Mohammed Faris Abdulghani
Sadeq Al-Fayyadh- Nursing College, University of Baghdad, Baghdad, Iraq
Introduction: Metabolic syndrome comprises a collection of metabolic disorders stemming from factors like genetic predisposition, inadequate nutrition, stress, decreased physical activity, aging, and ethnicity. Although traditional pharmaceutical treatments exist for metabolic syndrome, their limited popularity is attributed to high costs and adverse effects. Consequently, natural products with fewer side effects have been explored for managing this condition. This literature review aims to explore the role of natural products including herbs, botanicals, vitamins, minerals, probiotics, and dietary supplements in managing metabolic syndrome.
Methods: This scoping review was conducted in five steps, involving the formulation of a research question, the retrieval and extraction of relevant studies, the selection of pertinent studies, the organization of information into tables, and the reporting of results. Data was collected from various databases including Embase, Science Direct, PubMed, Google Scholar, Scopus, and Web of Science, with a focus on studies published from 2010 to the present, available in English and with full-text accessibility.
Results: We identified 1,259 articles, screened their titles, abstracts, and full texts, ultimately incorporating 169 pertinent articles into this review (comprising 90 review articles, 32 trial articles, 6 in vitro articles, 38 in vivo articles, 1 experimental article and 2 observational articles). The study’s outcomes revealed that natural products, encompassing plants and their derivatives, vitamins and supplements, as well as probiotics, can exert a beneficial influence on metabolic syndrome by regulating blood sugar, blood pressure, lipid profiles, obesity, and abnormal cholesterol and triglyceride levels.
Conclusion: The current study underscores the significance of natural products in addressing metabolic syndrome. Consequently, it is advisable to conduct further extensive research to assess the efficacy of these products, potentially integrating them into treatment regimens for individuals with metabolic syndrome.
1 Introduction
Metabolic syndrome (MetS) is a cluster of metabolic disorders, including impairments in protein, glucose, lipid, and carbohydrate (Di et al., 2019). It is characterized by a combination of risk factors for atherosclerotic cardiovascular diseases (ASCVD) and type 2 diabetes (Hou et al., 2019; Nna et al., 2023). These risk factors lead to the development of high blood pressure, high blood sugar or diabetes, obesity, excess abdominal fat, and abnormal cholesterol or triglyceride levels (Hou et al., 2019). The diagnosis of metabolic syndrome typically requires the presence of three or more of the following conditions: (Di et al., 2019): waist circumference ≥102 cm in men and ≥88 cm in women, (Nna et al., 2023), triglycerides ≥150 mg/dL or undergoing drug therapy for high triglycerides, (Hou et al., 2019), HDL-C < 40 mg/dL in men and <50 mg/dL in women or undergoing drug therapy for lowering cholesterol, (Jang et al., 2016a), systolic blood pressure ≥130 mmHg, diastolic blood pressure ≥85 mmHg or undergoing antihypertensive treatment for individuals with a history of hypertension, and (van der Pal et al., 2018) fasting glucose ≥100 mg/dL or undergoing treatment to control glucose levels (Jang et al., 2016a; van der Pal et al., 2018). However, the specific measurement for waist size may vary slightly based on country and ethnicity (Jang et al., 2016a). Factors contributing to the development of metabolic syndrome include genetic predisposition, poor dietary habits, stress, sedentary lifestyle, age, and ethnicity (Raja Kumar et al., 2019; Nna et al., 2023). Some of these factors, such as diet and physical activity, can be managed over time (Raja Kumar et al., 2019).
The treatment of metabolic syndrome has traditionally involved dietary modifications and the use of chemical drugs targeting specific biochemical pathways involved in food metabolism (Hameed and Al-Ameri, 2022). Beta-blockers, statins, fibrates and glibenclamide are usually known as the most commonly used drugs for patients with metabolic syndrome (Gharipour et al., 2011). However, these drugs are often costly, poorly tolerated by patients, associated with various side effects and do not have sustainable effectiveness (Nigussie, 2021). Additionally, typically represent monotherapy and address only a limited range of health outcomes associated with metabolic disorders (Tola et al., 2023). Consequently, there is a need to explore and develop alternative and complementary approaches with fewer complications for managing metabolic diseases (Nigussie, 2021).
Complementary and alternative medicine (CAM) has been used globally for centuries and consists of a wide range of therapies (Suganya et al., 2017; Adeniyi et al., 2021; Nasiri et al., 2023). One of these treatments is the use of natural products (Nasiri et al., 2023). Many medicinal plants and natural products are considered by the public as a safe and natural alternative to synthetic drugs (Waltenberger et al., 2016b). It has been shown that natural products or their derivatives are a valuable source of therapeutic agents (Atanasov et al., 2015; Fadhel and Hassan, 2023). Growing evidence indicates that natural products and their bioactive compounds can provide various benefits to the human health (Nainu et al., 2023). Natural products such as herbal drugs in addition to their secondary metabolites act as endless sources of promising drug leads that revealed significant anti-inflammatory as well as anti-obesity potential (Youssef et al., 2022). They revealed higher safety margins, eco-friendly, and less expensive with respect to synthetic chemical entities (Li et al., 2021). Consistent with this approach, researchers have focused on natural products in the field of prevention or treatment of MetS (Dong et al., 2012; Taghipour et al., 2019). In this regard, a study by Jang et al. (2016) demonstrated the effect of herbal medicines on reducing waist circumference, blood glucose, blood lipids, and blood pressure, suggesting their potential for treating metabolic syndrome (Jang et al., 2016a). Sabarathinam et al. (2022) highlighted that certain plant extracts contain natural active components that target multiple biological pathways, offering the opportunity to address various defects associated with metabolic syndrome simultaneously (Sabarathinam et al., 2022). Additionally, a study by Taghipour et al. (2019) revealed that Plant-based natural products improve obesity-associated MetS such as hyperglycemia, hyperlipidemia, and insulin resistance, reduce systolic and diastolic blood pressure, and reduce body weight gain (Taghipour et al., 2019).
Metabolic syndrome is now recognized as a disease with developmental origins, and it has become a significant focus of recent research (Hou et al., 2019). Given the increasing popularity of complementary and alternative medicine (CAM) for managing various health conditions, including metabolic syndrome, a review of the existing literature is crucial to comprehend the scope of CAM usage, its reported effectiveness, and potential safety considerations in relation to metabolic syndrome. While there is evidence suggesting that certain natural products can positively affect components of metabolic syndrome (Jang et al., 2016a; Taghipour et al., 2019; Sabarathinam et al., 2022), a comprehensive review is necessary to evaluate the quality of this evidence. Moreover, there are still gaps in understanding which natural products show the most promising outcomes, their mechanisms of action, and their potential interactions with conventional therapies. A scoping review can help identify these gaps and guide the design of future studies.
Healthcare practitioners and patients require evidence-based information to make informed decisions about the use of natural products for managing metabolic syndrome. Therefore, conducting a scoping review can offer a comprehensive overview of the current state of knowledge and help elucidate the potential role of natural products in this field. This scoping review aimed to investigate natural products in the management of metabolic syndrome.
2 Materials and methods
This scoping review was conducted in five stages: 1) formulating the research question, 2) searching for and extracting relevant studies, 3) selecting related studies, 4) tabulating, summarizing, and synthesizing the information and data, and 5) reporting the results (Mak and Thomas, 2022). Following the formulation of the research question (what is the role of natural products in the management of patients with metabolic syndrome?), a search strategy was devised, inclusion criteria for the selected studies were established, data extraction forms were prepared, and data analysis program was specified.
