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Effects of Omega-3 Fatty Acids Supplementation on Serum Lipid Profile and Blood Pressure in Patients with Metabolic Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Liu, YX, Yu, JH, Sun, JH, Ma, WQ, Wang, JJ, Sun, GJ
Foods (Basel, Switzerland). 2023;12(4)
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Metabolic syndrome (MetS) is a group of disorders that cause disturbed metabolism, including abdominal obesity, insulin resistance, hypertension, and dyslipidaemia. People with MetS may have a higher risk of coronary heart disease and stroke than those without MetS. Omega-3 polyunsaturated fatty acids (n-3 PUFAs) have cardioprotective, anti-inflammatory, and triglyceride-lowering properties, so they may help treat obesity and improve metabolic syndrome. The aim of this study was to explore the effects of n-3 PUFAs on lipid profile and blood pressure in patients with MetS. This study is a meta-analysis of eight studies. One of the studies was a crossover trial, whereas the remaining seven studies were parallel-controlled trials. The mean age of the participants was 45.54 years old. Results show that following supplementation with n-3 PUFAs in patients with metabolic syndrome: - there weren’t significant changes in serum total cholesterol, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol. - there was a significant reduction in serum triglycerides and blood pressure. Authors conclude that n-3 PUFA supplementation may serve as a potential dietary supplement for improving lipids and blood pressure in patients with metabolic syndrome.
Expert Review
Conflicts of interest:
None
Take Home Message:
- Omega 3 PUFA may be beneficial for patients with metabolic syndrome by improving serum lipid profile and blood pressure.
- Omega-3 rich foods include fatty fish, walnuts, flaxseeds and chia seeds.
- While Omega-3 PUFA may be beneficial, they should be considered as part of a comprehensive approach to managing metabolic syndrome that include physical activity and a balanced diet.
Evidence Category:
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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:
Background
This journal article presents a systematic review and meta-analysis of randomised controlled trials (RCTs) investigating the effects of omega-3 fatty acid supplementation on serum lipid profile and blood pressure in patients with metabolic syndrome. Metabolic syndrome is a cluster of conditions that increase the risk of cardiovascular disease and type 2 diabetes.
Methods
This meta-analysis included 8 RCTs with 387 participants with metabolic syndrome. Participants in the intervention group took omega-3 fatty acid supplements and the outcomes included total cholesterol (TC), high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol (LDL-c), systolic blood pressure (SBP), and diastolic blood pressure (DBP).
Results
- Based on a meta-analysis of data from the included trials, supplementation with omega 3- PUFAs led to no reduction in serum LDL-c level among patients with metabolic syndrome (Standardised Mean Difference (SMD) = 0.18; 95% CI: −0.18 ~ 0.53, I2 = 55%); did not increase serum high-density lipoprotein cholesterol levels (SMD = 0.02; 95% CI: −0.21 ~ 0.25, I2 = 0%); and had no reduction in serum total cholesterol level (SMD = −0.02; 95% CI: −0.22~0.18, I2 = 24%).
- On the other hand, in patients with metabolic syndrome, supplementation with omega 3- PUFAs may decrease serum triglyceride levels (SMD = −0.39; 95% CI: −0.59 ~ −0.18, I2 = 17.2%); systolic blood pressure (SMD = −0.54; 95% CI: −0.86 ~ −0.22, I2 = 48.6%); and diastolic blood pressure (SMD = −0.56; 95% CI: −0.79~ −0.33, I2 = 14.0%).
- Sensitivity analyses indicated that the pooled estimates wererobust for all outcomes.
- The following mechanisms may explain how PUFAs may reduce the risk of metabolic syndrome. First, adequate intake of omega 3 PUFAs may reduce triglyceride and LDL synthesis in the liver. In addition, they may lower blood pressure by reducing angiotensin-converting enzyme levels in the aorta. Finally, PUFAs can increase insulin sensitivity and prevent hyperglycaemia.
