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Costa A, Lucarini E. Treating chronic stress and chronic pain by manipulating gut microbiota with diet: can we kill two birds with one stone? Nutr Neurosci 2024:1-24. [PMID: 38889540 DOI: 10.1080/1028415x.2024.2365021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/20/2024]
Abstract
Background: Chronic stress and chronic pain are closely linked by the capacity to exacerbate each other, sharing common roots in the brain and in the gut. The strict intersection between these two neurological diseases makes important to have a therapeutic strategy aimed at preventing both to maintain mental health in patients. Diet is an modifiable lifestyle factor associated with gut-brain axis diseases and there is growing interest in its use as adjuvant to main therapies. Several evidence attest the impact of specific diets or nutrients on chronic stress-related disorders and pain with a good degree of certainty. A daily adequate intake of foods containing micronutrients such as amino acids, minerals and vitamins, as well as the reduction in the consumption of processed food products can have a positive impact on microbiota and gut health. Many nutrients are endowed of prebiotic, anti-inflammatory, immunomodulatory and neuroprotective potential which make them useful tools helping the management of chronic stress and pain in patients. Dietary regimes, as intermittent fasting or caloric restriction, are promising, although further studies are needed to optimize protocols according to patient's medical history, age and sex. Moreover, by supporting gut microbiota health with diet is possible to attenuate comorbidities such as obesity, gastrointestinal dysfunction and mood disorders, thus reducing healthcare costs related to chronic stress or pain.Objective: This review summarize the most recent evidence on the microbiota-mediated beneficial effects of macro- and micronutrients, dietary-related factors, specific nutritional regimens and dietary intervention on these pathological conditions.
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Affiliation(s)
- Alessia Costa
- Department of Neuroscience, Psychology, Drug Area and Child Health (NEUROFARBA), University of Florence, Florence, Italy
| | - Elena Lucarini
- Department of Neuroscience, Psychology, Drug Area and Child Health (NEUROFARBA), University of Florence, Florence, Italy
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Hou Y, Zhao X, Wang Y, Li Y, Chen C, Zhou X, Jin J, Ye J, Li D, Gan L, Wu R. Oleuropein-Rich Jasminum Grandiflorum Flower Extract Regulates the LKB1-PGC-1α Axis Related to the Attenuation of Hepatocellular Lipid Dysmetabolism. Nutrients 2023; 16:58. [PMID: 38201888 PMCID: PMC10780778 DOI: 10.3390/nu16010058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 12/12/2023] [Accepted: 12/21/2023] [Indexed: 01/12/2024] Open
Abstract
Diets() rich in fat are a major() cause() of metabolic disease(), and nutritional() food has been widely() used() to counteract the metabolic disorders such() as obesity() and fatty() liver(). The present study investigated the effects of oleuropein-enriched extract() from Jasminum grandiflorum L. flowers (OLE-JGF) in high-fat diet() (HFD)-fed mice and oleic acid() (OA)-treated AML-12 cells. Treatment() of HFD-fed mice with 0.6% OLE-JGF for 8 weeks significantly reduced body and liver() weights, as well as attenuating lipid dysmetabolism and hepatic steatosis. OLE-JGF administration() prominently suppressed the mRNA expressions() of monocyte chemoattractant protein()-1 (MCP-1) and cluster of differentiation 68 (CD68), and it also downregulated acetyl-CoA carboxylase (ACC) and fatty() acid() synthase (FAS) as well as sterol-regulatory-element()-binding protein() (SREBP-1c) in the liver(). Meanwhile, mitochondrial DNA and uncoupling protein() 2 (UCP2) were upregulated along with the increased expression() of mitochondrial biogenic promoters including liver() kinase B1 (LKB1), peroxisome proliferator-activated receptor-γ coactivator-1α (PGC-1α), nuclear() factor()-erythroid-derived 2-like 2 (Nrf2), and mitochondrial transcription factor() A (Tfam), but did not change AMP-activated protein() kinase (AMPK) in liver(). The lipid droplets were decreased significantly after treatment() with 80 μM oleuropein for 24 h in OA-induced AML-12 cells. Furthermore, oleuropein significantly inhibited ACC mRNA expression() and upregulated LKB1, PGC-1α, and Tfam mRNA levels, as well as increasing the binding level of LKB1 to PGC-1α promoter in OA-induced cells. These findings indicate() that OLE-JGF reduces hepatic lipid deposition in HFD-fed mice, as well as the fact that OA-induced liver() cells may be partly() attributed to upregulation of the LKB1-PGC-1α axis, which mediates hepatic lipogenesis and mitochondrial biogenesis. Our study provides a scientific() basis() for the benefits and potential() use() of the J. grandiflorum flower as a food supplement() for the prevention() and treatment() of metabolic disease().
