Effects of cumin (Cuminum cyminum L.) essential oil supplementation on metabolic syndrome components: A randomized,triple‐blind,placebo‐controlled clinical trial

Prevalence of metabolic syndrome (MetS), as a major health problem, is increasing. Very limited data exist on the effect of Cuminum cyminum L. essential oil (CuEO) on MetS components. Accordingly, this study aimed to examine the effect of CuEO supplementation on anthropometric indices, glycemic control, blood pressure, lipid profile, and insulin resistance in patients with MetS. In a randomized, triple‐blind, placebo‐controlled clinical trial, 56 patients with MetS aged 18–60 years received either 75 mg CuEO or placebo soft gel thrice daily for 8 weeks. Anthropometric indices and biochemical measurements were assessed at baseline and end of the study. At the end of study, except for diastolic blood pressure (DBP), the other assessed variables were not significantly different between two groups. In intra group analysis, placebo and CuEO groups both had nonsignificant decrements in DBP (mean difference [MD] with 95% CI: ?3.31 [?7.11, 0.47] and ?1.77 [?5.95, 2.40] mmHg, respectively). However, DBP was significantly lower in CuEO compared with the placebo group at the end of study (81.41 ± 5.88 vs. 84.09 ± 5.54 mmHg, MD with 95% CI: ?3.98 [?7.60, ?0.35] mmHg, p < .05). The results indicated that CuEO does not have any effect on MetS components, except for DBP in patients with MetS.     

The effect of sumac supplementation on insulin resistance,inflammation, oxidative stress,and antioxidant capacity in adults with metabolic syndrome: A randomized crossover clinical trial

The impact of sumac supplementation was not previously examined in patients with metabolic syndrome (MetS). So, we investigated the influence of sumac supplementation on insulin resistance, inflammation, oxidative stress, and antioxidant markers in adults with MetS. The current study was a single-center, triple-blind, randomized, placebo-controlled crossover clinical trial that was conducted on 47 patients with MetS. Participants were randomly divided into two groups of intervention and control in the first phase. They received capsules containing 500 mg sumac or placebo (lactose) twice a day, after lunch and dinner, for 6 weeks. After a 2-week washout period, the subjects crossed over to the alternate arm. In both arms, fasting venous blood samples were obtained at baseline and at the sixth week of the intervention to determine glycemic status, high-sensitivity C-reactive protein (hs-CRP), malondialdehyde (MDA), total antioxidant capacity (TAC), and antioxidant enzymes activity. The mean (±SD) age, weight, and body mass index of participants were respectively 58.7 ± 5.83 years, 79.9 ± 14.35 kg, and 31.6 ± 4.6 kg/m²; 80.9% of subjects were females (n = 38). Based on per-protocol analyses, the serum fasting insulin concentration was unexpectedly decreased in the placebo group (change in sumac vs. control: 0.95 ± 3.9 vs. −1.17 ± 3.9 mU/L; p = 0.04). Sumac supplementation, compared to control, has marginally enhanced catalase activity (change in sumac vs. control: 2.91 ± 9.5 vs. −1.07 ± 9.1 nmol/min/ml; p = 0.06). This supplementation has also increased serum TAC and the activity of superoxide dismutase, but these changes were not significant. This intervention did not affect other insulin resistance, inflammatory, or oxidative stress markers. We found that 1 g/day sumac consumption for 6 weeks, as adjuvant therapy, could improve the antioxidant defense system in adults with MetS but did not affect insulin resistance, inflammation, or oxidative stress.     

The effects of curcumin‐containing supplements on biomarkers of inflammation and oxidative stress: A systematic review and meta‐analysis of randomized controlled trials

