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Links between metabolic syndrome and the microbiome.
Gildner, TE
Evolution, medicine, and public health. 2020;2020(1):45-46
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Metabolic syndrome (MetS) is a cluster of co-occurring pathological conditions, characterised by insulin resistance, abdominal obesity, hypertension and dyslipidaemia One possible factor contributing to MetS risk is change in microbiome composition. Diets high in processed foods appear to alter microbiome composition in ways that promote higher fat mass and insulin resistance. Additionally, a sedentary lifestyle decreases microbiome diversity, elevating inflammation and metabolic disease risk. Research on how the microbiome responds to modest, attainable changes in diet and physical activity will help identify which dietary adjustments and exercise types have the greatest potential to protect patients from MetS.
Abstract
Metabolic syndrome (MetS) is a cluster of harmful conditions which occur together, such as insulin resistance, abdominal obesity, and hypertension. The global prevalence of MetS is growing rapidly, with some estimates suggesting over one billion people worldwide experience increased morality and disease rates linked with this syndrome. One possible factor contributing to MetS risk is changes in microbiome composition. Approximately 100 trillion bacteria and other microbes reside in the human intestinal tract, collectively termed the gut microbiome. Humans and microbes share a long evolutionary history, with many of these microbes influencing human health outcomes. However, environmental conditions have changed dramatically with human technological innovations; many of these changes (e.g., diets high in processed foods and sedentary lifestyles) appear to impact human-microbe relationships. In general, recent changes in diet and activity patterns have been linked to decreased microbiome diversity, elevating inflammation and metabolic disease risk and likely promoting the development of MetS. Targeting patient diet or exercise patterns may therefore help doctors better treat patients suffering from MetS. Still, additional work is needed to determine how the microbiome responds to changes in patient activity and diet patterns across culturally and biologically diverse human populations.
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Effects of Synbiotic Supplement on Human Gut Microbiota, Body Composition and Weight Loss in Obesity.
Sergeev, IN, Aljutaily, T, Walton, G, Huarte, E
Nutrients. 2020;12(1)
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The gut microbiota plays a role in the development of obesity and associated diseases. Whilst energy-restricted, low-carbohydrate, high-protein diets can facilitate substantial weight-loss, they also have been linked to ill-effects and unfavourable changes in the gut microbiota from excess protein fermentation. Pro-and prebiotics (synbiotics) have become a promising intervention in the management of obesity. This small placebo-controlled clinical trial involved 20 obese adults following an energy-restricted (approx.950 kcal/day) low-carbohydrate, high-protein diet. The study examined whether a supplementary synbiotic contributed to additional changes in body composition and metabolic biomarkers. The synbiotic contained Lactobacilli spp. and Bifidobacteria spp. and a prebiotic mixture of galactooligosaccharides. Overall, at the end of the 3-month trial, there was no remarkable difference between the groups. Both experienced a significant and decreasing trend in body mass, waist circumference, body mass index, fat mass, fat percentage, and glucose level, affirming the known benefits of the described weight-loss diet. However, the synbiotic supplementation group had a greater decrease in HbA1C and significant alterations in gut microbiota, showing an increased abundance of gut bacteria associated with positive health effects. Due to the complexity of microbial species and host interactions, the authors advocate for more research to identify their significance and shed light on contradictory findings. This study identified that synbiotics may not contribute to additional changes in body composition when combined with an energy-restricted, low-carbohydrate, high-protein diet but they can offer additional health benefits by inducing favourable changes to the gut microbiota.