Limitations
This study presents some limitations: The literature search may have some omissions. The conclusions may be hindered by the risk of bias of the trials included. No bias test was performed due to the limited number of studies.
Clinical practice applications:
- Improved serum lipid profile: The findings from the paper indicate that omega-3 fatty acid supplementation can have a positive impact on the serum lipid profile in patients with metabolic syndrome.
- Blood pressure management: omega-3 fatty acid supplementation may help reduce blood pressure in patients with metabolic syndrome.
- Nutritional therapists can use this information to consider omega-3 supplementation as part of nutritional therapy
- Complementary approach: Nutritional therapists can utilise the findings as supportive evidence for a holistic approach to managing metabolic syndrome. By incorporating omega-3 fatty acids into personalized nutrition plans, therapists may be able to offer additional dietary or supplemental interventions for individuals with metabolic syndrome, aiming to lower triglyceride levels and manage blood pressure, alongside other lifestyle modifications.
- Patient education: Nutritional therapists can educate their patients with metabolic syndrome about the benefits of omega-3 fatty acids on lipid profile and blood pressure. By explaining the findings from the systematic review and meta-analysis, therapists can empower patients to make informed choices regarding their dietary habits and supplement use, promoting self-management and improved long-term outcomes.
Considerations for future research:
- Future research could focus on determining the optimum dosage of Omega-3 PUFAs for improving lipid profile and BP.
- More investigation is needed to analyse the long term effect of the supplements. The longest RCT was 90 days.
- Comparative studies comparing the effects of omega-3 fatty acids supplementation with other interventions commonly used in metabolic syndrome management, such as pharmacological approaches or diet, would provide a comprehensive understanding of their relative effectiveness.
- Future research could explore potential variations in the effects of omega-3 fatty acids supplementation based on different patient characteristics, such as age, gender, baseline lipid profile, and blood pressure levels.
- Conducting mechanistic studies could shed light on the underlying pathways through which omega-3 fatty acids exert their effects on serum lipid profile and blood pressure.
Abstract
The purpose of this study was to explore the effect of omega-3 polyunsaturated fatty acids (n-3 PUFAs) supplementation on serum lipid profile and blood pressure in patients with metabolic syndrome. We searched PubMed, Web of Science, Embase, and the Cochrane library from database inception to 30 April 2022. This meta-analysis included eight trials with 387 participants. We found that supplementation of n-3 PUFAs has no significant reduction in TC level (SMD = -0.02; 95% CI: -0.22 ~ 0.18, I2 = 23.7%) and LDL-c level in serum (SMD = 0.18; 95% CI: -0.18 ~ 0.53, I2 = 54.9%) of patients with metabolic syndrome. Moreover, we found no significant increase in serum high-density lipoprotein cholesterol level (SMD = 0.02; 95% CI: -0.21 ~ 0.25, I2 = 0%) in patients with metabolic syndrome after consuming n-3 PUFAs. In addition, we found that n-3 PUFAs can significantly decrease serum triglyceride levels (SMD= -0.39; 95% CI: -0.59 ~ -0.18, I2 = 17.2%), systolic blood pressure (SMD = -0.54; 95% CI: -0.86 ~ -0.22, I2 = 48.6%), and diastolic blood pressure (SMD = -0.56; 95% CI: -0.79 ~ 0.33, I2 = 14.0%) in patients with metabolic syndrome. The results from the sensitivity analysis confirmed that our results were robust. These findings suggest that n-3 PUFA supplementation may serve as a potential dietary supplement for improving lipids and blood pressure in metabolic syndrome. Given the quality of the included studies, further studies are still needed to verify our findings.
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Increased ultra-processed food consumption is associated with worsening of cardiometabolic risk factors in adults with metabolic syndrome: Longitudinal analysis from a randomized trial.
