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

Spirulina versus metformin for controlling some insulin signaling pathway genes in induced polycystic ovary syndrome rat model

Polycystic ovary syndrome (PCOS) is a prevalent endocrinologic and gynecologic disorder that affects women of reproductive age; besides, insulin resistance (IR) occurs in 50-70 % of PCOS cases. Metformin (Met) is commonly prescribed for IR management; however, it does not affect IR with some gastrointestinal symptoms. Spirulina platensis (SP) is a blue-green alga that may increase insulin sensitivity. Therefore, our study aims to evaluate SP as an alternative treatment to Met for improving glucose homeostasis by assessing the expression of 11 crucial genes involved in the insulin signaling pathway. After induction of the PCOS model using dehydroepiandrosterone (DHEA) (60 mg/kg bwt) for 30 consecutive days, rats were allocated into six groups. Relative liver weight, glutamic pyruvic transaminase (GPT) serum levels, glutamic-oxaloacetic transaminase (GOT), and insulin were determined. Furthermore, the gene expression of Ins1, Irs1, Pik3ca, Prkcz, Foxo1, Srebf1, Ppargc1a, Pklr, Gk, G6pc, and Pepck in the rat's liver tissue was determined using qRT-PCR. Treatment of the PCOS control group with Met or SP revealed a decrease in all these parameters compared with the PCOS model. Additionally, we found a statistically significant difference in the expression of both the Gk and Prkcz genes. To summarize our study results, SP or Met supplementation to PCOS rats had almost the same effect on assessed relative liver weight, GOT, GPT, and insulin levels compared with PCOS control rats. If further studies confirm and detect more impact of SP on IR in PCOS, SP could be used instead of Met since the latter causes many side effects.

Anti-Glycation Properties of Zinc-Enriched Arthrospira platensis (Spirulina) Contribute to Prevention of Metaflammation in a Diet-Induced Obese Mouse Model

Advanced glycation end products (AGEs) exert a key pathogenic role in the development of obesity and insulin resistance. Thanks to its abundance in bioactive compounds, the microalga Arthrospira platensis (spirulina, SP) is proposed as a nutritional supplement. Here, we investigated the potential anti-glycating properties of SP enriched with zinc (Zn-SP) and the following impact on diet-induced metabolic derangements. Thirty male C57Bl6 mice were fed a standard diet (SD) or a high-fat high-sugar diet (HFHS) for 12 weeks, and a subgroup of HFHS mice received 350 mg/kg Zn-SP three times a week. A HFHS diet induced obesity and glucose intolerance and increased plasma levels of pro-inflammatory cytokines and transaminases. Zn-SP administration restored glucose homeostasis and reduced hepatic dysfunction and systemic inflammation. In the liver of HFHS mice, a robust accumulation of AGEs was detected, paralleled by increased expression of the main AGE receptor (RAGE) and depletion of glyoxalase-1, whereas Zn-SP administration efficiently prevented these alterations reducing local pro-inflammatory responses. 16S rRNA gene profiling of feces and ileum content revealed altered bacterial community structure in HFHS mice compared to both SD and HFHS + Zn-SP groups. Overall, our study demonstrates relevant anti-glycation properties of Zn-SP which contribute to preventing AGE production and/or stimulate AGE detoxification, leading to the improvement of diet-related dysbiosis and metabolic derangements.

The effect of spirulina sauce on glycemic index, lipid profile, and oxidative stress in type 2 diabetic patients: A randomized double-blind clinical trial