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Affiliation(s)
- Yajun Hou
- School of Pharmacy and Food Engineering, Wuyi University, Jiangmen 529020, China; (Y.H.); (X.Z.); (Y.W.); (Y.L.); (C.C.); (X.Z.); (J.J.); (J.Y.); (D.L.); (L.G.)
- International Healthcare Innovation Institute (Jiangmen), Jiangmen 529040, China
| | - Xuan Zhao
- School of Pharmacy and Food Engineering, Wuyi University, Jiangmen 529020, China; (Y.H.); (X.Z.); (Y.W.); (Y.L.); (C.C.); (X.Z.); (J.J.); (J.Y.); (D.L.); (L.G.)
| | - Yalin Wang
- School of Pharmacy and Food Engineering, Wuyi University, Jiangmen 529020, China; (Y.H.); (X.Z.); (Y.W.); (Y.L.); (C.C.); (X.Z.); (J.J.); (J.Y.); (D.L.); (L.G.)
| | - Yapeng Li
- School of Pharmacy and Food Engineering, Wuyi University, Jiangmen 529020, China; (Y.H.); (X.Z.); (Y.W.); (Y.L.); (C.C.); (X.Z.); (J.J.); (J.Y.); (D.L.); (L.G.)
| | - Caihong Chen
- School of Pharmacy and Food Engineering, Wuyi University, Jiangmen 529020, China; (Y.H.); (X.Z.); (Y.W.); (Y.L.); (C.C.); (X.Z.); (J.J.); (J.Y.); (D.L.); (L.G.)
| | - Xiu Zhou
- School of Pharmacy and Food Engineering, Wuyi University, Jiangmen 529020, China; (Y.H.); (X.Z.); (Y.W.); (Y.L.); (C.C.); (X.Z.); (J.J.); (J.Y.); (D.L.); (L.G.)
| | - Jingwei Jin
- School of Pharmacy and Food Engineering, Wuyi University, Jiangmen 529020, China; (Y.H.); (X.Z.); (Y.W.); (Y.L.); (C.C.); (X.Z.); (J.J.); (J.Y.); (D.L.); (L.G.)
- International Healthcare Innovation Institute (Jiangmen), Jiangmen 529040, China
| | - Jiming Ye
- School of Pharmacy and Food Engineering, Wuyi University, Jiangmen 529020, China; (Y.H.); (X.Z.); (Y.W.); (Y.L.); (C.C.); (X.Z.); (J.J.); (J.Y.); (D.L.); (L.G.)
| | - Dongli Li
- School of Pharmacy and Food Engineering, Wuyi University, Jiangmen 529020, China; (Y.H.); (X.Z.); (Y.W.); (Y.L.); (C.C.); (X.Z.); (J.J.); (J.Y.); (D.L.); (L.G.)
- International Healthcare Innovation Institute (Jiangmen), Jiangmen 529040, China
| | - Lishe Gan
- School of Pharmacy and Food Engineering, Wuyi University, Jiangmen 529020, China; (Y.H.); (X.Z.); (Y.W.); (Y.L.); (C.C.); (X.Z.); (J.J.); (J.Y.); (D.L.); (L.G.)