2.1 Information sources and searches
In the book authored by Pinzon-Perez et al. (2015) (Pinzon-Perez and Pérez, 2016), 6 sub-categories for natural products (herbs, botanicals, vitamins, minerals, probiotics, and dietary supplements) are delineated, and the researchers also employed this keywords to devise an optimal search strategy. For this purpose, researchers conducted searches across several databases, including Embase, Science Direct, PubMed, Google Scholar, Scopus, and Web of Science. They used a range of keywords such as “herbs”, “botanicals”, “vitamins”, “minerals”, “probiotics”, “dietary supplements”, “natural product”, “essential oils” and “metabolic syndrome” to retrieve information from these databases.
2.2 Inclusion and exclusion criteria
The inclusion criteria included reviewing all experimental, quasi-experimental, systematic and Meta-analysis, clinical trial, review, interventional, observational, in vivo and in vitro articles, A full texts articles which were published in reputable journals were included. Additionally, articles related to animal phases were considered. The exclusion criteria covered articles that did not specifically investigate the impact of complementary and alternative medicine on metabolic syndrome, studies published before 2010, and studies published in languages other than English.
2.3 Selection of relevant studies
Initially, one of the researchers imported all search results from the databases into the EndNote Desktop program, with duplicates removed. Subsequently, two researchers independently reviewed articles titles and abstracts based on predetermined eligibility criteria. Any discrepancies in study selection between the two researchers were resolved through a full-text evaluation. Efforts were made to obtain inaccessible articles and unpublished data by contacting the corresponding authors of eligible studies. Initially, 1,256 articles were identified through the database search. Following the elimination of 83 duplicates, 1,176 titles and abstracts were screened, leading to the review of 311 full texts. All of them underwent assessment for eligibility criteria culminating in the inclusion of 169 articles in the study (see Figure 1). Furthermore, the reference lists of the extracted articles were examined, but no additional articles meeting the inclusion criteria were identified for this study.
Figure 1. Flowchart of review and selection of articles.
Data extraction and synthesis were carried out using a standardized form, which included categories such as study identifiers (study’s author, year of publication), country and language, study type, study objective, sample size, materials and methods, results, and conclusion(s).
To comprehensively understand the research landscape on natural products for the treatment of metabolic syndrome (MetS), researchers have adopted a systematic approach to categorize studies based on their methodology and focus. This classification includes clinical trials, in vitro and in vivo studies, observational studies, and review studies. Clinical trials provide empirical evidence on the efficacy and safety of interventions in human subjects, while in vitro and in vivo studies offer mechanistic insights into the effects of natural products on metabolic pathways and physiological functions. Observational studies identify associations between product consumption, natural outcomes related to metabolic syndrome, and contributing populations. These studies are referred to as original studies (see Table 1). Additionally, review studies provide a synthesis of the existing literature and highlight the importance of herbs and natural products in addressing MetS; therefore, they are considered complementary studies. Studies are categorized based on the type of natural product investigated, including herbs, vitamins, minerals, probiotics, and dietary supplements.
Table 1. Studies conducted on the effect of different natural products on metabolic syndrome.
2.4 Quality assessment of articles
The Mixed Methods Appraisal Tool (MMAT) was used to evaluate the quality of the studies (Pace et al., 2012). Each section of the tool is categorized based on the research design employed. This tool is valuable for assessing the appropriateness of a study’s objective, methods, study design, data collection, study selection, data analysis, presentation of findings, discussion, and conclusion(s). The quality of the articles and their inclusion after data extraction are determined by reviewing these aspects. Articles in each domain are assessed for quality using a percentage scale ranging from 25% (indicating that only one criterion is met) to 100% (indicating that all criteria are met). In this study, articles scoring below 25% are considered low quality, while those scoring above 80% are considered high quality (Pace et al., 2012; Madlabana et al., 2020). Based on the findings of the current study, the evaluation of article quality yielded an average score of 67.5%.
3 Results
The analysis of Table 1 data presents a comprehensive view of the impact of natural products on metabolic syndrome, reflecting a broad spectrum of research methodologies including clinical trials, in vitro and in vivo studies, and observational analyses. This diversity underscores the multifaceted approach in investigating the potential of natural interventions. Categorization by type of natural product reveals a predominant focus on plant-based interventions, signalling a notable scientific interest in exploring their efficacy in addressing metabolic syndrome. However, amidst the majority of studies demonstrating high to moderate quality, one in vivo article stands out for its notably low quality. Nonetheless, the collective outcomes suggest promising benefits associated with natural products, spanning various metabolic parameters such as blood pressure, glucose levels, lipid profile, and markers of obesity. These findings underscore the potential utility of natural interventions in managing the complexities of metabolic syndrome.
The predominance of clinical trials and in vivo studies in Table 1 underscores a comprehensive approach to investigating the therapeutic potential of natural products for managing metabolic syndrome. Clinical trials, being directly relevant to human health outcomes, provide crucial evidence regarding the efficacy and safety of interventions in real-world settings, reflecting a commitment to evidence-based medicine. Additionally, the inclusion of in vivo studies offers valuable insights into the underlying biological mechanisms of natural interventions, informing the design and interpretation of clinical trials. This diversity of research approaches not only contributes to a nuanced understanding of the efficacy and safety profiles of natural products but also highlights their translational potential from preclinical research to clinical practice.
3.1 Herbs
Upon evaluating the results of the studies, it becomes evident that herbs play a significant role in addressing various aspects of metabolic syndrome. A wide array of herbs have demonstrated the capacity to directly influence key metabolic parameters such as blood pressure, blood glucose levels, lipid profiles, obesity, and cholesterol and triglyceride levels (Nikaein et al., 2016; Seong et al., 2021; Amin et al., 2015; Belcaro et al., 2013; Devaraj et al., 2013; Najmi et al., 2013; Mansouri et al., 2012; Shah et al., 2012; Basu et al., 2010; Gupta Jain et al., 2017; Mopuri et al., 2018; Cicolari et al., 2020; Chae et al., 2022; Dobhal et al., 2022; Jakovljevic et al., 2018; Reshidan et al., 2019; Verhoeven et al., 2015; Gurrola-Dlaz et al., 2010; Benkhaled et al., 2022; Li et al., 2020; Hermans et al., 2020; De Martin et al., 2018; Mayer et al., 2022; Kasabri et al., 2014; Tan et al., 2011; Kuate et al., 2015; Kho et al., 2016). However, while the breadth of herbs studied is extensive, evaluations reveal variations in their efficacy and mechanisms of action.
Several plants exhibit promising effects through mechanisms such as antibacterial activity (Ghitea et al., 2021), antioxidant properties (Basu et al., 2013; Lopes et al., 2014), and the presence of bioactive compounds (Jakubczyk et al., 2021). These mechanisms contribute to the prevention of inflammation and insulin resistance (Kulabas et al., 2018), reduction of fat mass, and even serve as sources of essential amino acids and prebiotics (du Preez et al., 2021). Additionally, certain plants show potential in improving kidney function (Owis et al., 2017), regulating glucose and fatty acid metabolism (Reshidan et al., 2019), and balancing lipoprotein secretion and energy homeostasis (Singh et al., 2017). Furthermore, some plants demonstrate the ability to restore abnormal blood glucose regulation and rebalance intestinal microbiota (Wang et al., 2020), thus presenting multifaceted approaches to addressing metabolic syndrome.
