A randomized, double-blind placebo-controlled add-on trial to assess the efficacy, safety, and anti-atherogenic effect of spirulina platensis in patients with inadequately controlled type 2 diabetes mellitus

Shedding light on the impacts of Spirulina platensis on gut microbiota and related health benefits

Spirulina (S.) platensis is a blue-green algae with reported nutritional and health-promoting properties, such as immunomodulating, antioxidant, cholesterol-lowering properties, and beneficial effects on inflammatory diseases. Spirulina platensis can improve the function and composition of the gut microbiota and exert systemic beneficial effects. Gut dysbiosis is characterized by an imbalance in the composition and function of gut microbiota and is associated with several diseases. Some dietary bioactive compounds can restore the composition, diversity, and function of the gut microbiota and improve health-related parameters. This review proposes to gather relevant information on the effects of S. platensis supplementation on the modulation of the function and composition of gut microbiota and local and systemic measures related to gut health, such as inflammation, oxidative stress, and glucose and lipid metabolism. The body of evidence conducted with animals and clinical studies shows that S. platensis supplementation increased gut microbiota diversity and improved gut microbiota composition, as reported by a decrease in the Firmicutes/Bacteroides ratio, increase in the relative abundance of Prevotella and Lactobacillaceae, increase in short-chain fatty acid production and decrease of gut permeability. Improvements in gut microbiota have been associated with host health benefits such as anti-obesity, anti-diabetic, anti-hypertensive, anti-lipemic, anti-inflammatory, and antioxidant effects.

Beneficial Effects of Spirulina Supplementation in the Management of Cardiovascular Diseases

In recent decades, as a result of rising mortality rates due to cardiovascular diseases (CVDs), there has been a growing urgency to find alternative approaches to conventional pharmaceutical treatment to prevent the onset of chronic diseases. Arthrospira platensis, commonly known as Spirulina, is a blue-green cyanobacterium, classified as a "superfood", used worldwide as a nutraceutical food supplement due to its remarkable nutritional value, lack of toxicity, and therapeutic effects. Several scientific studies have evaluated the cardioprotective role of Spirulina. This article presents a comprehensive review of the therapeutic benefits of Spirulina in improving cardio- and cerebrovascular health. It focuses on the latest experimental and clinical findings to evaluate its antihypertensive, antidiabetic, and antihyperlipidemic properties. The objective is to highlight its potential in preventing and managing risk factors associated with cardiovascular disease (CVD).

The Effects of Spirulina Supplementation on Cardiometabolic Risk Factors: A Narrative Review

Spirulina (Arthrospira platensis) is a cyanobacterium associated with multiple health benefits. Cardiometabolic diseases such as cardiovascular disease, nonalcoholic fatty liver disease, and diabetes are prevalent yet usually preventable non-communicable diseases. Modifiable risk factors for cardiometabolic diseases include excessive body weight, body inflammation, atherogenic lipid profile, and imbalanced glucose metabolism. This review explores the effects of spirulina on cardiometabolic diseases risk factors. Spirulina was effective in reducing body weight, body mass index, and waist circumference, with a potential dose-dependent effect. It also decreased interleukin 6, an important biomarker of body inflammation, by inhibiting NADPH oxidase enzyme, and lowering insulin resistance. spirulina supplementation also reduced triglycerides, low-density lipoprotein cholesterol, and increased high-density lipoprotein cholesterol. Additionally, spirulina reduced fasting blood sugar and post-prandial blood sugar and increased insulin sensitivity, but no effect was observed on glycated hemoglobin A1c. The diverse nutrients, such as phycocyanin, gamma-linolenic acid, and vitamin B12, present in spirulina contribute to its cardiometabolic benefits. The doses used are heterogeneous for most studies, ranging from 1 to 8 grams daily, but most studies administered spirulina for 3 months to observe an effect. The collective evidence suggests that spirulina supplements may help improve risk factors for cardiometabolic diseases, thus, preventing its development. However, due to the heterogeneity of the results, more randomized clinical trials are needed to draw robust conclusions about spirulina's therapeutic potential in ameliorating risk factors for cardiometabolic diseases and fully elucidate the mechanisms by which it exerts its effects.