González-Palacios, S, Oncina-Cánovas, A, García-de-la-Hera, M, Martínez-González, MÁ, Salas-Salvadó, J, Corella, D, Schröder, H, Martínez, JA, Alonso-Gómez, ÁM, Wärnberg, J, et al
Atherosclerosis. 2023;377:12-23
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Evidence is increasing linking the consumption of ultra-processed foods (UPF) and an increased risk for the development of heart disease. However, there is still uncertainty surrounding how changes in UPF consumption can affect heart disease risk factors. This secondary analysis of a randomised control trial, which looked at the effects of an energy restricted Mediterranean diet in combination with exercise on the prevention of heart disease, aimed to determine how changes in UPF consumption can affect indicators of heart disease risk over a 12-month period. The results showed that high UPF consumption was associated with higher heart disease risk factors including weight, body mass index, waist circumference, diastolic blood pressure, blood sugar levels, measures of insulin resistance, and triglycerides. Further detrimental effects were seen with UPF consumption increasing, and high-density lipoprotein cholesterol decreasing. No associations were seen with systolic blood pressure, total cholesterol, and low-density lipoprotein cholesterol. It was concluded that high UPF consumption has a detrimental effect on heart disease risk. This study could be used by healthcare professionals to recommend a diet low or devoid of UPF to stay heart healthy.
Abstract
BACKGROUND AND AIMS The association between changes in ultra-processed food (UPF) consumption and cardiometabolic risk (CMR) factors remains understudied. We evaluated the association between changes in UPF consumption over 12 months of follow-up and changes in CMR factors in adults diagnosed with metabolic syndrome. METHODS We analysed data from 5373 adults (aged 55-75 years) participating in the PREDIMED-Plus trial. Diet was evaluated at baseline, 6- and 12-month visits using a validated food frequency questionnaire, and UPF consumption (in grams/day and percentage of total daily dietary intake in grams) was categorized based on NOVA classification. We used mixed-effects linear models with repeated measurements at baseline, 6 and 12 months of follow-up to assess the associations between changes in UPF consumption and changes in CMR factors adjusting for sociodemographic and lifestyles variables. RESULTS In multivariable-adjusted models, when comparing the highest versus the lowest quartile of UPF consumption, positive associations were found for several CMR factors: weight (kg, β = 1.09; 95% confidence interval 0.91 to 1.26); BMI (kg/m2, β = 0.39; 0.33 to 0.46); waist circumference (cm, β = 1.03; 0.81 to 1.26); diastolic blood pressure (mm Hg, β = 0.67; 0.29 to 1.06); fasting blood glucose (mg/dl, β = 1.66; 0.61 to 2.70); HbA1c (%, β = 0.04; 0.01 to 0.07); triglycerides (mg/dl, β = 6.79; 3.66 to 9.91) and triglycerides and glucose index (β = 0.06; 0.04 to 0.08). CONCLUSIONS Higher UPF consumption was associated with adverse evolution in objectively measured CMR factors after 12 months of follow-up in adults with metabolic syndrome. Further research is needed to explore whether these changes persist for longer periods.
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Probiotics and non-alcoholic fatty liver disease in children and adolescents: a systematic review.
Avelar-Rodríguez, D, Peña-Vélez, R, Popov, J, Hill, L, Ryan, PM
Revista espanola de enfermedades digestivas. 2023;115(8):418-427
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Non-alcoholic fatty liver disease (NAFLD), as a direct result of the escalating childhood obesity epidemic, is a significant public health issue globally. NAFLD is the most common cause of chronic liver disease in the paediatric population. The aim of this study was to assess the quality of evidence currently available for the use of microbial therapies (i.e., prebiotics, probiotics, and synbiotics) in the treatment of NAFLD in children with obesity. This study was a systematic review and meta-analysis of five randomised controlled studies. Results showed that although there is a range of promising effects on both clinical and biochemical parameters, significant interstudy discrepancies reduce reliability and generalisability of these results. Authors concluded there is insufficient evidence to support the beneficial role of probiotics and synbiotics in the treatment of pediatric NAFLD given the substantial degree of discordance amongst the available trials.
