Omega-3 fatty acids: Current insights into mechanisms of action in systemic lupus erythematosus.

Systemic lupus erythematosus (SLE) is one of the autoimmune diseases characterized by the lack of self-tolerance and the formation of immune complexes and nuclear autoantigens resulting in inflammation in multiple organs. Nowadays, the major aim of SLE therapy is the control of disease activity. However, the biological heterogeneity between patients and the absence of safe and specific targeted treatments complicate the lupus management. Therefore, the potential prophylactic effects of natural therapy considering the potential side effects of classical pharmacology, also the role of diet therapy in decreasing co-morbidities and improving quality of life in SLE patients could be a promising approach to SLE disease. Omega-3 polyunsaturated fatty acids (omega-3 PUFAs) are one of the agents that are considered for their preventive and therapeutic properties in disease activity of SLE and the related complications. The intake of omega-3 PUFAs likely has a direct relationship with improvements in inflammatory, cardiovascular, depressive, and neuromotor symptoms of the patients. The current review summarizes clinical and preclinical studies with comprehensive insights into the mechanisms of action of omega-3 fatty acids (omega-3 FAs) in Systemic Lupus Erythematosus to provide an update on the negative and positive aspects of the intake of omega-3 FAs in SLE patients.

The effect of psyllium supplementation on blood pressure: a systematic review and meta-analysis of randomized controlled trials.

BACKGROUND/AIMS: Global incidence of hypertension is estimated to be, in excess of, one billion people, and given the efficacy of soluble dietary fibers, in particular, Psyllium, to positively impact blood pressure in patients with hypertension, it is of clinical importance that consensus on its supplementation be established. Therefore, the aim of the study was systematically review and meta-analyze the effect of psyllium supplementation on blood pressure of hypertensive patients in randomized controlled trials. METHODS: We searched six universal databases including; Pubmed/Medline, Ovid, Cochrane Library, Google Scholar, Embase, and Scopus until November 2018. Both combined and stratified analyzes were conducted. A fixed-effects or random- effects model was used to assess the mean effect sizes. RESULTS: An eventual 11 trials with 592 participants were considered as eligible for inclusion in the present meta-analysis. The meta-analysis revealed a significant reduction of 2.04 mmHg in systolic blood pressure (weighted mean difference, -2.04; 95% confidence interval, -2.82 to -1.63; p < 0.001). Whilst meta-regression highlighted that the hypotensive effect of psyllium was stronger in subjects with higher baseline blood pressure. CONCLUSION: Given the overarching benefits and lack of reported side effects, particularly for hypertensive patients, health care providers and clinicians should consider the use of psyllium supplementation for the treatment or abatement of hypertension, or hypertensive symptoms.

Cocoa Consumption and Blood Pressure in Middle-Aged and Elderly Subjects: a Meta-Analysis.

PURPOSE OF REVIEW: The effect of cocoa consumption on blood pressure (BP) has been investigated in previous studies; however, to date, no meta-analysis has been conducted specific to middle-aged and elderly subjects. Thus, the aim of the present study was to evaluate the effect of cocoa consumption on indices of blood pressure, in middle-aged and elderly subjects. RECENT FINDINGS: Pubmed/Medline™, Cochrane Library™, Google Scholar™, and Scopus™ were searched until March 2019. The quantitative Jadad scale was used as the systematic assessment of bias in the included trials. We used a random effects model to estimate the pooled weighted mean differences (WMDs) with 95% confidence intervals (CIs). We further conducted sensitivity analysis and stratified analysis by baseline blood pressure, follow-up duration, and mean age. Thirteen studies with 758 total participants were included in the present meta-analysis. A significant reduction in SBP by 2.77 (95% CI - 5.28, - 0.27, P = 0.03, I2 = 89%) and DBP by 1.47 mm/Hg (- 95% CI - 2.40, - 0.55, P = 0.001, I2 = 45%) were observed after cocoa consumption. Stratified analyses showed BP-lowering effects of cocoa consumption in longer-term duration and hypertensive subgroups. Our meta-analysis showed a significant inverse association between cocoa consumption and SBP/DBP. However, the analysis could not conclude any beneficial effect of cocoa consumption on blood pressure in normotensive/elevated blood pressure subjects. Therefore, further studies are warranted to affirm the efficacy of cocoa consumption for the improvement of blood pressure in elderly subjects.

N-3 fatty acids as preventive and therapeutic agents in attenuating PCOS complications.

To our knowledge, in spite of several trials exploring the beneficial effect of n-3 polyunsaturated fatty acids (PUFA) on polycystic ovary syndrome (PCOS), no comprehensive evidence has investigated the effects of n-3 PUFA consumption on PCOS complications. Therefore, our aim was to conduct a review to investigate the possible effect and related mechanisms. A comprehensive systematic search was conducted in Embase, MEDLINE/PubMed, Google Scholar, and SCOPUS, to identify studies investigating n-3 fatty acids as a preventative or therapeutic agent for the attenuation of PCOS complications. Subsequently, the impact of omega-3 on PCOS, omega-3 and inflammation, omega-3 and insulin resistance, omega-3 and adipokines, omega-3 and lipid metabolism, omega-3 and endothelial function and omega-3 and hormonal factors were discussed. There are multiple mechanisms by which n-3 PUFAs may exert their beneficial effects on PCOS, including anti-obesity, glycemic and hormonal hemostasis, anti-inflammatory, regulation of adipokine production and enhancement of endothelial function. N-3 PUFAs are a promising agent in relieving complications associated with PCOS. Although most of the studies in patients with PCOS reported an improvement in most complications after administration of omega-3 supplements, there is a distinct dearth of studies investigating the dietary intake of these types of fatty acids. Moreover, favorable effects regarding the improvement of dyslipidemia, regulation of adipokines, regulation of hormonal factors and enhancement of endothelial function are limited. Therefore, more trials are warranted to investigate palatable mechanisms for clarifying the metabolic and hormonal effects of these agents in PCOS.