We aimed to evaluate the effect of spirulina sauce on glycemic indices, lipid profile, oxidative stress markers, and anthropometric measurement in type 2 diabetic patients. Forty patients were randomly assigned to receive 20 g/day spirulina sauce (containing 2 g of spirulina) or placebo for 2 months. Anthropometric and biochemical indices were measured at the beginning and end of the intervention. Fasting blood glucose (mean difference (MD): -15.3 mg/dL, 95% confidence (CI): -44.2 to 13.60, p = .26), HbA1c (MD: 0.13%, 95% CI: -0.83 to 0.57, p = .75), insulin (MD: -1.46 μIU/mL, 95% CI: -4.0 to 1.09, p = .28), and HOMA-IR (MD: -0.35, 95% CI: -2.0 to 1.32, p = .68) did not change significantly between groups. QUICKI increased significantly (MD: 0.025, 95% CI: 0.006 to 0.045, p = .03). Among the lipid profile, triglyceride (TG) (MD: -68.6 mg/dL, 95% CI: -107.21 to -29.98, p < .001), total cholesterol (MD: -29.55 mg/dL, 95% CI: -55.28 to -3.81, p = .02), and LDL (MD: -17.7 mg/dL, 95% CI: -33.24 to -2.15, p = .01) were significantly decreased in the spirulina group compared to the control; whereas, the change in HDL was non-significant. No significant change was observed in body composition and anthropometric measurements, except waist circumference, which was reduced (MD: -2.65 cm, 95% CI: -3.91 to -1.38, p = .001). Hunger index significantly decreased and fullness increased marginally significantly. Although malondialdehyde was significantly reduced, no change was observed in total antioxidant capacity (TAC). Spirulina sauce was not effective for glycemic control in type 2 diabetes; however, could be useful for controlling appetite and ameliorating lipid profile.

C-Phycocyanin: A Phycobiliprotein from Spirulina with Metabolic Syndrome and Oxidative Stress Effects

Spirulina maxima is a cyanobacterium considered a "superfood" due to its metabolites and nutrient content. These include a complex mixture of minerals, vitamins, fatty acids, proteins, and accessory pigments. In recent years, it has positioned itself as a promising source of bioactive molecules for the treatment of several diseases, including metabolic syndrome, coronary diseases, cancer, and the improvement of health modulating oxidative stress. C-Phycocyanin (C-PC) is a photosynthetic pigment from green-blue cyanobacterium and the most abundant phycobiliprotein in the Spirulina genus with various pharmacological properties attributed due to its antioxidant capacity but has no specific cellular target. This has made it a molecule of great interest in biomedical research. This review focuses on the pharmacological effects and the benefits on metabolic syndrome and oxidative stress of C-PC.

A Review of the Health-Promoting Properties of Spirulina with a Focus on athletes' Performance and Recovery

Spirulina species are photosynthetic and filamentous bacteria, commonly called 'blue-green microalgae'. Spirulina has a high nutrient content. It contains 60-70% protein with all essential amino acids present, and is rich in several vitamins, minerals, and bioactive compounds. Spirulina is also rich in essential fatty acids, and antioxidants. This rich nutritional content provides to Spirulina several health benefits including antioxidant, anti-inflammatory, immunomodulation, and insulin-sensitizing properties as well as positive effects in various diseases which could be also interesting for athletes. This paper mainly aims to review the interest and effects of Spirulina supplementation in athletes at rest, and in relation to exercise/training. Spirulina's biochemical composition, health properties/effects in humans, and effects in athletes including nutritional status, body composition, physical performance and intense exercise-related disorders were discussed in this review. Literature data showed that Spirulina seems to have positive effects on body composition especially in overweight and obese subjects which could not be the case in other pathologies and athletes. Spirulina appears to be also effective in improving aerobic fitness especially in untrained and moderately trained subjects. Results reported in the literature suggest that Spirulina may improve strength and power performance despite the minor or no significant effects in highly trained subjects. Most studies have shown that Spirulina improves antioxidant status, prevents and accelerates the recovery of exercise-induced lipid peroxidation, muscle damage and inflammation in trained and untrained subjects. Taken together, the results from these studies are encouraging and may demonstrate the potential benefits of Spirulina supplementation in athletes despite methodological differences.