Abstract
Targeting gut microbiota with synbiotics (probiotic supplements containing prebiotic components) is emerging as a promising intervention in the comprehensive nutritional approach to reducing obesity. Weight loss resulting from low-carbohydrate high-protein diets can be significant but has also been linked to potentially negative health effects due to increased bacterial fermentation of undigested protein within the colon and subsequent changes in gut microbiota composition. Correcting obesity-induced disruption of gut microbiota with synbiotics can be more effective than supplementation with probiotics alone because prebiotic components of synbiotics support the growth and survival of positive bacteria therein. The purpose of this placebo-controlled intervention clinical trial was to evaluate the effects of a synbiotic supplement on the composition, richness and diversity of gut microbiota and associations of microbial species with body composition parameters and biomarkers of obesity in human subjects participating in a weight loss program. The probiotic component of the synbiotic used in the study contained Lactobacillus acidophilus, Bifidobacterium lactis, Bifidobacterium longum, and Bifidobacterium bifidum and the prebiotic component was a galactooligosaccharide mixture. The results showed no statistically significant differences in body composition (body mass, BMI, body fat mass, body fat percentage, body lean mass, and bone mineral content) between the placebo and synbiotic groups at the end of the clinical trial (3-month intervention, 20 human subjects participating in weight loss intervention based on a low-carbohydrate, high-protein, reduced energy diet). Synbiotic supplementation increased the abundance of gut bacteria associated with positive health effects, especially Bifidobacterium and Lactobacillus, and it also appeared to increase the gut microbiota richness. A decreasing trend in the gut microbiota diversity in the placebo and synbiotic groups was observed at the end of trial, which may imply the effect of the high-protein low-carbohydrate diet used in the weight loss program. Regression analysis performed to correlate abundance of species following supplementation with body composition parameters and biomarkers of obesity found an association between a decrease over time in blood glucose and an increase in Lactobacillus abundance, particularly in the synbiotic group. However, the decrease over time in body mass, BMI, waist circumstance, and body fat mass was associated with a decrease in Bifidobacterium abundance. The results obtained support the conclusion that synbiotic supplement used in this clinical trial modulates human gut microbiota by increasing abundance of potentially beneficial microbial species.
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You Are What You Eat-The Relationship between Diet, Microbiota, and Metabolic Disorders-A Review.
Moszak, M, Szulińska, M, Bogdański, P
Nutrients. 2020;12(4)
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The gut microbiota (GM) is a collection of microorganisms living in the digestive tract of humans, which if unbalanced, may have a role in the development of certain disorders such as type 2 diabetes and obesity. A number of factors can imbalance the gut microbiota, one of the main being diet. This review paper of 190 papers aimed to summarise the relationship between GM, diet and modifiable diseases such as type 2 diabetes and obesity. Dietary components and the role of carbohydrates, protein and fats in shaping the GM were discussed. It was determined that carbohydrates have the greatest influence, with simple carbohydrates such as the sugars fructose and sucrose having a negative impact and the more complex forms being beneficial. Diet types were also reviewed. Vegetarian and vegan diets appear to increase the diversity of the GM, the Mediterranean diet changes the species balance, and the Western diet imbalances the GM causing diseases such as heart disease. Interestingly the literature points towards a negative impact of the gluten free diet. Diseases such as type 2 diabetes, obesity and increased fats in the blood all display an imbalanced GM causing increased energy harvest from food and disruption of various energy pathways in the body. It was concluded that a balanced diet rich in fruit, vegetables, fibre and healthy fats can promote GM diversity and activity. This study could be used by health care professionals to understand the importance of certain dietary components to promote GM diversity in order to reduce the risk of diseases such as obesity and type 2 diabetes.
Abstract
The gut microbiota (GM) is defined as the community of microorganisms (bacteria, archaea, fungi, viruses) colonizing the gastrointestinal tract. GM regulates various metabolic pathways in the host, including those involved in energy homeostasis, glucose and lipid metabolism, and bile acid metabolism. The relationship between alterations in intestinal microbiota and diseases associated with civilization is well documented. GM dysbiosis is involved in the pathogenesis of diverse diseases, such as metabolic syndrome, cardiovascular diseases, celiac disease, inflammatory bowel disease, and neurological disorders. Multiple factors modulate the composition of the microbiota and how it physically functions, but one of the major factors triggering GM establishment is diet. In this paper, we reviewed the current knowledge about the relationship between nutrition, gut microbiota, and host metabolic status. We described how macronutrients (proteins, carbohydrates, fat) and different dietary patterns (e.g., Western-style diet, vegetarian diet, Mediterranean diet) interact with the composition and activity of GM, and how gut bacterial dysbiosis has an influence on metabolic disorders, such as obesity, type 2 diabetes, and hyperlipidemia.
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Total and Subtypes of Dietary Fat Intake and Its Association with Components of the Metabolic Syndrome in a Mediterranean Population at High Cardiovascular Risk.
