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The Therapeutic Roles of Cinnamaldehyde against Cardiovascular Diseases.
Lu, L, Xiong, Y, Zhou, J, Wang, G, Mi, B, Liu, G
Oxidative medicine and cellular longevity. 2022;2022:9177108
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Cardiovascular disease (CVD) is still a growing concern around the world. Current treatments for the prevention of CVD are inadequate due to limited efficacy and the occurrence of side effects and so there is a need for new therapies. Cinnamaldehyde (CA), which is an active constituent of cinnamon has been reported to have protective effects against certain diseases and evidence is growing for its use against the initiation and development of CVD. This review study aimed to evaluate the cardioprotective effects of CA. The review reported that CA is a compound that is relatively safe but is not easily absorbed by the body, however it can be encapsulated into capsules that enable it to be more easily absorbed. CA was reported to have anti-inflammatory, antioxidant, antithrombotic, blood cell dilatory and blood sugar lowering properties. In addition, CA was shown to prevent the death of cells of the heart and modulate the gut microbiota all of which may be cardioprotective. It was concluded that CA can benefit the heart in several ways. This study could be used by healthcare professionals to understand that cinnamon may be of benefit to heart health, however as studies in humans were not reviewed, further research is warranted before recommendations are made.
Abstract
Evidence from epidemiological studies has demonstrated that the incidence and mortality of cardiovascular diseases (CVDs) increase year by year, which pose a great threat on social economy and human health worldwide. Due to limited therapeutic benefits and associated adverse effects of current medications, there is an urgent need to uncover novel agents with favorable safety and efficacy. Cinnamaldehyde (CA) is a bioactive phytochemical isolated from the stem bark of Chinese herbal medicine Cinnamon and has been suggested to possess curative roles against the development of CVDs. This integrated review intends to summarize the physicochemical and pharmacokinetic features of CA and discuss the recent advances in underlying mechanisms and potential targets responsible for anti-CVD properties of CA. The CA-related cardiovascular protective mechanisms could be attributed to the inhibition of inflammation and oxidative stress, improvement of lipid and glucose metabolism, regulation of cell proliferation and apoptosis, suppression of cardiac fibrosis, and platelet aggregation and promotion of vasodilation and angiogenesis. Furthermore, CA is likely to inhibit CVD progression via affecting other possible processes including autophagy and ER stress regulation, gut microbiota and immune homeostasis, ion metabolism, ncRNA expression, and TRPA1 activation. Collectively, experiments reported previously highlight the therapeutic effects of CA and clinical trials are advocated to offer scientific basis for the compound future applied in clinical practice for CVD prophylaxis and treatment.
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Curcuminoids for Metabolic Syndrome: Meta-Analysis Evidences Toward Personalized Prevention and Treatment Management.
Nurcahyanti, ADR, Cokro, F, Wulanjati, MP, Mahmoud, MF, Wink, M, Sobeh, M
Frontiers in nutrition. 2022;9:891339
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Metabolic syndrome (MS) is a cluster of conditions including high blood pressure, high blood sugar, excess body fat around the waist and an unfavourable blood lipid profile. With so many conditions come multiple causes and although drugs are often used as part of the treatment, several need to be prescribed to target the differing causes. These are associated with numerous side effects, which can exacerbate the condition. In contrast, natural products such as curcumin and its derivatives may offer broader therapeutic effects, which can target MS with minimal side effects. This meta-analysis aimed to review the clinical effect of curcumin, to understand how pre-existing metabolic disorder and environmental factors may affect an individual’s response. Curcumin was shown to interact in many of the cellular pathways involved in the development of MS. Despite it being easily degraded once released into the body, it was also shown to have antioxidant and anti-inflammatory effects, which can be involved in the development of MS. Genetic factors were shown to influence the breakdown and carriage of curcumin limiting its therapeutic effects. Its role in improving several diseases was mixed with unclear effects on obesity, beneficial effects on improving weight, blood sugar levels, and diastolic blood pressure but not systolic blood pressure, blood lipid levels or sleep duration. In combination with other substances, it was shown to help improve non-alcoholic fatty liver disease. It was concluded that curcumin may be of benefit to individuals with type 2 diabetes, and possibly those with uncontrolled high diastolic blood pressure. However, all recommendations should be made after thorough metabolic and genetic screening to ensure maximum effect. This study could be used by healthcare professionals to understand that curcumin may be of benefit to aspects of MS but only in those who have certain genetics.