Therapeutic Potentials of Microalgae and Their Bioactive Compounds on Diabetes Mellitus

Diabetes mellitus is a metabolic disorder characterized by hyperglycemia due to impaired insulin secretion, insulin resistance, or both. Oxidative stress and chronic low-grade inflammation play crucial roles in the pathophysiology of diabetes mellitus. There has been a growing interest in applying natural products to improve metabolic derangements without the side effects of anti-diabetic drugs. Microalgae biomass or extract and their bioactive compounds have been applied as nutraceuticals or additives in food products and health supplements. Several studies have demonstrated the therapeutic effects of microalgae and their bioactive compounds in improving insulin sensitivity attributed to their antioxidant, anti-inflammatory, and pancreatic β-cell protective properties. However, a review summarizing the progression in this topic is lacking despite the increasing number of studies reporting their anti-diabetic potential. In this review, we gathered the findings from in vitro, in vivo, and human studies to discuss the effects of microalgae and their bioactive compounds on diabetes mellitus and the mechanisms involved. Additionally, we discuss the limitations and future perspectives of developing microalgae-based compounds as a health supplement for diabetes mellitus. In conclusion, microalgae-based supplementation has the potential to improve diabetes mellitus and be applied in more clinical studies in the future.

The effect of Spirulina supplementation on lipid profile: GRADE-assessed systematic review and dose-response meta-analysis of data from randomized controlled trials

BACKGROUND

Cardiovascular diseases (CVD) are one of the most important causes of death worldwide. Dyslipidemia is one of the main causal risk factors for CVD that can be controlled by modifying lifestyle, which entails the use of healthy diets containing functional foods. The present study was conducted to summarize the effects of Spirulina on the lipid profile in previous randomized controlled trials.

METHODS

MEDLINE, Scopus, Clarivate Analytics Web of Science, and the Cochrane Library databases were searched systematically until January 2023, for clinical interventions that investigated the effect of Spirulina supplementation on plasma lipid profile concentrations.

RESULTS

ooled results of 20 studies (with 23 arms and 1076 participants) indicated that Spirulina intervention significantly reduced LDL-C (SMD: -0.6, 95% CI: -0.9, -0.2, P˂0.05), TC (SMD: -0.6, 95% CI: -0.9, -0.2, P˂0.05) and TG (SMD: -0.6, 95% CI: -0.9, -0.2, P˂0.05) levels while HDL-C levels were significantly increased (SMD: 0.3, 95% CI: 0.0, 0.6, P˂0.05).

CONCLUSIONS

The findings of the present meta-analysis and review show the usefulness of supplementing with Spirulina in improving serum levels of TC, TG, LDL-C, and HDL-C.

Probiotics for glycemic and lipid profile control of the pre-diabetic patients: a randomized, double-blinded, placebo-controlled clinical trial study

BACKGROUND

Pre-diabetes is a condition in which blood glucose levels are high but not as high as in diabetic patients. However, it can lead to diabetes, making it a serious global health issue. Previous studies have shown that the gut microbiome can affect insulin sensitivity and improve glucose management, which can reduce or delay the progression of pre-diabetes to type 2 diabetes mellitus. This study was designed to investigate the effects of probiotics on glycemic and lipid profile control in pre-diabetic patients.

METHODS

This randomized, double-blinded clinical trial was conducted on 70 pre-diabetic patients at the Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. Participants were divided into two groups, both of which received lifestyle modification training. One of the groups also received 500 mg/day probiotic capsules for three months, while the other group received a placebo. Before and after the three-month period, systolic and diastolic blood pressure, serum insulin level, hemoglobin A1c (HbA1c), fasting blood sugar (FBS), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides (TG) were measured and compared using statistical tests to examine the effect of probiotics.

RESULTS

A total of 70 individuals participated in the trial, including 50 women (71.4%) and 20 men (28.6%), with an average age of 43.53 ± 8.54 years. At the end of the trial, the mean weight (P < 0.001), FBS (P < 0.001), HbA1c (P = 0.035), TG (P = 0.004), and LDL (P = 0.016) were significantly reduced in the intervention group, while their insulin level (P = 0.041) and HDL (P = 0.001) were significantly increased. However, mean systolic (P = 0.459) and diastolic blood pressure (P = 0.961) and insulin resistance (P = 0.235) did not show any significant difference in the intervention group from the beginning of the study.

CONCLUSION

Our study showed that probiotic administration is effective in improving the glucose and lipid profile of pre-diabetic patients. However, it was not significantly different from the placebo.