Julibert, A, Bibiloni, MDM, Bouzas, C, Martínez-González, MÁ, Salas-Salvadó, J, Corella, D, Zomeño, MD, Romaguera, D, Vioque, J, Alonso-Gómez, ÁM, et al
Nutrients. 2019;11(7)
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Obesity, Metabolic Syndrome (MetS) and Cardiovascular Disease (CVD) are becoming a global epidemic and the role of dietary fats is still unclear. The PREDIMED trial is a large study of 6560 Mediterranean men and women, aged 55–75 years old, with overweight/obesity and MetS in which they have tracked all types of dietary fat consumed over a 6-year period to assess the risk factors for CVD. Quality of fat is thought to play an important role in MetS. This study used food questionnaires to measure intake of the following fats: total fat, monounsaturated fatty acids: MUFA, polyunsaturated fatty acids: PUFA, saturated fatty acids: SFA, trans-fatty acids: trans-FA, linoleic acid, a-linolenic acid, and w-3 FA). They were able to divide the participants into groups ranging from highest to lowest fat intake and assess the types of foods and fats being consumed. They found that the group with the highest fat intakes ate less carbohydrates, protein and fibre and had a higher risk of hyperglycaemia (high blood glucose levels). The total fats consumed in this group also included high levels of harmful trans-fatty acids so the researchers concluded that the risk is influenced by the combination of nutrients of the food consumed. They also found that participants who consumed high levels of linoleic acid had significantly higher healthy HDL cholesterol levels and those who consumed high levels of saturated fatty acids and omega 3 had significantly less risk of high triglycerides (another cholesterol marker). Overall they recommend further studies into types of dietary fat to help reduce MetS in the population.
Abstract
Background: The effect of dietary fat intake on the metabolic syndrome (MetS) and in turn on cardiovascular disease (CVD) remains unclear in individuals at high CVD risk. Objective: To assess the association between fat intake and MetS components in an adult Mediterranean population at high CVD risk. Design: Baseline assessment of nutritional adequacy in participants (n = 6560, men and women, 55-75 years old, with overweight/obesity and MetS) in the PREvención con DIeta MEDiterránea (PREDIMED)-Plus randomized trial. Methods: Assessment of fat intake (total fat, monounsatured fatty acids: MUFA, polyunsaturated fatty acids: PUFA, saturated fatty acids: SFA, trans-fatty acids: trans-FA, linoleic acid, α-linolenic acid, and ω-3 FA) using a validated food frequency questionnaire, and diet quality using 17-item Mediterranean dietary questionnaire and fat quality index (FQI). Results: Participants in the highest quintile of total dietary fat intake showed lower intake of energy, carbohydrates, protein and fiber, but higher intake of PUFA, MUFA, SFA, TFA, LA, ALA and ω-3 FA. Differences in MetS components were found according to fat intake. Odds (5th vs. 1st quintile): hyperglycemia: 1.3-1.6 times higher for total fat, MUFA, SFA and ω-3 FA intake; low high-density lipoprotein cholesterol (HDL-c): 1.2 higher for LA; hypertriglyceridemia: 0.7 lower for SFA and ω-3 FA intake. Conclusions: Dietary fats played different role on MetS components of high CVD risk patients. Dietary fat intake was associated with higher risk of hyperglycemia.
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Dietary Fructose and the Metabolic Syndrome.
Taskinen, MR, Packard, CJ, Borén, J
Nutrients. 2019;11(9)
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Fructose is a naturally occurring sugar in carbohydrate foods and is often used as an ingredient in foods and sugar sweetened beverages (SSB) such as sport and energy drinks. The consumption of these drinks accounts for up to 15-17% of calorie intake in the modern western diet. Excessive sugar consumption is becoming a major public health issue with high sugar intake linked to Metabolic Syndrome (MetS), cardiovascular disease, type II diabetes and non-alcoholic fatty liver disease. Fructose is largely absorbed in the small intestines however the liver is considered the major organ for fructose metabolism. Too much fructose in the diet appears to stimulate the liver to produce more sugars and triglyceride fats which can raise cholesterol levels and promote insulin resistance. This partially explains the role of fructose in promoting a build-up of fat around the liver leading to non-alcoholic fatty liver disease and central obesity. Too much fructose is also linked to unfavourable changes in gut bacteria which may contribute to obesity and MetS. Overall the study concludes that too much fructose contributes to an unhealthy lifestyle and is a risk factor for metabolic disturbances.
Abstract
Abstract: Consumption of fructose, the sweetest of all naturally occurring carbohydrates, has increased dramatically in the last 40 years and is today commonly used commercially in soft drinks, juice, and baked goods. These products comprise a large proportion of the modern diet, in particular in children, adolescents, and young adults. A large body of evidence associate consumption of fructose and other sugar-sweetened beverages with insulin resistance, intrahepatic lipid accumulation, and hypertriglyceridemia. In the long term, these risk factors may contribute to the development of type 2 diabetes and cardiovascular diseases. Fructose is absorbed in the small intestine and metabolized in the liver where it stimulates fructolysis, glycolysis, lipogenesis, and glucose production. This may result in hypertriglyceridemia and fatty liver. Therefore, understanding the mechanisms underlying intestinal and hepatic fructose metabolism is important. Here we review recent evidence linking excessive fructose consumption to health risk markers and development of components of the Metabolic Syndrome.
