Olive leaf extract as a hypoglycemic agent in both human diabetic subjects and in rats

Efficacy and safety of olive leaf extract (Olea europaea L.) for glycaemic control in adults with type 2 diabetes mellitus (ESOLED): A pilot randomised controlled trial

BACKGROUND

Maintaining optimum glycaemic control is essential to reducing comorbidity and mortality in diabetes. However, research indicates that <50 % of patients achieve their target HbA1c ranges. Laboratory studies suggest that olive leaf extract (OLE) may improve glycaemic control, however clinical studies in persons with diabetes are lacking.

METHODS

ESOLED is a pilot, randomised, placebo-controlled trial. Adults with a diagnosis of type 2 diabetes of ≥12 months duration, and not receiving insulin therapy, were eligible to participate. Participants were randomised to receive OLE or placebo capsules for 24 weeks. The primary outcome was change in HbA1c. Secondary outcomes included changes in the homeostasis model assessment of insulin resistance, diabetes-related stress, health-related quality of life, and safety.

RESULTS

Thirty-one participants were randomly assigned to the OLE (n = 16) and placebo (n = 15) groups. Analyses found no statistically significant time-group interactions for HbA1c, diabetes-related distress or health-related quality of life. Although participants receiving OLE demonstrated greater improvements in insulin sensitivity than those on placebo, there was no significant difference between groups over time. OLE and placebo were found to be well-tolerated, with no severe or serious adverse events reported in either group.

CONCLUSION

The ESOLED trial has provided preliminary evidence on the tolerability of OLE in adults with type 2 diabetes, but was inconclusive in determining whether OLE is effective at improving glycaemic control, insulin sensitivity, diabetes-related distress and quality of life. Larger trials and further exploration of the bioavailability of OLE are needed to fully assess the therapeutic potential of OLE in diabetes.

TRIAL REGISTRATION

Australian New Zealand Clinical Trials Registry (ACTRN12622000616774).

Antidiabetic potential of vanadium complexes combined with olive leaf extracts: a viable approach to reduce metal toxicity

Vanadium compounds are known for their antidiabetic properties due to their ability to interfere with numerous mechanisms that lead to the decrease of blood glucose levels. Although some of these compounds have reached clinical trials and have the advantage of being orally administrable, no vanadium-containing drugs are currently available on the market, primarily due to the high doses required, which can lead intestinal and renal problems in case of long-term treatments. In this study, plant extracts obtained from olive leaves (Olea europaea L.) were combined with vanadium complexes with established antidiabetic activity with the aim of reducing their metal toxicity and, at the same time, amplifying their hypoglycemic action. The extracts were characterized by chromatographic and spectroscopic methods showing a composition rich in polyphenols and a high antioxidant activity. Formulations containing a vanadium complex (bis(maltolato)oxidovanadium(IV), BMOV, or bis(picolinato)oxidovanadium(IV), BPOV) mixed with different amount of olive leaves extract were tested in vitro to evaluate intestinal toxicity and hypoglycemic activity. The results demonstrated that the plant extracts are generally non-toxic toward human colon fibroblast in the whole range of tested concentrations and some of them are particularly effective in reducing the toxicity of the two vanadium compounds. Further in vitro tests conducted on differentiated human adipocyte cell lines revealed a significant increase in glucose uptake following treatment with the mixed formulations, compared to the effect of the individual components, indicating a synergistic effect. Immunocytochemical assays suggested that the translocation of GLUT4 transporter can be involved in the mechanism of action.

A Narrative Review on Plant Extracts for Metabolic Syndrome: Efficacy, Safety, and Technological Advances

Metabolic syndrome, a global health concern, is characterized by visceral obesity, hyperglycemia, dyslipidemia, hypertension, and chronic low-grade inflammation. Current therapeutic options are limited by their varying efficacy and significantly adverse side effects, fueling interest in natural products, particularly plant extracts, as potential preventive interventions for high-risk individuals. This review examines the role of plant extracts in mitigating metabolic syndrome risk factors, addressing safety concerns and exploring associated technological advancements. The literature indicates that plant extracts hold promise for addressing the pathophysiology of metabolic dysfunction. However, challenges such as safety concerns, a lack of standardized regulation, and potential drug-plant interactions currently limit their clinical application. Rigorous, long-term clinical trials are necessary to confirm the efficacy and safety of plant extracts before they can be established as a preventive strategy for managing metabolic syndrome.

Oleuropein Supplementation Increases Resting Skeletal Muscle Fractional Pyruvate Dehydrogenase Activity but Does Not Influence Whole-Body Metabolism: A Randomized, Double-Blind, and Placebo-Controlled Trial in Healthy, Older Males

BACKGROUND

The polyphenol oleuropein activates mitochondrial calcium import, which increases pyruvate dehydrogenase (PDH) activity. Preclinically, this increase in PDH activity following oleuropein supplementation resulted in improved mitochondrial bioenergetics and fatigue resistance.

OBJECTIVES

This study aimed to examine the effects of acute and chronic oleuropein supplementation on muscle energy metabolism, whole-body substrate metabolism, strength, and fatigue resistance in older males.

METHODS

In a randomized, double-blind, placebo-controlled trial, 40 healthy older males (60 ± 5y) received either placebo (PLA) or 100 mg oleuropein from 250 mg olive leaf extract (OLE) supplementation daily for 36 d. On day 1 and day 36, muscle and blood samples were collected, and indirect calorimetry was performed before and ≤120 min following supplement intake. Leg strength and fatigue were measured before and after 29 d of supplementation. Results were analyzed using analysis of covariance or robust analysis of covariance.

RESULTS

OLE ingestion on day 1 and day 36 increased plasma oleuropein metabolites (P < 0.001). On day 1, no differences were observed in muscle PDH activity, mitochondrial respiration, or whole-body substrate metabolism 120 min after acute OLE ingestion. Ribonucleic acid sequencing revealed upregulation of oxidative phosphorylation gene pathways (false discovery rate < 0.05), whereas PDH-Serine293-phosphorylation was higher after acute OLE compared with PLA ingestion (P = 0.015). Following chronic supplementation, fractional PDH activity was ∼25% greater in OLE compared with PLA (49 ± 14 compared with 38 ± 10%; P = 0.016) with no differences in absolute PDH activity and PDH-Serine293-phosphorylation between groups. Mitochondrial respiration and protein content, whole-body substrate metabolism, leg strength, and fatigue resistance were not different between OLE and PLA. Plasma low-density lipoprotein cholesterol was lower after chronic OLE compared with PLA (P = 0.043), with no differences in other blood metabolic markers.

CONCLUSIONS

Chronic OLE supplementation resulted in higher skeletal muscle fractional PDH activity in healthy, older males, which may impact resting energy metabolism. Acute or chronic oleuropein supplementation does not modulate skeletal muscle mitochondrial respiration, muscle strength, muscle fatigue, or whole-body substrate metabolism. This trial was registered at clinicaltrials.gov as NCT05217433.

Nutraceuticals and Supplements in Management of Prediabetes and Diabetes

Dysglycemia is a condition preceding diabetes mellitus. The two situations inherent in this condition are called impaired fasting glucose (IFG) and impaired glucose tolerance (IGT). If one of these situations is found in the patient, after the advice of an appropriate diet and physical activity, the addition of nutraceuticals or supplements can be considered, which can stop or delay the progression to diabetes mellitus over time. The purpose was to compile a systematic review about the use of nutraceuticals for treating diabetes and prediabetes and to offer a valuable resource for colleagues working on this crucial subject, thereby improving patient health. The added value of the paper compared to other reviews is that it was written by experts appointed by five different scientific societies dealing with diabetes, nutrition, and complications.

Olive leaf extract effect on cardiometabolic risk factors: a systematic review and meta-analysis of randomized clinical trials

CONTEXT

Olive leaf extract (OLE) is rich in phenolic compounds, which are known for their health benefits. Cardiovascular diseases, primarily coronary heart disease and stroke, are leading causes of mortality globally.

OBJECTIVE

This systematic review aimed to assess the impact of OLE on cardiometabolic risk factors in adults. The selection of studies was based on intervention and outcomes, using relevant search descriptors.

DATA SOURCES

The databases PubMed, EMBASE, and Web of Science were systematically searched for pertinent studies published up to August 2021.