Abstract
BACKGROUND non-alcoholic fatty liver disease (NAFLD) in childhood is an increasing global public health issue with significant long-term consequences. NAFLD management mainly consists of lifestyle modifications, however, adjunct pharmacological therapies are currently lacking. Gut microbiota manipulation via probiotics may alter the course of pediatric NAFLD. The objective of this systematic review was to synthesize all the available literature on the use of probiotics in children and adolescents with NAFLD. METHODS PubMed, EBSCOhost, Scopus, Web of Science, and Cochrane Library were systematically searched for trials on the use of probiotics in pediatric NAFLD. A quantitative DerSimonian Laird random effects meta-analysis was performed when possible; otherwise, a narrative summary of the study outcomes was presented and discussed. A separate search was completed to include all the ongoing registered trials on probiotics use in pediatric NAFLD. RESULTS five randomized controlled trials met the inclusion criteria. Of these, four trials were included in the final quantitative analysis. Probiotic therapy significantly reduced the levels of alanine aminotransferase (ALT) (mean difference: -10.39 [-19.85, -0.93]), however significant heterogeneity between studies was identified (I2, 93 %). CONCLUSIONS there is insufficient evidence to support probiotics in the treatment of pediatric NAFLD given the substantial degree of discordance amongst the available trials. Lifestyle modifications focusing on maintaining a normal BMI and regular exercise continue to be the gold standard approach to treating NAFLD in children.
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The effects of olive leaf extract on cardiovascular risk factors in the general adult population: a systematic review and meta-analysis of randomized controlled trials.
Razmpoosh, E, Abdollahi, S, Mousavirad, M, Clark, CCT, Soltani, S
Diabetology & metabolic syndrome. 2022;14(1):151
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Modifiable unhealthy behaviours, such as sedentary lifestyle, smoking, and unhealthy food habits, are regarded as important contributors to the widespread prevalence of cardiovascular diseases (CVDs), which occur concurrently in overweight/obesity, hypertension, dyslipidaemia, hyperglycaemia, and inflammation. The aim of this study was to investigate whether olive leaf extract (OLE) could improve the major cardiovascular-related variables, including lipid profile, glucose haemostasis, blood pressure, as well as liver/kidney and inflammatory markers in the general adult population. This study is a systematic review and meta-analysis of twelve randomised controlled studies. Results show that OLE supplementation: - significantly decreased triglycerides and systolic blood pressure levels. - only had short-term positive effects on blood pressure and lipid profiles, which may be attributed to the active constituents in OLE. - had more profitable effects on the improvement of triglycerides, blood pressure, total cholesterol and low-density lipoprotein cholesterol measures among participants with hypertension and individuals with normal body weight. Authors conclude that stronger randomised controlled trial investigations, assessing different doses and durations of OLE, are required to better elucidate the effects of OLE supplementation.