Besides other benefits, curcumin is getting more recognized for its antioxidant and anti‐inflammatory properties, highlighting the importance of curcumin application for chronic disease prevention. This systematic review and meta‐analysis of randomized controlled trials (RCTs) was conducted to assess the influence of curcumin‐containing supplements on biomarkers of inflammation and oxidative stress. MEDLINE, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials were searched till January 2018 for eligible studies. The selected studies were evaluated for their quality using the Cochrane risk of bias tool and relevant data were extracted from included studies. Data were pooled using the inverse variance method and expressed as standardized mean difference (SMD) with 95% confidence intervals (95% CI). Fifteen RCTs were included in the final analysis. The meta‐analysis indicated that curcumin supplementation significantly decreased interleukin 6 (IL‐6) (SMD ?2.08; 95% CI [?3.90, ?0.25]; p = 0.02), high‐sensitivity C‐reactive protein (hs‐CRP) (SMD ?0.65; 95% CI [?1.20, ?0.10], p = 0.02), and malondialdehyde (MDA) concentrations (SMD ?3.14; 95% CI [‐4.76, ?1.53], p < 0.001). Though, curcumin supplementation had no significant effect on tumor necrosis factor‐alpha (SMD ?1.62; 95% CI [?3.60, 0.36]; p = 0.10) and superoxide dismutase levels (SMD 0.34; 95% CI [?1.06, 1.74], p = 0.63). Overall, this meta‐analysis suggests that taking curcumin‐containing supplements may exert anti‐inflammatory and antioxidant properties through a significant reduction in IL‐6, hs‐CRP, and MDA levels.     

The Effects of Curcumin and Curcumin–Phospholipid Complex on the Serum Pro‐oxidant–Antioxidant Balance in Subjects with Metabolic Syndrome

Metabolic syndrome (MetS) is defined by a clustering of metabolic and anthropometric abnormalities and is associated by an increased risk of cardiovascular disease. We have investigated the effect of curcumin supplementation on the serum pro‐oxidant–antioxidant balance (PAB) in patients with MetS. This double‐blind, randomized, placebo‐controlled trial was conducted over 6 weeks. Subjects (n = 120) were randomly allocated to one of three groups (curcumin, phospholipidated curcumin, and placebo). The curcumin group received 1 g/day of simple curcumin, the phospholipidated curcumin group received 1 g/day of phospholipidated curcumin (containing 200 mg of pure curcumin), and the control group received 1 g/day of placebo. Serum PAB was measured before and after the intervention (at baseline and at 6 weeks). Data analyses were performed using spss software (version 16.0). Serum PAB increased significantly in the curcumin group (p < 0.001), but in the phospholipidated curcumin group, elevation of PAB level was not significant (p = 0.053). The results of our study did not suggest any improvement of PAB following supplementation with curcumin in MetS subjects. Copyright © 2017 John Wiley & Sons, Ltd.     

The effects of rutin flavonoid supplement on glycemic status,lipid profile,atherogenic index of plasma,brain-derived neurotrophic factor (BDNF), some serum inflammatory,and oxidative stress factors in patients with type 2 diabetes mellitus: A double-blind,placebo-controlled trial

This study aimed to investigate the effects of rutin flavonoid in type 2 diabetes mellitus (T2DM) patients. In this trial (double-blind, placebo-controlled), 50 T2DM patients (supplement, n = 25 and placebo, n = 25) were randomized and supplemented with 500 mg rutin or placebo per day for 3-months. At the beginning and at the end of the study, metabolic parameters including fasting blood glucose (FBG), insulin, glycosylated hemoglobin (HbA1c), homeostasis model assessment of insulin resistance (HOMO-IR), quantitative insulin sensitivity check index (QUICKI), homeostasis model assessment of β-cell function (HOMA-β), triglyceride (TG), total cholesterol (CHOL), high-density and low-density lipoprotein cholesterol (HDL-c and LDL-c), and atherogenic index of plasma (AIP), inflammatory and oxidative stress markers such as interleukin 6 (IL-6), total antioxidant capacity (TAC), and malondialdehyde (MDA) and brain-derived neurotrophic factor (BDNF) were assessed. The results showed a significant decrease in FBG, insulin, HbA1c, HOMO-IR, LDL-c, TG, VLDL, CHOL, LDL-c.HDL-c ratio, AIP, IL-6, and MDA and a significant increase in HDL-c, QUICKI index, BDNF, and TAC compared with the initial value (p for all <.05). In the adjusted model, the mean changes of FBG, insulin, HbA1c, HOMO-IR, LDL-c, CHOL, LDL.HDL ratio, AIP, MDA, and IL-6 were significantly lower and mean changes of QUICKI index, HDL-c, and TAC were significantly higher in the rutin group compared with the placebo group (adjusted p for all <.05). It seems that rutin may have beneficial effects on improving metabolic parameters, BDNF, and inflammatory and oxidative stress factors in T2DM patients.     

