The effect of green tea on blood pressure and lipid profile: a systematic review and meta-analysis of randomized clinical trials

Effects of green tea on lipid profile in overweight and obese women

The effect of green tea administration on serum lipids' concentrations remains unclear as various investigations, which have explored this topic, have produced conflicting results. Gender might be one of the factors influencing the impact of green tea on the lipid profile. Hence, we conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to assess the effect of green tea intake on the lipid profile in overweight and obese women. We searched five databases (Web of Science, SCOPUS, Embase, PubMed/Medline, and Google Scholar) using a combination of MeSH and non-MeSH terms. Results were expressed as weighted mean differences (WMDs) and 95% confidence intervals (CIs) and synthesized with a random-effects model. In total, 15 eligible RCTs with 16 arms (1818 participants) were included in the meta-analysis. The combined effect size revealed a significant reduction in total cholesterol (TC) (WMD: -4.45 mg/dl, 95% CI: -6.63, -2.27, P<0.001) and low-density lipoprotein cholesterol (LDL-C) (WMD: -4.49 mg/dl, 95% CI: -7.50 to -1.47, P=0.003) concentrations following green tea supplementation in overweight and/or obese women. In addition, a more pronounced reduction of triglyceride (TG) levels occurred when the baseline TG value was ≥150 mg/dL (WMD: -24.45 mg/dL, 95% CI: -40.63 to -8.26, P=0.003). Moreover, a significant decrease in TG concentrations occurred in RCTs conducted on overweight subjects (BMI: 25-29.99 kg/m2) (WMD: -5.88 mg/dl, 95% CI: -10.76 to -0.99, P=0.01). In the subgroup analyses based on the study population, a notable increase in high-density lipoprotein cholesterol (HDL-C) values was observed in obese individuals (>30 kg/m2) (WMD: 2.63 mg/dl, 95% CI: 0.10 to 5.16, P=0.041). Consumption of green tea causes a reduction in LDL-C and TC concentrations in overweight and obese women. The decline in TG levels was notable particularly in overweight patients with hypertriglyceridemia at baseline. In addition, a significant increase in HDL-C was detected in obese subjects following intake of green tea.

Green tea polyphenols alleviate di-(2-ethylhexyl) phthalate-induced liver injury in mice

BACKGROUND

Di (2-ethylhexyl) phthalate (DEHP) is a common plasticizer known to cause liver injury. Green tea is reported to exert therapeutic effects on heavy metal exposure-induced organ damage. However, limited studies have examined the therapeutic effects of green tea polyphenols (GTPs) on DEHP-induced liver damage.

AIM

To evaluate the molecular mechanism underlying the therapeutic effects of GTPs on DEHP-induced liver damage.

METHODS

C57BL/6J mice were divided into the following five groups: Control, model [DEHP (1500 mg/kg bodyweight)], treatment [DEHP (1500 mg/kg bodyweight) + GTP (70 mg/kg bodyweight), oil, and GTP (70 mg/kg bodyweight)] groups. After 8 wk, the liver function, blood lipid profile, and liver histopathology were examined. Differentially expressed micro RNAs (miRNAs) and mRNAs in the liver tissues were examined using high-throughput sequencing. Additionally, functional enrichment analysis and immune infiltration prediction were performed. The miRNA-mRNA regulatory axis was elucidated using the starBase database. Protein expression was evaluated using immunohistochemistry.

RESULTS

GTPs alleviated DHEP-induced liver dysfunction, blood lipid dysregulation, fatty liver disease, liver fibrosis, and mitochondrial and endoplasmic reticulum lesions in mice. The infiltration of macrophages, mast cells, and natural killer cells varied between the model and treatment groups. mmu-miR-141-3p (a differentially expressed miRNA), Zcchc24 (a differentially expressed mRNA), and Zcchc24 (a differentially expressed protein) constituted the miRNA-mRNA-protein regulatory axis involved in mediating the therapeutic effects of GTPs on DEHP-induced liver damage in mice.

CONCLUSION

This study demonstrated that GTPs mitigate DEHP-induced liver dysfunction, blood lipid dysregulation, fatty liver disease, and partial liver fibrosis, and regulate immune cell infiltration. Additionally, an important miRNA-mRNA-protein molecular regulatory axis involved in mediating the therapeutic effects of GTPs on DEHP-induced liver damage was elucidated.

Supplements for Lipid Lowering: What Does the Evidence Show?

PURPOSE

In this review, the regulation, proposed hypolipidemic mechanism, and efficacy of common dietary supplements (DSs) marketed for cardiovascular health are discussed.

RECENT FINDINGS

Data demonstrate modest but inconsistent lipid-lowering effects with common DSs such as probiotics, soluble fibers, plant sterols, green tea, berberine, guggul, niacin, and garlic. Furthermore, data is limited regarding turmeric, hawthorn, and cinnamon. Red yeast rice has shown to be a beneficial DS, but its safety and efficacy are dependent upon its production quality and monacolin K content, respectively. Finally, soy proteins and omega-3 fatty acid-rich foods can have significant health benefits if used to displace other animal products as part of a healthier diet. Despite the rising use of DSs, data demonstrate unpredictable results. Patients should be educated on the difference between these DSs and evidence-based lipid-lowering medications proven to improve cardiovascular outcomes.

The effect of green tea supplementation on the anthropometric outcomes in overweight and obese women: a time and dose-response meta-analysis of randomized controlled trials

Inconsistencies are evident within the literature regarding the role of Green Tea (GT) supplementation on women living with obesity. To address this, we conducted to determine the impact of GT supplementation on the weight, body mass index (BMI), and waist circumference (WC) in overweight and obese women using time and dose-response meta-analysis of randomized controlled trials (RCTs). This meta-analysis searched electronic Scopus, Web of Science, Embase, and PubMed/Medline databases from inception to December 1^st, 2022. Data were reported as weighted mean difference (WMD) with 95% confidence interval (CI). A total of 2061 references were identified, and 15 articles with 16 RCT arms on body weight, 17 RCT arms on BMI, and 7 RCT arms on WC were included in the meta-analysis. GT supplementation significantly decreases body weight (WMD: -1.23 kg, 95% CI: -2.13 to -0.33, p = 0.007), BMI (WMD: -0.47 kg/m², 95% CI: -0.87 to -0.07, p = 0.020) and WC (WMD: -3.46 cm, 95% CI: -6.75 to -0.16, p = 0.040). In subgroup analyses, GT consumption demonstrated lowered body weight with dosaes ≥1000 mg/day (WMD: -1.38 kg), in the RCTs, which lasted ≥8 wk (WMD: -1.24 kg). The non-linear dose-response assessment detected a negative correlation between the changes in body weight and BMI in green tea consumption of more than 1000 (mg/day). The GT supplementation reduced the weight, BMI, and WC in overweight and obese women. In clinical practice, healthcare professionals can recommend using GT with dosages ≥ 1000mg/day and duration ≥ 8 wk in obese women.

Nutraceutical approaches to non-alcoholic fatty liver disease (NAFLD): A position paper from the International Lipid Expert Panel (ILEP)

Non-Alcoholic Fatty Liver Disease (NAFLD) is a common condition affecting around 10-25% of the general adult population, 15% of children, and even > 50% of individuals who have type 2 diabetes mellitus. It is a major cause of liver-related morbidity, and cardiovascular (CV) mortality is a common cause of death. In addition to being the initial step of irreversible alterations of the liver parenchyma causing cirrhosis, about 1/6 of those who develop NASH are at risk also developing CV disease (CVD). More recently the acronym MAFLD (Metabolic Associated Fatty Liver Disease) has been preferred by many European and US specialists, providing a clearer message on the metabolic etiology of the disease. The suggestions for the management of NAFLD are like those recommended by guidelines for CVD prevention. In this context, the general approach is to prescribe physical activity and dietary changes the effect weight loss. Lifestyle change in the NAFLD patient has been supplemented in some by the use of nutraceuticals, but the evidence based for these remains uncertain. The aim of this Position Paper was to summarize the clinical evidence relating to the effect of nutraceuticals on NAFLD-related parameters. Our reading of the data is that whilst many nutraceuticals have been studied in relation to NAFLD, none have sufficient evidence to recommend their routine use; robust trials are required to appropriately address efficacy and safety.