Oral Palatability and Owners' Perception of the Effect of Increasing Amounts of Spirulina (Arthrospira platensis) in the Diet of a Cohort of Healthy Dogs and Cats

The nutraceutical supplementation of Spirulina (Arthrospira platensis) in dogs and cats has not yet been investigated. The aim of this study was to evaluate if the dietary supplementation of increasing amounts of Spirulina for 6 weeks is palatable to pets and to assess the owner's perception of such supplementation. The owners of the 60 dogs and 30 cats that participated in this study were instructed to daily provide Spirulina tablets starting with a daily amount of 0.4 g, 0.8 g, and 1.2 g for cats as well as small dogs, medium dogs, and large dogs, respectively, and allowing a dose escalation of 2× and 3× every 2 weeks. The daily amount (g/kg BW) of Spirulina ranged from 0.08 to 0.25 for cats, from 0.06 to 0.19 for small-sized dogs, from 0.05 to 0.15 for medium-sized dogs, and from 0.04 to 0.12 for large-sized dogs. Each owner completed a questionnaire at the time of recruitment and the end of each 2-week period. No significant effect on the fecal score, defecation frequency, vomiting, scratching, lacrimation, general health status, and behavioral attitudes was detected by the owners' reported evaluations. Most animals accepted Spirulina tablets either administrated alone or mixed with food in the bowl. Daily supplementation of Spirulina for 6 weeks in the amounts provided in this study is therefore palatable and well tolerated by dogs and cats.

The effects of spirulina intake on clinical and metabolic parameters in Alzheimer's disease: A randomized, double-blind, controlled trial

The current study aimed to determine the effects of spirulina intake on cognitive function and metabolic status among patients with Alzheimer's disease (AD). This randomized, double-blind, controlled clinical trial was done among 60 subjects with AD. Patients were randomly assigned to receive either 500 mg/day spirulina or a placebo (each n = 30) twice a day for 12 weeks. Mini-mental state examination score (MMSE) was recorded in all patients before and after intervention. Blood samples were obtained at baseline and after 12 weeks' intervention to determine metabolic markers. Compared with placebo, spirulina intake resulted in a significant improvement in MMSE score (spirulina group: +0.30 ± 0.99 vs. Placebo group: -0.38 ± 1.06, respectively, p = 0.01). In addition, spirulina intake decreased high-sensitivity C-reactive protein (hs-CRP) (spirulina group: -0.17 ± 0.29 vs. Placebo group: +0.05 ± 0.27 mg/L, p = 0.006), fasting glucose (spirulina group: -4.56 ± 7.93 vs. Placebo group: +0.80 ± 2.95 mg/dL, p = 0.002), insulin (spirulina group: -0.37 ± 0.62 vs. Placebo group: +0.12 ± 0.40 μIU/mL, p = 0.001) and insulin resistance (spirulina group: -0.08 ± 0.13 vs. Placebo group: 0.03 ± 0.08, p = 0.001), and increased insulin sensitivity (spirulina group: +0.003 ± 0.005 vs. Placebo group: -0.001 ± 0.003, p = 0.003) compared with the placebo. Overall, our study showed that spirulina intake for 12 weeks in patients with AD improved cognitive function, glucose homeostasis parameters, and hs-CRP levels.

Short-Term Effects of Spirulina Consumption on Glycemic Responses and Blood Pressure in Healthy Young Adults: Results from Two Randomized Clinical Trials

The effects of spirulina consumption added in foods were investigated in two crossover clinical trials (n = 13 different healthy adults). In Trial-1 adults consumed cookies with-and-without spirulina (3.12 g per 100 g final product; 2.5 g spirulina per 50 g available carbohydrates) according to glycemic index (GI) methodology. In Trial-2, adults consumed 4 g, 6 g, and 8 g spirulina as beverage diluted in 50 g D-glucose vs. 50 g plain D-glucose. Capillary blood glucose samples were collected at 0, 15, 30, 45, 60, 90, and 120 min and blood pressure (BP) was measured at beginning and end of each visit in both trials. Trial-1: both cookies with and without spirulina provided medium GI values (59 and 60, respectively, on glucose-scale), but no significant differences were found for BP. Trial-2: both 4 g and 8 g spirulina lowered postprandial glucose at 120 min (95% CI: -1.64 to -16.12 and -1.23 to -15.87, respectively). The results explained 29% of variation. Only 8 g spirulina decreased significantly 90-120 min area under the curve (AUC) for glucose and systolic BP (-4%). No differences were found for fasting glucose. Adding spirulina to cookies did not affect glucose responses and BP. Only 8 g provided significantly lower 90-120 min-AUC for glucose and BP compared to 4 g, 6 g-and-D-glucose, indicating advantages to glycemic control and hypertension.