Effects of Curcumin on Serum Vitamin E Concentrations in Individuals with Metabolic Syndrome

Vitamin E is an important lipid‐soluble antioxidant. The aim of the present study was to investigate the effect of curcumin on serum vitamin E levels in subjects with metabolic syndrome (MetS). A total of 120 subjects aged 18–65 years old with MetS were recruited in this study according to the International Diabetic Federation Criteria. Included subjects were randomized into three groups: subjects receiving lecithinized curcumin (1 g/day equivalent to 200‐mg pure curcumin per day) for a period of 6 weeks )n = 40), patients receiving unformulated curcumin (1 g/day) for a period of 6 weeks )n = 40) and a control group receiving placebo for the same period (n = 40). Vitamin E was determined in all patients before and after the intervention using high‐performance liquid chromatography method. Results showed that curcumin has no improving effect on serum levels of vitamin E (p > 0.05). There were significant differences between pre‐trial and post‐trial levels of vitamin E/low‐density lipoprotein cholesterol ratio (p < 0.05), vitamin E/high‐density lipoprotein cholesterol ratio (p < 0.05), vitamin E/total cholesterol ratio (p < 0.01) and vitamin E/triglyceride ratio (p < 0.05) between the three groups of the study. Results of the present study did not suggest any improving effect of curcumin supplementation on serum vitamin E concentrations in subjects with MetS. Copyright © 2017 John Wiley & Sons, Ltd.     

The effects of fenugreek seed extract supplementation in patients with Alzheimer's disease: A randomized,double-blind,placebo-controlled trial

The aim of the current randomized control trial (RCT) study was to investigate the effects of fenugreek seed extract on memory, depression, quality of life, blood pressure, and serum malondialdehyde (MDA) and total antioxidant capacity (TAC) levels in adult AD patients. This randomized clinical trial was conducted in geriatric homes in Iran. The study participants included 82 AD patients with mild-to-moderate memory deficit. Patients in the intervention group received 5 cc of fenugreek seed extract for 4 months and subjects in the control group received a placebo. Memory, depression, quality of life, and BP levels, as well as serum MDA and TAC, were assessed before and after the intervention. There was a significant increase in serum levels of TAC (p < 0.001) and a reduction in serum MDA status (p < 0.001) after 4 months of fenugreek seed extract supplementation. In addition, increasing levels of memory (p < 0.001) and quality of life (p < 0.001), as well as reduction of depression (p = 0.002), systolic BP (p < 0.001), and diastolic BP (p < 0.001) levels were detected in the intervention group compared with baseline. Fenugreek seed extract supplementation in AD patients shows promising positive effects on memory, quality of life, BP, and selective oxidative indices levels.     

The effects of spirulina on glycemic control and serum lipoproteins in patients with metabolic syndrome and related disorders: A systematic review and meta‐analysis of randomized controlled trials

The aim of this systematic review and meta‐analysis was to evaluate the effects of spirulina on glycemic control and serum lipoproteins in patients with metabolic syndrome (MetS) and related disorders. Two independent authors systematically searched online database including EMBASE, Scopus, PubMed, Cochrane Library, and Web of Science from inception until April 30, 2019. The Cochrane Collaboration's risk of bias tool was applied to assess the methodological quality of included trials. The heterogeneity among the included studies was assessed using Cochrane's Q test and I‐square (I²) statistic. Pooling effect sizes from studies showed a significant reduction in fasting plasma glucose (FPG; weighted mean difference [WMD]: ?10.31; 95% confidence interval, CI [?16.21, ?4.42]) and insulin concentrations (WMD: ?0.53; 95% CI [?0.62, ?0.44]) following the administration of spirulina. Pooled analysis showed also a significant reduction in total cholesterol (WMD: ?20.50; 95% CI [?38.25, ?2.74]), low‐density lipoprotein cholesterol (LDL‐C; WMD: ?19.02; 95% CI [?36.27, ?1.78]), and very low‐density lipoprotein cholesterol (VLDL‐C) concentrations (WMD: ?6.72; 95% CI [?9.19, ?4.26]) and a significant increase in high‐density lipoprotein cholesterol (HDL‐C) levels (WMD: 1.42; 95% CI [0.16, 2.68]) following spirulina therapy. This meta‐analysis demonstrated the beneficial effects of spirulina supplementation on improving FPG, insulin, total cholesterol, LDL‐C, VLDL‐C, and HDL‐C levels in patients with MetS and related disorders.     