Efficacy of Dietary Polyphenols from Whole Foods and Purified Food Polyphenol Extracts in Optimizing Cardiometabolic Health: A Meta-Analysis of Randomized Controlled Trials

The evidence from clinical trials concerning the efficacy of dietary polyphenols on cardiometabolic health is divergent. Therefore, this review aimed to determine the pooled effect of dietary polyphenols on cardiometabolic risk markers and compare the difference in efficacy between whole polyphenol-rich foods and purified food polyphenol extracts. We conducted a random-effect model meta-analysis of randomized controlled trials (RCTs) on the effect of polyphenols on blood pressure, lipid profile, flow-mediated dilation (FMD), fasting blood glucose (FBG), waist circumference, and markers of inflammation. Effect size was expressed as weighted mean difference and 95% CI. RCTs published in English between 2000 and 2021 involving adult participants with cardiometabolic risks were searched in electronic databases. Forty-six RCTs involving 2494 participants with a mean age of 53.3 ±10 y were included in this review. Whole polyphenol-rich food but not purified food polyphenol extracts significantly reduced systolic blood pressure (SBP, -3.69 mmHg; 95% CI: -4.24, -3.15 mmHg; P = 0.00001) and diastolic blood pressure (DBP, -1.44 mmHg; 95% CI: -2.56, -0.31 mmHg; P = 0.0002). Concerning waist circumference, purified food polyphenol extracts led to a larger effect (-3.04 cm; 95% CI: -7.06, -0.98 cm; P = 0.14). Significant effects on total cholesterol (-9.03 mg/dL; 95% CI: -16.46, -1.06 mg/dL; P = 0.02) and TGs (-13.43 mg/dL; 95% CI: -23.63, -3.23; P = 0.01) were observed when purified food polyphenol extracts were considered separately. None of the intervention materials significantly affected LDL-cholesterol, HDL-cholesterol, FBG, IL-6, and CRP. When both whole food and extracts were pooled together, there was a significant reduction in SBP, DBP, FMD, TGs, and total cholesterol. These findings suggest that polyphenols both as whole food and purified extracts can be efficacious in reducing cardiometabolic risks. However, these results must be interpreted with caution because of high heterogeneity and risk of bias among RCTs. This study was registered on PROSPERO as CRD42021241807.

The effects of green tea supplementation on cardiovascular risk factors: A systematic review and meta-analysis

Purpose

A bulk of observational studies have revealed the protective role of green tea supplementation in cardiovascular diseases. The current systematic review and meta-analysis study aimed to establish the effects of green tea supplementation on cardiovascular risk factors including lipid profile, blood pressure, glycemic control markers and CRP.

Methods

A systematic literature search of randomized clinical trials (RCTs) that investigated the effects of green tea supplementation and cardiovascular risk factors was undertaken in online databases including PubMed/Medline, Scopus, Web of Science, and Embase using a combination of green tea and cardiovascular risk factors search terms. Meta-analyses were carried out using a random-effects model. The I2 index was used to assess the heterogeneity of RCTs.

Results

Among the initial 11,286 studies that were identified from electronic databases search, 55 eligible RCTs with 63 effect sizes were eligible. Results from the random effects meta-analysis showed that GTE supplementation significantly reduced TC (WMD = -7.62; 95% CI: -10.51, -4.73; P = < 0.001), LDL-C (WMD = -5.80; 95% CI: -8.30, -3.30; P = < 0.001), FBS (WMD = -1.67; 95% CI: -2.58, -0.75; P = < 0.001), HbA1c (WMD = -0.15; 95% CI: -0.26, -0.04; P = 0.008), DBP (WMD = -0.87; 95% CI: -1.45, -0.29; P = 0.003), while increasing HDL-C (WMD = 1.85; 95% CI: 0.87, 2.84; P = 0.010). Subgroup analyses based on the duration of supplementation (≥ 12 vs. < 12 weeks), dose of green tea extract (GTE) (≥1,000 vs. < 1,000 mg/d), sex (male, female, and both), baseline serum levels of lipid profile, and glycemic control factors demonstrated different results for some risk factors.

Conclusion

The current study suggests improvements in the lipid and glycemic profiles following green tea supplementation. These findings support previous evidence showing the health benefits of green tea supplementation on cardiometabolic risk factors.

Can Bioactive Food Substances Contribute to Cystic Fibrosis-Related Cardiovascular Disease Prevention?

Advances in cystic fibrosis (CF) care have significantly improved the quality of life and life expectancy of patients. Nutritional therapy based on a high-calorie, high-fat diet, antibiotics, as well as new therapies focused on CFTR modulators change the natural course of the disease. They do so by improving pulmonary function and growing BMI. However, the increased weight of such patients can lead to unwanted long-term cardiovascular effects. People with CF (pwCF) experience several cardiovascular risk factors. Such factors include a high-fat diet and increased dietary intake, altered lipid metabolism, a decrease in the level of fat-soluble antioxidants, heightened systemic inflammation, therapeutic interventions, and diabetes mellitus. PwCF must pay special attention to food and eating habits in order to maintain a nutritional status that is as close as possible to the proper physiological one. They also have to benefit from appropriate nutritional counseling, which is essential in the evolution and prognosis of the disease. Growing evidence collected in the last years shows that many bioactive food components, such as phytochemicals, polyunsaturated fatty acids, and antioxidants have favorable effects in the management of CF. An important positive effect is cardiovascular prevention. The possibility of preventing/reducing cardiovascular risk in CF patients enhances both quality of life and life expectancy in the long run.

Progress in molecular biology and translational science: Epigenetics in cardiovascular health and disease

Conrad Waddington's epigenetics landscape has provided a metaphorical framework for how cells progress from undifferentiated states to one of several discrete, distinct, differentiated cell fates. The understanding of epigenetics has evolved over time, with DNA methylation being the most studied epigenetic modification, followed by histone modifications and non-coding RNA. Cardiovascular diseases (CVD) are leading contributors to death worldwide, with the prevalence of CVDs increasing across the last couple of decades. Significant amount of resources being poured into researching key mechanisms and underpinnings of the various CVDs. These molecular studies looked at the genetics, epigenetics as well as the transcriptomics of various cardiovascular conditions, aiming to provide mechanistic insights. It has paved the way for therapeutics to be developed and in recent years, epi-drugs for the treatment of CVDs. This chapter aims to cover the various roles of epigenetics in the context of cardiovascular health and disease. The following will be examined in detail: the developments in basic experimental techniques used to study epigenetics, the role of epigenetics in various CVDs (hypertension, atrial fibrillation, atherosclerosis, and heart failure), and current advances in epi-therapeutics, providing a holistic view of the current concerted efforts in advancing the field of epigenetics in CVDs.

Association between tea consumption and prevention of coronary artery disease: A systematic review and dose-response meta-analysis

Background

Evidence from previous studies reporting on the relationship between tea consumption and its preventive effect on coronary artery disease (CAD) has conflicting outcomes. With the accumulation of new clinical evidence, we conducted this meta-analysis to assess tea consumption and CAD risk.

Methods

We searched PubMed, EMBASE, Cochrane Library, and Medline databases for published observational studies from their inception to May 2022. A random-effects model was used to calculate risk ratios with 95% confidence intervals. We also conducted linear and non-linear dose-response meta-analyses to analyze the association. We regarded that one cup equals 237 mL. Subgroup analyses and univariate meta-regression were conducted to explore the source of heterogeneity.

