Impact of Micronutrients on Hypertension: Evidence from Clinical Trials with a Special Focus on Meta-Analysis

Hypertension (HT) is one of the pivotal risk factors for various detrimental diseases like cardiovascular diseases (CVDs), cerebrovascular disease, and renal dysfunction. Currently, many researchers are paying immense attention to various diet formula (dietary approach) with a special focus on micro and macronutrients along with modified lifestyle and standard anti-hypertensive drugs. Micronutrients (minerals/vitamins) play a central role in the regulation of blood pressure (BP) as they aid the function of macronutrients and also improve the anti-hypertensive functions of some anti-hypertensive agents. Even though several studies have demonstrated the beneficial effects of micronutrients on controlling BP, still some ambiguity exists among the nutritionists/doctors, which combination or individual mineral (dietary approach) contributes to better BP regulation. Therefore, this critical review article was attempted to delineate the underlying role of micronutrients (minerals and vitamins) for the management and prevention or delaying of HT and their related complications with strong affirmation from clinical trials as well as its mechanism of controlling BP. Moreover, the major source and recommended daily allowance (RDA) of various micronutrients are included in this review for guiding common readers (especially HT subjects) and dieticians to choose/recommend a better micronutrient and their combinations (other nutrients and standard anti-hypertensive drugs) for lowering the risk of HT and its related co-morbid conditions like CVDs

Regulatory efficacy of fermented plant extract on the intestinal microflora and lipid profile in mildly hypercholesterolemic individuals

In recent years, the use of fermented plant products to protect against various metabolic syndromes has been increasing enormously. The objective of this study was to check the regulatory efficacy of fermented plant extract (FPE) on intestinal microflora, lipid profile, and antioxidant status in mildly hypercholesterolemic volunteers. Forty-four mildly hypercholesterolemic individuals (cholesterol 180–220 mg/dL) were recruited and assigned to two groups: experimental or placebo. Volunteers were requested to drink either 60 mL of FPE or placebo for 8 weeks. Anthropometric measurements were done in the initial, 4th, 8th, and 10th weeks. The anthropometric parameters such as body weight, body fat, and body mass index were markedly lowered (p < 0.05) on FPE intervention participants. Moreover, the total antioxidant capacity and total phenolics in plasma were considerably increased along with a reduction (p < 0.05) in total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-c) after FPE supplementation. Participants who drank FPE showed a pronounced increase (p < 0.05) in the number of beneficial bacteria such as Bifidobacterium spp. and Lactobacillus spp., whereas the number of harmful bacteria such as Escherichia coli and Clostridium perfringens (p < 0.05) were concomitantly reduced. Furthermore, the lag time of LDL oxidation was substantially ameliorated in FPE-administered group, thus indicating its antioxidative and cardioprotective properties. Treatment with FPE substantially improved the intestinal microflora and thereby positively regulated various physiological functions by lowering the anthropometric parameters, TC, and LDL-c, and remarkably elevated the antioxidant capacity and lag time of LDL oxidation. Therefore, we recommended FPE beverage for combating hypercholesterolemia

Photoprotective effects of cranberry juice and its various fractions against blue light-induced impairment in human retinal pigment epithelial cells

Context: Cranberry has numerous biological activities, including antioxidation, anticancer, cardioprotection, as well as treatment of urinary tract infection (UTI), attributed to abundant phenolic contents. Objective: The current study focused on the effect of cranberry juice (CJ) on blue light exposed human retinal pigment epithelial (ARPE-19) cells which mimic age-related macular degeneration (AMD). Materials and methods: Preliminary phytochemical and HPLC analysis, as well as total antioxidant capacity and scavenging activity of cranberry ethyl acetate extract and different CJ fractions (condensed tannins containing fraction), were evaluated. In cell line model, ARPE-19 were irradiated with blue light at 450 nm wavelength for 10 h (mimic AMD) and treated with different fractions of CJ extract at different doses (5–50 μg/mL) by assessing the cell viability or proliferation rate using MTT assay (repairing efficacy). Results: Phytochemical and HPLC analysis reveals the presence of several phenolic compounds (flavonoids, proanthocyanidin, quercetin) in ethyl acetate extract and different fractions of CJ. However, the condensed tannin containing fraction of ethyl acetate extract of CJ displayed the greater (p < 0.05) scavenging activity especially at the dose of 1 mg/mL. Similarly, the condensed tannin containing fraction at 50 μg/mL presented better (p < 0.05) repairing ability (increased cell viability). Furthermore, the oligomeric condensed tannin containing fraction display the best (p < 0.05) repairing efficiency at 50 μg/mL. Discussion and conclusion: In conclusion, this study distinctly proved that condensed tannin containing fraction of CJ probably exhibits better free radicals scavenging activity and thereby effectively protected the ARPE-19 cells and thus, hampers the progress of AMD