The effect of l‐carnitine supplementation on serum levels of omentin‐1, visfatin and SFRP5 and glycemic indices in patients with pemphigus vulgaris: A randomized,double‐blind,placebo‐controlled clinical trial

Pemphigus vulgaris (PV) is a chronic autoimmune disorder with potentially fatal outcomes. The aim of this study was to investigate the effect of l ‐carnitine (LC) on secreted frizzled‐related protein‐5 (SFRP5), omentin, visfatin, and glycemic indices in PV patients under corticosteroid treatment. In this randomized, double‐blind, placebo‐controlled clinical trial, 52 patients with PV were divided randomly into two groups to receive 2 g of LC or a placebo for 8 weeks. Serum levels of SFRP5, omentin, visfatin, and also glycemic indices were evaluated at the baseline and end of the study. LC supplementation significantly decreased the serum level of visfatin (95% CI [?14.718, ?0.877], p = .05) and increased the serum levels of SFRP5 (95%CI [1.637, 11.380], p < .006) and omentin (95% CI [9.014, 65.286], p < .01). However, LC supplementation had no significant effects on the serum levels of glycemic factors such as insulin (95% CI [?1.125, 3.056], p = .426), fasting blood sugar (95% CI [?4.743, 3.642], p = .894), homeostatic model assessment of insulin resistance (95% CI [?0.305, 0.528], p = .729), and quantitative insulin‐sensitivity check index (95% CI [?0.016, ?0.010], p = .81). LC supplementation decreased visfatin serum level and increased omentin‐1 and SFRP5 serum levels in patients with PV. However, it has no significant effect on the serum levels of insulin and glycemic indices.     

Effects of artichoke leaf extract supplementation on metabolic parameters in women with metabolic syndrome: Influence of TCF7L2‐rs7903146 and FTO‐rs9939609 polymorphisms

The metabolic syndrome (MetS) is a multicomponent condition with a complex etiology involving genetic and environmental factors. Artichoke leaf extract (ALE) has shown favorable effects on lipid and glucose metabolism. The present study aimed to investigate the effects of ALE supplementation on metabolic parameters in women with MetS, using a nutrigenetics approach. In this double‐blind randomized clinical trial, 50 women (aged 20–50 years) with MetS were randomly allocated into the two groups: “ALE group” (received 1,800 mg hydroalcoholic extract of artichoke as four tablets per day) and “placebo group” (received placebo consisted of corn starch, lactose, and avicel as four tablets per day) for 12 weeks. The biochemical and anthropometric parameters were determined before and after the intervention. The FTO‐rs9939609 and the TCF7L2‐rs7903146 polymorphisms were genotyped by polymerase chain reaction‐restriction fragment length polymorphism. In carriers of A allele of the FTO‐rs9939609, ALE supplementation resulted in a statistically significant decrease in serum triglyceride level compared with placebo (?19.11% vs. 10.83%; p < .05), with no other significant differences between the two groups. The TCF7L2‐rs7903146 polymorphism showed no interaction with response to ALE (p > .05). These findings suggest that ALE supplementation may improve serum triglyceride level in A allele genotype of FTO‐rs9939609 polymorphism in women with MetS.     

A comparison between the effects of flaxseed oil and fish oil supplementation on cardiovascular health in type 2 diabetic patients with coronary heart disease: A randomized,double‐blinded,placebo‐controlled trial

This study compared the effects of flaxseed and fish oil supplementation on cardiovascular risk parameters in diabetic patients with coronary heart disease. Participants were randomly allocated into three intervention groups to receive either 1,000 mg of omega‐3 fatty acids from fish oil or 1,000 mg of omega‐3 fatty acids from flaxseed oil or placebo (n = 30 each group) twice a day for 12 weeks. A significant reduction in insulin levels (.04) was observed following flaxseed oil and fish oil supplementation compared with the placebo. In addition, a significant reduction in high‐sensitivity C‐reactive protein (.02) was seen after flaxseed oil supplementation compared with the placebo and a significant increase in total nitrite (.001) was seen after flaxseed oil and fish oil intake compared with placebo. Additionally, a significant increase in total antioxidant capacity (p < .001) after consuming flaxseed oil and fish oil compared with placebo and glutathione levels (.001) after consuming fish oil compared with flaxseed oil and placebo was observed. Overall, our study revealed the beneficial effects of flaxseed oil and fish oil supplementation on few metabolic profiles. This study suggests that the effect of flaxseed oil in reducing insulin and increasing total nitrite and total antioxidant capacity is similar to fish oil.     