DATA EXTRACTION

Only randomized clinical trials, either cross-over or parallel, involving adult individuals aged ≥18 years, were considered. Additionally, trials that had a comparative or placebo group and used pure OLEs for oral treatment were included.

DATA ANALYSIS

Twelve randomized clinical trials (RCTs) met the inclusion criteria. These trials had follow-up periods ranging from 2 days to 12 weeks and involved 703 patients aged 18 years-79 years. The outcomes demonstrated a positive correlation between the intervention group and glucose metabolism (4 RCTs), blood pressure (2 RCTs), lipid profile (2 RCTs), and inflammatory markers (2 RCTs). The RoB2 tool and the GRADE system were used to evaluate the risk of bias and the quality of evidence in the studies.

CONCLUSIONS

In the meta-analysis, fasting glycemia, as evaluated in studies using a low dose of OLE, showed a significant result favoring the control group. To obtain more consistent results, further clinical studies in humans, using similar methodologies, are required.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO registration no. CRD42020200877.

The role of selected nutraceuticals in management of prediabetes and diabetes: An updated review of the literature. Part II

We have already published a review about the results of clinical trials evaluating the effects of selected nutraceuticals on glycemia in humans. In this second part, we describe the role of other nutraceuticals involved in dysglycemia. The available evidence showed promising hypoglycemic effects of the nutraceuticals reviewed both for their efficacy and safety profile. However, contradictory results as regard the efficacy of some supplements such as Allium sativum, Juglans regia, and Lycium barbarum on glucose homeostasis have emerged from some clinical studies. Other nutraceuticals including Aloe vera, Amorphophallus Konjac, Bauhinia forficata, Coccinia, Ganoderma lucidum, Ipomoea batatas, and Lupinus mutabilis require larger and long-term studies rigorously designed to confirm their hypoglycemic effects due to the scarce data available and the poor quality of clinical trials. Further studies are also required for Cinnamomum, Cynara scolymus, Momordica charantia, Olea europaea, and Opuntia streptacantha. Moreover, well-designed large and long-term clinical trials including the use of standardized nutraceutical preparations are necessary for Phaseolus vulgaris and Vaccinium myrtillus.

The Role of Greek Olive Leaf Extract in Patients with Mild Alzheimer's Disease (the GOLDEN Study): A Randomized Controlled Clinical Trial

Background: Olive leaves are a significant source of biophenols, which have a beneficial impact on cognitive performance. Objective: To examine, for the first time, in humans the effect of the daily consumption of a beverage containing olive leaf extract (OLE) versus a Mediterranean diet (MeDi) on patients diagnosed with mild Alzheimer's Disease (AD), in addition to their regular treatment. Methods: A randomized clinical trial compared OLE's effects on cognitive and functional performance in 55 mild AD patients. Each participant was randomly assigned to two groups: (1) Group 1 was given olive leaves for making a daily beverage and MeDi instructions through monthly diet programs; (2) Group 2 received only the MeDi instructions. After six months, all participants underwent a second neuropsychological evaluation. Results: Group 1 participants had statistically significantly higher MMSE scores compared to Group 2 with a p-value of 0.0135. Specifically, the mean MMSE difference in patients receiving OLE was close to 0, indicating no memory deterioration, whereas in controls it was -4.1, indicative of cognitive decline. The remaining neuropsychological assessments (FRSSD, FUCAS, ADAS-Cog, CDR, GDS, and NPI) revealed better results in the OLE group, except for GDS, which showed no change, but without statistically significant differences between the two groups.

A Comprehensive Review of Moroccan Medicinal Plants for Diabetes Management

Moroccan flora, renowned for its diverse medicinal plant species, has long been used in traditional medicine to manage diabetes. This review synthesizes ethnobotanical surveys conducted during the last two decades. Among these plants, 10 prominent Moroccan medicinal plants are evaluated for their phytochemical composition and antidiabetic properties through both in vitro and in vivo studies. The review encompasses a comprehensive analysis of the bioactive compounds identified in these plants, including flavonoids, phenolic acids, terpenoids, and alkaloids. Phytochemical investigations revealed a broad spectrum of secondary metabolites contributing to their therapeutic efficacy. In vitro assays demonstrated the significant inhibition of key enzymes α-amylase and α-glucosidase, while in vivo studies highlighted their potential in reducing blood glucose levels and enhancing insulin secretion. Among the ten plants, notable examples include Trigonella foenum-graecum, Nigella Sativa, and Artemisia herba-alba, each showcasing distinct mechanisms of action, such as enzymatic inhibition and the modulation of glucose metabolism pathways. This review underscores the necessity for further chemical, pharmacological, and clinical research to validate the antidiabetic efficacy of these plants and their active compounds, with a view toward their potential integration into therapeutic practices.

Potential synergistic antihyperglycemic effects of co-supplemental Amla and Olive extracts in hyperlipidemic adults with prediabetes and type 2 diabetes: results from a real-life clinical study

Background

Hyperglycemia and type 2 diabetes mellitus (T2DM) pose a significant risk for cardiovascular diseases and associated complications in individuals with hyperlipidemia. Statin therapy, effective in reducing cholesterol and cardiovascular risks, paradoxically increases incident T2DM risk due to its adverse impact on glucose homeostasis. Therefore, there is a pressing need for safe, and effective adjunctive or alternative therapies to manage hyperglycemia in hyperlipidemic individuals. There is growing body of pharmacological evidence suggesting that Amla and Olive extract supplementation can be beneficial in managing hyperglycemia in individuals with hyperlipidemia.

Objective

The present study aimed to assess for the first time the potential synergistic antihyperglycemic effects of a daily co-supplementation of 1,000 mg Amla fruit and 50 mg Olive fruit standardized extracts (Cholesfytol NG®) over a 2-months period in hyperlipidemic adults with T2DM or prediabetes.

Methods

This retrospective cross-sectional observational study analyzed treatment outcomes in 191 hyperlipidemic adults under the care of their physicians at 57 General Practitioner clinics in Belgium during real-life clinical practice between March 19, 2020, and January 31, 2022. These participants received Cholesfytol NG® as supplementary therapy to improve their metabolic health. The supplement was prescribed in an open-label, non-randomized manner, tailored to each participant's need.

Results

After 2-months of Cholesfytol NG® supplementation, participants showed significant reductions in glycemia levels: in the T2DM group, levels decreased by 42.7 ± 17.9 mg/dL (27.9%, p < 0.0001), and in the prediabetic group, by 2.26 ± 11.5 mg/dL (4.7%, p = 0.0020). Conversely, no significant change was observed in participants with normal baseline glycemia (1.55 ± 10.3 mg/dL, p = 0.088). Overall, glycemia levels decreased from 96.4 ± 18.2 mg/dL to 94.0 ± 13.5 mg/dL (mean decrease of 2.4 ± 14.5 mg/dL, p < 0.0001). The supplement was well tolerated and no side-effects, serious adverse events, or treatment-emergent effects were reported.

Conclusion

The findings of this real-life clinical study highlight the potential synergistic antihyperglycemic effects of co-supplementation with Amla and Olive fruit extracts in managing hyperglycemia, particularly in individuals with hyperlipidemia. These results suggest that this botanical combination may help mitigate risks associated with hyperglycemia and cardiovascular disease in hyperlipidemic population.

Clinical trial registration

ClinicalTrials.gov, NCT06187298.

Multiple nanotechnological approaches using natural compounds for diabetes management

Objectives

Diabetes mellitus (DM) is a long-standing and non-transmissible endocrine disease that generates significant clinical issues and currently affects approximately 400 million people worldwide. The aim of the present review was to analyze the most relevant and recent studies that focused on the potential application of plant extracts and phytocompounds in nanotechnology for the treatment of T2DM.

Methods

Various databases were examined, including Springer Link, Google Scholar, PubMed, Wiley Online Library, and Science Direct. The search focused on discovering the potential application of nanoparticulate technologies in enhancing drug delivery of phytocompounds for the mentioned condition.

Results

Several drug delivery systems have been considered, that aimed to reduce adverse effects, while enhancing the efficiency of oral antidiabetic medications. Plant-based nanoformulations have been highlighted as an innovative approach for DM treatment due to their eco-friendly and cost-effective synthesis methods. Their benefits include targeted action, enhanced availability, stability, and reduced dosage frequency.