However, evaluations also reveal complexities and contradictions within the findings. For instance, while the majority of plants studied exhibit beneficial effects, the use of green Elettaria cardamomum in one particular in vivo study led to unexpected outcomes. Contrary to expectations, green cardamom was found to exacerbate obesity, impair liver function, and adversely affect cardiovascular structure and function (Bhaswant et al., 2015). On the other hand, one clinical trial concluded that Ganoderma lucidum had no significant impact on hyperglycemia and cardiovascular risk factors (Klupp et al., 2016). Similarly, another clinical trial found that Cuminum cyminum L only decreased diastolic blood pressure without affecting other parameters of metabolic syndrome (Morovati et al., 2019). Additionally, the results of a clinical trial study indicated that Nigella Sativa failed to yield no significant differences between the two study groups regarding BMI, blood serum glucose, blood pressure, weight, WC and cholesterol levels (Mohtashami, 2019).
3.2 Vitamins and minerals
The results gleaned from studies investigating the impact of vitamins and minerals on metabolic syndrome and its components shed light on the potential benefits and limitations of various vitamin interventions. Specifically, vitamins C, D, E, A, B2, and U and zinc have demonstrated efficacy in influencing key parameters associated with metabolic syndrome, including blood pressure, blood glucose levels, lipid profiles, obesity, cholesterol, and triglycerides (Kelishadi et al., 2010; Farag et al., 2018; Farag et al., 2019; Ferreira et al., 2020). Additionally, these vitamins have shown promise in reducing DNA damage and oxidative stress (Wenclewska et al., 2019), as well as inflammatory markers (Erbaş et al., 2014; Mazur-Bialy and Pocheć, 2016; Salekzamani et al., 2017), while also decreasing plasma non-esterified fatty acids (NEFA), thereby contributing to the improvement of metabolic syndrome. However, critical evaluation of the findings reveals inconsistencies and challenges in translating these results into clinical practice. For instance, two clinical trial studies reported no significant effect of vitamin E on endothelial function, insulin levels, or glucose levels, highlighting a discrepancy between theoretical benefits and observed outcomes (Manning et al., 2013; Ahmadi et al., 2014). Similarly, two other clinical trials found that vitamin D supplementation failed to yield beneficial effects on cardiometabolic risk factors, high-sensitivity C-reactive protein levels, and carotid intima-media thickness (Salekzamani et al., 2016; Salekzamani et al., 2017).
3.3 Dietary supplements
Dietary supplements represent another category of natural products that have shown promise in addressing various aspects of metabolic syndrome, as indicated by the findings of studies included in this review. These supplements have demonstrated the ability to mitigate early growth restriction and inhibit fat accumulation by effectively modulating key metabolic parameters such as blood pressure, blood glucose levels, dyslipidemia, obesity, cholesterol, and triglycerides (Pedersen et al., 2010; Barrios-Ramos et al., 2012; Usui et al., 2013; McPherson et al., 2016; Ak et al., 2018; Sanchez-Rodriguez et al., 2018; Ramírez-Higuera et al., 2020; Shen et al., 2020; Ruyvaran et al., 2022). Additionally, they have been associated with improvements in insulin resistance (Mert et al., 2022), exerting antioxidant and anti-inflammatory effects (Nimrouzi et al., 2020), reducing oxidative stress (Pilar et al., 2017), decreasing coronary artery resistance (Pérez-Torres et al., 2016), and ameliorating inflammatory fatty liver conditions such as steatohepatitis (Al-Okbi et al., 2014). Noteworthy among these supplements are nutrients, garlic, as well as vegetable and animal oils. Despite various findings on the effectiveness of nutritional supplements for metabolic syndrome, an observational study yielded inconclusive results. It showed that black seed exhibited no significant difference between the two studied groups in terms of BMI, serum glucose, blood pressure, weight, waist circumference, and cholesterol levels (Hi and Endang, 2020).
4 Discussion
This scoping review was conducted to investigate the influence of natural products on metabolic syndrome. Based on the findings from the reviewed studies, we obtained a wide range of natural products, including herbs, vitamins, minerals and dietary supplements that affected the treatment and prevention of metabolic syndrome. These products have effects on blood pressure, blood sugar, obesity, waist circumference fat, and abnormal cholesterol or triglyceride levels.
The findings of this research show that plants play a role in improving metabolic syndrome by influencing blood glucose levels, lipid profile, obesity, cholesterol, and triglyceride levels. Various studies have identified a wide range of plants for this purpose. For instance, a review study by Pérez-Muñoz et al. (2022) (Pérez-Muñoz et al., 2022) demonstrated that the Eryngium plant reduces LDL and HDL levels, improves glucose metabolism, and controls dyslipidemia and blood glucose. In another study, Akber Aisa et al. (2019) (Aisa et al., 2019) found that Cicer arietinum L modulates glycemic response and regulates dyslipidemia. A systematic review and meta-analysis by García-Muñoz et al. (2023) (García-Muñoz et al., 2023) reported the effectiveness of Hibiscus sabdariffa in weight loss, reduction of fat tissue, lowering blood pressure, and improving lipid profiles. Apart from studies directly emphasizing the effects of plants on the main components of metabolic syndrome, some studies have also shown that plants can improve metabolic syndrome through antibacterial activities, antioxidant properties, anti-inflammatory activities, and reduction of insulin resistance. One such plant is spirulina, which possesses anti-inflammatory properties. By reducing inflammation, this herb can help improve vascular function and blood pressure, thereby positively impacting metabolic health (Yousefi et al., 2018).
Green tea and turmeric also possess antioxidant and anti-inflammatory properties. In metabolic syndrome, chronic low-grade inflammation and oxidative stress can contribute to insulin resistance and impaired glucose metabolism. Therefore, these herbs can help mitigate these effects, leading to improved insulin sensitivity and lower blood sugar levels (Basu et al., 2013; Amin et al., 2015). Additionally, green tea contains polyphenols such as epigallocatechin gallate (EGCG), which have demonstrated the potential to increase fat oxidation and thermogenesis, aiding in weight management (Basu et al., 2013; Wong et al., 2020). Another herb that can assist in regulating blood sugar levels is cinnamon, which can impact fat storage and metabolism by regulating blood sugar levels (Mollazadeh and Hosseinzadeh, 2016).
Contrary to the aforementioned findings, some studies present conflicting results and suggest that herbs may not have a significant impact on metabolic syndrome and its components. For instance, one study revealed that G. lucidum does not exhibit a significant effect on blood sugar and cardiovascular risk factors (Klupp et al., 2016). Similarly, another study found that Nigella Sativa did not yield statistically significant differences between the two study groups regarding BMI, blood serum glucose, blood pressure, weight, waist circumference, and cholesterol levels (Mohtashami, 2019). Additionally, according to the results of another study, E. cardamomum was associated with obesity, liver dysfunction, and adverse effects on cardiovascular structure and function (Bhaswant et al., 2015). Several factors could contribute to these discrepancies in results. Variations in study design, such as sample size and duration, as well as the diversity of bioactive compounds in plants, may be among the reasons. Demographic differences, dosage variations, and confounding variables such as diet and lifestyle could also play a role. Furthermore, publication bias, study quality, and the inherent complexity of metabolic syndrome itself contribute to variability in outcomes. Ultimately, these findings underscore the necessity for further research, particularly clinical trials, to elucidate the precise mechanisms and potential adverse effects associated with specific herbal interventions for metabolic syndrome.