Results

A total of 35 studies, including 24 on green tea and 11 on black tea consumption, were included in this meta-analysis. An inverse association for the risk of CAD was observed for black tea (RR: 0.85; 95% CI: 0.76, 0.96) and green tea (RR: 0.93; 95% CI: 0.88, 0.99). The dose-response meta-analysis showed that drinking less than four cups of black tea daily may effectively prevent CAD, while more than 4-6 cups/d will promote disease risk. Furthermore, the dose-response relationship between green tea consumption and the prevention of CAD showed that the risk of CAD gradually decreased as green tea consumption increased. We also demonstrated that the more cups of green tea consumed, the lower the risk of CAD. In the subgroup analysis by continent, a significant negative correlation between CAD risk and green tea consumption was observed in the Asian population (RR: 0.92; 95% CI: 0.85, 0.99) but not in the western population [North America (RR: 0.97; 95% CI: 0.92, 1.03), Europe/Oceana (RR: 0.91; 95% CI: 0.78, 1.07)].

Conclusions

Higher green tea consumption was associated with reduced CAD risk, but drinking more than 4-6 cups of black tea per day may increase the risk. This study offers new insight into the relationship between tea consumption and its preventive effect on CAD. However, further large prospective cohort studies are needed to validate these findings.

Systematic review registration

The protocol of this systematic review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) system (CRD42022348069).

Cardiovascular Effects of Cydonia oblonga Miller (Quince)

Cydonia oblonga Miller (quince) is a monotypic genus in the Rosaceae family which used to treat or prevent many medical conditions such as diabetes, cancer, infections, and ulcer. This review will summarize the current state of knowledge available on botany, phytochemistry, and pharmacology of this plant with a focus on its effect on some cardiovascular risk factors such as diabetes, blood pressure, lipid profile, and body weight. Databases of Google Scholar, Web of Science, PubMed, Scopus, and SID were searched systematically for English published articles with no date limitation. There were no human studies found, and all of the studies were conducted on animals or in vitro models. Reviewing of all 12 included articles showed that different types of quince extract have positive effects on cardiovascular-related factors such as blood pressure, diabetes, glucose metabolism, lipid profile, ROS, body weight, liver dysfunction, and thrombosis. An antihypertensive effect of quince showed to be a magnitude that is comparable to captopril and the lipid-lowering effect of quince showed to be a magnitude that is comparable to simvastatin. However, two studies evaluated the effect of quince fruit extract on insulin levels; one of them reported no positive effect, and the other one reported a significant positive effect. It can be concluded that different parts of quince including leaf, seed, and fruit could be used for improving cardiovascular-related factors including blood pressure, glucose metabolism and diabetes, obesity, and lipid-adjusting purposes. Quince was also found to have strong anti-inflammatory and antioxidant capacity. This study paves the way for further studies on the cardiovascular effect of quince consumption as a beneficial nutraceutical in humans.

A comprehensive overview on the effects of green tea on anthropometric measures, blood pressure, glycemic and lipidemic status: An umbrella review and meta meta-analysis study

AIM

The aim of this meta-review was to establish the effects of green tea (GT) intake on some cardiometabolic risk factors including anthropometric measures, blood pressure as well as blood glucose and lipids using evidence from previous systematic reviews and meta-analyses.

DATA SYNTHESIS

Articles were identified via searches in PubMed, Embase, and the Cochrane Library, Web of Knowledge database from the index date of each database through January 31, 2021. A total of 13 meta-analyses were finally included in the synthesis. Meta-meta-analysis revealed significant effects of GT on weight and waist circumference with weighted mean difference (WMD) of -0.89 (95% CI -1.43 to -0.34, p < 0.001) and -1.01 (95% CI -1.63 to -0.39, p < 0.001), systolic and diastolic blood pressure, with WMDs of -1.17 (95% CI -2.18 to -0.16) and -1.24 (95% CI -2.07 to -0.4), respectively. There was similar effect on fasting blood glucose (WMD, -1.3, 95% CI -2.09 to -0.51, p < 0.001) but not on other glycemic indicators. The findings also revealed a significant effect size of total cholesterol and LDL-C (WMD -4.93; 95% CI -6.41 to -3.46, p < 0.001, WMD -4.31; 95% CI -6.55 to -2.07, p < 0.001, respectively).

CONCLUSION

Regular consumption of GT and probably its bioactive constituents as supplements have beneficial effects on different health aspects including weight, blood pressure, blood glucose and lipids. However, these effects might be influenced by several factors such as the amount and frequency of consumption, health/disease condition and life style including dietary habits and physical activity.

GC-MS biocomponents characterization and antibacterial potency of ethanolic crude extracts of Camellia sinensis

Objective:

The menace of antibacterial resistance among enteropathogenic bacteria continues to raise therapeutic management concerns within public health system. As a strategy toward alternative control of resistant pathogen proliferation, a folkloric plant (green tea leaves: Camellia sinensis) was collected from Ishaka municipality and characterized for biomolecular components and antibacterial potency.

Methods:

The bioactive and biomolecular components of the plant’s ethanol extract were characterized using gas chromatography–mass spectrometry. A preliminary in vitro susceptibility test of the extract against characterized multiple antibiotic-resistant potential diarrheagenic bacterial strains was done.

Results:

The result revealed an exponential increase in susceptibility with a distinctive unit component of the C. sinensis extract at concentrations of 60 and 80 μg/ml. The extract also possessed antibacterial and antioxidant activities while having phytochemical constituents (flavonoids, alkaloids, phenolics, saponin, cardiac glycosides, etc.). The gas chromatography–mass spectrometry analysis further affirmed the potential of the extract by revealing 52 bioactive components/compounds as shown in the chromatogram.

Conclusion:

The C. sinensis has antimicrobial and antioxidant potentials, and the constituents of the plant might be of therapeutic importance in the management of various diseases, especially those related to Escherichia coli and Salmonella.

Caloric restriction-mimetics for the reduction of heart failure risk in aging heart: with consideration of gender-related differences

The literature is full of claims regarding the consumption of polyphenol or polyamine-rich foods that offer some protection from developing cardiovascular disease (CVD). This is achieved by preventing cardiac hypertrophy and protecting blood vessels through improving the function of endothelium. However, do these interventions work in the aged human hearts? Cardiac aging is accompanied by an increase in left ventricular hypertrophy, along with diastolic and systolic dysfunction. It also confers significant cardiovascular risks for both sexes. The incidence and prevalence of CVD increase sharply at an earlier age in men than women. Furthermore, the patterns of heart failure differ between sexes, as do the lifetime risk factors. Do caloric restriction (CR)-mimetics, rich in polyphenol or polyamine, delay or reverse cardiac aging equally in both men and women? This review will discuss three areas: (1) mechanisms underlying age-related cardiac remodeling; (2) gender-related differences and potential mechanisms underlying diminished cardiac response in older men and women; (3) we select a few polyphenol or polyamine rich compounds as the CR-mimetics, such as resveratrol, quercetin, curcumin, epigallocatechin gallate and spermidine, due to their capability to extend health-span and induce autophagy. We outline their abilities and issues on retarding aging in animal hearts and preventing CVD in humans. We discuss the confounding factors that should be considered for developing therapeutic strategies against cardiac aging in humans.

Japanese-Style Diet and Cardiovascular Disease Mortality: A Systematic Review and Meta-Analysis of Prospective Cohort Studies

This systematic review and meta-analysis elucidate the effects of the Japanese-style diet and characteristic Japanese foods on the mortality risk of cardiovascular disease (CVD), cerebrovascular disease (stroke), and heart disease (HD). This review article followed the PRISMA guidelines. A systematic search in PubMed, The Cochrane Library, JDreamIII, and ICHUSHI Web identified prospective cohort studies on Japanese people published till July 2020. The meta-analysis used a random-effects model, and heterogeneity and publication bias were evaluated with I² statistic and Egger’s test, respectively. Based on inclusion criteria, we extracted 58 articles, including 9 on the Japanese-style diet (n = 469,190) and 49 (n = 2,668,238) on characteristic Japanese foods. With higher adherence to the Japanese-style diet, the pooled risk ratios (RRs) for CVD, stroke, heart disease/ischemic heart disease combined (HD/IHD) mortality were 0.83 (95% CI, 0.77–0.89, I² = 58%, Egger’s test: p = 0.625, n = 9 studies), 0.80 (95% CI, 0.69–0.93, I² = 66%, Egger’s test: p = 0.602, n = 6 studies), and 0.81 (95% CI, 0.75–0.88, I² = 0%, Egger’s test: p = 0.544, n = 6 studies), respectively. Increased consumption of vegetables, fruits, fish, green tea, and milk and dairy products decreased the RR for CVD, stroke, or HD mortality. Increased salt consumption elevated the RR for CVD and stroke mortality. Increased consumption of dietary fiber and plant-derived protein decreased the RR for CVD, stroke, and HD/IHD mortality. The Japanese-style diet and characteristic Japanese foods may reduce CVD mortality. Most studies conducted diet surveys between 1980 and the 1990s. This meta-analysis used articles that evaluated the same cohort study by a different method. A new large-scale cohort study matching the current Japanese dietary habits is needed to confirm these findings.