Abstract
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.
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The association between vitamin D status and inflammatory bowel disease among children and adolescents: A systematic review and meta-analysis.
Fatahi, S, Alyahyawi, N, Albadawi, N, Mardali, F, Dara, N, Sohouli, MH, Prabahar, K, Rohani, P, Koushki, N, Sayyari, A, et al
Frontiers in nutrition. 2022;9:1007725
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Vitamin D deficiency is often seen in children with inflammatory bowel disease (IBD). This meta-analysis of 35 different studies aimed to determine the relationship between blood vitamin D levels and IBD in children. The results showed that compared to healthy controls, individuals with IBD had slightly but not significantly lower vitamin D levels. It was unclear how different classifications of the disease i.e whether the disease manifests as diarrhoea, constipation, or a mixture of both, may affect vitamin D levels. The paper concluded that vitamin D levels may be slightly lower in children with IBD. This study can be used by healthcare professionals to understand that some children with IBD may have lower than normal vitamin D levels, however it does not provide justification to measure these without further clinical signs of deficiency.
Expert Review
Conflicts of interest:
None
Take Home Message:
- Without further research, justification to measure vitamin D levels in children with IBD would require other clinical signs of deficiency.
Evidence Category:
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X
A: Meta-analyses, position-stands, randomized-controlled trials (RCTs)
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B: Systematic reviews including RCTs of limited number
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C: Non-randomized trials, observational studies, narrative reviews
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D: Case-reports, evidence-based clinical findings
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E: Opinion piece, other
Summary Review:
Introduction
The aim of the study was to determine the relationship between serum vitamin D levels and paediatric inflammatory bowel disease (IBD).
Methods
- This systematic review and meta-analysis of 35 case-control, cross-sectional or cohort studies followed PRISMA and MOOSE guidelines
- Five different libraries were searched
- 4803 children were included with the majority from the United States, and the remainder from Australia, Finland, Denmark, Italy, South Korea, and Israel.
Results
- 16 studies were appropriate for meta-analysis and showed a trend of lower vitamin D levels in children with IBD compared to healthy controls, but this was not statistically significant (-1.159 ng/ml; 95% CI: -2.783, 0.464)
- 18 studies with 2602 children showed that the prevalence of vitamin D deficiency or insufficiency was 44% (95% CI: -0.34- 0.54)
- There was significant heterogeneity between the prevalence studies (P=<0.001; I2=97.31%) as they included children with different classifications of IBD such as ulcerative colitis and Crohn’s Disease and used different assessments of serum vitamin D levels
- A strength was that most studies included in the systematic review and meta-analysis were of high quality.
Conclusion
- There is a non-significant trend towards lower serum vitamin D levels in children with IBD.
Clinical practice applications:
- Practitioners could consider measuring serum vitamin D levels in children with IBD
- However, as vitamin D levels were not lower in children with IBD in the present paper, practitioners should be aware that lower vitamin D concentrations may be due to other factors
- Furthermore, heterogeneity in the study means that it is unclear as to how different forms of the disease may affect levels
- Vitamin D regulates the immune response and as this is an immune disease, a better understanding of levels may be beneficial.
Considerations for future research:
- Future research could consider the effect of supplementary vitamin D intakes on IBD symptoms.
Abstract
AIM: Vitamin D deficiency is very common among children with IBD. Since there are conflicting results regarding the association of vitamin D with IBD, we conducted this systematic review to confirm the association of vitamin D with IBD. METHODS We conducted a systematic search in Scopus, Cochrane Library, Web of Science, PubMed, and Google Scholar to find relevant studies. Articles with cross-sectional and case-control designs that reported the association between vitamin D and IBD among children were included. RESULTS Eventually, 9 studies (with 16 effect sizes) reported the mean and SD or the median and the interquartile range of serum vitamin D levels in both subjects with IBD and control subjects. The random effects meta-analysis revealed that subjects with IBD had -1.159 ng/ml (95% CI: -2.783, 0.464) lower serum vitamin D concentrations compared with their healthy counterparts, but this difference was not significant. A total of 14 studies (with 18 effect sizes) with 2,602 participants provided information for the prevalence of vitamin D deficiency or insufficiency in patients with IBD as 44% (95% CI: 0.34-0.54) with significant heterogeneity noted among studies (p < 0.001; I2 = 97.31%). CONCLUSION This systematic and meta-analysis study revealed that vitamin D deficiency was associated with IBD. Longitudinal studies should be conducted in the future to confirm our findings. Large randomized controlled trials assessing the doses of supplementation of vitamin D would provide a better understanding of the association between vitamin D and IBD.