- International Healthcare Innovation Institute (Jiangmen), Jiangmen 529040, China
| | - Rihui Wu
- School of Pharmacy and Food Engineering, Wuyi University, Jiangmen 529020, China; (Y.H.); (X.Z.); (Y.W.); (Y.L.); (C.C.); (X.Z.); (J.J.); (J.Y.); (D.L.); (L.G.)
- International Healthcare Innovation Institute (Jiangmen), Jiangmen 529040, China
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de Aguiar Sobral P, Miyahira RF, Zago L. Health Outcomes Related to the Consumption of Olive Products: A Brief Review. PLANT FOODS FOR HUMAN NUTRITION (DORDRECHT, NETHERLANDS) 2023; 78:643-653. [PMID: 37932611 DOI: 10.1007/s11130-023-01119-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/20/2023] [Indexed: 11/08/2023]
Abstract
Olive oil, as well as by-products and waste that are left after production, particularly olive pomace and olive leaf, have been extensively researched as sources of phenolic compounds. These compounds are known for their biological properties and have been associated with the prevention of chronic non-communicable diseases. Metabolomics has been used as a methodological tool to elucidate the molecular mechanisms underlying these properties. The present review explores the health outcomes and changes in endogenous metabolite profiles induced by olive derivatives. A literature search was conducted using the scientific databases Scopus, Web of Science and PubMed, and the selected articles were published between the years 2012 and 2023. The reviewed studies have reported several health benefits of olive derivatives and their phenolic components, including appetite regulation, fewer cardiovascular disorders, and antiproliferative properties. This review also addressed the bioavailability of these compounds, their impact on the microbiota, and described biomarkers of their intake. Therefore, there should be further research using this methodology for a better understanding of the performance and therapeutic potential of olive derivatives.
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Affiliation(s)
- Pamela de Aguiar Sobral
- Graduate Program in Food, Nutrition and Health, Institute of Nutrition, State University of Rio de Janeiro, Rua São Francisco Xavier, 524, 12◦ andar, sala 12006 D - Maracanã, Rio de Janeiro, RJ, 20550-013, Brazil
| | - Roberta Fontanive Miyahira
- Graduate Program in Food, Nutrition and Health, Institute of Nutrition, State University of Rio de Janeiro, Rua São Francisco Xavier, 524, 12◦ andar, sala 12006 D - Maracanã, Rio de Janeiro, RJ, 20550-013, Brazil
| | - Lilia Zago
- Graduate Program in Food, Nutrition and Health, Institute of Nutrition, State University of Rio de Janeiro, Rua São Francisco Xavier, 524, 12◦ andar, sala 12006 D - Maracanã, Rio de Janeiro, RJ, 20550-013, Brazil.
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Almanza-Aguilera E, Cano A, Gil-Lespinard M, Burguera N, Zamora-Ros R, Agudo A, Farràs M. Mediterranean diet and olive oil, microbiota, and obesity-related cancers. From mechanisms to prevention. Semin Cancer Biol 2023; 95:103-119. [PMID: 37543179 DOI: 10.1016/j.semcancer.2023.08.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 07/02/2023] [Accepted: 08/01/2023] [Indexed: 08/07/2023]
Abstract
Olive oil (OO) is the main source of added fat in the Mediterranean diet (MD). It is a mix of bioactive compounds, including monounsaturated fatty acids, phytosterols, simple phenols, secoiridoids, flavonoids, and terpenoids. There is a growing body of evidence that MD and OO improve obesity-related factors. In addition, obesity has been associated with an increased risk for several cancers: endometrial, oesophageal adenocarcinoma, renal, pancreatic, hepatocellular, gastric cardia, meningioma, multiple myeloma, colorectal, postmenopausal breast, ovarian, gallbladder, and thyroid cancer. However, the epidemiological evidence linking MD and OO with these obesity-related cancers, and their potential mechanisms of action, especially those involving the gut microbiota, are not clearly described or understood. The goals of this review are 1) to update the current epidemiological knowledge on the associations between MD and OO consumption and obesity-related cancers, 2) to identify the gut microbiota mechanisms involved in obesity-related cancers, and 3) to report the effects of MD and OO on these mechanisms.
