Effects of Silybum marianum, Pueraria lobate, combined with Salvia miltiorrhiza tablets on non-alcoholic fatty liver disease in adults: A triple-blind, randomized, placebo-controlled clinical trial.

BACKGROUND & AIMS: Several medicinal plant extracts have demonstrated hepatoprotective effects. However, data are scarce regarding their combined effects on non-alcoholic fatty liver disease (NAFLD). This study aimed to investigate the effects of tablets containing Silybum marianum, Pueraria lobata, and Salvia miltiorrhiza (SPS) on NAFLD progression in Chinese adults. METHODS: In this randomized, triple-blind, placebo-controlled clinical trial, 121 NAFLD patients (60 female and 61 male), diagnosed via magnetic resonance imaging (MRI) and aged 18-65 years, were enrolled. Participants were randomly allocated to receive SPS tablets (n = 60; three tablets per dose, twice daily) or placebo (n = 61) for 24 weeks. Each SPS tablet contained approximately 23.0 mg of silybin, 11.4 mg of puerarin, and 10.9 mg of salvianolic acid. There were no differences in appearance, taste and odour between the SPS tablets and placebo manufactured by BYHEALTH Co., LTD (Guangzhou, China). The primary endpoints were changes in the liver fat content (LFC) and steatosis grade from baseline to 24 weeks. Secondary outcomes included changes in biomarkers/scores of liver fibrosis and steatosis, oxidative stress, inflammatory cytokines, alcohol metabolism, and glucose metabolism. RESULTS: A total of 112 participants completed the research. The intention-to-treat results showed a trend toward reduction in both absolute LFC (-0.52%) and percentage of LFC (-4.57%) in the SPS group compared to the placebo group after 24 weeks, but these changes didn't reach statistical significance (p > 0.05). The SPS intervention (vs. placebo) significantly decreased hypersensitive C-reactive protein level (-6.76%) and increased aldehyde dehydrogenase activity (+18.1%) at 24 weeks post-intervention (all p < 0.05). Per-protocol analysis further supported these effects. This trial is registered at Clinical Trials.gov (NCT05076058). CONCLUSION: SPS supplementation may have potential benefits in improving NAFLD, but further larger-scale trials are necessary to confirm these findings.

The Association between Circulating 25-Hydroxyvitamin D and Carotid Intima-Media Thickness Is Mediated by Gut Microbiota and Fecal and Serum Metabolites in Adults.

SCOPE: Vitamin D is vital to cardiovascular health. This study examines the association between plasma 25-hydroxyvitamin D (25[OH]D) and the progression of carotid intima-media thickness (cIMT) and identifies the potential mediating biomarkers of gut microbiota and metabolites in adults. METHODS AND RESULTS: This 9-year prospective study includes 2975 subjects with plasma 25(OH)D at baseline and determined cIMT every 3 years. Higher circulating 25(OH)D is associated with decreased odds of higher (≥median) 9-year cIMT changes at the common carotid artery (hΔCCA-cIMT) (p-trend < 0.001). Multivariable-adjusted OR (95%CI) of hΔCCA-cIMT for tertiles 2 and 3 (vs. 1) of 25(OH)D is 0.87 (0.73-1.04) and 0.68 (0.57-0.82). Gut microbiome and metabolome analysis identify 18 biomarkers significantly associated with both 25(OH)D and hΔCCA-cIMT, including three microbial genera, seven fecal metabolites, eight serum metabolites, and pathway of synthesis and degradation of ketone bodies. Mediation/path analyses show the scores generated from the overlapped differential gut microbiota, fecal and serum metabolites, and serum acetoacetic acid alone could mediate the beneficial association between 25(OH)D and hΔCCA-cIMT by 10.8%, 23.1%, 59.2%, and 62.0% (all p < 0.05), respectively. CONCLUSIONS: These findings show a beneficial association between plasma 25(OH)D and the CCA-cIMT progression. The identified multi-omics biomarkers provide novel mechanistic insights for the epidemiological association.

Formula Milk Supplementation and Bone Acquisition in 4-6 Years Chinese Children: A 12-Month Cluster-Randomized Controlled Trial.