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Cinnamon and its possible impact on COVID-19: The viewpoint of traditional and conventional medicine.
Yakhchali, M, Taghipour, Z, Mirabzadeh Ardakani, M, Alizadeh Vaghasloo, M, Vazirian, M, Sadrai, S
Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie. 2021;143:112221
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COVID-19 is a disease that is associated with extremely high inflammation within the body, because of the body’s immune system trying to fight the infection. Conventional treatments focus on decreasing the immune response and controlling the disease; however, no treatment strategy has been shown to be effective. Traditional Persian Medicine (TPM) focuses on a holistic approach to the prevention and treatment of disease. Cinnamon has been thought as a TPM, which may be effective in the treatment of COVID-19 and this systematic review aimed to analyse the data behind these claims. Cinnamon was found to have anti-viral, anti-inflammatory, and antioxidant effects. Anti-viral effects were shown in cells against several viruses including the virus responsible for COVID-19. Cinnamon was shown to have extensive anti-inflammatory and antioxidant effects in various cells, however no specific research was found on COVID-19. It was concluded that as cinnamon has the potential to target different aspects of COVID-19 it could be used as an effective therapy. This study could be used by healthcare professionals to understand that cinnamon may have therapeutic effects in COVID-19, however clinical trials need to be performed before specific recommendations are made.
Abstract
The COVID-19 global epidemic caused by coronavirus has affected the health and other aspects of life for more than one year. Despite the current pharmacotherapies, there is still no specific treatment, and studies are in progress to find a proper therapy with high efficacy and low side effects. In this way, Traditional Persian Medicine (TPM), due to its holistic view, can provide recommendations for the prevention and treatment of new diseases such as COVID-19. The muco-obstruction of the airway, which occurs in SARS-CoV-2, has similar features in TPM textbooks that can lead us to new treatment approaches. Based on TPM and pharmacological studies, Cinnamomum verum (Darchini)'s potential effective functions can contribute to SARS-CoV-2 infection treatment and has been known to be effective in corona disease in Public beliefs. From the viewpoint of TPM theories, Cinnamon can be effective in SARS-CoV-2 improvement and treatment through its anti-obstructive, diuretic, tonic and antidote effects. In addition, there is pharmacological evidence on anti-viral, anti-inflammatory, antioxidant, organ-o-protective and anti-depression effects of Cinnamon that are in line with the therapeutic functions mentioned in TPM.Overall, Cinnamon and its ingredients can be recommended for SARS-CoV2 management due to multi-targeting therapies. This review provides basic information for future studies on this drug's effectiveness in preventing and treating COVID-19 and similar diseases.
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Is Premenstrual Syndrome Associated with Inflammation, Oxidative Stress and Antioxidant Status? A Systematic Review of Case-Control and Cross-Sectional Studies.
Granda, D, Szmidt, MK, Kaluza, J
Antioxidants (Basel, Switzerland). 2021;10(4)
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Premenstrual syndrome (PMS) is a set of emotional and physical symptoms, which occurs in the days leading up to a woman’s period. The cause of PMS is unknown; however, it is thought that the occurrence of inflammation in the body, an imbalance in the number of free radicals in the body and a lack of dietary antioxidants may all contribute. This systematic review of observational studies aimed to determine if inflammation and imbalanced free radicals contribute to the development of PMS. The results showed that based on 11 studies, there was a small amount of evidence to suggest that increased inflammation and decreased antioxidants is present in women with PMS. However, there was inconsistent results and insufficient data to determine whether free radical imbalance may contribute. It was concluded that further research is required to make firm conclusions on the role of free radicals and inflammation in the development of PMS. This study could be used by healthcare professionals to understand the possible mechanisms behind the development of PMS.