The effects of lycopene supplement on the spermatogram and seminal oxidative stress in infertile men: A randomized,double‐blind,placebo‐controlled clinical trial

Infertility is a major, worldwide problem that is affected, and mediated, by several factors, in particular, oxidative stress. Thus, the aim of this study was to evaluate the effect of lycopene supplementation on spermatogram and seminal oxidative stress. In this randomized, double‐blind, placebo‐controlled trial study, 44 infertile men with oligozoospermia were randomly divided into two groups: The experimental group was supplemented with 25 mg of lycopene, and the control group received placebo for 12 weeks. Anthropometric, physical activity and dietary assessment, semen analysis, total antioxidant capacity (TAC), malondialdehyde, and glutathione peroxidase were measured pre‐ and post‐intervention. At the end of the study, there was a significant increase in total sperm count and concentration in the lycopene group, and the latter total count remained significant after adjustment (p < .05). Intragroup analysis showed a significant increase in ejaculate volume, total sperm count, concentration total motility, nonprogressive, and nonmotility in lycopene group (p < .05). The TAC changes, in both groups, remained significant after adjustment (p < .05). Also, within‐group analysis showed a significant increase in TAC levels (p < .05). Lycopene supplement can improve sperm parameters and oxidative stress biomarkers in oligozoospermia infertile men; however, further studies with larger sample size and duration are required.     

Flaxseed Supplementation in Metabolic Syndrome Management: A Pilot Randomized,Open‐labeled,Controlled Study

The aim of this study was to evaluate the efficacy of flaxseed supplementation plus lifestyle modification in comparison with lifestyle modification alone in the management of metabolic syndrome (MetS). A randomized controlled clinical trial was conducted on 44 patients with MetS. Participants were assigned to receive either the lifestyle advice and 30‐g brown milled flaxseed daily or only the lifestyle advice as the control group. The percentage of individuals with MetS decreased from baseline by 50% and 82% in the control and intervention group, respectively. The reversion rate of central obesity was higher in the flaxseed group (36%) than control group (13%). Moreover, greater reduction in insulin resistance was observed in flaxseed group in comparison with control group (p < 0.001). Body weight, waist circumference, and body mass index decreased significantly in both groups with a significantly greater reduction in flaxseed group in comparison with controls (p < 0.05). There were no significant changes in blood pressure in any groups. Our results indicate that co‐administration of flaxseed with lifestyle modification is more effective than lifestyle modification alone in management of MetS; whether these effects will be sustained with longer treatment durations remains to be determined. Copyright © 2016 John Wiley & Sons, Ltd.     

Blood pressure lowering and anti‐inflammatory effects of hesperidin in type 2 diabetes; a randomized double‐blind controlled clinical trial

Elevated levels of reactive oxygen species under diabetic condition lead to vascular complications and inflammation. This study aimed to examine the effects of hesperidin supplement on blood pressure and inflammatory markers in type 2 diabetes. In this research, 64 patients were randomly allocated to receive 500 mg/day hesperidin or placebo capsules for 6 weeks. Data on systolic blood pressure (SBP), diastolic blood pressure, serum total antioxidant capacity (TAC), tumor necrosis factor alpha, interleukin 6 (IL‐6), and high‐sensitivity C‐reactive protein (hs‐CRP) were collected at the baseline and at the end of the study. In the hesperidin group, SBP (122.7 ± 8.5 vs. 119.0 ± 7.4; p = .005), mean arterial blood pressure (94.2 ± 5.5 vs. 91.8 ± 5.5; p = .009), IL‐6 (8.3 ± 2.1 vs. 7.4 ± 1.8; p = .001), and hs‐CRP (1.9 ± 1.2 vs. 1.1 ± 0.9; p < .000) decreased whereas TAC increased (0.74 ± 0.1 vs. 0.82 ± 0.1; p < .000) in comparison to the baseline values. There was a significant difference in mean percent change of SBP, diastolic blood pressure, mean arterial blood pressure, serum TAC, and inflammatory markers (tumor necrosis factor alpha, IL‐6, and hs‐CRP) between hesperidin and control groups following intervention in adjusted models (p < .05). These results suggest that hesperidin may have antihypertensive and anti‐inflammatory effects in type 2 diabetes.     