Abstract
BACKGROUND The aim of this systematic review and meta-analysis was to determine the effect of olive leaf extract (OLE) supplementation on cardiovascular-related variables, including lipid, glycemic, inflammatory, liver and renal-related factors, as well as blood pressure. METHODS PubMed, ISI Web of Science, Scopus, and Cochrane library were searched, up to October 2021, for relevant controlled trials. Mean differences and standard deviations were pooled for all outcomes, using a random-effects model. The methodological quality, as well as quality of evidence were assessed using standard tools. RESULTS Twelve studies (n = 819 participants) were included in our analyses. Overall analyses showed that OLE supplementation significantly decreased triglyceride (TG) levels (WMD = - 9.51 mg/dl, 95% CI - 17.83, - 1.18; P = 0.025; I2 = 68.7%; P-heterogeneity = 0.004), and systolic blood pressure (SBP) (WMD = - 3.86 mmHg, 95% CI - 6.44, - 1.28 mmHg; P = 0.003; I2 = 19.9%; P-heterogeneity = 0.28). Subgroup analyses also revealed a significant improvement in SBP (- 4.81 mmHg) and diastolic blood pressure (- 2.45 mmHg), TG (- 14.42 mg/dl), total cholesterol (TC) (- 9.14 mg/dl), and low-density lipoprotein-C (LDL-C) (- 4.6 mg/dl) measurements, in patients with hypertension. Significant reductions were also observed in TC (- 6.69 mg/dl), TG (- 9.21 mg/dl), and SBP (- 7.05 mmHg) in normal-weight individuals. However, no meaningful changes were seen in glucose hemostasis, liver and kidney, or inflammatory markers. CONCLUSION The present study revealed that supplementation with OLE yielded beneficial effects for blood pressure and lipid profile in adults, especially in patients with hypertension. As the quality of evidence for glucose hemostasis variables, liver, kidney, and inflammatory markers, were low-to-very low, higher quality RCTs may impact the overarching results. This study was registered at PROSPERO with the code CRD42022302395.
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The Effect of Yoga on the Lipid Profile: A Systematic Review and Meta-Analysis of Randomized Clinical Trials.
Ghazvineh, D, Daneshvar, M, Basirat, V, Daneshzad, E
Frontiers in nutrition. 2022;9:942702
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Modernisation has brought increased comforts and limited mobility in our lives at the cost of an increased prevalence of hypertension, diabetes mellitus, dyslipidaemia, and obesity, which are predecessors of major cardiovascular diseases. Prevention and control of coronary heart disease and its associated diseases are essential and can be achieved by modifying the lipid profile. The aim of this study was to systematically assess the effects of yoga on blood lipid levels. This study is a systematic review and meta-analysis of fifty-three randomised controlled studies. All studies employed a parallel design with a total of 13,191 participants whom were divided into 6,700 individuals in the control group and 6,517 in the intervention group. Results show that yoga had decreased total cholesterol, low-density lipoprotein cholesterol, triglycerides, and very low-density lipoprotein cholesterol and increased high-density lipoprotein cholesterol among yoga practitioners. Authors conclude that yoga had a striking effect on balancing lipid profiles.
Abstract
OBJECTIVES Yoga is a mind-body stress-relieving exercise that increases mental and physical health, which may have a role in the improvement of metabolic disorders. The present study has reviewed the effect of yoga on lipid profiles as a systematic review and meta-analysis. METHODS We evaluated the available randomized controlled trials on the effects of yoga-based programs, and lipid profiles by searching PubMed/Medline, Scopus, Web of Science, and the Cochrane central register of control trials up to January 2022. Both fixed and random effect analyses were used to find the relationships. Subgroup analysis was performed based on the continent, duration of the included studies, gender, and health condition of participants to discover the sources of heterogeneity. RESULT Fifty-three studies were included in the current systematic review and meta-analysis with a total sample size of 13,191. There was a striking association between yoga and total cholesterol (-10.31 mg/dl; 95% CI: -14.16, -6.45; I 2 = 82.5%, P < 0.001), low-density lipoprotein cholesterol (-8.64 mg/dl; 95% CI: -12.03, -5.25; I 2 = 75.0%, P < 0.001), high-density lipoprotein cholesterol (1.98 mg/dl; 95% CI: 0.81, 3.14; I 2 = 91.6%, P < 0.001), triglycerides (-13.50 mg/dl; 95% CI: -20.09, -6.92; I 2 = 90.7%, P < 0.001) and very low-density lipoprotein (-3.94 mg/dl; 95%CI: -6.31, -1.56; I 2 = 72.2%, P < 0.001). CONCLUSION It seems yoga interventions had a substantial effect on lipid profiles, however, more qualified trials or cohort studies are needed to conclude exactly.