Efficacy of protein rich pearl powder on antioxidant status in a randomized placebo-controlled trial

Pearl is one of the well-known traditional Chinese medicine (TCM) prescribed for treating various skin and bone related disorders due to its abundant proteins and mineral contents. The present investigation focused on antioxidation and life span prolonging effects from different extracts of pearl powder. During in vitro studies, various oxidative indices were evaluated, along with lifespan-prolonging effect were checked using wild-type Caenorhabditis elegans. For the clinical trial, 20 healthy middle-aged subjects were recruited and separated into 2 groups as experimental and placebo group, who received 3 g of pearl powder/d (n = 10) and 3 g of placebo/d (n = 10) for 8 weeks, respectively. During the initial, 2nd, 4th, 6th, 8th and 10th weeks the blood samples were collected for biochemical analysis. The protein extract of pearl powder recorded maximum (p < 0.05) antioxidant activity (20–68%) as well as efficiently prolonged the life span of C. elegans by 18.87%. Pearl powder supplemented subjects showed a substantial increase (p < 0.05) in total antioxidant capacity from 0.45 to 0.69 mM, total thiols from 0.23 to 0.29 mM, Glutathione content from 5.89 to 9.19 μM, enzymic antioxidant activity (SOD-1248 to 1308; Gpx-30 to 32; GR-2.4 to 2.9) as well as considerably suppressed the lipid peroxidation products from 4.95 to 3.27 μM. The outcome of both in-vitro and in-vivo antioxidant activity inferred that protein extract of pearl powder was a potent antioxidant and thereby prolonged the lifespan of C. elegans. Hence, pearl powder could be recommended for treating various age-related degenerative disorders

Cyclooxygenase-2 expression in oral precancerous and cancerous conditions and its inhibition by caffeic acid phenyl ester-enriched propolis in human oral epidermal carcinoma KB cells

Oral cancer accounts for 3-5% of all cancers worldwide. The present study was undertaken to investigate the correlation between overexpression of cyclooxygenase-2 (COX-2) and various grades of oral cancer, and to ascertain the inhibitory effect of propolis in the human oral carcinoma cell line. For ex vivo studies, 45 patients with oral submucous fibrosis (OSF; n=15), oral leukoplakia (OLP; n=18) and oral squamous cell carcinoma (OSCC; n=18) were recruited, and a biopsy was done to determine COX-2 protein expression by Western blotting and immunohistochemistry (IHC). For the in vitro study, COX-2 levels were measured in human oral epidermal carcinoma cell line by immune blotting and IHC. The results of ex vivo studies by Western blotting revealed that COX-2 protein levels were highly upregulated in OSCC tissue, followed by OLP and OSF. The levels of COX-2 expression also showed a positive correlation with the grade (severity) of each oral precancerous and cancerous condition. Immunohistochemistry analysis revealed the presence of intense COX-2 staining in the cells of OSCC tissue, equivalent to the OLP and OSF specimens. In the in vitro study of oral carcinoma KB cells, Western blotting and IHC analysis showed that caffeic acid phenyl ester (CAPE)-rich propolis and celecoxib, a standard COX-2 inhibitor, markedly downregulated COX-2 expression. These results suggest that propolis exhibits a chemopreventive potential by lowering COX-2 expression in the oral carcinoma KB cell line. Hence, propolis might be used as an adjuvant therapy for treating oral cancer with standard chemotherapy drugs

Triterpenoids and polysaccharide peptides-enriched Ganoderma lucidum: a randomized, double-blind placebo-controlled crossover study of its antioxidation and hepatoprotective efficacy in healthy volunteers