Abstract
Premenstrual syndrome (PMS) is a cyclically occurring combination of various symptoms, leading to decreased life quality among approximately 30% of women of childbearing age. PMS etiology remains unknown; however, there are some suggestions that inappropriate inflammatory response and oxidative stress are involved. This study aimed to systematically review case-control and cross-sectional studies investigating inflammation markers, oxidative stress, and antioxidant status among women with PMS and controls. The study protocol was registered with PROSPERO (no. CRD42020178545), and the authors followed the guidelines for performing a systemic review recommended by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). By searching PubMed and Scopus databases (up to 8 January 2021), six case-control studies and five cross-sectional studies of medium or high quality were classified to the review. The systematic review included 652 women with PMS and 678 controls, for whom 36 eligible markers were determined. Limited evidence indicates increased levels of inflammatory parameters and suggests decreased antioxidant status in PMS women. Insufficient data with inconsistent results made it impossible to formulate a firm conclusion on the contribution of oxidative stress in PMS occurrence. To acknowledge the role of inflammation, oxidative stress, and antioxidant status in the pathophysiology of PMS, further research with case-control design and large study groups is needed.
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Nutraceutical Approaches of Autophagy and Neuroinflammation in Alzheimer's Disease: A Systematic Review.
Gruendler, R, Hippe, B, Sendula Jengic, V, Peterlin, B, Haslberger, AG
Molecules (Basel, Switzerland). 2020;25(24)
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Ageing and the emergence of age-associated illnesses are currently one of the main health challenges in our society. Alzheimer’s disease (AD) is closely associated with ageing and is characterized by progressive memory loss and severe dementia. Currently, there are no therapy options available that halt the progression of the disease. Despite the condition being known for decades, the definitive causes and pathways of the disease and its development are not fully understood. Many drug developments that target some of the known aspects of the disease have failed in the clinical stages, and for nearly 20 years, no new drugs have met FDA approval for the treatment of AD. As increasing evidence suggests diet is an influencing risk factor for AD, the concept of exploring cost-effective, food-derived novel substances with low adverse effects has become more attractive. The first part of this work discusses AD, the prevalence of cognitive decline, limitations of current therapies, the three hallmarks of the disease (autophagy, neuroinflammation, and senescence) and the potential role of food derived substances (nutraceuticals). The second part introduces three nutraceuticals of interest, being epigallocatechin gallate, fisetin, and spermidine. All three compounds have captured scientific interest in regards to aspects of longevity over the recent years. In detail are discussed the current evidence of these compounds concerning autophagy, neuroinflammation, and senescence. This article yields a comprehensive summary of the current evidence from epigallocatechin gallate, fisetin, and spermidine and their potential role in the clinical management of AD.
Abstract
Aging and the emergence of age-associated illnesses are one of the major challenges of our present society. Alzheimer's disease (AD) is closely associated with aging and is defined by increasing memory loss and severe dementia. Currently, there are no therapy options available that halt AD progression. This work investigates three hallmarks of the disease (autophagy, neuroinflammation, and senescence) and systematically analyzes if there is a beneficial effect from three substances derived from food sources, the so called "nutraceuticals" epigallocatechin gallate, fisetin, and spermidine, on these hallmarks. The results imply a positive outlook for the reviewed substances to qualify as a novel treatment option for AD. A combination of nutraceutical substances and other preventive measures could have significant clinical impact in a multi-layered therapy approach to counter AD.
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The Long Haul of COVID-19 Recovery: Immune Rejuvenation versus Immune Support.
Bland, JS
Integrative medicine (Encinitas, Calif.). 2020;19(6):18-22
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Following Covid-19 infection, sufferers have reported various residual symptoms, which have been likened to those experienced by chronic fatigue sufferers and those with Gulf War syndrome. This review paper aimed to assess whether the body has a similar immune response to these diseases during Covid-19, and if so, what therapies could be used. It also reviewed any diet and lifestyle factors that may be affecting the immune response. The paper stated that Covid-19 infection is associated with inflammation, which can damage immune cells and inflammation prior to Covid-19 infection may contribute to severity of the infection. Prior research in seemingly healthy individuals indicates that environment, diet, and lifestyle factors can all contribute to differing “immune identities” and eliminating immune cells which carry the imprint of memories should be a therapy focus in Covid-19 patients. Fasting, diets low in refined sugars and high in omega-3 and plant chemicals were discussed as ways for the body to clear out immune cells. It was concluded that personalising therapy strategies based on an individual’s immune identity to reduce inflammation could ultimately support the immune system. This paper could be used by healthcare professionals to understand the importance of diet and lifestyle changes to reduce inflammation and support the immune system.