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Psoriasis and cardiovascular disease risk in European and East Asian populations: evidence from meta-analysis and Mendelian randomization analysis.
Zhang, L, Wang, Y, Qiu, L, Wu, J
BMC medicine. 2022;20(1):421
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Psoriasis constitutes a chronic, inflammatory skin disease with an immune-genetic basis that has been linked to numerous diseases, including metabolic syndrome, cancer, as well as cardiovascular disease (CVD). The aim of this study was to determine if the relationship of psoriasis with CV events (CVE) risk is congruent with causal associations. This study is a report employing a meta-analysis of observational studies and a two-sample mendelian randomised trial (MR). Results from the meta-analysis show that psoriasis was remarkably associated with a higher risk of incident coronary artery disease (CAD) and myocardial infarction (MI) and was not associated with heart failure risk. Furthermore, the MR approach showed that psoriasis was linked with a higher risk of CAD in both European and East Asian populations. Additionally, psoriasis was also causally linked to an elevated risk of MI in European population. Authors conclude that their findings indicate a causal association of psoriasis with CAD and MI. However, further studies are needed to establish the mechanisms of the causal relationship of psoriasis with CAD and MI.
Abstract
BACKGROUND Psoriasis has been linked to cardiovascular disease (CVD), including coronary artery disease (CAD), myocardial infarction (MI), and heart failure (HF). However, available studies regarding this relationship have shown inconsistent results. Therefore, in this report, we performed a comprehensive review of the literature to assess the effects of psoriasis on risk of these CVDs. METHODS A search of literature until 24 December 2021 was done in PubMed, the Cochrane Library, Web of Science, Google Scholar, and Embase. Within European and East Asian populations, meta-analyses of observational studies assessing correlations between psoriasis and various CVD risk factors were conducted. Mendelian randomization (MR) was then employed to assess the causative impact of genetic pre-disposition for psoriasis on these CVD risk factors. RESULTS The results of the meta-analyses indicated that, in both the European and East Asian populations, psoriasis was significantly linked to an elevated risk in the incidence of CAD (RR = 1.51, 95% confidence interval (CI): 1.04-2.18, p = 0.028 and RR = 1.91, 95% CI: 1.62-2.25, p < 0.001) and MI (RR = 1.23, 95% CI: 1.04-1.46, p = 0.017 and RR = 2.17, 95% CI: 1.44-3.28, p < 0.001). A positive genetic relationship of psoriasis with CAD was found in European individuals (IVW OR1.03; 95% CI: 1.01-1.06, p = 0.005) and in East Asian individuals (IVW OR1.18; 95% CI: 1.03-1.32, p = 0.031). We also established that psoriasis was causally linked with an elevated risk of MI (IVW OR1.05; 95% CI: 1.01-1.09, p = 0.026) in the European population as determined using an MR approach. Moreover, our MR results were congruent with the null findings from the meta-analysis assessing associations of psoriasis with HF risk. CONCLUSIONS This research work provides preliminary evidence that psoriasis and CVD have a common genetic origin and that targeted psoriasis treatment might improve cardiovascular outcomes. These results not only increase our knowledge of the genetic underpinnings linking a comorbidity of psoriasis with CVD but also suggests a novel approach for CVD prevention.
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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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Effect of Intermittent Fasting on Reproductive Hormone Levels in Females and Males: A Review of Human Trials.