Context: Ganoderma lucidum (Leyss: Fr) Karst. (Polyporaceae) is an oriental medicinal fungus, commonly used in traditional Chinese medicine (TCM) for treating various condition or diseases such as hypertension, hyperglycaemia, hepatitis and cancer. Objective: The current study examines whether triterpenoids and polysaccharide-enriched G. lucidum (GL) influence antioxidation and hepatoprotective efficacy by suppressing oxidative stress. Materials and methods: Forty-two healthy subjects (22 male and 20 female) were recruited and segregated into two groups as experimental or placebo and requested to intake GL (n = 21) or placebo (n = 21) capsule (225 mg; after lunch or dinner) for six consecutive months and vice versa with one month washout period in between. The anthropometric analysis and biochemical assays, as well as abdominal ultrasonic examination were performed. Results: Consumption of GL substantially improved (p < 0.05) the total antioxidant capacity (TEAC; 79.33–84.04), total thiols and glutathione content (6–8.05) in plasma as well as significant (p < 0.05) enhanced the activities of antioxidant enzymes. Whereas, the levels of thiobarbituric acid reactive substances (TBARS; 3.37–2.47), 8-hydroxy-deoxy-guanosine (8-OH-dG; 15.99–11.98) and hepatic marker enzymes (glutamic-oxaloacetic transaminase; GOT and glutamic-pyruvic transaminase; GPT) were concomitantly reduced (42 and 27%) on treatment with GL. Furthermore, the abdominal ultrasonic examination in GL subjects displayed a notable alteration on hepatic condition by reversing from mild fatty liver condition (initial) to normal condition. Discussion and Conclusion: The outcome of the present intervention demonstrated the antioxidation, anti-aging and hepatoprotective nature of GL by effectively curbing oxidative stress

Hypocholesterolemic efficacy of royal jelly in healthy mild hypercholesterolemic adults

Context: Royal jelly (RJ) has been reported for its health promoting factors such as antioxidant, anti-inflammatory and lipid lowering activities. Objective: The present randomized, placebo-controlled study examines the hypolipidemic beneficial effect of RJ through evaluating anthropometric measurements, lipid profile and various hormone levels in mildly hypercholesterolemic participants. Materials and methods: Forty subjects with mild hypercholesterolemia (180–200 mg/dL) were randomly selected and divided into two groups as experimental or placebo, who requested to intake nine capsules (350 mg/capsule) of RJ or placebo/day, respectively, for three months with one month of follow-up without any supplementation. Results: No significant changes were noted in any of the anthropometric parameters like body weight, waist and body fat. The serum total cholesterol (TC; 207.05–183.15 mg/dL) and low-density lipoprotein cholesterol (LDL-c; 126.44–120.31 mg/dL) levels were reduced significantly (p < 0.05) after administration of RJ. However, triglyceride (TG) and high-density lipoprotein cholesterol (HDL-c) levels were not considerably altered. Moreover, three months of RJ consumption significantly ameliorated (p < 0.05) the concentration of sex hormones like dehydroepiandrosterone sulphate (DHEA-S; 1788.09–1992.31 ng/mL). Also, intake of RJ did not elicit any hepatic or renal damage. Discussion and conclusion: Intervention with RJ for three months considerably lowered the TC and LDL-c levels through improving the levels of DHEA-S and thus alleviates the risk of cardiovascular disease (CVD)

Down-regulation of partial substitution for staple food by oat noodles on blood lipid levels: A randomized, double-blind, clinical trial

This clinical trial was conducted to assess the lipid-lowering activity of oat noodles by replacing partial staple food (wheat or rice noodle) in normal and mildly hypercholesterolemic subjects. Totally 84 healthy and mild hypercholesterolemic subjects were recruited and divided into 2 groups as experimental (oat noodles) and placebo (wheat noodles) and instructed to consume 100 g of oat noodles or wheat noodles (replacing one or two meals/day) for 10 weeks and followed by 2 weeks of follow up (without noodle consumption). Various anthropometric measurements and biochemical analysis were carried out during initial (baseline), 2nd, 6th, 10th and 12th week (follow-up). Consumption of oat noodles by replacing staple food for 10 weeks significantly reduced (**p < 0.01) the levels of total cholesterol (TC; 17.46%) and low-density lipoprotein LDL-c (19.03%) in both healthy and mildly hypercholesterolemic subjects. However, the hypocholesterolemic effect is significantly higher in mildly hypercholesterolemic subjects as compared with normal subjects. A pronounced decline (*p < 0.05) in the levels of various cardiovascular diseases (CVDs) markers including TC/HDL and LDL/HDL ratios and blood pressure (SBP; 11.09% and DBP; 7.48%) were observed in oat noodles supplemented subjects as equivalence with the placebo group. The partial replacement of staple food with oat noodle could considerably improve the health status of all subjects especially in hypercholesterolemic subjects and thus lower the risk of CVDs. Keywords: Hypercholesterolemic, Oat noodles, Total cholesterol, Blood pressure, Staple foo

MOESM1 of Antioxidant and physiological effects of Si-Wu-Tang on skin and liver: a randomized, double-blind, placebo-controlled clinical trial

Additional file 1. Copy of Institutional Review Board approval (provided by Chung Shan Medical University Hospital,Taichung, Taiwan)