Clinical and metabolic responses to crocin in patients under methadone maintenance treatment: A randomized clinical trial

Patients under methadone maintenance treatment (MMT) programs are susceptible to several complications including metabolic and clinical disorders. This study was designed to determine the effect of crocin supplementation on mental health parameters and metabolic profiles in subjects under MMT. The current randomized, double‐blind, placebo‐controlled, clinical trial was conducted among 53 patients under MMT to receive either 15 mg/day of crocin (n = 26) or placebo (n = 27) twice a day for 8 weeks. Crocin administration significantly decreased Beck Depression Inventory score (P = 0.01) and Beck Anxiety Inventory score (P = 0.008) compared with the placebo. In addition, crocin administration resulted in a significant reduction in fasting glucose (P = 0.003), insulin levels (P = 0.01), insulin resistance (P = 0.008), triglycerides (P = 0.001), very low‐density lipoprotein (P = 0.001), total cholesterol levels (P = 0.03), and a significant increase in insulin sensitivity (.003) compared with the placebo. Additionally, crocin intake was associated with a significant reduction in high‐sensitivity C‐reactive protein (p < .001) and malondialdehyde (P = 0.001) and a significant rise in total antioxidant capacity levels (P = 0.01) compared with the placebo. The findings of this clinical trial indicate that taking crocin for 8 weeks by patients under MMT had beneficial effects on their mental health and improved their metabolic profiles.     

Effect of turmeric on glycemic status,lipid profile,hs‐CRP,and total antioxidant capacity in hyperlipidemic type 2 diabetes mellitus patients

Diabetes mellitus is the most common metabolic disorder worldwide. This study examined the effect of turmeric supplementation on glycemic status, lipid profile, hs‐CRP and total antioxidant capacity in hyperlipidemic type 2 diabetic patients. In this double‐blind, randomized clinical trial, 80 hyperlipidemic type 2 diabetic patients were divided into turmeric (2,100 mg powdered rhizome of turmeric daily) and placebo groups for 8 weeks. Body weight, fasting plasma glucose, hemoglobin A1c (HbA1c), serum insulin, triglyceride (TG), total cholesterol, low density lypoprotein cholesterol (LDL‐c), high density lypoprotein cholesterol, apolipoprotein A1, apolipoprotein B, high sensitivity C‐reactive protein (hs‐CRP), and total antioxidant capacity were measured before and after intervention. Statistical analysis was carried out using paired and independent t and chi‐square tests. Seventy five patients completed the study. The turmeric group showed significant decreases in body weight, TG, and LDL‐c compared with baseline (p value < 0.05). Body mass index, TG, and total cholesterol decreased significantly in the turmeric group compared with the placebo group (p value < 0.05). No significant changes were observed in other parameters between the two groups after intervention (p value < 0.05). Turmeric improved some fractions of lipid profile and decreased body weight in hyperlipidemic patients with type 2 diabetes. It had no significant effect on glycemic status, hs‐CRP, and total antioxidant capacity in these patients.     

Hesperidin,a major flavonoid in orange juice,might not affect lipid profile and blood pressure: A systematic review and meta‐analysis of randomized controlled clinical trials

Previous studies have led to conflicting results regarding the effect of hesperidin supplementation on cardiometabolic markers. This study aimed to evaluate the efficacy of hesperidin supplementation on lipid profile and blood pressure through a systematic review and meta‐analysis of randomized controlled trials (RCTs). PubMed, Web of Science, Scopus, and Google Scholar, as well as the reference lists of the identified relevant RCTs, were searched up to May 2018. Effect sizes were pooled by using the random effects model. Ten RCTs (577 participants) were eligible to be included in the systematic review. The meta‐analysis revealed that hesperidin supplementation had no effect on serum total cholesterol (weighted mean difference [WMD] = ?1.04 mg/dl; 95% confidence interval [CI]: ?5.65, 3.57), low‐density lipoprotein cholesterol (WMD = ?1.96 mg/dl; 95% CI [?7.56, 3.64]), high‐density lipoprotein cholesterol (WMD = 0.16 mg/dl; 95% CI [?1.94, 2.28]), and triglyceride (WMD = 0.69 mg/dl; 95% CI [?5.91, 7.30]), with no significant between‐study heterogeneity. Hesperidin supplement also had no effect on systolic (WMD = ?0.85 mmHg; 95% CI [?3.07, 1.36]) and diastolic blood pressure (WMD = ?0.48 mmHg; 95% CI [?2.39, 1.42]). Hesperidin supplementation might not improve lipid profile and blood pressure. Future well‐designed trials are still needed to confirm these results.     