Cienfuegos, S, Corapi, S, Gabel, K, Ezpeleta, M, Kalam, F, Lin, S, Pavlou, V, Varady, KA
Nutrients. 2022;14(11)
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Intermittent fasting is a term for three different diet regimes. Alternate day fasting involves a feast day where individuals can eat what they want followed by a water only day. The 5:2 diet involves 5 feast days and 2 fast days per week. Time-restricted eating (TRE) involves a short eating window of a specific number of hours per day. Although these are all popular diet regimes for weight loss, animal studies have highlighted concerns with regards to reproductive health. This review paper aimed to summarise the human research on the effects of intermittent fasting on reproductive hormone levels in both men and women. It was found that overall, there were very few studies, however evidence was found on the effect of intermittent fasting on some of the sex hormones. For women, moving calorie intake to earlier in the day may be of benefit to oestrogen, sex hormone binding globulin, and androgen levels in those with polycystic ovary syndrome (PCOS). In addition, a fasting diet may be of benefit to androgen and SHBG levels in women with PCOS. However even though weight loss may be achieved with intermittent fasting, this is insufficient to improve the gonadotrophins. Intermittent fasting was found to be safe in women who were breastfeeding, with no significant change to milk production. In men, TRE was found to negatively affect testosterone levels, but had no effect on SHBG. The effect of intermittent fasting on sex hormones may involve changes in the gut microbiome and circadian rhythms as a direct result of intermittent fasting. It was concluded that the sex hormone levels of women with PCOS may benefit from intermittent fasting, however in men it may be detrimental to sex hormone production. This study could be used by healthcare professionals to understand that recommending an intermittent fasting diet may be of benefit to hormone levels and fertility in women with PCOS, however this may not be the case for men.
Abstract
Intermittent fasting is a popular diet for weight loss, but concerns have been raised regarding the effects of fasting on the reproductive health of women and men. Accordingly, we conducted this literature review to clarify the effects of fasting on reproductive hormone levels in humans. Our results suggest that intermittent fasting decreases androgen markers (i.e., testosterone and the free androgen index (FAI)) while increasing sex hormone-binding globulin (SHBG) levels in premenopausal females with obesity. This effect was more likely to occur when food consumption was confined to earlier in the day (eating all food before 4 pm). In contrast, fasting did not have any effect on estrogen, gonadotropins, or prolactin levels in women. As for men, intermittent fasting reduced testosterone levels in lean, physically active, young males, but it did not affect SHBG concentrations. Interestingly, muscle mass and muscular strength were not negatively affected by these reductions in testosterone. In interpreting these findings, it is important to note that very few studies have been conducted on this topic. Thus, it is difficult to draw solid conclusions at present. From the limited data presented here, it is possible that intermittent fasting may decrease androgen markers in both genders. If this is the case, these results would have varied health implications. On the one hand, fasting may prove to be a valuable tool for treating hyperandrogenism in females with polycystic ovarian syndrome (PCOS) by improving menstruation and fertility. On the other hand, fasting may be shown to decrease androgens among males, which could negatively affect metabolic health and libido. More research is warranted to confirm these preliminary findings.
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Systemic Perturbations in Amine and Kynurenine Metabolism Associated with Acute SARS-CoV-2 Infection and Inflammatory Cytokine Responses.
Lawler, NG, Gray, N, Kimhofer, T, Boughton, B, Gay, M, Yang, R, Morillon, AC, Chin, ST, Ryan, M, Begum, S, et al
Journal of proteome research. 2021;20(5):2796-2811
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Understanding the action of Covid-19 and the host response is paramount to developing personalised treatments and improving recovery rates. This cohort study of 64 individuals aimed to determine underlying biological signatures of individuals with severe and mild Covid-19, to potentially risk stratify patients and provide targeted treatments. The results showed that several biological signatures were disrupted with infection, some increased and some decreased and indicated possible liver, brain, and inflammatory disruptions. There was also evidence of a time-based pattern of biological disruptions, which may be of significance when looking at “long Covid” syndrome. It was concluded that identifying the hosts biological response to the virus offers insights into the viral action on the body. The action of Covid-19 on processes in the brain may indicate a secondary effect of the virus. Using biological markers to predict recovery of individuals suffering from “long Covid” may also be a possibility. This study could be used by healthcare professionals to understand which biological processes may be disrupted during Covid-19 infection, with the view to testing to understand who may be at risk of long-term complications post recovery.