Abstract
With the COVID-19 pandemic still affecting communities all over the world and "Long Haul" chronic health issues emerging, it is time for us to look back at past multi-symptom health conditions that required a different approach to their treatment, beyond just managing symptoms. It is important for us to consider how to apply what we have learned about immune rejuvenation and its impact on conditions associated with chronic immune dysfunction. We know more than we ever have before about how to reduce chronic inflammation at its source through the support of selective immune cell autophagy/mitophagy and improved immune cell mitochondrial activity, followed by remodeling of the immune epigenome, and-ultimately-a reset of immune function.
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8.
Lifestyle changes for treating psoriasis.
Ko, SH, Chi, CC, Yeh, ML, Wang, SH, Tsai, YS, Hsu, MY
The Cochrane database of systematic reviews. 2019;7:CD011972
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Psoriasis is an inflammatory skin disease that results in patches of dry, scaly skin that can be itchy or sore. This Cochrane Database Systematic Review aimed to review and assess the effects of lifestyle factors such as diet, smoking, obesity, alcohol consumption and exercise on the severity of psoriasis. The study authors examined the research evidence up to July 2018. 10 randomised controlled trials (RCTs) with a total of 163 participants were included in the qualitative analysis, and 6 studies in the meta-analysis. Most of the studies included co-interventions such as medication or light therapy. The authors didn’t find any RCTs for smoking cessation or reduced alcohol consumption. Dietary interventions (low-calorie diets, based on the Ornish diet or South Beach diet) were likely to result in a 75% improvement in severity of psoriasis symptoms in obese people after 6 months. A combined low-calorie diet and exercise programme improved the severity of psoriasis compared to providing information on weight loss to improve psoriasis, although the difference wasn’t statistically significant. Participants generally adhered well to the lifestyle interventions assessed in the review. The authors concluded that the body of evidence regarding the effects of lifestyle changes for treating psoriasis is limited. More trials are needed on the effects of different dietary interventions such as vegetarian or ketogenic diets, different types of exercise programmes (e.g. yoga, walking, jogging) and whether other lifestyle changes such as reducing smoking and alcohol consumption, or stress management techniques are effective.
Abstract
BACKGROUND Psoriasis is an inflammatory skin disease that presents with itching, red, scaling plaques; its worsening has been associated with obesity, drinking, smoking, lack of sleep, and a sedentary lifestyle. Lifestyle changes may improve psoriasis. OBJECTIVES To assess the effects of lifestyle changes for psoriasis, including weight reduction, alcohol abstinence, smoking cessation, dietary modification, exercise, and other lifestyle change interventions. SEARCH METHODS We searched the following databases up to July 2018: the Cochrane Skin Specialised Register, CENTRAL, MEDLINE, Embase, and LILACS. We also searched the China National Knowledge Infrastructure, the Airiti Library, and five trials registers up to July 2018. We checked the references of included trials for further relevant trials, and we asked the authors of the included trials if they were aware of any relevant unpublished data. SELECTION CRITERIA We included randomised controlled trials (RCTs) of lifestyle changes (either alone or in combination) for treating psoriasis in people diagnosed by a healthcare professional. Treatment had to be given for at least 12 weeks. Eligible comparisons were no lifestyle changes or another active intervention. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by Cochrane. The primary outcome measures were 'Severity of psoriasis' and 'Adherence to the intervention'. Secondary outcomes were 'Quality of life', 'Time to relapse', and 'Reduction in comorbidities'. We used GRADE to assess the quality of the evidence for each outcome. MAIN RESULTS We included 10 RCTs with 1163 participants (mean age: 43 to 61 years; 656 men and 478 women were reported). Six trials examined the effects of dietary intervention (low-calorie diet) in 499 obese participants (mean age: 44.3 to 61 years; where reported, 395 had moderate-to-severe psoriasis). One trial assessed a combined dietary intervention and exercise programme in 303 obese participants with moderate-to-severe psoriasis who had started a systemic therapy for psoriasis and had not achieved clearance after four weeks of continuous treatment (median age: 53 