Dairy foods are crucial for adequate calcium intake in young children, but scarce data are available on the effects of formula milk on bone acquisition. This cluster-randomized controlled trial investigated the effects of the supplementation of formula milk on bone health in rural children accustomed to a low-calcium diet between September 2021 and September 2022. We recruited 196 healthy children aged 4-6 years from two kindergartens in Huining County, Northwest China. A class-based randomization was used to assign them to receive 60 g of formula milk powder containing 720 mg calcium and 4.5 µg vitamin D or 20-30 g of bread per day for 12 months, respectively. Bone mineral density (BMD) and bone mineral content (BMC) at the left forearm and calcaneus, bone biomarkers, bone-related hormones/growth factors, and body measures were determined at baseline, 6, and 12 months. A total of 174 children completed the trial and were included in the analysis. Compared with the control group, formula milk intervention showed significant extra increments in BMD (3.77% and 6.66%) and BMC (4.55% and 5.76%) at the left forearm at 6th and 12th months post-intervention (all p < 0.001), respectively. Similar trends were observed in BMD (2.83%) and BMC (2.38%) in the left calcaneus at 6 months (p < 0.05). The milk intervention (vs. control) also showed significant changes in the serum concentrations of osteocalcin level (-7.59%, p = 0.012), 25-hydroxy-vitamin-D (+5.54%, p = 0.001), parathyroid hormone concentration (-15.22%, p = 0.003), and insulin-like growth factor 1 (+8.36%, p = 0.014). The percentage increases in height were 0.34%, 0.45%, and 0.42% higher in the milk group than in the control group after 3-, 6-, and 9-month intervention, respectively (p < 0.05). In summary, formula milk supplementation enhances bone acquisition at the left forearm in young Chinese children.

The gut microbiota-bile acid axis mediates the beneficial associations between plasma vitamin D and metabolic syndrome in Chinese adults: A prospective study.

BACKGROUND & AIMS: Previous studies have suggested that circulating 25-hydroxyvitamin D (25 [OH]D, VD) and the gut microbiota-bile acid axis play crucial roles in metabolic health. Exploring the mediating role of the gut microbiota-bile acid axis would improve our understanding of the mechanisms underlying the effects of VD on human metabolic health. This study examined the association between plasma 25(OH)D and the prevalence/incidence of metabolic syndrome (MetS) and the mediating role of the gut microbiota-bile acid axis. METHODS: This prospective study included 3180 participants with plasma 25(OH)D data at baseline and 2966 participants with a 9-year follow-up. MetS was determined every three years. The gut microbiota was analyzed by 16S rRNA sequencing in 1752 participants, and targeted bile acid metabolites in feces were further determined in 974 participants using UPLC‒MS/MS at the middle of the study. Mediating roles of microbiota and bile acids in the VD-MetS associations were analyzed using mediation/path analyses adjusted for potential confounders. RESULTS: Among the 2966 participants who were followed-up, 1520, 193, 647, and 606 were MetS-free (normal), recovered, had incident MetS, and had persistent MetS, respectively. The multivariable-adjusted ORs (95% CIs) of MetS prevalence were 0.65 (0.50, 0.84) for baseline MetS and 0.46 (0.33, 0.65) for 9-year persistent MetS in quartile 4 (compared to quartile 1) of plasma 25(OH)D (median: 37.7 vs. 19.6, ng/ml). The corresponding HR (95% CI) of 9-year MetS incidence was 0.71 (0.56, 0.90) (all P-trend < 0.05). Higher VD concentrations were associated with greater α-diversity of the gut microbiota, which was inversely correlated with MetS risk. The groups classified by VD and MetS status had significantly different ß-diversity. Ruminiclostridium-6 and Christensenellaceae R-7 group were enriched in the high-VD group and were inversely associated with MetS. However, opposite associations were observed for Lachnoclostridium and Acidaminococcus. The overlapping differential microbial score (ODMS) developed from the four differential genera explained 12.2% of the VD-MetS associations (Pmediation = 0.015). Furthermore, the fecal bile acid score created from 11 differential bile acids related to ODMS and MetS mediated 34.2% of the association between ODMS and MetS (Pmediation = 0.029). Path analyses showed that the inverse association between plasma 25(OH)D and MetS could be mediated by the gut microbiota-bile acid axis. CONCLUSIONS: The findings suggest that the gut microbiota-bile acid axis partially mediates the beneficial association between plasma 25(OH)D and the risk of persistent MetS and incident MetS in the Chinese population.

Comparison of fecal and blood metabolome reveals inconsistent associations of the gut microbiota with cardiometabolic diseases.

