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Effects of tart cherry juice consumption on cardio-metabolic risk factors: A systematic review and meta-analysis of randomized-controlled trials.
Moosavian, SP, Maharat, M, Chambari, M, Moradi, F, Rahimlou, M
Complementary therapies in medicine. 2022;71:102883
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Cardiovascular disease (CVD) is a general term for disorders affecting the heart and blood vessels and is the number one cause of death world-wide. CVD risk factors include high blood pressure, high cholesterol, obesity, being overweight and diabetes. Tart cherry juice is a rich source of strong antioxidants such as proanthocyanidins, anthocyanins, and flavonols. These compounds have anti-inflammatory properties and are therefore potentially beneficial in CVD. The antioxidant potential of tart cherry juice has been extensively studied, but studies have shown contradictory results relating to the efficacy of tart cherry juice on cardio-metabolic risk factors. To date there is no meta-analysis looking at these effects. 10 RCTs were included and the results showed that cherry juice consumption led to a significant reduction in fasting blood sugar. However, there wasn’t any significant effect of cherry juice consumption on blood pressure, insulin, lipid profile levels, fat mass, and BMI. Further clinical trials using higher sample sizes are needed. The clinical importance of this study was that clinicians and nutritionists can recommend the consumption of tart cherry for the prevention and management of CVD related symptoms.
Abstract
BACKGROUND Tart cherries are rich in bioactive compounds, such as anthocyanins and other phytochemicals known to have antioxidant properties and exert cardiovascular protective effects. However, there is no definitive consensus on this context. The present systematic review and meta-analysis aimed to investigate the effect of tart cherry juice consumption on cardio-metabolic risk factors. METHODS A systematic search was conducted on electronic databases, including PubMed, Web of Science, Scopus, and Google Scholar from inception up to December 2021 to identify eligible RCT studies. A random-effect model was utilized to estimate the weighted mean difference (WMD) and 95% confidence (95% CI). RESULTS Ten RCTs were included in the present meta-analysis. The pooled analysis revealed that tart cherry juice consumption led to a significant reduction in the fasting blood sugar (FBS) levels (WMD = -0.51 mg/dl [95% CI: -0.98, -0.06]). This lowering effect of FBS was robust in subgroups with cross-over studies, participants with age range ≥ 40, duration of follow-up ≤ 4 weeks, and baseline BMI ≥ 30. In contrast, tart cherry juice had no effect on total cholesterol (TC), triglycerides (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), insulin, body mass index (BMI), fat mass, systolic and diastolic blood pressure. However, in the subgroup analysis, some significant effects were observed for insulin, TG, TC, LDL-C, and HDL-C. CONCLUSION In summary, this meta-analysis showed that tart cherry juice mostly had a favorable effect on FBG levels. However, further RCTs with long-term intervention with different doses of administration are needed.
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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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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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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.
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A novel boswellic acids delivery form (Casperome®) in the management of musculoskeletal disorders: a review.
Riva, A, Allegrini, P, Franceschi, F, Togni, S, Giacomelli, L, Eggenhoffner, R
European review for medical and pharmacological sciences. 2017;21(22):5258-5263
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Musculoskeletal conditions, including osteoarthritis, inflammatory arthritis, musculoskeletal injuries, gout and metabolic bone disease, are the most common cause of chronic disability worldwide. Treatment with analgesic and/or anti-inflammatory medication carries a significant risk of side effects. Botanical extracts are also commonly used for the management of musculoskeletal disorders, and in addition to having less side effects they may have a beneficial effect on the course of the disease. This review focuses on the use of boswellic acids (BA, from Frankincense, Boswellia serrata and Boswellia carterii) in the treatment of musculoskeletal conditions. In pre-clinical experiments, BAs have been shown to be anti-inflammatory and improve antioxidant status. In several clinical trials BSE was superior to placebo in reducing pain and increasing functionality in osteoarthritis. BSE are poorly absorbed, and both clinical and pre-clinical research has shown that a combination of BAs with lecithin (Casperome®) enhances absorption and bioavailability. Casperome® has been investigated in a number of clinical trials and has been shown to be of benefit in tendinopathies (inflammation of the elbow and Achilles tendon), radiculopathies (pinched nerves), sprained ankles and sports injuries. The authors conclude that Casperome® is a promising remedy as part of an integrated approach to musculoskeletal disorders.
Abstract
Standard pharmacological treatment of musculoskeletal conditions is often associated with relevant side effects. Botanical preparations endowed with a good tolerability profile, therefore, could have a role in the management of these disorders. Among different natural products, Boswellia serrata extracts have long been used for the treatment of musculoskeletal disorders, given their marked anti-inflammatory activity and their ability to promote tissue regeneration. However, standard preparations of Boswellia serrata show overall modest pharmacokinetic properties, a limitation which may ultimately lead to reduced efficacy. In an effort to improve the pharmacokinetic properties, Casperome®, a lecithin-based formulation of Boswellia serrata extract representing the whole natural bouquet, has been developed. This formulation was effective in the treatment of Achilles tendonitis, epicondylitis, radiculopathies, ankle sprains and sport injuries as shown in several clinical studies, the majority of which with a randomized design and all evaluating a number of well-recognized parameters of efficacy for the therapy of musculoskeletal disorder. All studies were consistent in showing a prompt decrease of pain and improvement of functionality of the affected area after supplementation with Casperome®, without any relevant adverse effect. Remarkably, these symptomatic improvements were paralleled by reduced plasmatic levels of inflammatory markers and by a diminished need for rescue analgesics. On these bases, Casperome® may have a role in the treatment of musculoskeletal disorders. Clinical studies in other similar conditions (e.g., osteoarthritis) appear warranted to further investigate the efficacy of this botanical product in more specific settings.