Abstract
We performed quantitative metabolic phenotyping of blood plasma in parallel with cytokine/chemokine analysis from participants who were either SARS-CoV-2 (+) (n = 10) or SARS-CoV-2 (-) (n = 49). SARS-CoV-2 positivity was associated with a unique metabolic phenotype and demonstrated a complex systemic response to infection, including severe perturbations in amino acid and kynurenine metabolic pathways. Nine metabolites were elevated in plasma and strongly associated with infection (quinolinic acid, glutamic acid, nicotinic acid, aspartic acid, neopterin, kynurenine, phenylalanine, 3-hydroxykynurenine, and taurine; p < 0.05), while four metabolites were lower in infection (tryptophan, histidine, indole-3-acetic acid, and citrulline; p < 0.05). This signature supports a systemic metabolic phenoconversion following infection, indicating possible neurotoxicity and neurological disruption (elevations of 3-hydroxykynurenine and quinolinic acid) and liver dysfunction (reduction in Fischer's ratio and elevation of taurine). Finally, we report correlations between the key metabolite changes observed in the disease with concentrations of proinflammatory cytokines and chemokines showing strong immunometabolic disorder in response to SARS-CoV-2 infection.
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Long COVID: An overview.
Raveendran, AV, Jayadevan, R, Sashidharan, S
Diabetes & metabolic syndrome. 2021;15(3):869-875
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Plain language summary
SARS-CoV-2 infection (COVID-19) is a major pandemic resulting in considerable mortality and morbidity worldwide. For some people who recover from COVID-19, symptoms persist or new ones develop for weeks or months after infection despite testing PCR negative. This is termed long-COVID or post-COVID syndrome and divided into two stages: post-acute-COVID with symptoms extending beyond three weeks, and chronic-COVID with symptoms extending beyond 12 weeks. Factors that increase the risk for long-COVID include being female, age, having more than five symptoms in the acute stage of infection and pre-existing health conditions. A mild disease course is not exclusive to long-COVID. Typically affected by long-COVID are the pulmonary or cardiovascular system, with neuropsychiatric presentations also being reported. Common symptoms are one or more of the following such as fatigue, breathlessness, cough, chest pain, heart racing, headache, joint pain, muscle pain and weakness, insomnia, pins and needles, diarrhoea, rash, hair loss, impaired balance, neurocognitive issues. Due to the novelty of the virus, the underline pathophysiology of long-COVID still requires further investigation. Contributing factors mentioned include: compromised body functions after illness and inactivity, organ damage, persistent inflammation, altered immune response and auto-antibody generation and viral persistence. The impact of medication, treatments, hospitalisation or associated post-traumatic stress is also urged to be accounted for. Diagnosis of long-COVID is made by thorough history taking, clinical examination and the exclusion of other conditions. For the management of long-COVID, the authors in this review suggest the sub-categorisation depending on the body system most affected to optimize treatment options. Furthermore, it is encouraged that medical treatment should also consider the monitoring for worsening of any pre-existing health conditions post-infection. This review yields a informative summary of the definition, symptom presentations, risk factors, diagnosis and medical treatment options relating to long-COVID.
Abstract
BACKGROUND AND AIMS Long COVID is the collective term to denote persistence of symptoms in those who have recovered from SARS-CoV-2 infection. METHODS WE searched the pubmed and scopus databases for original articles and reviews. Based on the search result, in this review article we are analyzing various aspects of Long COVID. RESULTS Fatigue, cough, chest tightness, breathlessness, palpitations, myalgia and difficulty to focus are symptoms reported in long COVID. It could be related to organ damage, post viral syndrome, post-critical care syndrome and others. Clinical evaluation should focus on identifying the pathophysiology, followed by appropriate remedial measures. In people with symptoms suggestive of long COVID but without known history of previous SARS-CoV-2 infection, serology may help confirm the diagnosis. CONCLUSIONS This review will helps the clinicians to manage various aspects of Long COVID.