Nutraceutical Prevention of Diabetic Complications—Focus on Dicarbonyl and Oxidative Stress

Oxidative and dicarbonyl stress, driven by excess accumulation of glycolytic intermediates in cells that are highly permeable to glucose in the absence of effective insulin activity, appear to be the chief mediators of the complications of diabetes. The most pathogenically significant dicarbonyl stress reflects spontaneous dephosphorylation of glycolytic triose phosphates, giving rise to highly reactive methylglyoxal. This compound can be converted to harmless lactate by the sequential activity of glyoxalase I and II, employing glutathione as a catalyst. The transcription of glyoxalase I, rate-limiting for this process, is promoted by Nrf2, which can be activated by nutraceutical phase 2 inducers such as lipoic acid and sulforaphane. In cells exposed to hyperglycemia, glycine somehow up-regulates Nrf2 activity. Zinc can likewise promote glyoxalase I transcription, via activation of the metal-responsive transcription factor (MTF) that binds to the glyoxalase promoter. Induction of glyoxalase I and metallothionein may explain the protective impact of zinc in rodent models of diabetic complications. With respect to the contribution of oxidative stress to diabetic complications, promoters of mitophagy and mitochondrial biogenesis, UCP2 inducers, inhibitors of NAPDH oxidase, recouplers of eNOS, glutathione precursors, membrane oxidant scavengers, Nrf2 activators, and correction of diabetic thiamine deficiency should help to quell this.

The effects of berberine on inflammatory markers in Chinese patients with metabolic syndrome and related disorders: a meta‑analysis of randomized controlled trials

Background

A meta-analysis of randomized controlled trials (RCTs) was conducted to systematically evaluate the effects of berberine on the inflammatory markers of metabolic syndrome (MetS) and related disorders.

Method

Databases that were searched from inception to October 2020 included PubMed, Web of Science, the Cochrane Library, CNKI, VIP, WanFang Data, and ClinicalTrials.gov. Two reviewers independently selected articles and extracted data. The pooled evaluations were entered and analyzed in Review Manager 5.3.

Results

Of the 7387 publications screened, 52 studies were included, and the related trials involved 4616 patients. Pooled estimates showed that the use of berberine could significantly reduce the concentration level of C-reactive protein (CRP) [standardized mean difference (SMD) = − 1.54, 95% confidence intervals (CI) − 1.86, − 1.22, p < 0.05], tumor necrosis factor-α (TNF-α) [SMD = − 1.02, 95% CI − 1.27, − 0.77, p < 0.05], and interleukin 6 (IL-6) [SMD = − 1.17, 95% CI − 1.53, − 0.81, p < 0.05] among patients with MetS and related disorders. However, it did not affect the level of interleukin 1β (IL-1β) [SMD = − 0.81, 95% CI − 1.80, 0.17, p = 0.11].

Conclusion

Overall, the use of berberine in patients with MetS and related disorders appeared to significantly decrease several inflammatory markers. Further multi-center and rigorous investigations with larger patient populations are encouraged to confirm the effect of berberine on MetS and related disorders.

Efficacy of spirulina in management of oral submucous fibrosis − a systematic review

Objective: The aim of this systematic review was to evaluate the efficacy of spirulina in the management of oral submucous fibrosis. Methodology: Databases (MEDLINE via PubMed, Cochrane, EBSCO-host, Scopus, Science Direct, Clinical Trial Registry- India (CTRI) and Google scholar), review articles, bibliographies and related journal were searched from 1st January 2010 to 30th May 2020, using various combinations of MeSH terms and keywords. Results: A total of 5 clinical trials were analysed for the review, of which 4 were randomized controlled trials and 1 was non-randomized controlled trial. Mouth opening and burning sensation were analysed as primary outcome in all 5 studies. For both outcomes some studies reported statistically significant difference whereas others showed non-significant results on comparing with different interventions. Also, high risk of bias was observed among studies after performing quality analysis. Conclusion: Although the studies suggest efficacy of spirulina in management of OSF, but due to the high risk of bias there is a weak evidence regarding the effectiveness of spirulina in treating OSF. So, more uniform and standard trials on larger population should be carried out.