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Affiliation(s)
- Enrique Almanza-Aguilera
- Unit of Nutrition and Cancer, Epidemiology Research Program, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), 08908 L'Hospitalet de Llobregat, Spain
| | - Ainara Cano
- Food Research, AZTI, Basque Research and Technology Alliance (BRTA), Parque Tecnológico de Bizkaia, Astondo Bidea, Edificio 609, 48160, Derio, Spain
| | - Mercedes Gil-Lespinard
- Unit of Nutrition and Cancer, Epidemiology Research Program, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), 08908 L'Hospitalet de Llobregat, Spain
| | - Nerea Burguera
- Food Research, AZTI, Basque Research and Technology Alliance (BRTA), Parque Tecnológico de Bizkaia, Astondo Bidea, Edificio 609, 48160, Derio, Spain
| | - Raul Zamora-Ros
- Unit of Nutrition and Cancer, Epidemiology Research Program, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), 08908 L'Hospitalet de Llobregat, Spain; Department of Nutrition, Food Sciences, and Gastronomy, Food Innovation Network (XIA), Institute for Research on Nutrition and Food Safety (INSA), Faculty of Pharmacy and Food Sciences University of Barcelona, Barcelona, Spain.
| | - Antonio Agudo
- Unit of Nutrition and Cancer, Epidemiology Research Program, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), 08908 L'Hospitalet de Llobregat, Spain
| | - Marta Farràs
- Unit of Nutrition and Cancer, Epidemiology Research Program, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), 08908 L'Hospitalet de Llobregat, Spain.
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Qusa MH, Abdelwahed KS, Hill RA, El Sayed KA. S-(-)-Oleocanthal Ex Vivo Modulatory Effects on Gut Microbiota. Nutrients 2023; 15:nu15030618. [PMID: 36771326 PMCID: PMC9920009 DOI: 10.3390/nu15030618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/18/2023] [Accepted: 01/19/2023] [Indexed: 01/27/2023] Open
Abstract
Compelling evidence points to the critical role of bioactive extra-virgin olive oil (EVOO) phenolics and gut microbiota (GM) interplay, but reliable models for studying the consequences thereof remain to be developed. Herein, we report an optimized ex vivo fecal anaerobic fermentation model to study the modulation of GM by the most bioactive EVOO phenolic S-(-)-oleocanthal (OC), and impacts therefrom, focusing on OC biotransformation in the gut. This model will also be applicable for characterization of GM interactions with other EVOO phenolics, and moreover, for a broadly diverse range of bioactive natural products. The fecal fermentation media and time, and mouse type and gender, were the major factors varied and optimized to provide better understanding of GM-OC interplay. A novel resin entrapment technique (solid-phase extraction) served to selectively entrap OC metabolites, degradation products, and any remaining fraction of OC while excluding interfering complex fecal medium constituents. The effects of OC on GM compositions were investigated via shallow shotgun DNA sequencing. Robust metabolome analyses identified GM bacterial species selectively altered (population numbers/fraction) by OC. Finally, the topmost OC-affected gut bacterial species of the studied mice were compared with those known to be extant in humans and distributions of these bacteria at different human body sites. OC intake caused significant quantitative and qualitative changes to mice GM, which was also comparable with human GM. Results clearly highlight the potential positive health outcomes of OC as a prospective nutraceutical.