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A structured weight loss program increases gut microbiota phylogenetic diversity and reduces levels of Collinsella in obese type 2 diabetics: A pilot study.
Frost, F, Storck, LJ, Kacprowski, T, Gärtner, S, Rühlemann, M, Bang, C, Franke, A, Völker, U, Aghdassi, AA, Steveling, A, et al
PloS one. 2019;14(7):e0219489
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The global obesity epidemic is a major cause of the increase in type 2 diabetes mellitus (T2DM) and ensuing cardiovascular disease. The causes of obesity are complex ,and it has been shown that changes in the microbiome are associated with obesity. The microbiome can be altered through dietary intervention and weight loss. The aim of this open label pilot study was to investigate the microbiome of obese patients with T2DM during a weight loss programme. During the first six weeks the diet consisted of formula drink providing 800kcal per day, followed by nine weeks during which a regular diet of 1,200-1,500kcal per day was reintroduced, depending on the individuals’ needs. All participants lost weight continuously over the 15 weeks, from an average BMI of 39.6 at the start to 33.1 at the end of the programme. This was accompanied with an improvement in glucose metabolism, total and LDL cholesterol and uric acid levels, but not HDL cholesterol or triglycerides. All participants experienced changes in their microbiome towards greater diversity after the first six weeks of the low-calorie formula diet but these changes were partially reversed at the end of the study period at 15 weeks. A particular type of bacteria, Collinsella, which has been associated with poor metabolic health, was the only type found to remain reduced at the end of the 15 weeks, an 8.4-fold decrease. The authors hypothesise that this reduction in Collinsella may be associated with the improvement of metabolic factor in these patients at the end of the study.
Abstract
The global obesity epidemic constitutes a major cause of morbidity and mortality challenging public health care systems worldwide. Thus, a better understanding of its pathophysiology and the development of novel therapeutic options are urgently needed. Recently, alterations of the intestinal microbiome in the obese have been discussed as a promoting factor in the pathophysiology of obesity and as a contributing factor to related diseases such as type 2 diabetes and metabolic syndrome. The present pilot study investigated the effect of a structured weight loss program on fecal microbiota in obese type 2 diabetics. Twelve study subjects received a low-calorie formula diet for six weeks, followed by a nine week food reintroduction and stabilization period. Fecal microbiota were determined by 16S rRNA gene sequencing of stool samples at baseline, after six weeks and at the end of the study after fifteen weeks. All study subjects lost weight continuously throughout the program. Changes in fecal microbiota were most pronounced after six weeks of low-calorie formula diet, but reverted partially until the end of the study. However, the gut microbiota phylogenetic diversity increased persistently. The abundance of Collinsella, which has previously been associated with atherosclerosis, decreased significantly during the weight loss program. This study underlines the impact of dietary changes on the intestinal microbiome and further demonstrates the beneficial effects of weight loss on gut microbiota. Trial registration: ClinicalTrials.gov NCT02970838.
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Whole grain-rich diet reduces body weight and systemic low-grade inflammation without inducing major changes of the gut microbiome: a randomised cross-over trial.
Roager, HM, Vogt, JK, Kristensen, M, Hansen, LBS, Ibrügger, S, Mærkedahl, RB, Bahl, MI, Lind, MV, Nielsen, RL, Frøkiær, H, et al
Gut. 2019;68(1):83-93
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Whole grain consumption has been linked with decreased risk of lifestyle-related diseases. While animal studies have shown the gut microbiome to be a mediator of metabolic health, human studies examining the effect of whole grain intake of the gut remain inconclusive. The aim of this study was to investigate the effects of a whole grain diet on the gut microbiome, gut functionality and biomarkers of metabolic health. In this randomised, controlled, crossover study, 50 participants completed two 8-week dietary intervention periods comprising of a whole grain diet and a refined grain diet with a 6-week washout period. Examinations were done at the beginning and end of each intervention period to assess anthropometry and various plasma and gut markers. This study found that a whole grain diet as compared with a refined grain diet reduced energy intake and body weight as well as circulating markers of inflammation. Contrary to the hypothesis, these benefits were all observed independent of changes in the gut microbiome. Based on these results, the authors conclude higher intake of whole grains should be recommended to those at risk of inflammation-related disease.
