Sumac fruit supplementation improve glycemic parameters in patients with metabolic syndrome and related disorders: A systematic review and meta-analysis.

BACKGROUND: Metabolic syndrome (MetS) is the one of the main causes of mortality worldwide. Several randomized controlled trials (RCTs) have revealed the beneficial effects of sumac (Rhus coriaria) on cardiometabolic risk factors. However, the entirety of the evidence has yet to be summarized in a systematic review. OBJECTIVE: The aim of this systematic review and meta-analysis was to evaluate the effects of sumac on several cardiometabolic risk factors in patients with MetS and related disorders. METHODS: We reviewed Medline, Scopus, Web of Science and Cochrane CENTRAL for RCTs published from inception to December 2020 evaluating the impact of sumac in adults with MetS or related disorders. Outcome measures included anthropometric measures, glycemic indices, blood lipids, blood pressure and liver enzymes. Pooled effect sizes were reported as standard mean differences (SMDs) and 95% confidence intervals (CIs). Trials were pooled using a random effects model. RESULTS: Nine studies enrolling 526 participants met the inclusion criteria for this meta-analysis. Our results indicate that sumac intake significantly decrease fasting blood sugar (FBS) (SMD: -0.28; 95% CI: -0.54, -0.02; I2 = 00.0%), insulin (SMD: -0.67; 95% CI: -0.99, -0.36; I2 = 03.7%), and insulin resistance (measured through the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR)) (SMD: -0.79; 95% CI: -1.24, -0.34; I2 = 50.1%). Sumac intake did not have a significant impact on weight, body mass index (BMI), waist circumference (WC), hip circumference (HC), waist to hip ratio (WHR), HbA1c, total cholesterol (TC), triglycerides (TG), high density lipoproteins (HDL), low density lipoprotein (LDL), systolic blood pressure (SBP), diastolic blood pressure (DBP), aspartate transaminase (AST) and alanine transaminase (ALT). CONCLUSION: Sumac, as an adjuvant therapy, may decrease serum levels of FBS, insulin and HOMA-IR. However, due to high heterogeneity in the included studies, these findings must be interpreted with great caution. Larger, well-designed placebo-controlled clinical trials are still needed to further evaluate the capacity of sumac as a complementary treatment to control MetS risk factors.

Effect of omega-3 fatty acids supplementation on cardio-metabolic and oxidative stress parameters in patients with chronic kidney disease: a systematic review and meta-analysis.

BACKGROUND: Omega-3 fatty acids (FAs) have been suggested as a beneficial supplement in chronic kidney disease (CKD) patients, but the results of randomized clinical trials (RCTs) are controversial. We conducted a systematic review and meta-analysis to evaluate all the RCTs about the impact of omega-3 FAs supplementation on cardiometabolic outcomes and oxidative stress parameters in patients with CKD. METHODS: We performed a systematic database search in PubMed/MEDLINE, EMBASE, Scopus, Web of Science, and Cochrane Central, up to May 2020. We included all placebo-controlled randomized trials that assessed the effect of omega-3 FAs supplementation on any cardiometabolic outcomes: blood pressure, total cholesterol (TC), low-density lipoprotein (LDL) and high-density lipoprotein (HDL) or triglycerides (TG) and oxidative stress parameters. Data were pooled using DerSimonian-Laird's random-effects model. RESULTS: Finally, thirteen articles met the inclusion criteria for this review omega-3 FAs supplementation significantly decrease TC (SMD: -0.26; 95% CI: - 0.51, - 0.02; I2 = 52.7%), TG (SMD: -0.22; 95% CI: - 0.43, - 0.02; I2 = 36.0%) and Malondialdehyde (MDA) levels (SMD: -0.91; 95% CI: - 1.29, - 0.54; I2 = 00.0%) and also significantly increase superoxide dismutase (SOD) (SMD: 0.58; 95% CI: 0.27, 0.90; I2 = 00.0%) and Glutathione peroxidase (GPx) (SMD: 0.50; 95% CI: 0.14, 0.86; I2 = 00.0%) activities. However our results show that omega-3 FAs supplementation have no significant effects on HDL, LDL and blood pressure. Conclusion This systematic review and meta-analysis supports current evidence for the clinical benefit of omega-3 FAs intake to improve cardiometabolic parameters in CKD patients. However, well-designed RCTs still needed to provide a conclusive picture in this field.