It is important to note that the mechanisms of action for natural products can vary widely, and not all natural products have been extensively studied in the context of metabolic syndrome. Additionally, individual responses to natural products can vary, and their effects may depend on factors such as dosage, duration of use, and specific characteristics of a person with metabolic syndrome. Therefore, it is necessary to conduct research, particularly clinical studies, on the effect of natural products on the components of metabolic syndrome.
Another finding of the present study suggests that vitamins and minerals can play an effective role in managing metabolic syndrome and its components. For instance, the study by Melguizo-Rodríguez et al. (2021) (Melguizo-Rodríguez et al., 2021) demonstrated that vitamin D supplementation improves lipid profile, insulin resistance, hyperglycemia, obesity, and high blood pressure. Similarly, Moukayed & Grant et al. (2019) (Moukayed and Grant, 2019)discovered that vitamin D possesses anti-inflammatory properties, inhibits primary adipogenesis, enhances glucose absorption, mitigates hyperleptinemia, ameliorates insulin resistance, and reduces high blood pressure. Wong et al. (2020) (Wong et al., 2020) confirmed the antioxidant and anti-inflammatory properties of vitamin C.
However, there are also several studies that contradict the positive effects of vitamins and nutrients on metabolic syndrome. Ahmadi et al. (2014) (Ahmadi et al., 2014) and Manning et al. (2015) (Manning et al., 2013) reported no significant effects of vitamin E on endothelial function, insulin levels, or glucose levels. Similarly, studies by Salekzamani et al. (2017) (Salekzamani et al., 2017) and Salekzamani et al. (2016) (Salekzamani et al., 2016) indicated that vitamin D supplementation failed to yield beneficial effects on cardiometabolic risk factors, high-sensitivity C-reactive protein levels, and carotid intima-media thickness. AlAnouti et al.’s study (2020) (AlAnouti et al., 2020)also demonstrated the limited impact of vitamin D on improving dyslipidemia. Furthermore, Panchal et al. (2017) (Panchal et al., 2017) suggested conflicting results regarding the effect of these micronutrients on metabolic syndrome.
The inconsistency in findings regarding the effect of vitamins on metabolic syndrome can be attributed to several factors. Variations in study design, such as sample size, duration of intervention, and methods used to measure outcomes, can lead to conflicting results. Studies with small sample sizes or short durations may fail to capture the full effects of vitamins and nutrients on components of the metabolic syndrome. Additionally, differences in study population characteristics, including age, gender, ethnicity, and baseline health status, can influence the response to vitamin and nutrient supplementation. What proves effective in one population may not yield the same results in another.
Furthermore, vitamins may interact with other nutrients or medications, potentially influencing their effects on metabolic syndrome, and these interactions can differ between studies. Conversely, the dose and duration of vitamin and nutrient supplementation can significantly impact their effectiveness. Therefore, it is essential to design studies with optimal doses and longer durations to observe the significant effects of vitamins and nutrients on the components of metabolic syndrome.
The results of the present study also confirmed the effect of food supplements, including nutrients and vegetable and animal oils, on the components of metabolic syndrome. Vegetable and animal oils exert their effect on metabolic syndrome through a combination of factors. The composition of their fatty acids plays an essential role. Oils rich in unsaturated fats, such as olive oil and certain vegetable oils, as well as those containing omega-3 fatty acids, such as flaxseed and fish oil, help improve lipid profiles and reduce inflammation, and are beneficial for people with metabolic syndrome. The results of the studies by Nimrouzi et al. (2020) (Nimrouzi et al., 2020), Mert et al. (2022) (Mert et al., 2022), and Al-Okbi et al. (2014) (Al-Okbi et al., 2014) confirmed these findings. Additionally, Olid et al. (2023) (Olid et al., 2023) stated that olive oil has antimicrobial activity to keep blood pressure low.
The results of a study showed that omega-3 fatty acids, which are found in some natural products such as flax seeds, have demonstrated the ability to reduce the levels of triglycerides and cholesterol by decreasing the production of triglycerides in the liver and increasing the clearance of triglycerides from the bloodstream (Yang et al., 2020). Additionally, flaxseed oil exhibited the ability to reduce oxidative stress in a study (Mohammadifard et al., 2021).
Garlic is another food supplement that contains allicin, and by increasing the production of nitric oxide in the blood vessels, it induces vasodilation. This widening of blood vessels can lead to a decrease in resistance to blood flow and subsequently result in a decrease in blood pressure (Al Disi et al., 2016). However, the results of Hi et al.’s study (2020) (Hi and Endang, 2020) showed that black seed oil did not cause significant differences in BMI, blood glucose, blood pressure, and cholesterol levels between the two groups. Furthermore, the results of Tamtaji et al. (2020) (Tamtaji et al., 2020) indicated that flaxseed oil had no effect on certain inflammatory factors and other biomarkers of oxidative stress. Similarly, Pastor et al. (2021) (Pastor et al., 2021) demonstrated that olive oil has no effect on metabolic syndrome.
Biological variability among participants, genetic factors, publication bias, different study designs, varied doses, and the overlap of some foods with dietary supplements may have influenced the study results, highlighting the importance of well-designed randomized controlled trials. Systematic reviews are essential to elucidate the true effects of dietary supplements on metabolic syndrome and to provide evidence-based recommendations.
The strength of the present study lies in comprehensive exploration of natural products in relation to their potential impact on metabolic syndrome and its components. This broad perspective adds to the existing body of knowledge and provides valuable insights into the potential benefits of these products for people with metabolic syndrome. However, this study also had limitations. For instance, despite the researchers’ efforts to obtain the full text of the articles, this was not achieved in the case of some articles, and as a result, some related articles were excluded from the research. Additionally, while eligible articles were identified and reviewed, it is possible that some unpublished studies may have been missed. Utilizing specific entry criteria, such as excluding articles published before 2010 in this study, may result in the omission of relevant articles. However, the researchers in this particular case adopted this criterion to enhancing the organization of the articles. Also, Utilizing a particular search strategy in articles may result in the omission of related articles.
5 Conclusion
This study underscores the considerable potential of natural products, including herbs, vitamins, minerals, and dietary supplements, in effectively managing metabolic syndrome. These interventions offer promising avenues for addressing various aspects of metabolic syndrome through diverse mechanisms of action. Among natural products, the study found that plants have been the subject of more research compared to other categories. While both positive and negative effects have been observed across all categories of natural products, there appears to be more uncertainty surrounding the effects of vitamins. This suggests that the effects of vitamins are often unclear and may differ depending on the specific circumstances. However, the study acknowledges the need for further research to validate these findings and determine the optimal dosage and duration of supplementation. Long-term randomized controlled trials with larger sample sizes are particularly necessary to provide more conclusive evidence regarding the efficacy and safety of natural products in managing metabolic syndrome.
Author contributions
MA: Writing–original draft, Writing–review and editing. SA-F: Writing–original draft, Writing–review and editing.
Funding
The author(s) declare that no financial support was received for the research, authorship, and/or publication of this article.
Acknowledgments
The researchers thank the officials of Baghdad University and all those who helped them in the implementation of this research.
Conflict of interest
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Publisher’s note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.