Conclusions

Nanomedicine has opened new opportunities for the diagnosis, treatment, and prevention of DM. The use of nanomaterials has demonstrated improved outcomes for both T1DM and T2DM. Notably, flavonoids, including substances such as quercetin, naringenin and myricitrin, have been recognized for their enhanced efficacy when delivered through novel nanotechnologies in preventing T2DM onset and associated complications. The perspectives on the addressed subject point to the development of more nanostructured phytocompounds with improved bioavailability and therapeutic efficacy.

A Narrative Review of the Significance of Popular Diets in Diabetes Mellitus Management

Diabetes mellitus is a collection of metabolic disorders marked by elevated levels of glucose in the blood due to irregularities in the generation or functioning of insulin. Medical nutrition therapy and weight loss are crucial elements in the management of diabetes and the prevention of complications. Several diets have become popular over time for the goal of achieving weight loss, but their popularity has declined due to a lack of reliable scientific evidence. This study classifies popular diets into three categories: diets that manage the composition of macronutrients, diets that restrict specific foods or food groups, and diets that manipulate meal timing. The review includes research studies that investigated the effects of popular diets on the prevention, management, and complications of diabetes. It is clear that different popular diets can have positive effects on both preventing and treating diabetes and preventing and treating complications related to diabetes. However, it is not practical to determine which diet is the most effective option for preventing or controlling diabetes. Thus, the main focus should be on common underlying factors that support well-being, such as decreasing the intake of refined grains and added sugar, choosing non-starchy vegetables, and giving priority to whole foods over processed foods whenever possible, until there is stronger evidence supporting the specific benefits of different dietary patterns.

Hydrogen-rich solvent method in phytochemical extraction: Potential mechanisms and perspectives

INTRODUCTION

Phytochemicals are used in many products, including foods, beverages, pharmaceuticals, and cosmetics. The extraction of phytochemicals is considered one of the best solutions to valorize these underestimated materials. Many methods have been developed to efficiently extract phytochemicals at high quality, high purity, and low costs without harming the environment. Recently, molecular hydrogen (H2 ) has shown its ability to improve the extraction of phytochemicals from plant materials. Due to its unique physicochemical and biological properties, H2 showed an efficient ability to extract phenolics and antioxidants at high yields with cost-effective potential. Without sophisticated equipment and high energy and solvent consumption, the hydrogen extraction method is a green and applicable alternative for the extraction of phytochemicals.

OBJECTIVES

This review aims to provide the latest knowledge and results concerning the studies on using hydrogen-rich solvents to extract phytochemicals from different agri-food wastes, by-products, and other plant materials.

MATERIALS AND METHODS

Recent literature relating to extracting phytochemicals by the hydrogen-rich solvent method and its potential mechanisms is summarized to provide a basic understanding of how hydrogen can improve the extraction of phytochemicals.

RESULTS

This review describes, for the first time, the practical procedure of how researchers and laboratories can apply the hydrogen extraction method under safe conditions at a low-budget scale. The review provides some examples of the hydrogen extraction method and the mechanisms and rationale behind its effectiveness.

CONCLUSIONS

It can be concluded that the hydrogen-rich solvent method is a green and cost-effective method for extracting phytochemicals from different plant materials.

Olive Oil Consumption and Cardiovascular Protection: Mechanism of Action

Cardiovascular diseases (CVDs) are still the leading cause of death and disability worldwide, and they could be prevented by a diet modification and a healthy lifestyle. Dietary modifications include a reduction in the consumption of saturated fatty acids and replacing them with mono or polyunsaturated fatty acids. Olive oil is a monounsaturated fatty acid and its increased consumption has been associated with a significant reduction of CVDs. Its significant cardiovascular benefits have been attributed to its high content of vitamin E, polyphenols, and other ingredients that possess significant anti-inflammatory and antioxidant properties. Several prospective and epidemiological studies have reported an inverse association between olive oil consumption and the incidence of CVD, hypertension, and type 2 diabetes mellitus. Also, a seminal study demonstrated that the use of a Mediterranean diet, which is rich in olive oil, fruits, vegetables, and fish, and low in red meat, was associated with significant reductions in CVD and mortality. However, despite its proven cardiovascular benefits, olive oil is scarcely used in the United States and other Western countries. To determine the current use of olive oil in the United States and other Western countries, a Medline search of the English literature between 2012 and January 2022 was conducted, and 36 pertinent articles were selected. The data from these articles, together with collateral literature, will be discussed in this concise review.

Hematinic Potential of Olive Leaf Extract: Evidence from an In Vivo Study in Mice and a Pilot Study in Healthy Human Volunteers

Natural resources have recently received considerable attention as complementary or alternative hematinic agents. In this regard, olive leaf extract, which is rich in bioactive phenolic compounds, has been reported to induce erythroid differentiation in human hematopoietic stem cells. Therefore, in the present study, we aimed to explore the potential hematinic properties of aqueous olive leaf extract (WOL) in vivo. After 24 days of administering WOL to healthy mice orally, red blood cell (RBC), hematocrit, reticulocyte, and reticulocyte hemoglobin content (CHr) showed a significant increase. Additionally, WOL promoted plasma iron levels and the expression of splenic ferroportin (Fpn), an iron transporter. Additionally, a single-arm pilot study involving a limited number of healthy volunteers was conducted to assess WOL's feasibility, compliance, and potential benefits. Following an 8-week intervention with WOL, RBC count and hemoglobin level were significantly increased. Notably, there were no significant changes in the safety measures related to liver and kidney functions. Furthermore, we identified oleuropein and oleuroside as the active components in WOL to induce erythroid differentiation in the K562 cell line. Altogether, our study presents evidence of the hematinic potential of WOL in the in vivo studies, opening up exciting possibilities for future applications in preventing or treating anemia.

Phenolic Extract from Olive Leaves as a Promising Endotherapeutic Treatment against Xylella fastidiosa in Naturally Infected Olea europaea (var. europaea) Trees

(1) Background: Since 2013, the pathogenic bacterium Xylella fastidiosa has been severely affecting olive production in Apulia, Italy, with consequences for the economy, local culture, landscape and biodiversity. The production of a phenolic extract from fresh olive leaves was employed for endotherapeutic injection into naturally infected olive trees by Xylella fastidiosa in Apulia region, Italy. (2) Methods: The effectiveness of the extract was tested in vitro and in planta in comparison with analogous treatments based on garlic powder and potassium phosphite. (3) Results: The uptake of phenolic compounds from olive leaves through a trunk injection system device resulted in a statistically significant increase in leaf area index and leaf area density, as well as in the growth of newly formed healthy shoots. Plant growth-promoting effects were also observed for potassium phosphite. Moreover, the bacteriostatic activities of the phenolic extract and of the garlic-powder-based solution have been demonstrated in in vitro tests. (4) Conclusions: The results obtained and the contained costs of extraction make the endotherapeutic treatment with phenolic compounds a promising strategy for controlling X fastidiosa to be tested on a larger scale, although the experiments conducted in this study proved not to be suitable for centenary trees.

Antioxidant and Anti-Diabetic Properties of Olive (Olea europaea) Leaf Extracts: In Vitro and In Vivo Evaluation

(1) Objective: The main objective of the current study was to evaluate in vitro and in vivo an antioxidant property of three genotypes of olive leaf extract (OLE) (picual, tofahi and shemlali), and furthermore to assess potential activity in the treatment and/or prevention of diabetes mellitus type II and related implications. (2) Methodology: Antioxidant activity was determined by using three different methods (DDPH assay, reducing power and nitric acid scavenging activity). In vitro α-glucosidase inhibitory activity and hemolytic protective activity were assessed for the OLE. Five groups of male rats were used in in vivo experiment for evaluating the antidiabetic potential of OLE. (3) Results: The genotypes of the extracts of the three olive leaves exhibited meaningful phenolic and flavonoids content with superiority for picual extract (114.79 ± 4.19 µg GAE/g and 58.69 ± 1.03 µg CE/g, respectively). All three genotypes of olive leaves demonstrated significant antioxidant activity when using DPPH, reducing power and nitric oxide scavenging activity with IC50 ranging from 55.82 ± 0.13 to 19.03 ± 0.13 μg/mL. OLE showed a significant α-glucosidase inhibition activity and dose-dependent protection from hemolysis. In vivo experimentation revealed that the administration of OLE alone and the combination of OLE+ metformin clearly restored the blood glucose and glycated hemoglobin, lipid parameters and liver enzymes to the normal level. The histological examination revealed that the OLE and its combination with metformin successfully repaired the liver, kidneys and pancreatic tissues to bring them close to the normal status and maintain their functionality. (4) Conclusion: Finally, it can be concluded that the OLE and its combination with metformin is a promising treatment for diabetes mellitus type 2 due to their antioxidant activity, which emphasizes the potential use of OLE alone or as an adjuvant agent in the treatment protocol of diabetes mellitus type II.