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Emir AA, Erunsal SC. Impact of oleuropein on LCD-based stereolithography-assisted fabrication of 3D printed PEGDMA hydrogels. Eur Polym J 2022. [DOI: 10.1016/j.eurpolymj.2022.111592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Costa M, Costa V, Lopes M, Paiva-Martins F. A biochemical perspective on the fate of virgin olive oil phenolic compounds in vivo. Crit Rev Food Sci Nutr 2022; 64:1403-1428. [PMID: 36094444 DOI: 10.1080/10408398.2022.2116558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The chemistry of the phenolic compounds found in virgin olive oil (VOO) is very complex due, not only to the different classes of polyphenols that can be found in it, but, above all, due to the existence of a very specific phenol class found only in oleaceae plants: the secoiridoids. Searching in the Scopus data base the keywords flavonoid, phenolic acid, lignin and secoiridoid, we can find a number of 148174, 79435, 11326 and 1392 research articles respectively, showing how little is devote to the latter class of compounds. Moreover, in contrast with other classes, that include only phenolic compounds, secoiridoids may include phenolic and non-phenolic compounds, being the articles concerning phenolic secoiridoids much less than the half of the abovementioned articles. Therefore, it is important to clarify the structures of these compounds and their chemistry, as this knowledge will help understand their bioactivity and metabolism studies, usually performed by researchers with a more health science's related background. In this review, all the structures found in many research articles concerning VOO phenolic compounds chemistry and metabolism was gathered, with a special attention devoted to the secoiridoids, the main phenolic compound class found in olives, VOO and olive leaf.
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Affiliation(s)
- Marlene Costa
- REQUIMTE-LAQV, Departamento de Química e Bioquímica, Faculdade de Ciências, Universidade do Porto, Porto, Portugal
| | - Vânia Costa
- REQUIMTE-LAQV, Departamento de Química e Bioquímica, Faculdade de Ciências, Universidade do Porto, Porto, Portugal
| | - Margarida Lopes
- REQUIMTE-LAQV, Departamento de Química e Bioquímica, Faculdade de Ciências, Universidade do Porto, Porto, Portugal
| | - Fátima Paiva-Martins
- REQUIMTE-LAQV, Departamento de Química e Bioquímica, Faculdade de Ciências, Universidade do Porto, Porto, Portugal
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D’Archivio M, Santangelo C, Silenzi A, Scazzocchio B, Varì R, Masella R. Dietary EVOO Polyphenols and Gut Microbiota Interaction: Are There Any Sex/Gender Influences? Antioxidants (Basel) 2022; 11:antiox11091744. [PMID: 36139818 PMCID: PMC9495659 DOI: 10.3390/antiox11091744] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/30/2022] [Accepted: 08/30/2022] [Indexed: 11/16/2022] Open
Abstract
Accumulating evidence indicates that regular consumption of extra virgin olive oil (EVOO), the main source of fat in the Mediterranean diet, is associated with beneficial health effects and a reduced risk of developing chronic degenerative disorders. The beneficial effects of EVOO can be attributed to its unique composition in monounsaturated fats and phenolic compounds that provide important antioxidant, anti-inflammatory, and immune-modulating activities. On the other hand, it is well known that the gut microbiota has several important roles in normal human physiology, and its composition can be influenced by a multitude of environmental and lifestyle factors, among which dietary components play a relevant role. In the last few years, the two-way interaction between polyphenols, including those in EVOO, and the gut microbiota, i.e., the modulation of the microbiota by polyphenols and that of polyphenol metabolism and bioavailability by the microbiota, has attracted growing attention, being potentially relevant to explain the final effects of polyphenols, as well as of the microbiota profile. Furthermore, sex and gender can affect dietary habits, polyphenol intake, and nutrient metabolism. Lastly, it has been recently suggested that differences in gut microbiota composition could be involved in the unequal incidence of metabolic diseases observed between women and men, due to sex-dependent effects on shaping gut microbiota profiles according to diet. This review summarizes the most recent studies on the relationship between EVOO polyphenols and the gut microbiota, taking into account possible influences of sex and gender in modulating such an interaction.