Abstract
OBJECTIVE To investigate whether a whole grain diet alters the gut microbiome and insulin sensitivity, as well as biomarkers of metabolic health and gut functionality. DESIGN 60 Danish adults at risk of developing metabolic syndrome were included in a randomised cross-over trial with two 8-week dietary intervention periods comprising whole grain diet and refined grain diet, separated by a washout period of ≥6 weeks. The response to the interventions on the gut microbiome composition and insulin sensitivity as well on measures of glucose and lipid metabolism, gut functionality, inflammatory markers, anthropometry and urine metabolomics were assessed. RESULTS 50 participants completed both periods with a whole grain intake of 179±50 g/day and 13±10 g/day in the whole grain and refined grain period, respectively. Compliance was confirmed by a difference in plasma alkylresorcinols (p<0.0001). Compared with refined grain, whole grain did not significantly alter glucose homeostasis and did not induce major changes in the faecal microbiome. Also, breath hydrogen levels, plasma short-chain fatty acids, intestinal integrity and intestinal transit time were not affected. The whole grain diet did, however, compared with the refined grain diet, decrease body weight (p<0.0001), serum inflammatory markers, interleukin (IL)-6 (p=0.009) and C-reactive protein (p=0.003). The reduction in body weight was consistent with a reduction in energy intake, and IL-6 reduction was associated with the amount of whole grain consumed, in particular with intake of rye. CONCLUSION Compared with refined grain diet, whole grain diet did not alter insulin sensitivity and gut microbiome but reduced body weight and systemic low-grade inflammation. TRIAL REGISTRATION NUMBER NCT01731366; Results.
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Diet-Gut Microbiota Interactions and Gestational Diabetes Mellitus (GDM).
Ponzo, V, Fedele, D, Goitre, I, Leone, F, Lezo, A, Monzeglio, C, Finocchiaro, C, Ghigo, E, Bo, S
Nutrients. 2019;11(2)
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Gestational diabetes mellitus (GDM) is an increasing public health concern that affects approximately 5-20% of pregnancies with rising prevalence. The potential impact of specific dietary interventions on the gut bacteria composition and function are of considerable interest to prevent and treat GDM. The aim of the study was to analyse the changes in the gut microbiota and the diet-microbiota interactions occurring during healthy pregnancies and pregnancies complicated by GDM. This study is a systemic review. Literature shows that pregnancies complicated with GDM may have an impaired gut microbiota, and this microbiota can be transmitted to the offspring. Diets can shape the gut microbiota, in fact dietary changes can rapidly change the gut microbiota. However, it generally reverts to the original status with short-term dietary modifications. Authors conclude that the optimal nutritional strategy in GDM patients remains unresolved. It is important that the potential benefits of diet are taken into consideration.
Abstract
Medical nutritional therapy is the first-line approach in managing gestational diabetes mellitus (GDM). Diet is also a powerful modulator of the gut microbiota, whose impact on insulin resistance and the inflammatory response in the host are well known. Changes in the gut microbiota composition have been described in pregnancies either before the onset of GDM or after its diagnosis. The possible modulation of the gut microbiota by dietary interventions in pregnancy is a topic of emerging interest, in consideration of the potential effects on maternal and consequently neonatal health. To date, very few data from observational studies are available about the associations between diet and the gut microbiota in pregnancy complicated by GDM. In this review, we analyzed the available data and discussed the current knowledge about diet manipulation in order to shape the gut microbiota in pregnancy.
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The Effect of Probiotic Yogurt on Glycemic Control in Type 2 Diabetes or Obesity: A Meta-Analysis of Nine Randomized Controlled Trials.
Barengolts, E, Smith, ED, Reutrakul, S, Tonucci, L, Anothaisintawee, T
Nutrients. 2019;11(3)
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The metabolic disorders type 2 diabetes and obesity are highly prevalent worldwide. There are multiple merging treatments for type 2 diabetes and obesity, but the management of both conditions remains challenging. The aim of the study was to review the effects of probiotics on glycaemic outcomes in type 2 diabetes or obesity. The study is a meta-analysis of RCTs that utilized probiotic yoghurt as a main intervention in participants with type 2 diabetes or obesity. Nine studies were included in the meta-analysis, seven of which were conducted in subjects with type 2 diabetes and the rest were conducted in subjects with obesity. Results indicate that probiotic yoghurt provides no significant improvement compared with the control in glycaemic markers. Authors conclude that their study did not demonstrate the benefits of consuming probiotic yoghurt compared with conventional yoghurt for improving glucose control in patients with type 2 diabetes or obesity.