Dietary Supplements for Weight Management: A Narrative Review of Safety and Metabolic Health Benefits

Dietary supplements for weight management include myriad ingredients with thermogenic, lipotropic, satiety, and other metabolic effects. Recently, the safety of this product category has been questioned. In this review, we summarize the safety evidence as well as relevant clinical findings on weight management and metabolic effects of six representative dietary supplement ingredients: caffeine, green tea extract (GTE), green coffee bean extract (GCBE), choline, glucomannan, and capsaicinoids and capsinoids. Of these, caffeine, GTE (specifically epigallocatechin gallate [EGCG]), and choline have recommended intake limits, which appear not to be exceeded when used according to manufacturers’ instructions. Serious adverse events from supplements with these ingredients are rare and typically involve unusually high intakes. As with any dietary component, the potential for gastrointestinal intolerance, as well as possible interactions with concomitant medications/supplements exist, and the health status of the consumer should be considered when consuming these components. Most of the ingredients reviewed also improved markers of metabolic health, such as glucose, lipids, and blood pressure, although the data are limited for some. In summary, weight management supplements containing caffeine, GTE, GCBE, choline, glucomannan, and capsaicinoids and capsinoids are generally safe when taken as directed and demonstrate metabolic health benefits for overweight and obese people.

Association between Green Tea Consumption and Abdominal Obesity Risk in Middle-Aged Korean Population: Findings from the Korean Genome and Epidemiology Study

The prevalence of general and abdominal obesity is increasing with rapid economic growth and the westernization of dietary habits in Korea, especially in the middle-aged population. Data were obtained from the Korean Genome and Epidemiology Study (KoGES), which recruited 10,030 participants between the ages of 40 and 69 years. Information on green tea consumption was obtained from the food frequency questionnaire and categorized as none, <1 cup, between 1 and <4 cups, and ≥4 cups. Multivariable logistic regression models were used to estimate the ORs and 95% CIs to examine any possible associations between green tea consumption and the risk of abdominal obesity after controlling for potential confounders. High consumption of green tea was associated with a 44% lower odds ratio for abdominal obesity (none vs. ≥4 cups/week: OR, 0.56; 95% CI 0.41-0.78; p for trend = 0.001). When stratified by sex, an inverse association between green tea consumption and abdominal obesity was observed only in women (none vs. ≥4 cups/week: OR, 0.71; 95% CI 0.57−0.88; p for trend = 0.004). No significant association was found among men. Our findings indicate that green tea consumption has beneficial effects in the prevention of abdominal obesity in middle-aged Korean women.

Effects of β-Carotin and Green Tea Powder Diets on Alleviating the Symptoms of Gouty Arthritis and Improving Gut Microbiota in C57BL/6 Mice

As a chronic metabolic disease caused by disorders of purine metabolism, gout has shown increasing incidence rate worldwide. Considering that gout is not easily treated and cured, further studies are explored to prevent gout development through diet modification. Both β-carotin and green tea powder are rich in dietary fiber, which helps maintain the balance of gut microbiota in humans. The aim of this study was to investigate the effects of β-carotin and green tea powder diet on the prevention of gouty arthritis in relation to the bacterial structure of gut microbiota in mice. We successfully induced gouty arthritis in C57BL/6 mice by injecting monosodium urate (MSU) crystals and feeding high-fat diet (HFD), and further investigated the effects of additional β-carotin and green tea powder in the diets of mice on the prevention of gouty arthritis in mice. Our results showed that diet of β-carotin and green tea powder reduced the joint swelling and pain in mice with gout, reduced the levels of serum uric acid (UA) and three types of pro-inflammatory cytokines, i.e., interleukin-1β (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α), improved the gut microbiota profile, and reduced the metabolic levels of purines and pyrimidines. In conclusion, our study provided evidence to support the application of β-carotin and green tea powder diet as a dietary adjustment method to prevent and treat gouty arthritis.

Physiology, pathology and the biomolecular corona: the confounding factors in nanomedicine design

The biomolecular corona that forms on nanomedicines in different physiological and pathological environments confers a new biological identity. How the recipient biological system's state can potentially affect nanomedicine corona formation, and how this can be modulated, remains obscure. With this perspective, this review summarizes the current knowledge about the content of biological fluids in various compartments and how they can be affected by pathological states, thus impacting biomolecular corona formation. The content of representative biological fluids is explored, and the urgency of integrating corona formation, as an essential component of nanomedicine designs for effective cargo delivery, is highlighted.

The Effects and Safety of Chinese Herbal Medicine on Blood Lipid Profiles in Placebo-Controlled Weight-Loss Trials: A Systematic Review and Meta-Analysis

This study was conducted to assess the effects and safety of Chinese herbal medicine (CHM) on blood lipids among adults with overweight or obesity. Fourteen bibliographic databases were comprehensively searched, from their respective inceptions up to April 2021, for randomised placebo-controlled weight-loss trials using CHM formulation on total cholesterol, triglycerides, LDL cholesterol, and HDL cholesterol over ≥4 weeks. Data collection, risk of bias assessment, and statistical analyses were guided by the Cochrane Handbook (v6.1). Continuous outcomes were expressed as the mean difference with 95% confidence intervals, and categorical outcomes were expressed as a risk ratio with 95% confidence intervals. All analyses were two-tailed with a statistical significance of p < 0.05. Fifteen eligible studies with 1,533 participants were included in this meta-analysis. Findings from meta-analyses indicated that CHM interventions, compared to placebo, reduced triglyceride (MD −0.21 mmol/L, 95% CI −0.41 to −0.02, I² = 81%) and increased HDL cholesterol (MD 0.16 mmol/L, 95% CI 0.04 to 0.27, I² = 94%) over a median of 12 weeks. The reduction in total cholesterol and LDL cholesterol were not statistically significant. Furthermore, the tendency of reduced triglycerides was identified among overweight participants with high baseline triglycerides. Attrition rates and frequency of adverse events were indifferent between the two groups. CHM may provide lipid-modulating benefits on triglycerides and HDL cholesterol among participants with overweight/obesity, with the tendency for significant triglyceride reduction observed among overweight participants with high baseline triglycerides. However, rigorously conducted randomised controlled trials with larger sample sizes are required to validate these findings.