Maintaining Effective Beta Cell Function in the Face of Metabolic Syndrome-Associated Glucolipotoxicity-Nutraceutical Options

In people with metabolic syndrome, episodic exposure of pancreatic beta cells to elevated levels of both glucose and free fatty acids (FFAs)-or glucolipotoxicity-can induce a loss of glucose-stimulated insulin secretion (GSIS). This in turn can lead to a chronic state of glucolipotoxicity and a sustained loss of GSIS, ushering in type 2 diabetes. Loss of GSIS reflects a decline in beta cell glucokinase (GK) expression associated with decreased nuclear levels of the pancreatic and duodenal homeobox 1 (PDX1) factor that drives its transcription, along with that of Glut2 and insulin. Glucolipotoxicity-induced production of reactive oxygen species (ROS), stemming from both mitochondria and the NOX2 isoform of NADPH oxidase, drives an increase in c-Jun N-terminal kinase (JNK) activity that promotes nuclear export of PDX1, and impairs autocrine insulin signaling; the latter effect decreases PDX1 expression at the transcriptional level and up-regulates beta cell apoptosis. Conversely, the incretin hormone glucagon-like peptide-1 (GLP-1) promotes nuclear import of PDX1 via cAMP signaling. Nutraceuticals that quell an increase in beta cell ROS production, that amplify or mimic autocrine insulin signaling, or that boost GLP-1 production, should help to maintain GSIS and suppress beta cell apoptosis in the face of glucolipotoxicity, postponing or preventing onset of type 2 diabetes. Nutraceuticals with potential in this regard include the following: phycocyanobilin-an inhibitor of NOX2; agents promoting mitophagy and mitochondrial biogenesis, such as ferulic acid, lipoic acid, melatonin, berberine, and astaxanthin; myo-inositol and high-dose biotin, which promote phosphatidylinositol 3-kinase (PI3K)/Akt activation; and prebiotics/probiotics capable of boosting GLP-1 secretion. Complex supplements or functional foods providing a selection of these agents might be useful for diabetes prevention.

The effects of spirulina (Arthrospira platensis) supplementation on anthropometric indices, blood pressure, sleep quality, mental health, fatigue status and quality of life in patients with ulcerative colitis: A randomised, double-blinded, placebo-controlled trial

BACKGROUND

An emerging body of evidence has highlighted the protective role of spirulina in human health. Thus, we conducted a randomised controlled trial to discern the effects of spirulina supplementation on anthropometric indices, blood pressure, sleep quality, mood, fatigue status and quality of life among ulcerative colitis patients.

METHODS

Eighty participants with ulcerative colitis were randomly allocated to receive, either, 1 g/day (two 500 mg capsules) spirulina (n = 40) or placebo (n = 40), in a clinical trial for eight weeks. Dietary intake, physical activity, sleep quality, mental health, fatigue status and quality of life were assessed for each participant at baseline and trial cessation. Anthropometric indices and blood pressure were also assessed.

RESULTS

Seventy-three participants completed the intervention. Our results revealed that spirulina supplementation significantly reduced sleep disturbances (P = .03), while no significant changes occurred in the sleep quality score or other sleep parameters, vs the placebo group (P > .05). Furthermore, a significant reduction in stress score (P = .04) and increase in quality of life (P = .03) was detected; but not anxiety, depression or fatigue scores (P > .05). Additionally, anthropometric indices and blood pressure did not significantly change (P > .05).

CONCLUSION

An improved quality of life was observed among ulcerative colitis patients following spirulina supplementation, which could be attributed to improved sleep disturbance and stress status. Further clinical studies, with longer duration interventions and suitably powered sample sizes, are necessary to elucidate the veracity of our findings.

Effect of Arthrospira powders from different producers on the formation of endothelial cell monolayers

Arthrospira platensis (AP) and some of its derived products have well-established biological activities as antioxidants or as agents to reduce cardiovascular disease risk factors. Furthermore, AP products have gained increasing importance as potential anti-cancer agents. However, the ingredients of the available products vary greatly with the origin, the type of production and processing, which could have significant consequences for their biological effects. Therefore, the composition and biological influence of five distinct AP powders, which were acquired commercially or produced at a public biotechnology institute, were investigated in regard to their endothelialization capacity using a cell impedance- (CI) based measurement method. The study revealed that the AP composition and especially the influence on HUVEC proliferation differed significantly between the five AP powders up to 109%.Thus, it could be shown that the method used allows the reliable detection of quantitative differences in biological effects of different AP preparations.