In vivo evidences of the health-promoting properties of bioactive compounds obtained from olive by-products and their use as food ingredient

Olea europaea L. is the source of virgin olive oil (VOO). During its extraction, a high amount of by-products (pomace, mill wastewaters, leaves, stones, and seeds) is originated, which possess an environmental problem. If the generation of waste cannot be prevented, its economic value must be recovered and its effects on the environment and climate change must be avoided or minimized. The bioactive compounds (e.g., phenols, pectins, peptides) of these by-product fractions are being investigated as nutraceutical due to the beneficial properties it might have. In this review, the aim is to summarize the in vivo studies carried out in animals and humans with bioactive compounds exclusively obtained from olive by-products, aiming to demonstrate the potential health benefits these products can exert, as well as to describe its use in the food industry as bioactive ingredient. Several food matrices have been fortified with olive by-products fractions, leading to an improvement of properties. Animal and human studies suggest the benefits of ingesting olive-derived products to promote health. However, the investigation until now is scarce and consequently, well-designed human studies are required in order to fully address and confirm the safety and health-promoting properties of olive oil by-products.

Root Cause for Metabolic Syndrome and Type 2 Diabetes: Can Lifestyle and Nutrition Be the Answer for Remission

Obesity and its association with metabolic syndrome are implicated in many disease states. Research has focused on the role of diet and lifestyle modifications in the evolution of prediabetes to diabetes seeking ways to intervene and improve outcomes. Proven nutritional include leaner proteins, an abundance of vegetables, extra-virgin olive oil, and controlled portioning of carbs and starches. The transition from a sedentary state to an exercise routine of moderate intensity has shown efficacy in lowering metabolic risks. The synergy of dietary and physical activity modifications are the building blocks for lifestyle modifications examined in this review as a means of preventing obesity-related diabetes.

Antioxidant and anti-inflammatory effect of olive leaf extract treatment in diabetic rat brain

OBJECTIVES

Olive (Olea europaea L.) plays a promising role in pharmaceutical, nutraceutical, and cosmetic production. On the other hand, olive leaf is widely used in folk medicine due to its antihyperglycemic activity. For this aim, possible effects of olive leaf extract (OLE) in the brain tissue of streptozotocin-induced diabetic rats were investigated.

METHODS

A total of 28 male rats were divided into four equal groups as control, diabetic (single dose of 45 mg/kg streptozotocin, i.p.), OLE (500 mg/kg/day), and diabetic + OLE groups. The study was terminated 21 days after the diabetes model was formed. At the end of the study, all the animals were sacrificed and blood and brain tissues were isolated. Relative brain weights, complete blood count, blood glycated hemoglobin, serum glucose, total protein, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, insulin, gonadal hormone levels, production and messenger ribonucleic acid (mRNA) levels of proinflammatory cytokines and mediators, total thiol, total oxidative stress, and total antioxidant status levels and fatty acid composition in brain tissue were measured in all study groups.

RESULTS

In diabetic rats, relative brain weight and serum insulin level decreased, glycated hemoglobin, oxidative stress, production and mRNA level of proinflammatory cytokines and mediators increased, hyperglycemia, hypercholesterolemia and hypertriglyceridemia, degraded fatty acid composition, anemia, leukopenia, and thrombocytopenia occurred. After OLE treatment, a remarkable improvement in most of these parameters, except gonadal hormones, has been observed in diabetic rats.

CONCLUSIONS

This study suggests that olive leaf can be a precious neuroprotective agent in diabetes.

In the Beginning Was the Bud: Phytochemicals from Olive (Olea europaea L.) Vegetative Buds and Their Biological Properties

Even though Olea europaea L. is one of the most important and well-studied crops in the world, embryonic parts of the plants remain largely understudied. In this study, comprehensive phytochemical profiling of olive vegetative buds of two Croatian cultivars, Lastovka and Oblica, was performed with an analysis of essential oils and methanol extracts as well as biological activities (antioxidant, antimicrobial, and cytotoxic activities). A total of 113 different volatiles were identified in essential oils with hydrocarbons accounting for up to 60.30% and (Z)-3-heptadecene being the most abundant compound. Oleacein, oleuropein, and 3-hydroxytyrosol had the highest concentrations of all phenolics in the bud extracts. Other major compounds belong to the chemical classes of sugars, fatty acids, and triterpenoid acids. Antioxidant, antimicrobial, and cytotoxic activities were determined for both cultivars. Apart from antioxidant activity, essential oils had a weak overall biological effect. The extract from cultivar Lastovka showed much better antioxidant activity than both isolates with both methods (with an oxygen radical absorbance capacity value of 1835.42 μM TE/g and DPPH IC₅₀ of 0.274 mg/mL), as well as antimicrobial activity with the best results against Listeria monocytogenes. The human breast adenocarcinoma MDA-MB-231 cell line showed the best response for cultivar Lastovka bud extract (IC₅₀ = 150 μg/mL) among three human cancer cell lines tested. These results demonstrate great chemical and biological potential that is hidden in olive buds and the need to increase research in the area of embryonic parts of plants.

Olive Leaf Tea Impact on Postprandial Glycemia: A Randomized Cross-Over Trial

This study investigates the effect of olive leaf tea (OLT) on postprandial glycemia in healthy volunteers when ingested with a high-carbohydrate meal, compared with a placebo tea (CON). Healthy adults participated in a double-blind, randomized, placebo-controlled, and cross-over design trial receiving a high-rich carbohydrate meal with either 250 mL of OLT or CON at two different times after a washout period. The sequence order was randomized at a ratio of 1:1. Capillary blood glucose was measured in a 2 h period after ingestion. Eighteen participants were initially randomized. Of these, thirteen completed the trial and were analyzed. The consumption of OLT resulted in a delay in peak time (48.5 ± 4.2 min vs. 35.7 ± 4.0 min, p = 0.03) and a significant increase in glucose area under the curve compared to placebo (14,502.7 ± 640.8 vs. 13,633.3 ± 869.4 mg/dL·min, p = 0.03). Results are depicted as mean ± SEM. The OLT and CON palatability were generally well accepted. No adverse effects were reported. OLT did not ameliorate a glycemic curve induced by carbohydrate-rich meal ingestion, suggesting that at least when ingested acutely in a single meal, OLT does not have antihyperglycemic effects. Future studies should account for chronic consumption providing a better understanding of glycemic regulation over time.

The Effect of Herbal Product Use on BMI and HbA1c in Patients with Diabetes

Aim: Patients with diabetes can use herbal products to better manage the disease. The aim of this study is to examine the rate of herbal product use and the effect of herbal product use on Body Mass Index (BMI) and hemoglobin A1c (HbA1c) values in patients with diabetes.Method: The descriptive and cross-sectional study was conducted in the diabetes outpatient clinic of a hospital in Istanbul with a total of 104 patients with diabetes. The data were collected using a data collection form, which questioned the patients' socio-demographic characteristics, disease information and herbal product use. Data analysis was performed using Chi-square, One-Sample Kolmogorov-Smirnov test and Mann Whitney U test in computer environment.Results: The mean age of patients with diabetes was 61,08±9,3 years, the mean BMI was 26,3±5,4kg/m², and the mean HbA1c value was 6,9%±1,8%. The BMI and HbA1c values of the patients using herbal products were lower than the patients not using herbal products (respectively; p=,002; p=,047). It was determined that the duration of herbal product use did not affect BMI and HbA1c values (p&gt;,05).Conclusion: The use of herbal products was high in patients with diabetes. It was determined that olive leaf, cinnamon leaf, thyme juice, garlic, black sesame, blueberry, fenugreek seeds, French lavender and bitter almond were used as herbal products. Herbal product use decreased BMI and HbA1c values.