Tea intake and cardiovascular disease: an umbrella review

Brewed tea (Camellia sinensis) is a major dietary source of flavonoids, in particular flavan-3-ols. Tea consumption has been suggested to be inversely associated with a decreased risk of cardiovascular disease (CVD). Several biological mechanisms support the inverse relationship between tea flavonoid intake and CVD risk. Given the recent accumulating evidence from various systematic reviews regarding the role of tea as a beverage in reducing CVD risk and severity, we conducted an umbrella review to describe and critically evaluate the totality of evidence to date. We searched the PubMed, Web of Science, Cochrane Database of Systematic Reviews, and BIOSIS databases for systematic reviews published between January 1, 2010 and February 22, 2020 reporting relationships between tea (C. sinensis) consumption and CVD mortality, CVD diagnosis or incidence, CVD events, stroke events, blood pressure, endothelial function, blood lipids and triglycerides, and inflammatory markers. Herein, we describe results from 23 included systematic reviews. Consistently consuming 2 cups of unsweet tea per day offers the right levels of flavonoids to potentially decrease CVD risk and its progression. This is supported by the consistency between a recent high-quality systematic review and dose-response meta-analyses of population-based studies demonstrating beneficial effects of consumption on CVD mortality, CVD events and stroke events and medium- to high-quality systematic reviews of intervention studies that further elucidate potential benefits on both validated (i.e., SBP, DBP, total cholesterol, and LDL-cholesterol) and emerging risk biomarkers of CVD (TNF-ɑ and IL-6). On the basis of this umbrella review, the consumption of tea as a beverage did not seem to be harmful to health; therefore, the benefits of moderate consumption likely outweigh risk. Future large, clinical intervention studies will provide better mechanistic insight with the ability to confirm the outcome effects shown across observational studies. The review protocol was registered on PROSPERO (https://www.crd.york.ac.uk/PROSPERO/) as CRD42020218159.KEY MESSAGESIt is reasonable to judge that 2 cups of unsweet tea per day has the potential to decrease CVD risk and progression due to its flavonoid content.The primary side effects of tea documented in human studies are hepatotoxicity and gastrointestinal disturbances (i.e., vomiting and diarrhea) after high-dose supplemental intake.Additional clinical research is needed to fully elucidate the effects of tea flavonoids on markers of CVD, as many studies were under-powered to detect changes.[Figure: see text].

Herbs and their bioactive ingredients in cardio-protection: Underlying molecular mechanisms and evidences from clinical studies

BACKGROUND

Medicinal plants or herbs produce a bounty of bioactive phytochemicals. These phytochemicals can influence a variety of physiological events related to cardiovascular health through multiple underlying mechanisms, such as their role as antioxidative, anti-ischemic, anti-proliferative, hypotensive, anti-thrombotic, and anti-hypercholesterolemic agents.

PURPOSE

The purpose of this review is to summarize and connect evidences supporting the use of phytotherapy in the management of some of the most common cardiovascular impairments, molecular mechanisms underlying cardio-protection mediated by herbs, and clinical studies which are positively linked with the use of herbs in cardiovascular biology. Additionally, we also describe several adverse effects associated with some of the herbal plants and their products to provide a balanced set of studies in favor or against phytotherapy in cardiovascular health that may help global discourses on this matter.

METHODS

Studies relating to the use of medicinal plants were mined by strategically searching scientific databases including Google Scholar, PubMed and Science Direct. Investigations involving approximately 175 articles including reviews, research articles, meta-analyses, and cross-sectional and observational studies were retrieved and analyzed in line with the stated purpose of this study.

RESULTS

A positive correlation between the use of medicinal plants and cardiovascular health was observed. While maintaining cardiovascular physiology, medicinal plants and their derivatives seem to govern a variety of cellular mechanisms involved in vasoconstriction and vasorelaxation, which in turn, are important aspects of cardiovascular homeostasis. Furthermore, a variety of studies including clinical trials, cross-sectional studies, and meta-analyses have also supported the anti-hypertensive and thus, cardio-protective effects, of medicinal plants. Apart from this, evidence is also available for the potential drawbacks of several herbs and their products indicating that the unsupervised use of many herbs may lead to severe health issues.

CONCLUSIONS

The cardio-protective outcomes of medicinal plants and their derivatives are supported by ever-increasing studies, while evidences exist for the potential drawbacks of some of the herbs. A balanced view about the use of medicinal plants and their derivative in cardiovascular biology thus needs to be outlined by researchers and the medical community. The novelty and exhaustiveness of the present manuscript is reflected by the detailed outline of the molecular basis of "herbal cardio-protection", active involvement of several herbs in ameliorating the cardiovascular status, adverse effects of medicinal plants, and the clinical studies considering the use of phytotherapy, all on a single platform.

Coffee and tea on cardiovascular disease (CVD) prevention

Coffee and tea are amongst the most consumed beverages worldwide, and are the main source of caffeine in adults. In this review we present findings on the effects of habitual coffee and tea consumption on cardiovascular disease (CVD) prevention. Mild-moderate coffee/ caffeine consumption, at 2-3 cups/day, is associated with beneficial effects on metabolic syndrome, including hypertension and diabetes mellitus, although may elevate lipid levels. Furthermore, coffee consumption reduces the risk of coronary heart disease, heart failure, arrhythmia, stroke, CVD and all cause mortality. Higher tea consumption, in particular green tea, confers similar cardiovascular benefits to coffee with 3 cups/day associated with improved survival in population based studies.

Nutraceuticals in the Management of Dyslipidemia: Which, When, and for Whom? Could Nutraceuticals Help Low-Risk Individuals with Non-optimal Lipid Levels?

Purpose of Review

The aim of this review is to summarize the available clinical efficacy and safety data related to the most studied and used lipid-lowering nutraceuticals.

Recent Findings

A growing number of meta-analyses of randomized clinical trials supports the effectiveness and tolerability of some lipid-lowering nutraceuticals such as red yeast rice, plant sterols and stanols, soluble fibers, berberine, artichoke extracts, bergamot polyphenol fraction, garlic, green tea, and spiruline. No significant safety concern has been raised for the use of such products. Association of more lipid-lowering nutraceuticals and of some nutraceuticals with lipid-lowering drugs has been tested as well.

Summary

Current evidence suggests that some clinically tested lipid-lowering nutraceuticals could be safely used to improve plasma lipid levels in subjects affected by mild-to-moderate dyslipidaemia with low cardiovascular risk.

Green Tea from the Far East to the Drug Store: Focus on the Beneficial Cardiovascular Effects

Cardiovascular diseases (CVD) are the leading cause of death worldwide. Evidence from observational and randomized controlled studies showing the potential benefits of green tea on lowering CVD risk has been emerging rapidly during the past few decades. These benefits include reduced risk for major cardiovascular events, lowering of blood pressure, decreased LDL cholesterol levels and weight loss. At the same time, the understanding of the physiological mechanisms behind these alterations is advancing. Consumption of green tea originated from China thousands of years ago, but since then, it expanded all over the world. Recent advances in understanding the role of tea polyphenols, mainly catechins, as mediators of tea's health benefits, have caused the emergence of various types of green tea extracts (GTE) on the market. While taking green tea is generally considered safe, there are concerns about the safety of using tea extracts. The present article reviews the current evidence of green tea consumption leading to reduced CVD risk, its potential biological mechanisms and the safety of using GTE.

Herbal drugs and natural bioactive products as potential therapeutics: A review on pro-cognitives and brain boosters perspectives

Memory, one of the most vital aspects of the human brain, is necessary for the effective survival of an individual. 'Memory' can be defined in various ways but in an overall view, memory is the retention of the information that the brain grasps. Different factors are responsible for the disbalance in the brain's hippocampus region and the acetylcholine level, which masters the memory and cognitive functions. Plants are a source of pharmacologically potent drug molecules of high efficacy. Recently herbal medicine has evolved rapidly, gaining great acceptance worldwide due to their natural origin and fewer side effects. In this review, the authors have discussed the mechanisms and pharmacological action of herbal bioactive compounds to boost memory. Moreover, this review presents an update of different herbs and natural products that could act as memory enhancers and how they can be potentially utilized in the near future for the treatment of severe brain disorders. In addition, the authors also discuss the differences in biological activity of the same herb and emphasize the requirement for a higher standardization in cultivation methods and plant processing. The demand for further studies evaluating the interactions of herbal drugs is mentioned.

Targeting dyslipidemia by herbal medicines: A systematic review of meta-analyses

ETHNOPHARMACOLOGICAL RELEVANCE

The worldwide increasing prevalence of dyslipidemia has become a global health concern. Various herbal remedies have been claimed to be effective for the treatment of dyslipidemia in traditional and folkloric medicine of different regions clinical trials have been conducted to investigate their efficacy. The aim of the current systematic review is to critically assess the meta-analyses of controlled trials (CT) evaluated herb medicines for dyslipidemia.