Effect of Microalgae Arthrospira on Biomarkers of Glycemic Control and Glucose Metabolism: A Systematic Review and Meta-analysis

Diabetes mellitus and insulin resistance are associated with an increased risk of cardiovascular disease (CVD) incidence and a higher rate of CVD-related death. In this study, the effects of Arthrospira (Spirulina) a blue-green algae supplementation on biomarkers of glycemic control and glucose metabolism has been evaluated. PubMed, Scopus, and ISI Web of Science were searched systematically of English human subjects and PubMed for pre-clinical animal studies (rats and mice) from January 2008 until November 2020. The pooled weighted mean difference (MD) and its 95% confidence interval (CI) were calculated and pooled using a random-effect model. Seven clinical and 27 preclinical studies were included. Pooled results of the clinical studies showed that Arthrospira supplementation significantly reduced the fasting blood sugar (FBS): (0.63- 2.90-) 1.77-, total cholesterol (TC): (0.46- ، 4.61-) 2.54-, triglycerides (TG): (0.89- ، 6.54-) 3.71- and increased the high-density lipoprotein cholesterol (HDL-C): (3.86 ، 0.67) 2.27; however, Arthrospira was not significantly effective in terms of reducing the glycated hemoglobin A1c (HbA1C): (1.04 ، 2.23-) 0.59- and low-density lipoprotein cholesterol (LDL-C). Pooled results of preclinical studies showed that Arthrospira supplementation reduced FBS [-10.31 (-12.49, -8.13)] and HbA1C [-5.12 (-8.06, -2.19)] significantly in diabetic animals. Sub-group analysis of clinical studies showed that intervention duration less than 2 months [-2.52 (-4.37, -0.67)] and the dose less than 2 gram [-3.22 (-5.67, -0.76)] showed significant improvement in terms of reducing the FBS in humans. It can be concluded that Arthrospira can be considered as an effective FBS, TG, TC, and HDL-C adjusting nutraceutical agent for diabetes mellitus. Due to the differences in the results of clinical and animal studies in terms of HbA1c, more studies are needed for a definitive conclusion.

Spirulina liquid extract prevents metabolic disturbances and improves liver sphingolipids profile in hamster fed a high-fat diet

PURPOSE

Metabolic syndrome is characterized by hyperglycemia, hyperlipemia and exacerbated oxidative stress. The aim of the study was to determine whether Spirulysat^®, a Spirulina liquid extract (SLE) enriched in phycocyanin, would prevent metabolic abnormalities induced by high-fat diet.

METHODS

The effect of acute SLE supplementation on postprandial lipemia and on triton-induced hyperlipidemia was studied in hamster fed control diet (C). The effect of chronic SLE supplementation on lipid content in plasma, liver and aorta, and on glycemia and oxidative stress was studied in hamster fed control (C) or high-fat diet (HF) for two weeks and then treated with SLE for two weeks (CSp and HFSp) or not (C and HF).

RESULTS

The acute SLE supplementation lowered plasma cholesterol and non-esterified fatty acid concentrations after olive oil gavage (P < 0.05) in CSp, while no effect was observed on triglyceridemia. HFD increased plasma MDA, basal glycemia, triglyceridemia, total plasma cholesterol, VLDL, LDL and HDL cholesterol, ceramide, sphingomyelin and glucosylceramide content in liver in HF compared to C (P < 0.05). SLE did not affect SOD and GPx activities nor total antioxidant status in HFSp group but lowered glycemia, glucoceramide and cholesterol in liver and cholesterol in aorta compared to HF (P < 0.05). SLE also decreased HMGCoA and TGF-β1 gene expression in liver (P < 0.05) and tended to lower G6Pase (P = 0.068) gene expression in HFSp compared to HF.

CONCLUSION

Although 2-week SLE supplementation did not affect oxidative stress, it protected from hyperglycemia and lipid accumulation in liver and aorta suggesting a protective effect against metabolic syndrome.

