortality and non-fatal event outcomes. In the statin group, 7/105 (6.7%) participants died within 30 days of surgery, as did 10/73 (13.7%) participants in the control group. Only one death in each group was from cardiovascular causes, with an incidence of 0.95% in statin participants and 1.4% in control participants, respectively. All deaths occurred in a single study population, and so effect estimates were derived from one study only. The risk ratio (RR) of all-cause mortality in statin users showed a non-significant decrease in risk (RR 0.73, 95% CI 0.31 to 1.75). For cardiovascular death, the risk ratio was 1.05 (95% CI 0.07 to 16.20). Non-fatal MI within 30 days of surgery was reported in three studies and occurred in 4/105 (3.8%) participants in the statin group and 8/73 (11.0%) participants receiving placebo, for a non-significant decrease in risk (RR 0.47, 95% CI 0.15 to 1.52). Several studies reported muscle enzyme levels as safety measures, but only three (with a total of 188 participants) reported explicitly on clinical muscle syndromes, with seven events reported and no significant difference found between statin users and controls (RR 0.94, 95% CI 0.24 to 3.63). The only participant-reported outcome was nausea in one small study,with no significant difference in risk between groups.Two studies compared different doses of atorvastatin, with a total of 145 participants, but reported data were not sufficient to allow us to determine the effect of higher doses on any outcome.
AUTHORS' CONCLUSIONS
Evidence was insufficient to allow review authors to conclude that statin use resulted in either a reduction or an increase in any of the outcomes examined. The existing body of evidence leaves questions about the benefits of perioperative use of statins for vascular surgery unanswered. Widespread use of statins in the target population means that it may now be difficult for researchers to undertake the large RCTs needed to demonstrate any effect on the incidence of postoperative cardiovascular events. However, participant-reported outcomes have been neglected and warrant further study.
Topics: Adult; Angioplasty; Atherosclerosis; Atorvastatin; Cardiovascular Diseases; Cause of Death; Cholestyramine Resin; Heptanoic Acids; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Lovastatin; Perioperative Care; Postoperative Complications; Pyrroles; Randomized Controlled Trials as Topic; Sitosterols; Vascular Surgical Procedures
PubMed: 23824754
DOI: 10.1002/14651858.CD009971.pub2 -
Journal of Ethnopharmacology Jan 2022Inula racemosa Hook. f., is a critically endangered perennial herb distributed throughout the Himalaya; commercially useful in pharmaceutical products mainly because of...
ETHNOPHARMACOLOGICAL RELEVANCE
Inula racemosa Hook. f., is a critically endangered perennial herb distributed throughout the Himalaya; commercially useful in pharmaceutical products mainly because of its expectorant, antispasmodic, hypotensive, anti-inflammatory, carminative, thermogenic, digestive, cardiotonic, acrid, alexipharmic, anodyne, aphrodisiac, febrifuge, and antiseptic properties. The roots including rhizomes of the plant were used in the treatment of various ailments like chest pain, liver dysfunction, dyspnoea, and cardiovascular diseases by the ethenic Himalayan residents.
AIM OF THE REVIEW
Even though there are plentiful studies involving I. racemosa for pharmacological properties, but there is gap or few records available on production technologies and patents. The purpose of review is to provide large unmanageable information in systematic form for researchers, health care contributors, and policy makers so that they efficiently integrate the existing information and provide balanced decision making.
MATERIALS AND METHODS
Relevant data search was completed through systematic searches using various scientific databases including e-resources viz., Scopus, Google Scholar, Science Direct, ACS, Springer Link, Taylor and Francis, Scifinder, PubMed, PubChem, Web of Science, LibGen, Wiley, and China National Knowledge Infrastructure (CNKI). The list of literature cited in this review are dated from 1959 to 2021.
RESULTS
Till date variety of ethnobotanical and pharmacological properties of essential oil including crude extract of I. racemosa have been documented. The shortlisted records revealed that the herb has a potential to treat stomach ulcer, respiratory tract infections including chronic obstructive pulmonary disease (COPD). Alantolactone and isoalloalantolactone were reported as the major bioactive constituents along with few fatty acids, phytosterols, and glycosides characterized by GC, GC/MS, HPLC, HPTLC and qNMR techniques.
CONCLUSIONS
Based on a detailed literature survey on the plant, evidences were found fascinating for biological, traditional, and pharmacological effects, whilst there are no genomic resources available for this medicinal herb. Thus, molecular studies are critical for unravelling the production process of bioactive metabolites inside herb, which will underlay a path for improving these metabolites at commercial scale. Moreover, the association and role of particular phytoconstituent in its biological properties still needs to be validated. In addition, there are no reports on measures on its conservation and mechanism of toxicity research, which also needs more attention. We hope this review can provide a basis for further studies concerning the protected and efficient utilization of I. racemosa.