MATERIALS AND METHODS

Relevant studies from Web of Science, PubMed, Scopus, and Cochrane Library databases based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist until January 2021 have been searched. All meta-analyses which pooled studies on the effect of herbal medicines on lipid profile including total cholesterol (TC), triglyceride (TG), and low- or high-density lipoprotein cholesterol (LDL-C, HDL-C) were also included. Meta-analyses of in vitro, animal or observational studies were excluded.

RESULTS

The overall of 141 meta-analyses were revealed. Vegetable oils, phytosterols, tea, soy protein, nuts, and curcumin have been studied frequently among the herbal medicines. Among 13 meta-analyses on vegetable oils, the greater reduce of TC (18.95 mg/dl), LDL-C (16.24 mg/dl) and TG (13.69 mg/dl) were exhibited from sunflower oil. Furthermore, rice bran oil (6.65 mg/dl) increased HDL-C significantly. Phytosterols in 12 meta-analyses demonstrated significant improvements in reducing TC, LDL-C and TG as 16.4, 23.7, and 8.85 mg/dl, respectively, and rise in HDL-C as 10.6 mg/dl. The highest reduction in serum level of TC, LDL-C and TG was reported while intake Green tea; 27.57, 24.75, and 31.87 mg/dl, accordingly within 9 meta-analyses. Average improvement of lipid profiles by 6 meta-analyses on plant proteins were 23.2, 21.7, 15.06, and 1.55 mg/dl for TC, LDL-C, TG, and HDL-C, respectively. Among 11 meta-analyses on nuts, almond showed better and significant alleviations in TC (10.69 mg/dl), walnut in LDL-C (9.23 mg/dl), pistachio in TG (22.14 mg/dl), and peanut in HDL-C (2.72 mg/dl). Overall, Curcumin, Curcuminoid, and Turmeric have resulted in the reduction of TC (25.13 mg/dl), LDL-C (39.83 mg/dl), TG (33.65 mg/dl), and an increase in the HDL-C (4.31 mg/dl).

CONCLUSION

The current systematic review shed light on the use of herbal medicines for the management of dyslipidemia. However, more well-conducted CTs are required to determine effective doses of herbal medicines.

The pros and cons of drinking tea

Tea is the most frequently consumed beverage worldwide besides water. Generally, there are five most popular types of tea: green, white, black, Pu’er, and oolong. Tea possesses significant antioxidant, anti-inflammatory, antimicrobial, anticarcinogenic, antihypertensive, neuroprotective, and cholesterol-lowering properties. Several research investigations, epidemiological studies, and meta-analyses suggest that tea and its bioactive polyphenolic constituents have numerous beneficial effects on health, including the prevention of many diseases, such as cancer, diabetes, arthritis, cardiovascular disease, stroke, and obesity. Recently, there are many reports about the resistance of tea to COVID-19 virus on the Internet, which has attracted a lot of attention to tea drinking and the discussion about the pros and cons of tea drinking. Based on our research results and relevant reports form literatures, this review is intended to highlight the beneficial effects and possible side-effects associated with tea consumption, answer 10 questions and point out a few matters for attention.

Lipid-lowering nutraceuticals update on scientific evidence

: Cardiovascular diseases (CVDs) are the main cause of mortality worldwide. Risk factors of CVD can be classified into modifiable (smoking, hypertension, diabetes, hypercholesterolemia) through lifestyle changes or taking drug therapy and not modifiable (age, ethnicity, sex and family history). Elevated total cholesterol (TC) and low-density lipoprotein-cholesterol (LDL-C) levels have a lead role in the development of coronary heart disease (CHD), while high levels of high-density lipoprotein-cholesterol (HDL-C) seem to have a protective role.The current treatment for dyslipidemia consists of lifestyle modification or drug therapy even if not pharmacological treatment should be always considered in addition to lipid-lowering medications.The use of lipid-lowering nutraceuticals alone or in association with drug therapy may be considered when the atherogenic cholesterol goal was not achieved.These substances can be classified according to their mechanisms of action into natural inhibitors of intestinal cholesterol absorption, inhibitors of hepatic cholesterol synthesis and enhancers of the excretion of LDL-C. Nevertheless, many of them are characterized by mixed or unclear mechanisms of action.The use of these nutraceuticals is suggested in individuals with borderline lipid profile levels or with drug intolerance, but cannot replace standard lipid-lowering treatment in patients at high, or very high CVD risk.Nutraceuticals can also have vascular effects, including improvement in endothelial dysfunction and arterial stiffness, as well as antioxidative properties. Moreover, epidemiological and clinical studies reported that in patients intolerant of statins, many nutraceuticals with demonstrated hypolipidemic effect are well tolerated.

Production stages, microbiological risk and benefits on health of herbal teas

Plants have been used to prepare herbal infusions for centuries. Production of herbal tea consists of several steps, beginning with harvesting, cleaning form residues, drying, storage of herb in a suitable material, grinding, and blending. Te plants grow in different regions and climatic conditions, varying by their physical properties. They are consumed for different purposes and due to their chemical constituents. Many of them have therapeutic effects. Besides their various benefits and even antimicrobial effects, they also carry some microorganisms. Thus, the botanical characteristics and effects on the health of frequently consumed herbal teas and recommendations on their consumption with considered microbial risks are reviewed in this article.

Phytotherapy for Cardiovascular Disease: A Bench-to-Bedside Approach

At present, cardiovascular disease (CVD) remains the leading cause of morbidity and mortality worldwide, and global trends suggest that this panorama will persist or worsen in the near future. Thus, optimization of treatment strategies and the introduction of novel therapeutic alternatives for CVD represent key objectives in contemporary biomedical research. In recent years, phytotherapy-defined as the therapeutic use of whole or minimally modified plant components-has ignited large scientific interest, with a resurgence of abundant investigation on a wide array of medicinal herbs (MH) for CVD and other conditions. Numerous MH have been observed to intervene in the pathophysiology of CVD via a myriad of molecular mechanisms, including antiinflammatory, anti-oxidant, and other beneficial properties, which translate into the amelioration of three essential aspects of the pathogenesis of CVD: Dyslipidemia, atherosclerosis, and hypertension. Although the preclinical data in this scenario is very rich, the true clinical impact of MH and their purported mechanisms of action is less clear, as large-scale robust research in this regard is in relatively early stages and faces important methodological challenges. This review offers a comprehensive look at the most prominent preclinical and clinical evidence currently available concerning the use of MH in the treatment of CVD from a bench-to-bedside approach.

Dietary Strategies by Foods with Antioxidant Effect on Nutritional Management of Dyslipidemias: A Systematic Review

Nutrition plays a fundamental role in the prevention and treatment of dyslipidemias and its oxidative-related complications. Currently, there is evidence about the beneficial effects of isolated antioxidants or foods enriched or added with antioxidant compounds. However, the application of the natural foods is more integrated than the analysis of a single nutrient. Our aim is compiling scientific literature regarding the nutritional strategies by foods with antioxidant effect in blood lipids, enzymatic and non-enzymatic antioxidants, and oxidative and inflammatory markers of subjects with dyslipidemia. We searched in MEDLINE/PubMed, Scopus, and Web of Science. From a total of 263 studies screened, 16 were included. Dietary strategies included walnuts, olive oil, raw almonds, G. paraguayase, white sesame, mate tea, Brazil nut flour, red wine, granulated Brazil nuts, grapes, wolfberry fruit, fermented beverage, coffee, orange, and blackberry juices showed significant differences in blood lipids, antioxidant activity, antioxidant enzymes, and oxidative and inflammatory markers. This systematic review compiling scientific studies about dietary strategies using foods with antioxidant effect to improve the antioxidant status in dyslipidemias.

Camellia Sinensis Mouthwashes in Oral Care: a Systematic Review

Herbal products are increasingly growing in the oral care market. Some of the related herbal compounds in this field have considerable clinical evidence for use in mouthwashes in their background. Camellia sinensis or tea plant has attracted numerous researchers of dentistry and pharmaceutical sciences, in recent years, for its biologic and medicinal properties. The effects such as anti-septic, anti-oxidative, and anti-inflammatory activities have made this plant a suitable candidate for preparation of mouthwashes. In this systematic review, we tried to find, evaluate, and categorize the sparse evidence in medical literature about Camellia sinensis mouthwashes. We explored three scientific databases with keywords including tea, dental care, Camellia sinensis, and mouthwashes and found 69 relevant studies including 41 randomized controlled trials (RCTs), which are generally proposing anti-microbial, anti-plaque, and analgesic indications for these tea formulations. Considering the main trend in clinical evidence and favorable safety profile, Camellia sinensis products are able to act as antiseptic, anti-plaque, and anti-inflammatory agents and can be used as useful mouthwashes in the future clinical studies and practice.