Effects of ginseng supplementation on selected markers of inflammation: A systematic review and meta‐analysis

The present meta‐analysis was performed to evaluate the efficacy of ginseng administration on serum level of inflammatory biomarkers. We performed a systematic search of all available randomized controlled trials (RCTs) conducted up to June 2018 in the following electronic databases: PubMed, Scopus, Cochrane, and Google Scholar. RCTs that investigated the effect ginseng supplementation on high‐sensitivity C‐reactive protein (hs‐CRP), tumor necrosis factor‐α (TNF‐α), and interleukin‐6 (IL‐6) were included for final analysis. A total of seven RCTs were included in the meta‐analysis. Results indicated significant reduction in IL‐6 (mean difference [MD]: ?0.265 pg/ml, 95% CI [?0.396, ?0.135], p < .001) and TNF‐α (MD: ?2.471 pg/ml, 95% CI [?2.904, ?2.039], p < .001) and no significant change in hs‐CRP (MD: ?0.125 mg/L, 95% CI [?0.597, 0.347], p = .604). Although there was publication bias across studies, trim and fill analysis showed that results from unpublished studies could not change the results for CRP. However, removing one study in sensitivity analysis did reveal a significant reduction in CRP. We conclude that ginseng supplementation significantly lowered IL‐6 and TNF‐α but did not significantly lower CRP. However, these findings were not robust, because they showed sensitivity for CRP and IL‐6, and future long‐term well‐designed dose‐escalating trials are required.     

Metabolic effect of berberine–silymarin association: A meta‐analysis of randomized,double‐blind,placebo‐controlled clinical trials

The aim of this study is to assess the impact of a combination of berberine and silymarin on serum lipids and fasting plasma glucose (FPG) through a systematic review of literature and meta‐analysis of the available randomized, double‐blind, placebo‐controlled clinical trials (RCTs). A systematic literature search in SCOPUS, PubMed‐Medline, ISI Web of Science, and Google Scholar databases was conducted up to October 2, 2018, in order to identify RCTs assessing changes in plasma concentrations of total cholesterol (TC), triglycerides (TG), high‐density lipoprotein cholesterol (HDL‐C), low‐density lipoprotein cholesterol (LDL‐C) and FPG during treatment with berberine and silymarin in combination. Two review authors independently extracted data on study characteristics, methods, and outcomes. Quantitative data synthesis was performed using a random‐effects model. We identified five eligible RCTs, with 497 subjects overall included. Berberine and silymarin combination treatment exerted a positive effect on TC (mean difference [MD]: ?25.3, 95% CI [?39.2, ?11.4] mg/dl; p < 0.001), TG (MD: ?28, 95% CI [?35.3, ?20.6] mg/dl; p < 0.001), HDL‐C [MD: 6, 95% CI [3.2, 8.8] mg/dl; p < 0.001), LDL‐C (MD: ?29.1, 95% CI [?39.7, ?18.6] mg/dl; p < 0.001), and FPG (MD: ?7.5, 95% CI [?13, ?1.9] mg/dl; p = 0.008). The present findings suggest that the coadministration of berberine and silymarin is associated with an advantageous improvement in lipid and glucose profile, suggesting the possible use of this nutraceutical combination in order to promote the cardiometabolic health.     

Metabolic benefits of curcumin supplementation in patients with metabolic syndrome: A systematic review and meta‐analysis of randomized controlled trials

The finding of studies on the effect of curcumin extract on metabolic factor in patients with metabolic syndrome has had arguable results. This systematic review with meta‐analysis of randomized controlled trials (RCT) aimed to analyze the effect of curcumin/turmeric on metabolic factors in patients with metabolic syndrome. The PICO strategy was used to establish the guiding question of this review. Several databases for RCT were searched until September 2018. Of the 144 articles initially identified, seven trials met the eligibility criteria. A random‐effects model with a mean weight difference (WMD) and a 95% confidence interval was performed for quantitative data synthesis. Pooled estimates of WMD were calculated between intervention and control groups using random‐effects model in the presence of high level of heterogeneity between the studies. The results showed significant improvement of fasting blood glucose (p = 0.01), triglycerides (p < 0.001), high‐density lipoprotein cholesterol (p = 0.003), and diastolic blood pressure (p = 0.007) levels. Curcumin was not associated with a significant change in waist circumference measurement (p = 0.6) and systolic blood pressure level (p = 0.269). Curcumin supplementation improves some components of metabolic syndrome.