References
Adeniyi, O., Washington, L., Glenn, C. J., Franklin, S. G., Scott, A., Aung, M., et al. (2021). The use of complementary and alternative medicine among hypertensive and type 2 diabetic patients in Western Jamaica: a mixed methods study. PLOS ONE 16 (2), e0245163. doi:10.1371/journal.pone.0245163
Ahamad, J., Toufeeq, I., Khan, M. A., Ameen, M. S. M., Anwer, E. T., Uthirapathy, S., et al. (2019). Oleuropein: a natural antioxidant molecule in the treatment of metabolic syndrome. Phytother. Res. 33 (12), 3112–3128. doi:10.1002/ptr.6511
Ahmadi, A., Gharipour, M., Arabzadeh, G., Moin, P., Hashemipour, M., and Kelishadi, R. (2014). The effects of vitamin E and omega-3 PUFAs on endothelial function among adolescents with metabolic syndrome. Biomed. Res. Int. 2014, 906019. doi:10.1155/2014/906019
Aisa, H. A., Gao, Y., Yili, A., Ma, Q., and Cheng, Z. (2019). “Beneficial role of chickpea (cicer arietinum L.) functional factors in the intervention of metabolic syndrome and diabetes mellitus,” in Bioactive food as dietary interventions for diabetes. Editors R. R. Watson, and V. R. Preedy (Cambridge, Massachusetts, United States: Academic Press), 615–627. doi:10.1016/B978-0-12-813822-9.00039-4
Akrami, A., Nikaein, F., Babajafari, S., Faghih, S., and Yarmohammadi, H. (2018). Comparison of the effects of flaxseed oil and sunflower seed oil consumption on serum glucose, lipid profile, blood pressure, and lipid peroxidation in patients with metabolic syndrome. J. Clin. Lipidol. 12 (1), 70–77. doi:10.1016/j.jacl.2017.11.004
Alam, M., Uddin, R., Subhan, N., Rahman, M., Jain, P., and Mahmud Reza, H. (2015). Beneficial role of bitter melon supplementation in obesity and related complications in metabolic syndrome. J. Lipids. doi:10.1155/2015/496169
AlAnouti, F., Abboud, M., Papandreou, D., Mahboub, N., Haidar, S., and Rizk, R. (2020). Effects of vitamin D supplementation on lipid profile in adults with the metabolic syndrome: a systematic review and meta-analysis of randomized controlled trials. Nutrients 12 (11), 3352. doi:10.3390/nu12113352
Alauddin, M., Shirakawa, H., Koseki, T., Kijima, N., et al. (2016). Fermented rice bran supplementation mitigates metabolic syndrome in strokeprone spontaneously hypertensive rat. BMC Complementary Altern. Med. 16, 442. doi:10.1186/s12906-016-1427-z
Al Disi, S. S., Anwar, M. A., and Eid, A. H. (2016). Anti-hypertensive herbs and their mechanisms of action: Part I. Front. Pharmacol. 6, 323. doi:10.3389/fphar.2015.00323
Alembagheri, A., Hajimehdipoor, H., Choopani, R., and Esmaeili, S. (2023). The role of selected medicinal plants from Iranian traditional medicine for the treatment of fatigue in metabolic syndrome. Tradit. Med. Res. 8 (4), 23. doi:10.53388/TMR20220706001
Alkhatib, D. H., Jaleel, A., Tariq, M. N. M., Feehan, J., Apostolopoulos, V., Cheikh Ismail, L., et al. (2021). The role of bioactive compounds from dietary spices in the management of metabolic syndrome: an overview. Nutrients 14 (1), 175. doi:10.3390/nu14010175
Al-Okbi, S. Y., Mohamed, D. A., Hamed, T. E., and Edris, A. E. (2014). Protective effect of clove oil and eugenol microemulsions on fatty liver and dyslipidemia as components of metabolic syndrome. J. Med. Food 17 (7), 764–771. doi:10.1089/jmf.2013.0033
Amin, F., Islam, N., Anila, N., and Gilani, A. H. (2015). Clinical efficacy of the co-administration of Turmeric and Black seeds (Kalongi) in metabolic syndrome — a double blind randomized controlled trial — TAK-MetS trial. Complement. Ther. Med. 23 (2), 165–74. doi:10.1016/j.ctim.2015.01.008
Atanasov, A. G., Waltenberger, B., Pferschy-Wenzig, E.-M., Linder, T., Wawrosch, C., Uhrin, P., et al. (2015). Discovery and resupply of pharmacologically active plant-derived natural products: a review. Biotechnol. Adv. 33 (8), 1582–1614. doi:10.1016/j.biotechadv.2015.08.001
Awwad, A., Poucheret, P., Idres, A. Y., Bidel, L., and Tousch, D. (2020). The bitter Asteraceae: an interesting approach to delay the metabolic syndrome progression. NFS J. 18, 29–38. doi:10.1016/j.nfs.2020.01.001
Babajafari, S., Nikaein, F., Mazloomi, S., Zibaeenejad, M., and Zargaran, A. (2015). A review of the benefits of satureja species on metabolic syndrome and their possible mechanisms of action. J. Evidence-Based Complementary Altern. Med., 1–12. doi:10.1177/21565872145641
Barrios-Ramos, J. P., Garduño-Siciliano, L., Loredo, M., Chamorro-Cevallos, G., and Jaramillo-Flores, M. E. (2012). The effect of cocoa, soy, oats and fish oil on metabolic syndrome in rats. J. Sci. Food Agric. 92 (11), 2349–2357. doi:10.1002/jsfa.5637
Basu, A., Betts, N. M., Mulugeta, A., Tong, C., Newman, E., and Lyons, T. J. (2013). Green tea supplementation increases glutathione and plasma antioxidant capacity in adults with the metabolic syndrome. Nutr. Res. 33 (3), 180–187. doi:10.1016/j.nutres.2012.12.010
Basu, A., Sanchez, K., Leyva, M. J., Wu, M., Betts, N. M., Aston, C. E., et al. (2010). Green tea supplementation affects body weight, lipids, and lipid peroxidation in obese subjects with metabolic syndrome. J. Am. Coll. Nutr. 29 (1), 31–40. doi:10.1080/07315724.2010.10719814
Bayliak, M. M., Dmytriv, T. R., Melnychuk, A. V., Strilets, N. V., Storey, K. B., and Lushchak, V. I. (2021). Chamomile as a potential remedy for obesity and metabolic syndrome. EXCLI J. 20, 1261–1286. doi:10.17179/excli2021-4013
Belcaro, G., Ledda, A., Hu, S., Cesarone, M., Feragalli, B., and Dugall, M. (2013). Greenselect phytosome for borderline metabolic syndrome. Evidence-Based Complementary Altern. Med., doi:10.1155/2013/869061
Benkhaled, A., Réggami, Y., Boudjelal, A., Senator, A., Bouriche, H., Demirtaş, I., et al. (2022). Chemical characterisation, hypoglycaemic and renoprotective effects of aqueous leaf extract of Limoniastrum guyonianum on fructose-induced metabolic syndrome in rats. Arch. Physiol. Biochem. 128 (4), 914–923. doi:10.1080/13813455.2020.1739715
Bhaswant, M., Poudyal, H., Mathai, M. L., Ward, L. C., Mouatt, P., and Brown, L. (2015). Green and black cardamom in a diet-induced rat model of metabolic syndrome. Nutrients 7 (9), 7691–7707. doi:10.3390/nu7095360
Bilbis, L. S., Muhammad, S. A., Saidu, Y., and Adamu, Y. (2012). Effect of vitamins a, C, and e supplementation in the treatment of metabolic syndrome in albino rats. Biochem. Res. Int. 2012, 678582. doi:10.1155/2012/678582
Bobescu, E., Bălan, A., Moga, M. A., Teodorescu, A., Mitrică, M., and Dima, L. (2020). Are there any beneficial effects of spirulina supplementation for metabolic syndrome components in postmenopausal women? Mar. Drugs 18 (12), 651. doi:10.3390/md18120651