Cardiac hypertrophy and fibrosis were attenuated by olive leaf extract treatment in a rat model of diabetes

The key role of fibrosis and hypertrophy processes in developing diabetes-induced heart injury has been demonstrated. Considering the known hypoglycemic effects of olive leaf extract (OLE), we decided to investigate its potential effect and associated mechanisms on cardiac fibrosis and myocardial hypertrophy in streptozotocin (STZ)-induced diabetic rats. Eight groups were included in this study: control, diabetic, diabetic-OLEs (100, 200 and 400 mg/kg), diabetic-metformin (300 mg/kg), diabetic-valsartan (30 mg/kg), and diabetic-metformin/valsartan (300/30 mg/kg). After a treatment period of 6 weeks, echocardiography was used to assess cardiac function. Heart-to-body weight ratio (HW/BW) and fasting blood sugar (FBS) were measured. Myocardial histology was examined by Masson's trichrome staining. Gene expressions of atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), β-myosin heavy chain (β-MHC), TGF-β1, TGF-β3, angiotensin II type 1 receptor (AT1), alpha-smooth muscle actin (α-SMA), and collagen were evaluated by the quantitative real-time PCR in heart tissue. A reduction in the FBS level and HW/BW ratio in the extract groups was obvious. The improvement of left ventricular dysfunction, cardiac myocytes hypertrophy, and myocardial interstitial fibrosis was also observed in treated groups. A lowering trend in the expression of all hypertrophic and fibrotic indicator genes was evident in the myocardium of OLE treated rats. Our data indicated that OLE could attenuate fibrosis and reduce myocardial hypertrophy markers, thus improving the cardiac function and structure in the STZ-induced diabetic rats. PRACTICAL APPLICATIONS: This study demonstrates that olive leaf extract in addition to lowering blood glucose levels and the heart-to-body weight ratio (HW/BW) may also improve cardiac function and reduce cardiac hypertrophy and fibrosis in cardiac tissue, which leads to inhibition of diabetic heart damage. Thus it is possible that including olive leaf extracts in the diets of individuals with diabetes may assist in lowering cardiovascular disease risk factors.

Global research trends on the links between insulin resistance and obesity: a visualization analysis

Background

Obesity increases the chance of developing insulin resistance. Numerous inflammatory markers have been linked to an increased risk of insulin resistance in obese individuals. Therefore, we performed a bibliometric analysis to determine global research activity and current trends in the field of obesity and insulin resistance.

Methods

Scopus was used between 2002 and 2021 to retrieve publications related to terms related to obesity and insulin resistance. Data were exported to Microsoft Excel. Additionally, we use VOSviewer software to create visualization maps that describe international collaborations and research hotspots.

Results

We identified 6626 publications, including 5754 journal articles, 498 review articles, and 109 letters to the editor. The most productive countries were the United States (n = 995, 30.11%), followed by China (n = 650, 9.81%), Italy (n = 412, 6.22%) and Spain (n = 386, 5.83%). Previously to 2012, this field was mainly focused on ‘adipocyte dysfunctions that link obesity with insulin resistance”; and ‘relationship between obesity, insulin resistance, and risk of cardiovascular disease’. ‘Supplements improve insulin sensitivity‘, and ‘obesity-induced inflammation and insulin resistance’ were found more recently (after 2014), indicating that research in this field has acquired significant interest and emphasis in recent years.

Conclusions

This is the first bibliometric study to focus on publications related to insulin resistance and obesity at the global level. Our reporting of quantifiable knowledge in this field may be useful in providing evidence and direction for future research, clinical practice, and educational initiatives.

The effects of olive leaf extract on cardiovascular risk factors in the general adult population: a systematic review and meta-analysis of randomized controlled trials

BACKGROUND

The aim of this systematic review and meta-analysis was to determine the effect of olive leaf extract (OLE) supplementation on cardiovascular-related variables, including lipid, glycemic, inflammatory, liver and renal-related factors, as well as blood pressure.

METHODS

PubMed, ISI Web of Science, Scopus, and Cochrane library were searched, up to October 2021, for relevant controlled trials. Mean differences and standard deviations were pooled for all outcomes, using a random-effects model. The methodological quality, as well as quality of evidence were assessed using standard tools.

RESULTS

Twelve studies (n = 819 participants) were included in our analyses. Overall analyses showed that OLE supplementation significantly decreased triglyceride (TG) levels (WMD = - 9.51 mg/dl, 95% CI - 17.83, - 1.18; P = 0.025; I2 = 68.7%; P-heterogeneity = 0.004), and systolic blood pressure (SBP) (WMD = - 3.86 mmHg, 95% CI - 6.44, - 1.28 mmHg; P = 0.003; I2 = 19.9%; P-heterogeneity = 0.28). Subgroup analyses also revealed a significant improvement in SBP (- 4.81 mmHg) and diastolic blood pressure (- 2.45 mmHg), TG (- 14.42 mg/dl), total cholesterol (TC) (- 9.14 mg/dl), and low-density lipoprotein-C (LDL-C) (- 4.6 mg/dl) measurements, in patients with hypertension. Significant reductions were also observed in TC (- 6.69 mg/dl), TG (- 9.21 mg/dl), and SBP (- 7.05 mmHg) in normal-weight individuals. However, no meaningful changes were seen in glucose hemostasis, liver and kidney, or inflammatory markers.

CONCLUSION

The present study revealed that supplementation with OLE yielded beneficial effects for blood pressure and lipid profile in adults, especially in patients with hypertension. As the quality of evidence for glucose hemostasis variables, liver, kidney, and inflammatory markers, were low-to-very low, higher quality RCTs may impact the overarching results. This study was registered at PROSPERO with the code CRD42022302395.

A Critical Review on Role of Available Synthetic Drugs and Phytochemicals in Insulin Resistance Treatment by Targeting PTP1B

Insulin resistance (IR) is a condition of impaired response of cells towards insulin. It is marked by excessive blood glucose, dysregulated insulin signalling, altered pathways, damaged pancreatic β-cells, metabolic disorders, etc. Chronic hyperglycemic conditions leads to type 2 diabetes mellitus (T2DM) which causes excess generation of highly reactive free radicals, causing oxidative stress, further leading to development and progression of complications like vascular dysfunction, damaged cellular proteins, and DNA. One of the causes for IR is dysregulation of protein tyrosine phosphatase 1B (PTP1B). Advancements in drug therapeutics have helped people manage IR by regulating PTP1B, however have been reported to cause side effects. Therefore, there is a growing interest on usage of phytochemical constituents having IR therapeutic properties and aiding to minimize these complications. Medicinal plants have not been utilized to their full potential as a therapeutic drug due to lack of knowledge of their active and effective chemical constituents, mode of action, regulation of IR parameters, and dosage of administration. This review highlights phytochemical constituents present in medicinal plants or spices, their potential effectiveness on proteins (PTP1B) regulating IR, and reported possible mechanism of action studied on in vitro models. The study gives current knowledge and future recommendations on the above aspects and is expected to be beneficial in developing herbal drug using these phytochemical constituents, either alone or in combination, for medication of IR and diabetes.

Assessment of seasonal variation of the bioactive oleuropein in Olea europaea L. leaves cultivated in Saudi Arabia

Plants secondary metabolites undergoes qualitative and quantitative variation due to environmental and growth factors. It is a crucial factor to select the proper time for collection of medicinal plants to assure maximum content of active components reflected as maximum efficacy. Olive leaves (Olea europaea L.) are known traditionally for their antidiabetic effect. The secoiridoid glycoside oleuropein is the main active component of Olive leaves responsible for the biological activity. The current study was conducted to monitor the seasonal variation of oleuropein in Olives leaves collected from the same location. To achieve this goal a validated HPLC method following the ICH guidelines was established. Separation was conducted using RP18 column and a mobile phase consisted of ultrapure water containing 20% acetonitrile and 1% acetic acid. Detection was performed at 254 nm with 1 mL/min flow rate. The method was simple, linear, accurate, precise, specific and robust. The analyses revealed considerable variations in the level of oleuropein throughout the year. This variation cannot be explained by temperature variation during the year. Two points of high levels of oleuropein were detected prior to flowering stage and ripening of the fruits. The levels of growth regulators most likely is responsible for the increased production of oleuropein. It is recommended that leaves intended for medicinal use to be collected during the fruiting stage prior to fruit ripening.