Phytonutrient supplements and metabolic biomarkers of cardiovascular disease: An umbrella review of meta-analyses of clinical trials

Phytonutrients exert several pharmacological effects on humans. In this study, we performed an umbrella review of the association of phytonutrient supplements (PNSs) with biomarkers of cardiovascular disease. Relevant published systematic reviews and meta-analyses of clinical trials were identified by searching PubMed, Embase, and Cochrane Library until July 4, 2020. Weighted mean differences (WMDs) and 95% confidence intervals (CIs) for summarized effects and I² statistics of heterogeneity were extracted from individual studies or reanalyzed using a random-effects model. Of the 50 included studies, pooled effects of PNSs on blood pressure, lipid profiles, and glycemic control were reported in 16, 25, and 14 articles, respectively. The findings appeared to be highly heterogeneous among individual trials of included systematic reviews and meta-analyses. Ginger (WMD = -6.36 mmHg, 95% CI = -11.27, -1.46) and Hibiscus sabdariffa (WMD = -7.58 mmHg, 95% CI = -9.69, -5.46) were associated with lowered systolic blood pressure, whereas Aloe vera, Nigella sativa, and spirulina were associated with beneficial effects on both lipid profiles and glycemic control. In summary, this umbrella review has provided up-to-date evidence for the effect of PNSs on biomarkers related to hypertension, dyslipidemia, and diabetes. The results must be interpreted with caution due to potential heterogeneity.

A Novel Promising Frontier for Human Health: The Beneficial Effects of Nutraceuticals in Cardiovascular Diseases

Cardiovascular diseases (CVDs) such as hypertension, atherosclerosis, myocardial infarction, and diabetes are a significant public health problem worldwide. Although several novel pharmacological treatments to reduce the progression of CVDs have been discovered during the last 20 years, the better way to contain the onset of CVDs remains prevention. In this regard, nutraceuticals seem to own a great potential in maintaining human health, exerting important protective cardiovascular effects. In the last years, there has been increased focus on identifying natural compounds with cardiovascular health-promoting effects and also to characterize the molecular mechanisms involved. Although many review articles have focused on the individual natural compound impact on cardiovascular diseases, the aim of this manuscript was to examine the role of the most studied nutraceuticals, such as resveratrol, cocoa, quercetin, curcumin, brassica, berberine and Spirulina platensis, on different CVDs.

Spirulina for the food and functional food industries

Humans are no strangers to the consumption of microalgae as already in the sixteenth century Spirulina was harvested from Lake Texcoco and consumed in markets in Tenochtitlan (today Mexico City). Nowadays, microalgae are being incorporated into many food formulations. Most of these use microalgae as a marketing strategy or as a colouring agent. However, Spirulina (and compounds derived thereof) show potential for being used as ingredients in the development of novel functional foods, which are one of the top trends in the food industry. Several human intervention studies demonstrated the potential of Spirulina for being used in the prevention or treatment of disorders related to metabolic syndrome. The aim of the current paper was to review current and potential applications of this microalga in the food and functional food industries. Health benefits associated with consuming Spirulina and/or some of the most important compounds derived from Spirulina were also discussed.

A Critical Review on the Role of Food and Nutrition in the Energy Balance

The mass media has increasingly frequently suggested to the general population that specific foods or nutritional schemes are able to affect both human metabolism and energy expenditure, thus facilitating weight loss. This critical review is aimed at assessing available evidence on the roles of nutrients, food and dietary regimens in energy intake and energy expenditure. We queried the National Library of Medicine, the Cochrane Library, Excerpta Medica dataBASEand the Cumulative Index to Nursing and Allied Health Literature database, and a search strategy was performed by using database-specific subject headings and keywords. We found that available scientific evidence on these topics is scarce, and that the limited number of available studies often have poor methodological quality. Only a few foods show beneficial effects on metabolism and energy expenditure, as the human energy balance is complex and multifactorial. Finally, microbiota may interfere with the intake, use and expenditure of energy in the human body. Conclusive evidence is still lacking, and, at present, it is not possible to identify a food or a diet with a significant impact on human energy expenditure.