Carrera-Lanestosa, A., Moguel-Ordóñez, Y., and Segura-Campos, M. (2017). Stevia rebaudiana bertoni: a natural alternative for treating diseases associated with metabolic syndrome. J. Med. Food 20 (10), 933–943. doi:10.1089/jmf.2016.0171
Carresi, C., Gliozzi, M., Musolino, V., Scicchitano, M., Scarano, F., Bosco, F., et al. (2020). The effect of natural antioxidants in the development of metabolic syndrome: focus on bergamot polyphenolic fraction. Nutrients 12 (5), 1504. doi:10.3390/nu12051504
Chae, H.-S., Dale, O., Mir, T. M., Avula, B., Zhao, J., Khan, I. A., et al. A multitarget approach to evaluate the efficacy of aquilaria sinensis flower extract against metabolic syndrome. Molecules 2022, 27, 629. doi:10.3390/molecules27030629
Chávez-Delgado, E. L., Jacobo-Velázquez, D. A., and Essential, O. (2023). Recent advances on their dual role as food preservatives and nutraceuticals against the metabolic syndrome. Foods 12, 1079. doi:10.3390/foods12051079
Chen, Y. K., Cheung, C., Reuhl, K. R., Liu, A. B., Lee, M. J., Lu, Y. P., et al. (2011). Effects of green tea polyphenol (-)-epigallocatechin-3-gallate on newly developed high-fat/Western-style diet-induced obesity and metabolic syndrome in mice. J. Agric. Food Chem. 59 (21), 11862–11871. doi:10.1021/jf2029016
Chen, M., Zheng, J., Zou, X., Ye, C., Xia, H., Yang, M., et al. (2021). Ligustrum robustum (Roxb.) blume extract modulates gut microbiota and prevents metabolic syndrome in high-fat diet-fed mice. J. Ethnopharmacol. 268, 113695. doi:10.1016/j.jep.2020.113695
Choi, E., Jang, E., and Lee, J. (2019). Pharmacological activities of alisma orientale against nonalcoholic fatty liver disease and metabolic syndrome: literature review. Evidence-Based Complementary Altern. Med., doi:10.1155/2019/2943162
Cicolari, S., Dacrema, M., Tsetegho Sokeng, A. J., Xiao, J., Atchan Nwakiban, A. P., Di Giovanni, C., et al. (2020). Hydromethanolic extracts from Adansonia digitata L. Edible parts positively modulate pathophysiological mechanisms related to the metabolic syndrome. Molecules 25 (12), 2858. doi:10.3390/molecules25122858
Dakshinamurti, K. (2015). Vitamins and their derivatives in the prevention and treatment of metabolic syndrome diseases (diabetes). Can. J. Physiol. Pharmacol. 93 (5), 355–362. doi:10.1139/cjpp-2014-0479
Davatgaran Taghipour, Y., Hajialyani, M., Naseri, R., Hesari, M., Mohammadi, P., et al. (2019). Nanoformulations of natural products for management of metabolic syndrome. Int. J. Nanomedicine 14, 5303–5321. doi:10.2147/IJN.S213831
Davì, G., Santilli, F., and Patrono, C. (2010). Nutraceuticals in diabetes and metabolic syndrome. Cardiovasc Ther. 28 (4), 216–226. doi:10.1111/j.1755-5922.2010.00179.x
De Martin, S., Gabbia, D., Carrara, M., and Ferri, N. (2018). The Brown algae fucus vesiculosus and ascophyllum nodosum reduce metabolic syndrome risk factors: a clinical study. Nat. Product. Commun. 13 (12). doi:10.1177/1934578X1801301228
Devaraj, S., Yimam, M., Brownell, L. A., Jialal, I., Singh, S., and Jia, Q. (2013). Effects of Aloe vera supplementation in subjects with prediabetes/metabolic syndrome. Metab. Syndr. Relat. Disord. 11 (1), 35–40. doi:10.1089/met.2012.0066
Di, S., Wang, Y., Han, L., Bao, Q., Gao, Z., Wang, Q., et al. (2019). The intervention effect of traditional Chinese medicine on the intestinal flora and its metabolites in glycolipid metabolic disorders. Evidence-Based Complementary Altern. Med. 2019, 2958920. doi:10.1155/2019/2958920
Di Lorenzo, C., Dell’Agli, M., Colombo, E., Sangiovanni, E., and Restani, P. (2013). Metabolic syndrome and inflammation: a critical review of in vitro and clinical approaches for benefit assessment of plant food supplements. Evidence-Based Complementary Altern. Med., doi:10.1155/2013/782461
Dobhal, S., Singh, M. F., Setya, S., and Bisht, S. (2022). Comparative assessment of the effect of lemongrass (cymbopogon citratus) ethanolic extract, aqueous extract and essential oil in high fat diet and fructose induced metabolic syndrome in rats. Indian J Pharm. Educ. Res. 56 (2s), s281–s293. doi:10.5530/ijper.56.2s.99
Dong, H., Lu, F. E., and Zhao, L. (2012). Chinese herbal medicine in the treatment of nonalcoholic fatty liver disease. Chin. J. Integr. Med. 18 (2), 152–160. doi:10.1007/s11655-012-0993-2
Dong, Y., Xu, M., Chen, L., and Bhochhibhoya, A. (2019). Probiotic foods and supplements interventions for metabolic syndromes: a systematic review and meta-analysis of recent clinical trials. Ann. Nutr. Metab. 74 (3), 224–241. doi:10.1159/000499028
du Preez, R., Majzoub, M. E., Thomas, T., Panchal, S. K., and Brown, L. (2021). Nannochloropsis oceanica as a microalgal food intervention in diet-induced metabolic syndrome in rats. Nutrients 13 (11), 3991. doi:10.3390/nu13113991
Ekeuku, S. O., Nur Azlina, M. F., and Chin, K.-Y. (2021). Effects of piper sarmentosum on metabolic syndrome and its related complications: a review of preclinical evidence. Appl. Sci. 11 (21), 9860. doi:10.3390/app11219860
Erbaş, O., Solmaz, V., Aksoy, D., Yavaşoğlu, A., Sağcan, M., and Taşkıran, D. (2014). Cholecalciferol (vitamin D 3) improves cognitive dysfunction and reduces inflammation in a rat fatty liver model of metabolic syndrome. Life Sci. 103 (2), 68–72. doi:10.1016/j.lfs.2014.03.035
Fadhel, M., and Hassan, A. (2023). Protective effect of omega-7 against doxorubicin-induced cardiotoxicity in male rats. Iraqi J. Pharm. Sci. 32 (3). doi:10.31351/vol32iss3pp35-40
Farag, H. A. M., Hosseinzadeh-Attar, M. J., Muhammad, B. A., Esmaillzadeh, A., and Bilbeisi, A. H. E. (2018). Comparative effects of vitamin D and vitamin C supplementations with and without endurance physical activity on metabolic syndrome patients: a randomized controlled trial. Diabetol. Metab. Syndr. 10, 80. doi:10.1186/s13098-018-0384-8
Farag, H. A. M., Hosseinzadeh-Attar, M. J., Muhammad, B. A., Esmaillzadeh, A., and El Bilbeisi, A. H. (2019). Effects of vitamin C supplementation with and without endurance physical activity on components of metabolic syndrome: a randomized, double-blind, placebo-controlled clinical trial. Clin. Nutr. Exp. 26, 23–33. doi:10.1016/j.yclnex.2019.05.003
Fernando, S., Ryu, B., Ahn, G., Yeo, I.-K., and Jeon, Y.-J. (2020). Therapeutic potential of algal natural products against metabolic syndrome: a review of recent developments. Trends Food Sci. Technol. 97. doi:10.1016/j.tifs.2020.01.020
Ferreira, P. P., Cangussu, L., Bueloni-Dias, F. N., Orsatti, C. L., Schmitt, E. B., Nahas-Neto, J., et al. (2020). Vitamin D supplementation improves the metabolic syndrome risk profile in postmenopausal women. Climacteric 23 (1), 24–31. doi:10.1080/13697137.2019.1611761