Therapeutic Properties and Use of Extra Virgin Olive Oil in Clinical Nutrition: A Narrative Review and Literature Update

Extra virgin olive oil (EVOO) is a cornerstone of the Mediterranean diet (MedD). In this narrative review, we synthesize and illustrate the various characteristics and clinical applications of EVOO and its components—such as oleic acid, hydroxytyrosol, and oleuropein—in the field of clinical nutrition and dietetics. The evidence is split into diet therapy, oleic acid-based enteral nutrition formulations and oral supplementation formulations, oleic acid-based parenteral nutrition, and nutraceutical supplementation of minor components of EVOO. EVOO has diverse beneficial health properties, and current evidence supports the use of whole EVOO in diet therapy and the supplementation of its minor components to improve cardiovascular health, lipoprotein metabolism, and diabetes mellitus in clinical nutrition. Nevertheless, more intervention studies in humans are needed to chisel specific recommendations for its therapeutic use through different formulations in other specific diseases and clinical populations.

Mechanisms Underlying the Antidiabetic Activities of Polyphenolic Compounds: A Review

Polyphenolic compounds are thought to show considerable promise for the treatment of various metabolic disorders, including type 2 diabetes mellitus (T2DM). This review addresses evidence from in vitro, in vivo, and clinical studies for the antidiabetic effects of certain polyphenolic compounds. We focus on the role of cytotoxic human amylin (hA) aggregates in the pathogenesis of T2DM, and how polyphenols can ameliorate this process by suppressing or modifying their formation. Small, soluble amylin oligomers elicit cytotoxicity in pancreatic islet β-cells and may thus cause β-cell disruption in T2DM. Amylin oligomers may also contribute to oxidative stress and inflammation that lead to the triggering of β-cell apoptosis. Polyphenols may exert antidiabetic effects via their ability to inhibit hA aggregation, and to modulate oxidative stress, inflammation, and other pathways that are β-cell-protective or insulin-sensitizing. There is evidence that their ability to inhibit and destabilize self-assembly by hA requires aromatic molecular structures that bind to misfolding monomers or oligomers, coupled with adjacent hydroxyl groups present on single phenyl rings. Thus, these multifunctional compounds have the potential to be effective against the pleiotropic mechanisms of T2DM. However, substantial further research will be required before it can be determined whether a polyphenol-based molecular entity can be used as a therapeutic for type 2 diabetes.

Green Synthesis of Silver Nanoparticles Using Olea europaea Leaf Extract for Their Enhanced Antibacterial, Antioxidant, Cytotoxic and Biocompatibility Applications

Herein, we report the green synthesis of silver nanoparticles (OE-Ag NPs) by ecofriendly green processes using biological molecules of Olea europaea leaf extract. Green synthesized OE-Ag NPs were successfully characterized using different spectroscopic techniques. Antibacterial activity of OE-Ag NPs was assessed against four different bacteriological strains using the dilution serial method. The cytotoxic potential was determined against MCF-7 carcinoma cells using MTT assay in terms of cell viability percentage. Antioxidant properties were evaluated in terms of 2,2-diphenyl-1-picrylhydrazyl (DPPH) free radical scavenging. Biocompatibility was further examined by incubating the synthesized NPs with hMSC cells for 24 h. The results were demonstrated that synthesized OE-Ag NPs presented excellent log10 reduction in the growth of all the tested bacterial strains, which as statistically equivalent (p > 0.05) to the standard antibiotic drug. Moreover, they also demonstrated excellent cytotoxic efficacy against the MCF-7 carcinoma cells compared to plant lead extract and Com-Ag NPs. Green synthesized OE-Ag NPs appeared more biocompatible to hMSC and 293T cells compared to Com-Ag NPs. Excellent biological results of the OE-Ag NPs might be attributed to the synergetic effect of NPs' properties and the adsorbed secondary metabolites of plant leaf extract. Hence, this study suggests that synthesized OE-Ag NPs can be a potential contender for their various biological and nutraceutical applications. Moreover, this study will open a new avenue to produce biocompatible nanoparticles with additional biological functionalities from the plants.

Olive Leaf Extract Supplementation Combined with Calorie-Restricted Diet on Reducing Body Weight and Fat Mass in Obese Women: Result of a Randomized Control Trial

The present trial aims to evaluate a supplementation of the olive leaf extract (OLE) in adjunct with a weight loss diet on anthropometric indices, glycemic indices, lipid profile, as well as the level of adipokines, and free fatty acid in obese women. We carried out an 8-week randomized, placebo-controlled, double-blind, parallel-group, clinical trial. The participants were randomly stratified according to age and they were assigned to one of the two study groups: Standard weight loss diet (estimated daily energy requirements minus 500 kcal) + OLE supplementation (n = 35) in intervention group or Standard weight loss diet (estimated daily energy requirements minus 500 kcal) + placebo (n = 35) in placebo group. The study groups were homogeneous regarding the baseline age, height, weight, body mass index (BMI), waist circumferences, married status, and physical activity levels (p > 0.05). The results of analysis of covariance presented significant decreases in BMI, fat mass, and body weight in the OLE group compared to those in the placebo group (p < 0.05). At the end of the study, the serum levels of fasting blood sugar, insulin, low-density lipoprotein cholesterol, total cholesterol, leptin, fatty free acid, and homeostasis model assessment–insulin resistance significantly decreased, and serum levels of high-density lipoprotein cholesterol and adiponectin elevated in the intervention group (p < 0.05). Based on results it seems that the addition of OLE to a hypocaloric diet for 8-week compared with a hypocaloric diet alone may be more effective in modifying obesity and metabolic risk factors.

HPTLC and FTIR Fingerprinting of Olive Leaves Extracts and ATR-FTIR Characterisation of Major Flavonoids and Polyphenolics

The aim of this study was to analyse the effect of spontaneous microbial maceration on the release and extraction of the flavonoids and phenolics from olive leaves. Bioprofiling based on thin-layer chromatography effect-directed detection followed by ATR-FTIR spectroscopy proved to be a reliable and convenient method for simultaneous comparison of the extracts. Results show that fermentation significantly enhances the extraction of phenolic compounds and flavonoids. The polyphenolic content was increased from 6.7 µg GAE (gallic acid equivalents) to 25.5 µg GAE, antioxidants from 10.3 µg GAE to 25.3 µg GAE, and flavonoid content from 42 µg RE (rutin equivalents) to 238 µg RE per 20 µL of extract. Increased antioxidant activity of fermented ethyl acetate extracts was attributed to the higher concentration of extracted flavonoids and phenolic terpenoids, while increased antioxidant activity in fermented ethanol extract was due to increased extraction of flavonoids as extraction of phenolic compounds was not improved. Lactic acid that is released during fermentation and glycine present in the olive leaves form a natural deep eutectic solvent (NADES) with significantly increased solubility for flavonoids.

Assessment of the Efficacy of Olive Leaf (Olea europaea L.) Extracts in the Treatment of Colorectal Cancer and Prostate Cancer Using In Vitro Cell Models

Cancer is one of the most serious public health issues worldwide, ranking second only to cardiovascular diseases as a cause of death. Numerous plant extracts have extraordinary health benefits and have been used for centuries to treat a variety of ailments with few side effects. Olive leaves have a long history of medicinal and therapeutic use. In this study, the anti-cancer properties of an olive leaf extract were investigated in vitro using colorectal and prostate cancer cell lines (HT29 and PC3, respectively). A high-performance liquid chromatography analysis showed that the olive leaf extract contained a high chlorogenic acid content. Accordingly, chlorogenic acid may be related to the observed effects of the aqueous extract on cancer cells, including increased inhibition of cancer cell growth, migration, DNA fragmentation, cell cycle arrest at the S phase, reactive oxygen species (ROS) production, and altered gene expression. The effects of the extracts were greater in HT29 than in PC3 cells. These results suggest that chlorogenic acid, the main constituent in the olive extract, is a promising new anti-cancer agent. Further analyses should focus on its in vivo effects on colorectal tumor models, both alone and in combination with established agents.

New trends in the use of medicinal plants by Algerian diabetic patients, considerations of herb-drug interactions

ETHNOPHARMACOLOGICAL RELEVANCE

Diabetes mellitus is a metabolic disorder, with a large prevalence in low- and middle-income countries. Numerous studies highlighted the use of medicinal plants for diabetes in Algeria. This use is influenced by cultural considerations. The industrialization of the country leads to the transformation of the trend of the utilization of plants, and the increase of polymedication. In this context, there is no information about the profile of diabetic patients using plants and the potential of herb-drug interactions.

AIM OF THE STUDY

The objective was to evaluate the use of plants by diabetic patients and to search the drug interactions with the most cited species.