Topics: Animals; Ethnobotany; Ethnopharmacology; Humans; India; Inula; Medicine, Traditional; Plant Extracts
PubMed: 34600078
DOI: 10.1016/j.jep.2021.114613 -
Food & Function Jun 2024The most significant contributor to global mortality are cardiovascular diseases. Dietary factors significantly impact the risk, advancement, and treatment of... (Review)
Review
The most significant contributor to global mortality are cardiovascular diseases. Dietary factors significantly impact the risk, advancement, and treatment of cardiometabolic conditions. Chocolate, known for its adaptability and capacity to stimulate pleasure centers, emerges as a promising vehicle for integrating different bioactive elements. This systematic review analyzed 10 randomized controlled trials investigating the health effects of consuming enriched, fortified, or supplemented chocolate. These trials varied in chocolate intake amounts (ranging from 5 to 101 g day), incorporated bioactive components (co-crystalized astaxanthin, lycopene, wood-based phytosterol-phytostanol mixture, canola sterol esters, .), and duration (from 2 weeks to 1 year). Some enriched chocolates were found to reduce total and LDL cholesterol and influence markers of oxidative damage, inflammation, immune function, and skin parameters. However, certain trials showed a minimal impact on health outcomes. Therefore, while enriched chocolate holds promise as a carrier for beneficial bioactive compounds, rigorous scientific inquiry and methodological rigor are crucial to fully substantiate these claims. Comprehensive evaluations covering cardiovascular health, metabolic function, immune response, and other aspects are needed to understand its potential benefits and limitations. Advancing robust research initiatives could help realize the full potential of enriched chocolate in promoting human health and well-being.
PubMed: 38864465
DOI: 10.1039/d4fo01574f -
Journal of the American College of... Feb 2006To-date, reviews regarding the cholesterol lowering capacity of phytosterols/stanols have focused on normo- and hypercholesterolemic (HC) subjects. Familial... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
To-date, reviews regarding the cholesterol lowering capacity of phytosterols/stanols have focused on normo- and hypercholesterolemic (HC) subjects. Familial hypercholestrolemia (FH) is characterized by very high low-density lipoprotein cholesterol (LDL-C) concentrations and is considered a world public health problem due to the high incidence of premature coronary heart disease (CHD) in these patients.
OBJECTIVE
To conduct a systematic review that investigates the efficacy of phytosterols/stanols in lowering total cholesterol (TC) and LDL-C concentrations in FH subjects.
DESIGN
Randomized controlled intervention trials with the primary objective to investigate the effects of phytosterols/stanols on lipid concentrations in FH subjects were identified through selected international journal databases and reference lists of relevant publications. Two researchers extracted data from each identified trial and only trials of sufficient quality (e.g. controlled, randomized, double-blind, good compliance, sufficient statistical power) were included in the review. The main outcome measures were differences between treatment and control groups for LDL-C, TC, high-density lipoprotein cholesterol (HDL-C) and triacylglycerol (TG).
RESULTS
Six out of 13 studies were of sufficient quality. Two were excluded from the meta-analysis because the sterols were administered in the granulate form at very high dosages (12 g/day and 24 g/day) compared to the other studies that used fat spreads as vehicle with dosages ranging from 1.6-2.8 g/day. The subjects were heterozygous, aged 2-69 years with baseline TC and LDL-C concentrations of +/-7 mmol/L and +/-5.4 mmol/L, respectively. The duration of the studies ranged from 4 weeks to 3 months. Fat spreads enriched with 2.3 +/- 0.5 g phytosterols/stanols per day significantly reduced TC from 7 to 11% with a mean decrease of 0.65 mmol/L [95% CI -0.88, -0.42 mmol/L], p < 0.00001 and LDL-C from 10-15% with a mean decrease of 0.64 mmol/L [95% CI -0.86, -0.43 mmol/L], p < 0.00001 in 6.5 +/- 1.9 weeks compared to control treatment, without any adverse effects. TG and HDL-C concentrations were not affected.
CONCLUSION
Phytosterols/stanols may offer an effective adjunct to the cholesterol lowering treatment strategy of FH patients.
Topics: Adolescent; Adult; Aged; Anticholesteremic Agents; Child; Child, Preschool; Cholesterol; Cholesterol, LDL; Dietary Fats; Female; Food, Fortified; Humans; Hyperlipoproteinemia Type II; Male; Middle Aged; Phytosterols; Treatment Outcome
PubMed: 16522931
DOI: 10.1080/07315724.2006.10719513 -
Marine Drugs May 2021Air pollution has recently become a subject of increasing concern in many parts of the world. The World Health Organization (WHO) estimated that nearly 4.2 million early...
Air pollution has recently become a subject of increasing concern in many parts of the world. The World Health Organization (WHO) estimated that nearly 4.2 million early deaths are due to exposure to fine particles in polluted air, which causes multiple respiratory diseases. Algae, as a natural product, can be an alternative treatment due to potential biofunctional properties and advantages. This systematic review aims to summarize and evaluate the evidence of metabolites derived from algae as potential anti-inflammatory agents against respiratory disorders induced by atmospheric particulate matter (PM). Databases such as Scopus, Web of Science, and PubMed were systematically searched for relevant published full articles from 2016 to 2020. The main key search terms were limited to "algae", "anti-inflammation", and "air pollutant". The search activity resulted in the retrieval of a total of 36 publications. Nine publications are eligible for inclusion in this systematic review. A total of four brown algae (, , and ) with phytosterol, polysaccharides and polyphenols were reported in the nine studies. The review sheds light on the pathways of particulate matter travelling into respiratory systems and causing inflammation, and on the mechanisms of actions of algae in inhibiting inflammation. Limitations and future directions are also discussed. More research is needed to investigate the potential of algae as anti-inflammatory agents against PM in in vivo and in vitro experimental models, as well as clinically.
Topics: Air Pollutants; Animals; Anti-Inflammatory Agents; Humans; Particulate Matter; Phaeophyceae; Respiratory Tract Diseases
PubMed: 34070821
DOI: 10.3390/md19060317