Blood metabolome is commonly used in human studies to explore the associations of gut microbiota-derived metabolites with cardiometabolic diseases. Here, in a cohort of 1007 middle-aged and elderly adults with matched fecal metagenomic (149 species and 214 pathways) and paired fecal and blood targeted metabolomics data (132 metabolites), we find disparate associations with taxonomic composition and microbial pathways when using fecal or blood metabolites. For example, we observe that fecal, but not blood butyric acid significantly associates with both gut microbiota and prevalent type 2 diabetes. These findings are replicated in an independent validation cohort involving 103 adults. Our results suggest that caution should be taken when inferring microbiome-cardiometabolic disease associations from either blood or fecal metabolome data.

Effects and mechanisms of tea on obesity.

Obesity has become a global health concern. It increases the risk of several diseases, such as type 2 diabetes mellitus, nonalcoholic fatty liver disease, and certain cancers, which threatens human health and increases social economic burden. As one of the most consumed beverages, tea contains various phytochemicals with potent bioactive properties and health-promoting effects, such as antioxidant, immune-regulation, cardiovascular protection and anticancer. Tea and its components are also considered as potential candidates for anti-obesity. Epidemiological studies indicate that regular consumption of tea is beneficial for reducing body fat. In addition, the experimental studies demonstrate that the potential anti-obesity mechanisms of tea are mainly involved in increasing energy expenditure and lipid catabolism, decreasing nutrient digestion and absorption as well as lipid synthesis, and regulating adipocytes, neuroendocrine system and gut microbiota. Moreover, most of clinical studies illustrate that the intake of green tea could reduce body weight and alleviate the obesity. In this review, we focus on the effect of tea and its components on obesity from epidemiological, experimental, and clinical studies, and discuss their potential mechanisms.

Effects of Different Green Teas on Obesity and Non-Alcoholic Fatty Liver Disease Induced by a High-Fat Diet in Mice.

Non-alcoholic fatty liver disease (NAFLD) and obesity are serious public health problems. Green tea is widely consumed in the world and different green teas could possess different bioactivities. In this study, the effects of 10 selected green teas on obesity and NAFLD were evaluated and compared. The mice fed with a high-fat diet were intervened with green tea extract (200 mg/kg body weight) for 15 weeks. Most of these teas were first evaluated for their effects on obesity and NAFLD. The results showed that Selenium-Enriched Chaoqing Green Tea and Jieyang Chaoqing Tea showed the most prominent inhibition of obesity and body weight gains of mice in these two tea intervention groups and model groups were 5.3, 5.5, and 13.7 g, respectively. In addition, Jieyang Chaoqing Tea, Taiping Houkui Tea, and Selenium-Enriched Chaoqing Green Tea exerted the most notable effect on NAFLD, which was attributed to decreasing body weight, and lipid content and ameliorating oxidative stress. Furthermore, 13 phytochemicals were determined in these teas by high-performance liquid chromatography and the correlation analysis found that epigallocatechin gallate, gallocatechin, and epigallocatechin might contribute to the decrease of hepatic weight, while epicatechin might reduce oxidative stress. In general, several green teas could prevent the development of obesity and NAFLD and could be developed into functional foods. This study was also helpful for the public to select appropriate tea to prevent obesity and NAFLD.

Protective effects of tea extracts against alcoholic fatty liver disease in mice via modulating cytochrome P450 2E1 expression and ameliorating oxidative damage.

The alcoholic fatty liver disease (AFLD) has been a severe public health problem. Oxidative stress is involved in the initiation and progression of AFLD. Tea is a popular beverage worldwide with strong antioxidant activity. In this research, our purpose is to explore and compare the effects of 12 selected teas on AFLD. The ethanol liquid diet was used to feed the mice, and 12 tea extracts were administrated at 200 mg/kg body weight every day for 4 weeks. The results showed that the application of several tea extracts exhibited different inhibitory effects on lipid accumulation induced by sub-acute alcohol consumption based on the determination of triglyceride concentration and the histological alteration in the liver. In addition, several teas significantly decreased serum alanine aminotransferase and aspartate aminotransferase activities, inhibited the cytochrome P450 2E1 expression, and promoted alcohol metabolism (p < .05). Besides, compared with the model group, several teas obviously elevated superoxide dismutase and glutathione peroxidase activities as well as glutathione content, and remarkably decreased malondialdehyde level (p < .05). In general, Fried Green Tea, Fenghuang Narcissus Oolong Tea, and Pu-erh Dark Tea possessed potential preventive effects on AFLD. Moreover, the main phytochemicals in the three tea extracts were determined and quantified via high-performance liquid chromatography, and the most commonly detected ingredients were catechins and caffeine, which could exert the protective effects on AFLD.