MATERIALS AND METHODS

Descriptive and comparative studies were carried out among diabetic patients and traditional healers, in the west of Algeria, to inventory the plants used in diabetes. Bivariate and multivariate analysis by logistic regression were performed to evaluate the associated factors with the use, to determine the profile of users. Bibliometric research in PubMed, Google Scholar, Cochrane Library and ClinicalTirals was conducted to look for herb-drug interactions.

RESULTS

Results show a decrease in the use of medicinal plants by diabetic patients, in comparison of previous findings, some of which have not been cited by traditional healers. The patients under oral anti-diabetic agents (ODA) have twice the risk to use plants in concomitant with drugs. Olea europea leaves and Trigonella feanum greacum seeds were the most cited herbals. Metformin was the most used drug. Several clinical trials revealed that the anti-diabetic plants had a synergistic effect with ODA, which can increase the hypoglycemia of diabetics. Non-important adverse reactions were noted.

CONCLUSIONS

New trends of the use of medicinal plants by diabetic patients were noted, this is due to the diversification of information sources. Patients under ODA must be educated about the use and the risk of herb-drug interactions.

Chemical analysis, biological and therapeutic activities of Olea europaea L. extracts

The Olea europaea L. is a very well-known and widely used plant, especially for its nutritional qualities. Its extracts from leaves and fruits are widely used in contrasting and preventing various pathologies. In this review, the collected data highlight important chemical analyses and biological effects of this plant extracts. It exhibits cholesterol-lowering, hypoglycemic, cytotoxic, antibacterial, neuroprotective, antioxidant, anti-inflammatory and hypotensive activities. The results show that extracts from O. europaea could be used as a food additive in the supplementary treatment of many diseases.

Efficacy and Mechanisms of Oleuropein in Mitigating Diabetes and Diabetes Complications

The global pandemic of diabetes and diabetes complications confers heavy pressure on public health. Novel antidiabetes strategies with negligible unwanted effects are urgently needed. Currently, the anti-hyperglycemic potential of plant-based functional ingredients has been explored to provide alternative strategies. As a kind of dietary bioactive compound, oleuropein has aroused the growing interest of researchers in diabetes and diabetes complications management. This review reveals the research progress of oleuropein in treating diabetes and diabetes complications and summarizes the molecular mechanisms involved in these beneficial effects of oleuropein. Oleuropein achieves amelioration of diabetes, the mechanisms of which include the modulation of insulin secretion, the repairment islet morphology, the activation of hepatic AMP-activated protein kinase singling, and the improvement of glucose tolerance and insulin resistance. Oleuropein also can relieve diabetes complications including diabetic nephropathy, diabetes cardiovascular complications, diabetic retinopathy, poor wound healing, diabetic neuropathy, and diabetic testicular dysfunction. Oleuropein reverses cell apoptosis, regenerates tissues, restores the histological organization, and decreases oxidative stress in treating diabetes complications. Taken together, oleuropein is a promising compound for diabetes and diabetes complications management and can be used as a nutraceutical to fight against these diseases.

Bioactive Compounds in Waste By-Products from Olive Oil Production: Applications and Structural Characterization by Mass Spectrometry Techniques

In recent years, a remarkable increase in olive oil consumption has occurred worldwide, favoured by its organoleptic properties and the growing awareness of its health benefits. Currently, olive oil production represents an important economic income for Mediterranean countries, where roughly 98% of the world production is located. Both the cultivation of olive trees and the production of industrial and table olive oil generate huge amounts of solid wastes and dark liquid effluents, including olive leaves and pomace and olive oil mill wastewaters. Besides representing an economic problem for producers, these by-products also pose serious environmental concerns, thus their partial reuse, like that of all agronomical production residues, represents a goal to pursue. This aspect is particularly important since the cited by-products are rich in bioactive compounds, which, once extracted, may represent ingredients with remarkable added value for food, cosmetic and nutraceutical industries. Indeed, they contain considerable amounts of valuable organic acids, carbohydrates, proteins, fibers, and above all, phenolic compounds, that are variably distributed among the different wastes, depending on the employed production process of olive oils and table olives and agronomical practices. Yet, extraction and recovery of bioactive components from selected by-products constitute a critical issue for their rational valorization and detailed identification and quantification are mandatory. The most used analytical methods adopted to identify and quantify bioactive compounds in olive oil by-products are based on the coupling between gas- (GC) or liquid chromatography (LC) and mass spectrometry (MS), with MS being the most useful and successful detection tool for providing structural information. Without derivatization, LC-MS with electrospray (ESI) or atmospheric pressure chemical (APCI) ionization sources has become one of the most relevant and versatile instrumental platforms for identifying phenolic bioactive compounds. In this review, the major LC-MS accomplishments reported in the literature over the last two decades to investigate olive oil processing by-products, specifically olive leaves and pomace and olive oil mill wastewaters, are described, focusing on phenolics and related compounds.

Olive leaf extract supplementation improves the vascular and metabolic alterations associated with aging in Wistar rats

Olive leaves are rich in bioactive substances which exert anti-inflammatory, antioxidant, insulin-sensitizing and antihypertensive effects. The aim of this study was to analyze the possible beneficial effects of an olive leaf extract (OLE) rich in secoiridoids and phenolic compounds on the aging-induced metabolic and vascular alterations. Three experimental groups of rats were used: 3-month-old rats, 24-month-old rats and 24-month-old rats supplemented 21 days with OLE (100 mg/kg). Administration of OLE to aged rats decreased the weight of adrenal glands and prevented the aging-induced loss of body weight and muscle mass. In the serum, OLE reduced the circulating levels of LDL-cholesterol and IL-6 and increased the concentrations of leptin and adiponectin. In the liver OLE attenuated the decreased gene expression of SOD-1, GSR, GCK and GSK-3β and reduced the aging-induced overexpression of NOX-4, Alox-5, iNOS and TNF-α. In aorta segments, OLE prevented endothelial dysfunction and vascular insulin resistance and improved vasoconstriction in response to KCl and NA. Improvement in vascular function was associated with the attenuation of the alterations in the gene expression of COX-2, IL-6, GPx, NOX-1 and IL-10. In conclusion, OLE exerts anti-inflammatory and antioxidant effects in aged rats and attenuates the alterations in vascular function associated with aging.

Middle East Medicinal Plants in the Treatment of Diabetes: A Review

Diabetes is a global health problem, and the number of diabetic patients is in continuous rise. Conventional antidiabetic therapies are associated with high costs and limited efficiency. The use of traditional medicine and plant extracts to treat diabetes is gaining high popularity in many countries. Countries in the Middle East region have a long history of using herbal medicine to treat different diseases, including diabetes. In this review, we compiled and summarized all the in vivo and in vitro studies conducted for plants with potential antidiabetic activity in the Middle East region. Plants of the Asteraceae and Lamiaceae families are the most investigated. It is hoped that this review will contribute scientifically to evidence the ethnobotanical use of medicinal plants as antidiabetic agents. Work has to be done to define tagetes, mechanism of action and the compound responsible for activity. In addition, safety and pharmacokinetic parameters should be investigated.

Phytochemicals as Potential Epidrugs in Type 2 Diabetes Mellitus

Type 2 diabetes Mellitus (T2DM) prevalence has significantly increased worldwide in recent years due to population age, obesity, and modern sedentary lifestyles. The projections estimate that 439 million people will be diabetic in 2030. T2DM is characterized by an impaired β-pancreatic cell function and insulin secretion, hyperglycemia and insulin resistance, and recently the epigenetic regulation of β-pancreatic cells differentiation has been underlined as being involved. It is currently known that several bioactive molecules, widely abundant in plants used as food or infusions, have a key role in histone modification and DNA methylation, and constituted potential epidrugs candidates against T2DM. In this sense, in this review the epigenetic mechanisms involved in T2DM and protein targets are reviewed, with special focus in studies addressing the potential use of phytochemicals as epidrugs that prevent and/or control T2DM in vivo and in vitro. As main findings, and although some controversial results have been found, bioactive molecules with epigenetic regulatory function, appear to be a potential replacement/complementary therapy of pharmacological hypoglycemic drugs, with minimal side effects. Indeed, natural epidrugs have shown to prevent or delay the T2DM development and the morbidity associated to dysfunction of blood vessels, eyes and kidneys due to sustained hyperglycemia in T2DM patients.