Herbal or Dietary Supplement Use and Hypertensive Medications: Does the Combination Relate to Medication Adherence and Blood Pressure Control?

Introduction: Medication nonadherence contributes to poor blood pressure control and increases cardiovascular disease risk in patients with hypertension. Identifying modifiable risk factors for low or nonadherence to antihypertensive medication is needed. Studies that have examined the relationship between herbal or dietary supplement (HDS) use and antihypertensive medication nonadherence provide inconsistent findings. Data from the National Health and Nutrition Examination Survey were used to examine the association between HDS use, current use of prescribed antihypertensive medication, and blood pressure status. Methods: The study sample included hypertensive adults (n = 5,478) who have been told by a health professional to take prescribed medication for their health condition. Respondents were classified as either HDS users or HDS nonusers. Depending on the kind of supplement used, HDS users were further divided into three mutually exclusive groups: hypertension HDS users, nonhypertension HDS users, and those who used both kinds of supplements. Supplements groupings were based on reports in the literature. Blood pressure status definition was based on Eighth Joint National Committee (JNC 8) recommendations. Adjusted odds ratios (aORs) and 95% confidence intervals (95% CIs) were obtained from logistic models. Results: Overall HDS use prevalence was 62%. Current medication use did not significantly differ between patients reporting no HDS use and those reporting HDS use (aOR: 1.45; 95% CI: 0.78-2.69). No observable differences were found in current medication use between patients reporting no HDS use and those taking nonhypertension HDS or both kinds of supplements. Use of hypertension HDS was associated with improved blood pressure (aOR: 1.90; 95% CI: 1.07-3.36) compared with no HDS use. Conclusion: In a nationally representative U.S. sample, HDS use did not compromise current use of prescribed medication and was associated with improved blood pressure control. More research is needed to better understand why HDS use is associated with better blood pressure control.

Effects of green tea extract combined with brisk walking on lipid profiles and the liver function in overweight and obese men: A randomized, double-blinded, placebo-control trial

This study was aimed to investigate the effect of green tea extract (GTE) combined with brisk walking on lipid profiles and the liver function in overweight and obese men. Twenty-four participants were randomized to either the GTE group or the placebo group for 12 weeks with a 4-week follow-up. The walking program consisted of four 60-min-sessions/week and all participants were asked to consume two GTE (150mg) or placebo tablets daily. After 12-week intervention, GTE group resulted in a significant difference in the low-density lipoprotein cholesterol (LDL-C) and total cholesterol (TC) levels when compared to placebo group (P < 0.01). There was also a significant reduction in the aspartate aminotransferase levels (P < 0.01) in the GTE group, but no change in the placebo group (P >0.05). There was no change in the triglyceride or high-density lipoprotein cholesterol (HDL-C) levels in the placebo group, but a significant reduction was noted in the HDL-C levels in the GTE group (P < 0.05). GTE combined with brisk walking resulted in a significant change in the LDL-C and TC levels, however, a significant reduce in HDL-C in the GTE group. The study has a more positive effect on the liver function than brisk walking alone.

Medicinal plants and bioactive natural compounds as inhibitors of HMG-CoA reductase: A literature review

Cardiovascular diseases (CVDs) are one of the most important causes for mortality worldwide. Elevated levels of total cholesterol, and particularly LDL-cholesterol (LDL-C) are the main risk factor for acute myocardial infarction (AMI) and ischemic heart disease. The risk of CVDs could be reduced by decreasing the elevated cholesterol levels. β-hydroxy β-methylglutaryl-CoA reductase (HMGCoAR) is the primary and rate-limiting enzyme in the cholesterol biosynthesis pathway. Recently, the crucial role of nutraceuticals in maintaining normal physiological function was established. Nutraceuticals play an important role in preventing several non-communicable diseases such as obesity, CVDs, cancer, diabetes, and reducing hyperlipidemia. Although the effect of nutraceuticals and herbal medicine on CVDs and dyslipidemia was previously investigated thoroughly, the effect of these natural products on HMGCoAR as one of the important enzymes involved in CVDs etiopathogenesis has not yet been investigated. Therefore, the major aim of this paper was to review the effects of nutraceuticals and medicinal plants on HMGCoAR. Results indicate that different types of natural foods, isolated nutrients, herbal products, and dietary supplements as nutraceuticals decrease the expression and activity of HMGCoAR. This review shows that medicinal plants and nutraceuticals could be used to decrease HMGCoAR activity as accessible and convenient and economical natural compounds to prevent dyslipidemia and CVDs.

Dietary green tea powder supplementation enriched egg nutrients and physicochemical property in an indigenous chicken breed

Dietary supplementation of green tea changes the antioxidative capacity of chickens. However, the effect of green tea supplementation in the diet on egg quality and the consequent change in processing capacity is still not well known. The aim of this study was to determine whether green tea powder (GTP) supplementation could affect egg quality, egg antioxidant capacity, and sensory and egg processing characteristics. Huainan partridge chickens (1,080) at 20 wk old were divided into 2 groups, one group fed a basal diet (control) and one group fed a basal diet plus 10 g kgˆ-1 GTP for 12 wk. After the levels of yolk cholesterol had been determined, chickens from the control group were further divided into low- and high-cholesterol groups and were fed a basal diet or a diet with 10 g kgˆ-1 GTP by orthogonal design. After 4 wk, the egg processing characteristics were investigated. Egg specific gravity, shell strength, shell thickness, albumin height, Haugh unit (HU) and cholesterol content were significantly lower in the GTP group than in the control group (P < 0.05). Egg weight, albumin height, yolk color, and HU increased in a time-dependent manner in both the control and GTP groups (P < 0.01). The yolk C16:0, C20:0, C18:1, C18:2, and polyunsaturated fatty acid (PUFA) contents were higher in the GTP group than in the control group (P < 0.05). Egg whites from the GTP group showed increased radical scavenging activity (P < 0.05). Egg appearance and texture from the GTP group were more preferred than those of the control group (P < 0.05). Eggs from the GTP group had lower hardness, chewiness, and water retention capacity than those of eggs from the control group (P < 0.05). Eggs from the GTP group with high yolk cholesterol showed lower chewiness than those from the basal diet group (P < 0.05). The results suggested that GTP supplementation could enrich the PUFA content in egg yolks, improve the overall taste, and change processing characteristics.

A META-ANALYSIS OF THE EFFECTS OF GREEN TEA COMBINED WITH PHYSICAL ACTIVITY ON BLOOD LIPIDS IN HUMANS

ABSTRACT Introduction: Most studies of green tea extract (GTE) combined with physical activity have reported a preventative effect for cardiovascular disease; however, the findings regarding the effects on serum lipids are controversial. Objective: This meta-analysis aimed to examine the evidence of the effects of GTE combined with physical activity on the serum lipid content in humans. Methods: In June 2017, we conducted electronic searches of PubMed, Web of Science, and Cochrane Library to identify pertinent studies: those with an experiment period exceeding two weeks, human randomized controlled trials (RCTs), and those that only assessed GTE with physical activity were included. A random effects model meta-analysis was used in this review. Results: A total of 271 citations were retrieved in our search of the electronic literature, and 7 RCTs, which included 608 individuals, were identified. Overall, there was no significant decrease in low-density lipoprotein cholesterol (LDL-C) (SMD:-0.169; 95% confidence interval [CI]:-0.414 to 0.076; I2=22.7%; p=0.177) or total cholesterol (TC) levels between the GTE and placebo combined with the physical activity group. Similar results were also observed for high density-lipoprotein cholesterol (HDL-C) and triglycerides (TG). In the subgroup and sensitivity analyses of the five studies, the TC levels of the subjects who received a lower dose of epigallocatechin gallate (EGCG) together with performing physical activity were significantly decreased. Conclusion: Current evidence suggests that green tea combined with physical activity does not improve the lipid and lipoprotein levels in humans. Level of evidence I; Systematic review.