Effects of several tea extracts on nonalcoholic fatty liver disease in mice fed with a high-fat diet.

Nonalcoholic fatty liver disease (NAFLD) is considered as a severe threat to human health. It has been reported that tea has abundant bioactive compounds and beneficial effects. In our study, the effects of 12 tea extracts on NAFLD were assessed and compared at the dose of 200 mg/kg body weight in mice fed with a high-fat diet (HFD) for 15 weeks. Enshi Yulu Tea, Fenghuang Narcissus Tea, and Yihong Tea showed strong effects in suppressing the accumulation of epididymal and perirenal adipose tissue as well as the increases of body weight and liver weight. The histopathological analysis revealed that hepatic steatosis and adipocyte hypertrophy induced by a HFD could be ameliorated by tea supplementation. In addition, Enshi Yulu Tea and Qing Brick Tea exerted more remarkable functions on decreasing the level of serum triglyceride and preventing hepatic fat accumulation, respectively. Furthermore, Fenghuang Narcissus Tea, Enshi Yulu Tea, and Qing Brick Tea could reverse the abnormal change in the levels of glutathione and superoxide dismutase. Moreover, 13 phytoconstituents were detected and quantified in these teas with high-performance liquid chromatography (HPLC) method. The correlation analysis demonstrated that gallic acid might decrease MDA level, and the reduction of liver weight might be attributed to ellagic acid. However, it should be paid attention to some teas that showed hepatotoxicity with elevated levels of aspartate transaminase and alanine aminotransferase. Several teas showed strong effects in the prevention of NAFLD, which could be developed into functional foods against NAFLD.

Antioxidant Food Components for the Prevention and Treatment of Cardiovascular Diseases: Effects, Mechanisms, and Clinical Studies.

Cardiovascular diseases (CVDs) have gained increasing attention because of their high prevalence and mortality worldwide. Epidemiological studies revealed that intake of fruits, vegetables, nuts, and cereals could reduce the risk of CVDs, and their antioxidants are considered as the main contributors. Moreover, experimental studies showed that some antioxidant natural products and their bioactive compounds exerted beneficial effects on the cardiovascular system, such as polyphenols, polysaccharides, anthocyanins, epigallocatechin gallate, quercetin, rutin, and puerarin. The mechanisms of action mainly included reducing blood pressure, improving lipid profile, ameliorating oxidative stress, mitigating inflammation, and regulating gut microbiota. Furthermore, clinical trials confirmed the cardiovascular-protective effect of some antioxidant natural products, such as soursop, beetroot, garlic, almond, and green tea. In this review, we summarized the effects of some antioxidant natural products and their bioactive compounds on CVDs based on the epidemiological, experimental, and clinical studies, with special attention paid to the relevant mechanisms and clinical trials.

Effects of Different Green Tea Extracts on Chronic Alcohol Induced-Fatty Liver Disease by Ameliorating Oxidative Stress and Inflammation in Mice.

Alcoholic fatty liver disease (AFLD) is a common chronic liver disease and has become a critical global public health problem. Green tea is a popular drink worldwide and contains several bioactive compounds. Different green teas could contain diverse compounds and possess distinct bioactivities. In the present study, the effects of 10 green teas on chronic alcohol induced-fatty liver disease in mice were explored and compared. The results showed that several green teas significantly reduced triacylglycerol levels in serum and liver as well as the aminotransferase activities in mice at a dose of 200 mg/kg, suggesting that they possess hepatoprotective effects. Moreover, several green teas remarkably decreased the expression of cytochrome P450 2E1, the levels of malondialdehyde and 4-hydroxynonenoic acid, and the contents of proinflammatory cytokines, indicating that they could alleviate oxidation damage and inflammation induced by chronic alcohol exposure. In addition, Seven Star Matcha Tea and Selenium-Enriched Matcha Tea could increase glutathione level. Furthermore, the main phytochemical components in green teas were determined and quantified by high-performance liquid chromatography, and the correlation analysis showed that gallic acid, gallocatechin, catechin, chlorogenic acid, and epigallocatechin gallate might at least partially contribute to protective effects on AFLD. In conclusion, Selenium-Enriched Chaoqing Green Tea, Xihu Longjing Tea, Taiping Houkui Tea, and Selenium-Enriched Matcha Tea showed the strongest preventive effects on AFLD. This research also provides the public with new insights about the effects of different green teas on AFLD.