years). Another trial assessed a walking exercise and continuous health education in 200 participants (mean age: 43.1 years, severity not reported). Finally, two trials included education programmes promoting a healthy lifestyle in 161 participants (aged 18 to 78 years), with one trial on mild psoriasis and the other trial not reporting severity.Comparisons included information only; no intervention; medical therapy alone; and usual care (such as continuing healthy eating).All trials were conducted in hospitals and treated participants for between 12 weeks and three years. One trial did not report the treatment period. Seven trials measured the outcomes at the end of treatment and there was no additional follow-up. In two trials, there was follow-up after the treatment ended. Five trials had a high risk of performance bias, and four trials had a high risk of attrition bias.We found no trials assessing interventions for alcohol abstinence or smoking cessation. No trials assessed time to relapse. Only two trials assessed adverse events; in one trial these were caused by the add-on therapy ciclosporin (given in both groups). The trial comparing two dietary interventions to a no-treatment group observed no adverse events.The results presented in this abstract are based on trials of obese participants.Outcomes for dietary interventions versus usual care were measured 24 weeks to six months from baseline. Compared to usual care, dietary intervention (strict caloric restriction) may lead to 75% or greater improvement from baseline in the Psoriasis Area and Severity Index (PASI 75) (risk ratio (RR) 1.66, 95% confidence interval (CI) 1.07 to 2.58; 2 trials, 323 participants; low-quality evidence). Adherence to the intervention may be greater with the dietary intervention than usual care, but the 95% CI indicates that the dietary intervention might also make little or no difference (RR 1.26, 95% CI 0.76 to 2.09; 2 trials, 105 participants; low-quality evidence). Dietary intervention probably achieves a greater improvement in dermatology quality-of-life index (DLQI) score compared to usual care (MD -12.20, 95% CI -13.92 to -10.48; 1 trial, 36 participants; moderate-quality evidence), and probably reduces the BMI compared to usual care (MD -4.65, 95% CI -5.93 to -3.36; 2 trials, 78 participants; moderate-quality evidence).Outcomes for dietary interventions plus exercise programme were measured 16 weeks from baseline and are based on one trial (303 participants). Compared to information only (on reducing weight to improve psoriasis), combined dietary intervention and exercise programme (dietetic plan and physical activities) probably improves psoriasis severity, but the 95% CI indicates that the intervention might make little or no difference (PASI 75: RR 1.28, 95% CI 0.83 to 1.98). This combined intervention probably results in a greater reduction in BMI (median change -1.10 kg/m², P = 0.002), but there is probably no difference in adherence (RR 0.95, 95% CI 0.89 to 1.01; 137/151 and 145/152 participants adhered in the treatment and control group, respectively). There were no data on quality of life. These outcomes are based on moderate-quality evidence. AUTHORS' CONCLUSIONS Dietary intervention may reduce the severity of psoriasis (low-quality evidence) and probably improves quality of life and reduces BMI (moderate-quality evidence) in obese people when compared with usual care, while combined dietary intervention and exercise programme probably improves psoriasis severity and BMI when compared with information only (moderate-quality evidence). None of the trials measured quality of life.We did not detect a clear difference in treatment adherence between those in the combined dietary intervention and exercise programme group and those given information only (moderate-quality evidence). Adherence may be improved through dietary intervention compared with usual care (low-quality evidence). Participants generally adhered well to the lifestyle interventions assessed in the review.No trials assessed the time to relapse. Trial limitations included unblinded participants and high dropout rate.Future trials should reduce dropouts and include comprehensive outcome measures; they should examine whether dietary intervention with or without an exercise programme is effective in non-obese people with psoriasis, whether an additional exercise programme is more effective than dietary intervention alone, whether the time to relapse prolongs in people who receive dietary intervention with or without exercise programme, and whether smoking cessation and alcohol abstinence are effective in treating psoriasis.
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Nordic Diet and Inflammation-A Review of Observational and Intervention Studies.