Nutrition, Bioenergetics, and Metabolic Syndrome

According to the World Health Organization (WHO), the global nutrition report shows that whilst part of the world’s population starves, the other part suffers from obesity and associated complications. A balanced diet counterparts these extreme conditions with the proper proportion, composition, quantity, and presence of macronutrients, micronutrients, and bioactive compounds. However, little is known on the way these components exert any influence on our health. These nutrients aiming to feed our bodies, our tissues, and our cells, first need to reach mitochondria, where they are decomposed into CO₂ and H₂O to obtain energy. Mitochondria are the powerhouse of the cell and mainly responsible for nutrients metabolism, but they are also the main source of oxidative stress and cell death by apoptosis. Unappropriated nutrients may support mitochondrial to become the Trojan horse in the cell. This review aims to provide an approach to the role that some nutrients exert on mitochondria as a major contributor to high prevalent Western conditions including metabolic syndrome (MetS), a constellation of pathologic conditions which promotes type II diabetes and cardiovascular risk. Clinical and experimental data extracted from in vitro animal and cell models further demonstrated in patients, support the idea that a balanced diet, in a healthy lifestyle context, promotes proper bioenergetic and mitochondrial function, becoming the best medicine to prevent the onset and progression of MetS. Any advance in the prevention and management of these prevalent complications help to face these challenging global health problems, by ameliorating the quality of life of patients and reducing the associated sociosanitary burden.

Green tea and cancer and cardiometabolic diseases: a review of the current epidemiological evidence

Green tea is commonly consumed in China, Japan, and Korea and certain parts of North Africa and is gaining popularity in other parts of the world. The aim of this review was to objectively evaluate the existing evidence related to green tea consumption and various health outcomes, especially cancer, cardiovascular disease and diabetes. This review captured evidence from meta-analyses as well as expert reports and recent individual studies. For certain individual cancer sites: endometrial, lung, oral and ovarian cancer, and non-Hodgkins lymphoma the majority of meta-analyses observed an inverse association with green tea. Mixed findings were observed for breast, esophageal, gastric, liver and a mostly null association for colorectal, pancreatic, and prostate cancer. No studies reported adverse effects from green tea related to cancer although consuming hot tea has been found to possibly increase the risk of esophageal cancer and concerns of hepatotoxity were raised as a result of high doses of green tea. The literature overall supports an inverse association between green tea and cardiovascular disease-related health outcomes. The evidence for diabetes-related health outcomes is less convincing, while the included meta-analyses generally suggested an inverse association between green tea and BMI-related and blood pressure outcomes. Fewer studies investigated the association between green tea and other health outcomes such as cognitive outcomes, dental health, injuries and respiratory disease. This review concludes that green tea consumption overall may be considered beneficial for human health.

What is the Impact of Cinnamon Supplementation on Blood Pressure? A Systematic Review and Meta-Analysis

AIM

This study was designed to make a systematic review and meta-analysis on randomized controlled trials (RCTs) assessing the effect of cinnamon on blood pressure (BP).

METHODS

A systematic computerized literature search of PubMed, Scopus, Web of Science, Cochrane Library and Google Scholar databases was conducted up to August 2019. All RCTs using cinnamon supplements in adults were included in this systematic review and meta-analysis.

RESULTS

Out of 927 records, 8 trials that enrolled 582 participants were included. The pooled effect size showed that SBP did not change following cinnamon supplementation. (WMD: -0.61mmHg; 95% CI: -1.36, 0.14, P= 0.111). Also cinnamon supplementation in long-duration (≥ 8weeks) had a significant effect on SBP (WMD: -1.25 mmHg; 95% CI: -2.22, -0.28, P= 0.012). Pooled analysis showed that cinnamon had a significant effect on DBP (WMD: -0.93mmHg, 95% CI: -1.55 to -0.32, P= 0.003). In addition, results from both duration subsets and high dose (>1500 mg/day) of cinnamon supplementation were significant.

CONCLUSION

Our findings revealed that cinnamon supplementation has favorable effects on DBP although results of SBP were not the same. Nonetheless, further studies are required.

Effect of green tea extract on lipid profile in patients with type 2 diabetes mellitus: A systematic review and meta-analysis

BACKGROUND

Previous studies have indicated controversial results regarding the efficacy of green tea extract (GTE) in improving the lipid profile of type 2 diabetes mellitus (T2DM) patients. We aimed to conduct a systematic review and meta-analysis to pool data from randomized controlled trials (RCTs).

METHODS

A systematic search was performed in Web of Science, PubMed, and Scopus databases, without any language and time restriction until August 2019, to retrieve the RCTs which examined the effects of GTE on serum concentrations of high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglyceride (TG) or total cholesterol (TC) in T2DM patients. Meta-analyses were carried out using a random effects model. I2 index was used to evaluate the heterogeneity.

RESULTS

Initial search yielded 780 publications. Of these, seven studies were eligible. The supplementary intake of GTE improved lipid profile by reducing serum TG concentrations in patients with T2DM. Meanwhile, subgroup analyses based on duration of interventions (≤8 and > 8 weeks) and intervention dosage (≤800 and > 800 mg/day) showed that the GTE supplementation longer than 8 weeks and in doses >800 mg/day resulted in a significant decrease in serum TG concentrations. Furthermore, intervention longer than 8 weeks with doses lower than 800 mg/day resulted in a significant reduction in serum TC concentrations.

CONCLUSION

In conclusion, present systematic review and meta-analysis revealed that the supplementary intake of GTE may improve lipid profile by reducing serum concentrations of TG in patients with T2DM. Furthermore, the results of our stratified analyses suggested that long-term GTE intervention may reduce serum concentrations of TG and TC.

Dietary Factors and Neurodegenerative Disorders: An Umbrella Review of Meta-Analyses of Prospective Studies

Diet has been hypothesized to be associated with neurodegenerative disorders. The aim was to conduct an umbrella review to summarize and evaluate the current evidence of prospective associations between any dietary factors and the incidence of neurodegenerative disorders. We conducted a systematic search in PubMed, Embase, and the Cochrane library up to November 2019 to identify systematic reviews with meta-analyses of prospective studies investigating the association between dietary factors (dietary patterns, foods and beverages, nutrients, and phytochemicals) and neurodegenerative disorders (cognitive decline, cognitive impairment, Alzheimer disease, all-cause dementia, and Parkinson disease). Summary risk ratios (SRRs) and 95% CIs were recalculated using a random effects model. We evaluated the risk of bias of identified meta-analyses and the quality of evidence for all associations. In total, 20 meta-analyses including 98 SRRs were identified. All original meta-analyses were rated as being at high risk of bias. Methodological concerns related mainly to the inappropriate synthesis, assessment, and discussion of the risk of bias of primary studies. For the recalculated meta-analyses, quality of evidence was moderate for inverse associations between higher adherence to the Mediterranean diet (SRR: 0.63; 95% CI: 0.48, 0.82; n = 4 primary studies) and higher fish intake (SRR: 0.72; 95% CI: 0.59, 0.89; n = 6) and Alzheimer disease, as well as for tea consumption and all-cause dementia (SRR: 0.74; 95% CI: 0.63, 0.88; n = 2) and Parkinson disease (SRR per 2 cups/d: 0.69; 95% CI: 0.54, 0.87; n = 5). This umbrella review provides a comprehensive overview of the available evidence on dietary factors and neurodegenerative disorders. The results indicate that the Mediterranean diet, fish, and tea could be inversely associated with neurodegenerative disorders. However, the quality of evidence was generally low, suggesting that further studies are likely to change the overall estimates. Thus, more well-conducted research, also investigating other dietary factors in association with neurodegenerative disorders, is warranted.