The In Vivo Antioxidant and Hepatoprotective Actions of Selected Chinese Teas.

Tea is a popular beverage and shows very strong in vitro antioxidant activity. However, the relationship among in vitro and in vivo antioxidant activities in teas is seldom reported. In this study, in vivo antioxidant and hepatoprotective activities of 32 selected Chinese teas were evaluated on a mouse model with acute alcohol-induced liver injury. The results showed that most teas significantly reduced the levels of alanine transaminase, aspartate transaminase, alkaline phosphatase, triacylglycerol, and total bilirubin in the sera of mice at a dose of 400 mg/kg. In addition, most teas greatly decreased the malondialdehyde level and increased the levels of superoxide dismutase, glutathione peroxidase, and glutathione in the liver of mice, indicating the antioxidant and hepatoprotective activities of teas. Furthermore, the in vivo antioxidant activity of dark tea was stronger than that of green tea, opposite to the results of the in vitro study. Among these 32 teas, Black Fu Brick Tea, Pu-erh Tea, and Qing Brick Tea showed the strongest antioxidant and hepatoprotective activities. Moreover, total phenolic content as well as the contents of epicatechin, gallocatechin gallate, and chlorogenic acid were found to contribute, at least partially, to the antioxidant and hepatoprotective actions of these teas. Overall, teas are good dietary components with antioxidant and hepatoprotective actions.

Effects of Food Processing on In Vivo Antioxidant and Hepatoprotective Properties of Green Tea Extracts.

Food processing can affect the nutrition and safety of foods. A previous study showed that tannase and ultrasound treatment could significantly increase the antioxidant activities of green tea extracts according to in vitro evaluation methods. Since the results from in vitro and in vivo experiments may be inconsistent, the in vivo antioxidant activities of the extracts were studied using a mouse model of alcohol-induced acute liver injury in this study. Results showed that all the extracts decreased the levels of aspartate transaminase and alanine aminotransferase in serum, reduced the levels of malondialdehyde and triacylglycerol in the liver, and increased the levels of catalase and glutathione in the liver, which can alleviate hepatic oxidative injury. In addition, the differences between treated and original extracts were not significant in vivo. In some cases, the food processing can have a negative effect on in vivo antioxidant activities. That is, although tannase and ultrasound treatment can significantly increase the antioxidant activities of green tea extracts in vitro, it cannot improve the in vivo antioxidant activities, which indicates that some food processing might not always have positive effects on products for human benefits.

Targeting Gut Microbiota for the Prevention and Management of Diabetes Mellitus by Dietary Natural Products.

Diabetes mellitus is one of the biggest public health concerns worldwide, which includes type 1 diabetes mellitus, type 2 diabetes mellitus, gestational diabetes mellitus, and other rare forms of diabetes mellitus. Accumulating evidence has revealed that intestinal microbiota is closely associated with the initiation and progression of diabetes mellitus. In addition, various dietary natural products and their bioactive components have exhibited anti-diabetic activity by modulating intestinal microbiota. This review addresses the relationship between gut microbiota and diabetes mellitus, and discusses the effects of natural products on diabetes mellitus and its complications by modulating gut microbiota, with special attention paid to the mechanisms of action. It is hoped that this review paper can be helpful for better understanding of the relationships among natural products, gut microbiota, and diabetes mellitus.

Effects of Tannase and Ultrasound Treatment on the Bioactive Compounds and Antioxidant Activity of Green Tea Extract.

The present study investigated the effects of tannase and ultrasound treatment on the bioactive compounds and antioxidant activity of green tea extract. The single-factor experiments and the response surface methodology were conducted to study the effects of parameters on antioxidant activity of green tea extract. The highest antioxidant activity was found under the optimal condition with the buffer solution pH value of 4.62, ultrasonic temperature of 44.12 °C, ultrasonic time of 12.17 min, tannase concentration of 1 mg/mL, and ultrasonic power of 360 W. Furthermore, phenolic profiles of the extracts were identified and quantified by high-performance liquid chromatography. Overall, it was found that tannase led to an increase in gallic acid and a decrease in epigallocatechin gallate, and ultrasounds could also enhance the efficiency of enzymatic reaction.