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BEYAZ S, GÖK Ö, ASLAN A. A research paper on the immunomodulatory and anti-inflammatory activities of olive tree (Olea europaea L.) leaf. INTERNATIONAL JOURNAL OF SECONDARY METABOLITE 2022. [DOI: 10.21448/ijsm.1075283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Olive tree (Olea europaea L.) leaf is known to have a number of bioactive properties being antioxidant, antihypertensive, antiatherogenic, anti-inflammatory, antifungal, antiviral and antimicrobial. In this study, the immunomodulatory roles of Olive tree (Olea europaea L.) leaf against oxidative damage caused by carbon tetrachloride (CCl4) in Saccharomyces cerevisiae were investigated. In the study, four groups were formed; namely, (i) Control Group: Yeast only planted group; (ii) CCl4 Group: Group given CCl4 (15 mM); (iii) Olive Tree Leaf Group: The group given olive tree leaf (10%); and (iv) Olive Tree Leaf + CCl4 Group: Olive tree leaf (10%) + CCl4 (15 mM) given group. Cultures of Saccharomyces cerevisiae were grown at 30 °C for 1, 3, 5, and 24 hours. Malondialdehyde (MDA), glutathione levels (GSH), cell growth and catalase (CAT) activity measurements were determined by spectrophotometer. Total protein concentrations were determined by SDS-PAGE electrophoresis and the Bradford protein method. According to the results obtained; compared to the CCl4 group, cell growth (1, 3, 5 and 24 hours), total protein synthesis, and GSH and CAT activities (24 hours) increased in olive tree leaf groups, while MDA level (24 hours) decreased. Thanks to its strong bioactive properties, olive tree leaf has been found to increase cell growth and total protein synthesis by decreasing CCl4 induced oxidative stress in Saccharomyces cerevisiae culture. It has been concluded that if the olive tree leaf is used regularly, it will be beneficial in eliminating many health problems.
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Mahmod AI, Haif SK, Kamal A, Al-Ataby IA, Talib WH. Chemoprevention effect of the Mediterranean diet on colorectal cancer: Current studies and future prospects. Front Nutr 2022; 9:924192. [PMID: 35990343 PMCID: PMC9386380 DOI: 10.3389/fnut.2022.924192] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 07/18/2022] [Indexed: 12/11/2022] Open
Abstract
Colorectal cancer (CRC) is the third most common cancer and the second most deadly cancer worldwide. Nevertheless, more than 70% of CRC cases are resulted from sporadic tumorigenesis and are not inherited. Since adenoma-carcinoma development is a slow process and may take up to 20 years, diet-based chemoprevention could be an effective approach in sporadic CRC. The Mediterranean diet is an example of a healthy diet pattern that consists of a combination of nutraceuticals that prevent several chronic diseases and cancer. Many epidemiological studies have shown the correlation between adherence to the Mediterranean diet and low incidence of CRC. The goal of this review is to shed the light on the anti-inflammatory and anti-colorectal cancer potentials of the natural bioactive compounds derived from the main foods in the Mediterranean diet.
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Affiliation(s)
- Asma Ismail Mahmod
- Department of Clinical Pharmacy and Therapeutic, Applied Science Private University, Amman, Jordan
| | - Shatha Khaled Haif
- Department of Pharmacy, Princess Sarvath Community College, Amman, Jordan
| | - Ayah Kamal
- Department of Clinical Pharmacy and Therapeutic, Applied Science Private University, Amman, Jordan
| | - Israa A Al-Ataby
- Department of Clinical Pharmacy and Therapeutic, Applied Science Private University, Amman, Jordan
| | - Wamidh H Talib
- Department of Clinical Pharmacy and Therapeutic, Applied Science Private University, Amman, Jordan
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