Lankinen, M, Uusitupa, M, Schwab, U
Nutrients. 2019;11(6)
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Inflammation is understood to play a major role in in the development of chronic diseases, such as cardiovascular disease, type 2 diabetes and neurodegenerative diseases. There has been considerable research carried out into the anti-inflammatory effects of particular diets, primarily the Mediterranean diet, which has consistently shown the potential to reduce inflammation and promote health. The positive results are consequential of the high intake of fresh fruit and vegetables along with fresh fish and olive oil along with minimal intake of inflammatory foods such as saturated fats and meat. The Nordic diet has similar requisites to the Mediterranean diet only it includes the use of canola oil as opposed to olive oil and includes the consumption of berries. Researchers attribute obesity as the main cause of increased inflammatory markers with weight loss being the most reliable method of reducing markers. They also stress the importance of good quality food, of which the Nordic diet offers. This review paper looks at the anti-inflammatory effect of foods consumed with the Nordic diet and includes research using randomised and controlled dietary trials and observational studies. Investigations into anti-inflammatory properties of the Nordic diet are in their infancy, so it is not yet possible to stipulate anti-inflammatory effects of the Nordic diet, but future research looks promising.
Abstract
Low-grade inflammation (LGI) has been suggested to be involved in the development of chronic diseases. Healthy dietary patterns, such as the Mediterranean diet (MD), may decrease the markers of LGI. Healthy Nordic diet (HND) has many similarities with MD, but its effects on LGI are less well known. Both of these dietary patterns emphasize the abundant use of fruits and vegetables (and berries in HND), whole grain products, fish, and vegetable oil (canola oil in HND and olive oil in MD), but restrict the use of saturated fat and red and processed meat. The aim of this narrative review is to summarize the results of studies, which have investigated the associations or effects of HND on the markers of LGI. Altogether, only two publications of observational studies and eight publications of intervention trials were found through the literature search. Both observational studies reported an inverse association between the adherence to HND and concentration of high sensitivity C-reactive protein (hsCRP). A significant decrease in the concentration of hsCRP was reported in two out of four intervention studies measuring hsCRP. Single intervention studies reported the beneficial effects on interleukin 1Ra and Cathepsin S. Current evidence suggests the beneficial effects on LGI with HND, but more carefully controlled studies are needed to confirm the anti-inflammatory effects of the HND.
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Inflammageing: chronic inflammation in ageing, cardiovascular disease, and frailty.
Ferrucci, L, Fabbri, E
Nature reviews. Cardiology. 2018;15(9):505-522
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Inflammageing is a term used to describe elevated blood inflammatory markers that leads to frailty and increases an individual’s risk for heart disease, kidney disease and other physical and mental illnesses. Whether inflammageing is causal in heart disease is still uncertain. This large review of 310 papers aimed to understand the causes and role of inflammageing in heart disease and other illnesses associated with ageing. Causes of inflammageing were discussed and mechanisms are not fully understood. Genetic susceptibility, obesity, gut microbiota, gut permeability, when cells can no longer divide, and chronic infections were all implicated. The role of inflammageing in heart disease was a focus and the authors deduced that it was likely to be both causal and a result of heart disease. However, the administration of anti-inflammatories in heart disease has not always proved a successful treatment. Possible causes of inflammageing are likely to be linked and cumulative and although inflammation may cause age related diseases, its role in protecting the body means that its benefits outweigh its consequences. It was concluded that controlling inflammageing may prevent heart disease and other diseases associated with ageing. This study could be used by healthcare professionals to help understand what inflammageing is and its role in age related diseases.
Abstract
Most older individuals develop inflammageing, a condition characterized by elevated levels of blood inflammatory markers that carries high susceptibility to chronic morbidity, disability, frailty, and premature death. Potential mechanisms of inflammageing include genetic susceptibility, central obesity, increased gut permeability, changes to microbiota composition, cellular senescence, NLRP3 inflammasome activation, oxidative stress caused by dysfunctional mitochondria, immune cell dysregulation, and chronic infections. Inflammageing is a risk factor for cardiovascular diseases (CVDs), and clinical trials suggest that this association is causal. Inflammageing is also a risk factor for chronic kidney disease, diabetes mellitus, cancer, depression, dementia, and sarcopenia, but whether modulating inflammation beneficially affects the clinical course of non-CVD health problems is controversial. This uncertainty is an important issue to address because older patients with CVD are often affected by multimorbidity and frailty - which affect clinical manifestations, prognosis, and response to treatment - and are associated with inflammation by mechanisms similar to those in CVD. The hypothesis that inflammation affects CVD, multimorbidity, and frailty by inhibiting growth factors, increasing catabolism, and interfering with homeostatic signalling is supported by mechanistic studies but requires confirmation in humans. Whether early modulation of inflammageing prevents or delays the onset of cardiovascular frailty should be tested in clinical trials.