Beneficial Effects of Low-Calorie-Carbohydrate/High-Agar Diet on Cardiometabolic Disorders Associated with Non-Alcoholic Fatty Liver Disease in Obese Rats

Time-restricted eating and supervised exercise for improving hepatic steatosis and cardiometabolic health in adults with obesity: protocol for the TEMPUS randomised controlled trial

INTRODUCTION

Metabolic dysfunction-associated steatotic liver disease is a major public health problem considering its high prevalence and its strong association with extrahepatic diseases. Implementing strategies based on an intermittent fasting approach and supervised exercise may mitigate the risks. This study aims to investigate the effects of a 12-week time-restricted eating (TRE) intervention combined with a supervised exercise intervention, compared with TRE or supervised exercise alone and with a usual-care control group, on hepatic fat (primary outcome) and cardiometabolic health (secondary outcomes) in adults with obesity.

METHODS AND ANALYSIS

An anticipated 184 adults with obesity (50% women) will be recruited from Granada (south of Spain) for this parallel-group, randomised controlled trial (TEMPUS). Participants will be randomly designated to usual care, TRE alone, supervised exercise alone or TRE combined with supervised exercise, using a parallel design with a 1:1:1:1 allocation ratio. The TRE and TRE combined with supervised exercise groups will select an 8-hour eating window before the intervention and will maintain it over the intervention. The exercise alone and TRE combined with exercise groups will perform 24 sessions (2 sessions per week+walking intervention) of supervised exercise combining resistance and aerobic high-intensity interval training. All participants will receive nutritional counselling throughout the intervention. The primary outcome is change from baseline to 12 weeks in hepatic fat; secondary outcomes include measures of cardiometabolic health.

ETHICS AND DISSEMINATION

This study was approved by Granada Provincial Research Ethics Committee (CEI Granada-0365-N-23). All participants will be asked to provide written informed consent. The findings will be disseminated in scientific journals and at international scientific conferences.

TRIAL REGISTRATION NUMBER

NCT05897073.

Algal polysaccharides and derivatives as potential therapeutics for obesity and related metabolic diseases

The potential and challenges of algal polysaccharides and their derivatives as potential therapeutic agents for obesity and its related metabolic diseases.

Hepatotoxicity or hepatoprotection of emodin? Two sides of the same coin by 1H-NMR metabolomics profiling

Emodin is the major anthraquinone component of many important traditional Chinese herbs, such as Rheum palmatum L. and Polygonum multiflorum Thunb. They have been popular health products but recently aroused concerns about their hepatotoxicity, which are believed to be arising from the contained anthraquinones, such as emodin. However, emodin exerts potent hepatoprotective ability, such as anti-fibrotic, anti-oxidative, and anti-inflammatory effects. In this study, 1H NMR based metabolomics approach, complemented with histopathological observation, biochemical measurements, western blotting analysis and real-time quantitative PCR (RT-qPCR), was applied to interpret the paradox of emodin (30 mg/kg, 10 mg/kg BW) using both healthy mice (male, ICR) and chronic CCl4-injured mice (0.1 mL/kg, 0.35% CCl4, 3 times a week for a month). Emodin exerted a weight loss property associated with its lipid-lowing effects, which helped alleviate CCl4-induced steatosis. Emodin effectively ameliorated CCl4-induced oxidative stress and energy metabolism dysfunction in mice liver via regulating glucose, lipid and amino acid metabolism, and inhibited excessive inflammatory response. In healthy mice, emodin only exhibited hepatoxicity on high-dosage by disturbing hepatic anti-oxidant homeostasis, especially GSH and xanthine metabolism. This integrated metabolomics approach identified the bidirectional potential of emodin, which are important for its rational use.

Hepatoprotective and Anti-Obesity Properties of Sardine By-Product Oil in Rats Fed a High-Fat Diet

Excess lipid intake can trigger liver lipid accumulation and oxidative responses, which can lead to metabolic disturbances and contribute to hepatic steatosis and obesity and increase the risk of cardiovascular disease. Production of fish oil rich in omega-3 is a good opportunity for valorizing fish by-products in the therapeutic field. In this study, we explored the effects of oil from Sardina pilchardus by-products on cardiometabolic and oxidative disorders caused by toxic effects of excess lipids in obese rats. Three groups of obese rats received either 20% sardine by-product oil (SBy-Ob-HS; experimental group), 20% fillet oil (SF-Ob-HS; positive control group), or a high-fat diet (Ob-HS). Normal weight rats received a standard diet (normal). There was a significant decrease in serum total cholesterol (TC), triacylglycerols (TG), and insulin concentrations in the SBy-Ob-HS group compared with the SF-Ob-HS group. Compared with the Ob-HS group, TC and TG, glycemia, glycosylated hemoglobin, and insulinemia were decreased in the SBy-Ob-HS (more notably) and SF-Ob-HS groups. Furthermore, hepatic lipids, low density lipoprotein-cholesterol (C), the non-esterified cholesterol/phos-pholipids ratio, serum transaminases activities and lipid peroxidation were lower and serum high density lipoproteins-C were higher in the SBy-Ob-HS and SF-Ob-HS groups compared with the Ob-HS group. Serum isoprostane concentrations were reduced in the SBy-Ob-HS (more notably) and SF-Ob-HS groups compared with the Ob-HS and normal groups. The activities of antioxidant enzymes in tissues were enhanced, particularly in the by-product oil group. The oil extracted from by-products demonstrate anti-obesity properties (hypolipemiant, hepatoprotective, antiatherogenic, antidiabetic, and antioxidant) that may be beneficial for the management of obesity and its complications, such as hepatic steatosis.

Gut Microbiota Metabolites in NAFLD Pathogenesis and Therapeutic Implications

Gut microbiota dysregulation plays a key role in the pathogenesis of nonalcoholic fatty liver disease (NAFLD) through its metabolites. Therefore, the restoration of the gut microbiota and supplementation with commensal bacterial metabolites can be of therapeutic benefit against the disease. In this review, we summarize the roles of various bacterial metabolites in the pathogenesis of NAFLD and their therapeutic implications. The gut microbiota dysregulation is a feature of NAFLD, and the signatures of gut microbiota are associated with the severity of the disease through altered bacterial metabolites. Disturbance of bile acid metabolism leads to underactivation of bile acid receptors FXR and TGR5, causal for decreased energy expenditure, increased lipogenesis, increased bile acid synthesis and increased macrophage activity. Decreased production of butyrate results in increased intestinal inflammation, increased gut permeability, endotoxemia and systemic inflammation. Dysregulation of amino acids and choline also contributes to lipid accumulation and to a chronic inflammatory status. In some NAFLD patients, overproduction of ethanol produced by bacteria is responsible for hepatic inflammation. Many approaches including probiotics, prebiotics, synbiotics, faecal microbiome transplantation and a fasting-mimicking diet have been applied to restore the gut microbiota for the improvement of NAFLD.