Oleuropein alleviates gestational diabetes mellitus by activating AMPK signaling

BACKGROUND

Gestational diabetes mellitus (GDM) has a high incidence rate among pregnant women. The objective of the study was to assess the effect of plant-derived oleuropein in attenuating inflammatory and oxidative stress of GDM.

METHODS

Oleuropein was administered to GDM mice at the doses of 5 or 10 mg/kg/day. Body weight, blood glucose, insulin and hepatic glycogen levels were recorded. To evaluate the effect of oleuropein in reducing oxidative stress, ELISA was used to measure the hepatic oxidative stress markers. The inflammation levels of GDM mice were evaluated by measuring serum levels of IL-6 and TNF-α by ELISA and mRNA levels of IL-1β, TNF-α and IL-6 by real-time PCR (RT-PCR). The AMP-activated protein kinase (AMPK) signaling pathway was assessed by Western blot. Gestational outcome was analyzed through comparing litter size and birth weight.

RESULTS

Oleuropein attenuated the elevated body weight of GDM mice and efficiently reduced blood glucose, insulin and hepatic glycogen levels. Oxidative stress and inflammation were alleviated by oleuropein treatment. The AMPK signaling was activated by oleuropein in GDM mice. Gestational outcome was markedly improved by oleuropein treatment.

CONCLUSIONS

Our study suggests that oleuropein is effective in alleviating symptoms of GDM and improving gestational outcome in the mouse model. This effect is achieved by attenuating oxidative stress and inflammation, which is mediated by the activation of the AMPK signaling pathway.

Herbal Medicines for Diabetes Management and its Secondary Complications

Diabetic Mellitus (DM) is a metabolic disorder that is concerning for people all over the world. DM is caused due to lack of insulin or ineffective production of insulin in the pancreas. A total of 463 million people were reported to have diabetes mellitus in 2019 and this number is predicted to rise up to 578 million by the year 2030 and 700 million by 2045. High blood sugar gives rise to many complications like diabetic retinopathy, diabetic nephropathy, atherosclerosis, hypercoagulability, cardiovascular disease, coronary heart disease, abdominal obesity, hypertension, hyperlipidemia, cerebrovascular disease, coronary artery disease, foot damage, skin complications, Alzheimer's disease, hearing impairment, and depression. These life-threatening complications make diabetes more severe than other diseases. Many synthetic drugs have been developed, but still, a complete cure is not provided by any of the molecules. Continuous use of some synthetic agents causes severe side effects, and thus the demand for non-toxic, affordable drugs still persists. Traditional treatments have been an extremely valued source of medicine all over human history. These are extensively used throughout the world, indicating that herbs are a growing part of modern and high-tech medicines. The World Health Organization (WHO) has listed a total of 21,000 plants, which are used for medicinal purposes around the world. Among them, more than 400 plants are available for the treatment of diabetes. Despite the fact that there are many herbal drugs available for treating diabetes, only a small number of these plants have undergone scientific and medical evaluation to assess their efficacy. Trigonella foenum-graecum, Allium sativum, Caesalpinia bonduc, Ferula assafoetida,etc., are some of the medicinal plants used for antidiabetic therapy. The presence of phenolic compounds, flavonoids, terpenoids, and coumarins is responsible for the antidiabetic nature of the medicinal plants. These constituents have shown a reduction in blood glucose levels. Pycnogenol, acarbose, miglitol, and voglibose are some of the examples of marketed drugs, which are obtained from natural origin and used as antidiabetic drugs. The active principles derived from the plants work through many antidiabetic mechanisms, which include inhibition of α-glucosidase, α-amylase, and protein tyrosine phosphatase 1B activities. One of the major advantages of herbal drugs is the low level of side effects attributed to these medicines, and this attracted various researchers to develop new molecules for the treatment of diabetes. In this review, recent advances in the field of herbal drugs to treat diabetes, prevent secondary complications from arising due to diabetes, and various herbal molecules in different stages of clinical trials will be emphasized upon.

The effect of olive leaf extract on cardiovascular health markers: a randomized placebo-controlled clinical trial

Purpose

Overweight and obesity are associated with many health problems, including cardiovascular disease (CVD). Evidence from previous studies has shown that extracts from olive leaves rich in olive phenolics are able to positively affect CVD risk factors, such as high blood pressure and dyslipidemia. The aim of this study was to investigate the effect of 8-week olive leaf extract (OLE) administration on blood lipid profiles in overweight/obese subjects with mildly elevated cholesterol levels.

Methods

In this randomized, double-blind, placebo-controlled study, 77 healthy adult overweight/obese subjects (aged 56 ± 10 years and BMI 29.0 ± 2.7 kg/m²) with total cholesterol levels of 5.0–8.0 mmol/L (5.9 ± 0.7 mmol/L) were randomly assigned to receive 500 mg of OLE (n = 39) or placebo (n = 38) for 8 weeks. In total, 74 subjects completed the entire study protocol. At baseline, after 4 weeks, and after 8 weeks of supplementation, blood lipid profiles, oxidized low-density lipoprotein (oxLDL), blood pressure, glucose, and insulin levels were assessed. In addition, liver function parameters were measured at baseline and after 8 weeks.

Results

OLE supplementation did not significantly affect blood lipid levels after 4 weeks or after 8 weeks compared to placebo (all p > 0.05). For oxLDL, blood pressure, glucose, and insulin levels and liver function parameters, also no statistically significant differences were found between the two intervention groups (all p > 0.05).

Conclusions

Blood lipid profiles were not significantly affected by 8 weeks OLE supplementation in overweight/obese subjects with mildly elevated cholesterol levels.

Trial registered

The trial has been registered at ClinicalTrials.gov (NCT02990637).

Electronic supplementary material

The online version of this article (10.1007/s00394-020-02397-9) contains supplementary material, which is available to authorized users.

Supplementation Effect of a Combination of Olive (Olea europea L.) Leaf and Fruit Extracts in the Clinical Management of Hypertension and Metabolic Syndrome

BACKGROUND

The role of herbal products in the prevention of cardiovascular disease requires supporting evidence. This open pilot study assessed the effect of 2-month supplementation of a combination of olive leaf and fruit extracts (Tensiofytol^®, Tilman SA, Baillonville, Belgium) in the clinical management of hypertension and metabolic syndrome (MetS).

METHODS

A total of 663 (pre)-hypertensive patients were enrolled by general practitioners and supplemented for two months with Tensiofytol^®, two capsules per day (100 mg/d of oleuropein and 20 mg/d of hydroxytyrosol). Systolic and diastolic blood pressures (SBP/DBP) were measured before and after treatment. Markers of MetS, high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), fasting blood glucose (FG) and waist circumference (WC), were also examined.

RESULTS

Significant reductions (p < 0.0001) in SBP/DBP (13 ± 10/7.1 ± 6.6 mmHg) were observed and similarly in pre-diabetic and diabetic patients. Improvements in SBP/DPB were independent of age and gender but greater for elevated baseline SBP/DBP. Tensiofytol^® supplementation also significantly improved markers of MetS, with a decrease of TG (11%), WC (1.4%) and FG (4.8%) and an increase of HDL-C (5.3%). Minor side effects were reported in 3.2% patients.

CONCLUSIONS

This real-life, observational, non-controlled, non-randomized pilot study shows that supplementation of a combination of olive leaf and fruit extracts may be used efficiently and safely in reducing hypertension and MetS markers.

Determining the correlation between olive oil consumption, BMI, and waist circumference in the adult Saudi population

Objective

This study aimed to explore the correlation between dietary intake of olive oil, body mass index (BMI), and waist circumference (WC).

Methods

In this cross-sectional study, we recruited 200 participants aged 20–30 years using pre-determined inclusion and exclusion criteria. Demographic data was collected via a questionnaire, while dietary data was collected for two days using a 24-hour dietary recall. Anthropometric data such as BMI and WC were collected, and all the information was entered into the Diet Organizer software and statistical package for social sciences (SPSS) software for statistical analysis. The test results were assessed on the basis of a significance level of 95% (p < 0.05).

Results

We did not find a significant difference in BMI and WC between high and low olive oil consumers. Carbohydrate intake was significantly higher among low olive oil consumers. Although high olive oil consumers had a significantly higher caloric intake, they had a similar BMI compared to low olive oil consumers.

Conclusion

This study provides baseline data on the intake of olive oil in a Saudi cohort aged 20–30 years. This study suggests that high olive oil intake may have a role in maintaining body weight.