Firouzi, S., Malekahmadi, M., Ghayour-Mobarhan, M., Ferns, G., and Rahimi, H. (2018). Barberry in the treatment of obesity and metabolic syndrome: possible mechanisms of action. Diabetes, Metabolic Syndrome and Obesity. Targets Ther. 11, 699–705. doi:10.2147/DMSO.S181572
Florentin, M., Elisaf, M. S., Mikhailidis, D. P., and Liberopoulos, E. N. (2010). Vitamin D and metabolic syndrome: is there a link? Curr. Pharm. Des. 16 (30), 3417–3434. doi:10.2174/138161210793563509
Gabbia, D., and De Martin, S. (2020). Brown seaweeds for the management of metabolic syndrome and associated diseases. Molecules 25 (18), 4182. doi:10.3390/molecules25184182
Galavi, A., Hosseinzadeh, H., and Razavi, B. M. (2021). The effects of Allium cepa L. (onion) and its active constituents on metabolic syndrome: a review. Iran. J. Basic Med. Sci. 24 (1), 3–16. doi:10.22038/ijbms.2020.46956.10843
García-Muñoz, A. M., García-Guillén, A. I., Victoria-Montesinos, D., Abellán-Ruiz, M. S., Alburquerque-González, B., and Cánovas, F. (2023). Effect of the combination of Hibiscus sabdariffa in combination with other plant extracts in the prevention of metabolic syndrome: a systematic review and meta-analysis. Foods 12, 2269. doi:10.3390/foods12112269
Ghandi Ibrahim, K., Ahmad Adeshina, K., Bashir Bello, M., Malami, I., Abubakar, B., Bello Abubakar, M., et al. (2021). Prophylactic use of natural products against developmentally programmed metabolic syndrome. Planta Med. 88 (8), 650–663. doi:10.1055/a-482-2343
Gharipour, M., Akhavan Tabib, A., Toghianifar, N., Tavassoli, A., Gharipour, A., and Sarrafzadegan, N. (2011). The pattern of pharmacological treatment in subjects with metabolic syndrome: findings from isfahan healthy heart program. J. Isfahan Med. Sch. 29 (2).
Ghitea, T. C., El-Kharoubi, A., Ganea, M., Bimbo-Szuhai, E., Nemeth, T. S., Ciavoi, G., et al. (2021). The antimicrobial activity of origanum vulgare L. Correlated with the gastrointestinal perturbation in patients with metabolic syndrome. Molecules 26 (2), 283. doi:10.3390/molecules26020283
Graf, B., Raskin, I., Cefalu, W., and Ribnicky, D. (2010). Plant-derived therapeutics for the treatment of metabolic syndrome. Curr. Opin. Investig. Drugs 11 (10), 1107–1115. PMID: 20872313; PMCID: PMC3755736.
Gumbarewicz, E., Jarząb, A., Stepulak, A., and Kukula-Koch, W. (2022). Zingiber officinale rosc. In the treatment of metabolic syndrome disorders-A review of in vivo studies. Int. J. Mol. Sci. 23 (24), 15545. doi:10.3390/ijms232415545
Gupta Jain, S., Puri, S., Misra, A., Gulati, S., and Mani, K. (2017). Effect of oral cinnamon intervention on metabolic profile and body composition of Asian Indians with metabolic syndrome: a randomized double -blind control trial. Lipids Health Dis. 16 (1), 113. doi:10.1186/s12944-017-0504-8
Gurrola-Dlaz, C., Garcı´a-Lo´pez, P., Sa´, nchez-E. ´quez S., Troyo-Sanroma´n, R., Andrade-Gonza´lez, I., and Go´mez-Leyva, J. (2010). Effects of Hibiscus sabdariffa extract powder and preventive treatment (diet) on the lipid profiles of patients with metabolic syndrome (MeSy). Phytomedicine 17, 500–505. doi:10.1016/j.phymed.2009.10.014
Hameed, E., and Al-Ameri, L. (2022). Surrogates markers of insulin resistance. Al-Kindy Coll. Med. J. 18, 1–2. doi:10.47723/kcmj.v18i1.837
Hashim, K. N., Chin, K. Y., and Ahmad, F. (2021). The mechanism of honey in reversing metabolic syndrome. Molecules 26 (4), 808. doi:10.3390/molecules26040808
Hassani, F. V., Shirani, K., and Hosseinzadeh, H. (2016). Rosemary (Rosmarinus officinalis) as a potential therapeutic plant in metabolic syndrome: a review. Naunyn Schmiedeb. Arch. Pharmacol. 389 (9), 931–949. doi:10.1007/s00210-016-1256-0
Hedayati, N., Bemani Naeini, M., Mohammadinejad, A., and Mohajeri, S. A. (2019). Beneficial effects of celery (Apium graveolens) on metabolic syndrome: a review of the existing evidences. Phytother. Res. 33 (12), 3040–3053. doi:10.1002/ptr.6492
Hermans, M. P., Lempereur, P., Salembier, J. P., Maes, N., Albert, A., Jansen, O., et al. (2020). Supplementation effect of a combination of olive (olea europea L.) leaf and fruit extracts in the clinical management of hypertension and metabolic syndrome. Antioxidants (Basel) 9 (9), 872. doi:10.3390/antiox9090872
Hi, W., and Endang, D. (2020). The effect of black seed oil as adjuvant therapy on nuclear factor erythroid 2-related factor 2 levels in patients with metabolic syndrome risk. Iran. J. Pharm. Sci. 16 (1), 9–18. doi:10.22037/ijps.v16.40441
Hosseini, A., and Hosseinzadeh, H. (2015). A review on the effects of Allium sativum (Garlic) in metabolic syndrome. J. Endocrinol. Invest. 38 (11), 1147–1157. doi:10.1007/s40618-015-0313-8
Hou, C. Y., Tain, Y. L., Yu, H. R., and Huang, L. T. (2019). The effects of resveratrol in the treatment of metabolic syndrome. Int. J. Mol. Sci. 20 (3), 535. doi:10.3390/ijms20030535
Ibrahim, K. G., Mukonowenzou, N. C., Usman, D., Adeshina, K. A., and Erlwanger, K. H. (2023). The potential of Artemisia species for use as broad-spectrum agents in the management of metabolic syndrome: a review. Arch. Physiol. Biochem. 129 (3), 752–770. doi:10.1080/13813455.2021.1871761
Jakovljevic, V., Milic, P., Bradic, J., Jeremic, J., Zivkovic, V., Srejovic, I., et al. (2018). Standardized aronia melanocarpa extract as novel supplement against metabolic syndrome: a rat model. Int. J. Mol. Sci. 20 (1), 6. doi:10.3390/ijms20010006
Jakubczyk, A., Kiersnowska, K., Ömero˘ glu, B., Gawlik-Dziki, U., Tutaj, K., Rybczy´ nska-Tkaczyk, K., et al. The influence of Hypericum perforatum L. Addition to wheat cookies on their antioxidant, anti-metabolic syndrome, and antimicrobial properties. Foods 2021,10, 1379. doi:10.3390/.foods10061379
Jamshidi, S., Hejazi, N., Golmakani, M. T., and Tanideh, N. (2018). Wild pistachio (Pistacia atlantica mutica) oil improve metabolic syndrome features in rats with high fructose ingestion. Iran. J. Basic Med. Sci. 21 (12), 1255–1261. doi:10.22038/ijbms.2018.30511.7351
Jang, S., Jang, B. H., Ko, Y., Sasaki, Y., Park, J. S., Hwang, E. H., et al. (2016a). Herbal medicines for treating metabolic syndrome: a systematic review of randomized controlled trials. Evid. Based Complement. Altern. Med. 2016, 5936402. doi:10.1155/2016/5936402
Jang, S., Jang, B.-H., Ko, Y., Sasaki, Y., Park, J.-S., Hwang, E.-H., et al. (2016b). Herbal medicines for treating metabolic syndrome: a systematic review of randomized controlled trials. Evidence-Based Complementary Altern. Med., 5936402.