Abstract
Probiotic yogurt is suggested as a nutritional approach in type 2 diabetes (T2D) and obesity. We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) evaluating the effects of probiotic yogurt on glycemic outcomes in T2D or obesity. The databases used to search for RCTs included Medline and Scopus. The RCTs were eligible if outcomes included selected glycemic markers. In nine eligible trials, 237 and 235 subjects were in treatment (probiotic yogurt) and control (mostly conventional yogurt) groups, respectively. There was no significant difference for pooled unstandardized mean difference (USMD) hemoglobin A1c (HbA1c) by probiotic yogurt compared with the control in T2D (USMD: -0.366; 95% CI: -0.755, 0.024, p = 0.066) and obesity (USMD: 0.116, 95% CI: -0.007, 0.238, p = 0.065). Similarly, there were no effects of probiotic yogurt on fasting blood glucose, fasting insulin, or insulin resistance (estimated by homeostatic model assessment of insulin resistance (HOMA-IR)) in either T2D or obesity. In conclusion, the present meta-analysis has not demonstrated the benefits of consuming probiotic compared with conventional yogurt for improving glucose control in patients with diabetes or obesity. Larger trials are needed to verify the benefits of probiotic and/or conventional yogurt or other probiotic fermented milk (e.g., kefir) on glycemic markers in patients with diabetes and obesity.
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Metabolic Syndrome Features: Is There a Modulation Role by Mineral Water Consumption? A Review.
Costa-Vieira, D, Monteiro, R, Martins, MJ
Nutrients. 2019;11(5)
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Metabolic syndrome, defined as having high blood pressure, triglycerides, blood glucose and being obese, is becoming an increasing worldwide health problem. It’s considered to be a result of modern-day life styles and there is no effective cure other than diet and life style interventions. This review paper looks at the mineral content and the alkalising effects of mineral water when consumed by participants with metabolic syndrome. The minerals within mineral water are thought to be more readily absorbed in the body than when consumed in foods and since Westernised diets are low in mineral content and high in acidity, consuming mineral water could help counteract mineral deficiencies and help to balance pH in those with metabolic syndrome. 20 studies, both animal and human, were selected for evaluation of the effect of mineral water on blood pressure, lipid profile, blood glucose and waist circumference. The authors conclude that mineral water is indeed beneficial to those with metabolic syndrome and can help counteract mineral deficiencies and balance pH. However, it is unclear whether mineral water in high quantities would be detrimental to a person with adequate mineral status and a pH within optimal range. Further studies are needed.
Abstract
Metabolic syndrome (MetSyn) promotes, among others, the development of atherosclerotic cardiovascular disease and diabetes. Its prevalence increases with age, highlighting the relevance of promoting precocious MetSyn primary prevention and treatment with easy-to-implement lifestyle interventions. MetSyn features modulation through mineral water consumption was reviewed on Pubmed, Scopus and Google Scholar databases, using the following keywords: metabolic syndrome, hypertension, blood pressure (BP), cholesterol, triglycerides, apolipoprotein, chylomicron, very low-density lipoprotein, low-density lipoprotein, high-density lipoprotein (HDL), glucose, insulin, body weight, body mass index, waist circumference (WC), obesity and mineral(-rich) water. Twenty studies were selected: 12 evaluated BP, 13 assessed total-triglycerides and/or HDL-cholesterol, 10 analysed glucose and/or 3 measured WC. Mineral waters were tested in diverse protocols regarding type and composition of water, amount consumed, diet and type and duration of the study. Human and animal studies were performed in populations with different sizes and characteristics. Distinct sets of five studies showed beneficial effects upon BP, total-triglycerides, HDL-cholesterol and glucose. WC modulation was not reported. Minerals/elements and active ions/molecules present in mineral waters (and their pH) are crucial to counterbalance their inadequate intake and body status as well as metabolic dysfunction and increased diet-induced acid-load observed in MetSyn. Study characteristics and molecular/physiologic mechanisms that could explain the different effects observed are discussed. Further studies are warranted for determining the mechanisms involved in the putative protective action of mineral water consumption against MetSyn features.