Jaramillo Flores, M. E. (2019). Cocoa flavanols: natural agents with attenuating effects on metabolic syndrome risk factors. Nutrients 11 (4), 751. doi:10.3390/nu11040751
Jungbauer, A., and Medjakovic, S. (2012). Anti-inflammatory properties of culinary herbs and spices that ameliorate the effects of metabolic syndrome. Maturitas 71 (3), 227–239. doi:10.1016/j.maturitas.2011.12.009
Kania-Dobrowolska, M., and Baraniak, J. D. (2022). Taraxacum officinale L. As a source of biologically active compounds supporting the therapy of Co-existing diseases in metabolic syndrome. Foods 11, 2858. doi:10.3390/foods11182858
Kasabri, V., Afifi, F., Abu-Dahab, R., Mhaidat, N., Bustanji, Y., Abaza, I., et al. (2014). In vitro modulation of metabolic syndrome enzymes and proliferation of obesity related-colorectal cancer cell line panel by Salvia species from Jordan. Rev. Roum. Chim. 59, 693–705.
Kaur, G., Mukundan, S., Wani, V., and Kumar, M. (2015). Nutraceuticals in the management and prevention of metabolic syndrome. Austin J. Pharmacol. Ther. 3 (1), 1063.
Kelishadi, R., Hashemipour, M., Adeli, K., Tavakoli, N., Movahedian-Attar, A., Shapouri, J., et al. (2010). Effect of zinc supplementation on markers of insulin resistance, oxidative stress, and inflammation among prepubescent children with metabolic syndrome. Metab. Syndr. Relat. Disord. 8 (6), 505–510. doi:10.1089/met.2010.0020
Kern, H. J., and Mitmesser, S. H. (2018). Role of nutrients in metabolic syndrome: a 2017 update. Nutr. Diet. Suppl. 10, 13–26. doi:10.2147/NDS.S148987
Kho, M., Lee, Y., Park, J., Cha, J., et al. (2016). Combination with Red ginseng and Polygoni Multiflori ameliorates highfructose diet induced metabolic syndrome. BMC Complementary Altern. Med. 16, 98. doi:10.1186/s12906-016-1063-7
Klupp, N. L., Kiat, H., Bensoussan, A., Steiner, G. Z., and Chang, D. H. (2016). A double-blind, randomised, placebo-controlled trial of Ganoderma lucidum for the treatment of cardiovascular risk factors of metabolic syndrome. Sci. Rep. 6, 29540. doi:10.1038/srep29540
Kuate, D., Nouemsi Kengne, N., Nya Biapa, C., Kingue Azantsa, B., and Manan Bin Wan Muda, W. (2015). Tetrapleura tetraptera spice attenuates high-carbohydrate, high-fat diet-induced obese and type 2 diabetic rats with metabolic syndrome features. Lipids Health Dis. 14, 50. doi:10.1186/s12944-015-0051-0
Kulabas, S. S., Ipek, H., Tufekci, A. R., Arslan, S., Demirtas, I., Ekren, R., et al. (2018). Ameliorative potential of Lavandula stoechas in metabolic syndrome via multitarget interactions. J. Ethnopharmacol. 223, 88–98. doi:10.1016/j.jep.2018.04.043
Li, D., Zhang, T., Lu, J., Peng, C., and Lin, L. (2021). Natural constituents from food sources as therapeutic agents for obesity and metabolic diseases targeting adipose tissue inflammation. Crit. Rev. Food Sci. Nutr. 61, 1947–1965. doi:10.1080/10408398.2020.1768044
Li, F., Li, Y., Li, Q., and Shi, X. (2020). Eriobotrya japonica leaf triterpenoid acids ameliorate metabolic syndrome in C57BL/6J mice fed with high-fat diet. Biomed. Pharmacother. 132, 110866. doi:10.1016/j.biopha.2020.110866
Liu, W., Wan, C., Huang, Y., and Li, M. (2020). Effects of tea consumption on metabolic syndrome: a systematic review and meta-analysis of randomized clinical trials. Phytotherapy Res., 1–10. doi:10.1002/ptr.6731
Lopes, G. D. M., Carvalho, R. P., Boleti, A. P., Lima, A. S., Oliveira de Almeida, P. D., Pacheco, C. C., et al. (2014). Extract from Eugenia punicifolia is an antioxidant and inhibits enzymes related to metabolic syndrome. Appl. Biochem. Biotechnol. 172 (1), 311–324. doi:10.1007/s12010-013-0520-8
Madlabana, C., Mashamba-Thompson, T., and Petersen, I. (2020). Performance management methods and practices among nurses in primary health care settings: a systematic scoping review protocol. Syst. Rev. 9, 40. doi:10.1186/s13643-020-01294-w
Mahdian, D., Abbaszadeh-Goudarzi, K., Raoofi, A., Dadashizadeh, G., Abroudi, M., Zarepour, E., et al. (2020). Effect of Boswellia species on the metabolic syndrome: a review. Iran. J. Basic Med. Sci. 23 (11), 1374–1381. doi:10.22038/ijbms.2020.42115.9957
Mak, S., and Thomas, A. (2022). Steps for conducting a scoping review. J. Grad. Med. Educ. 14 (5), 565–567. doi:10.4300/JGME-D-22-00621.1
Mallappa, R. H., Rokana, N., Duary, R. K., Panwar, H., Batish, V. K., and Grover, S. (2012). Management of metabolic syndrome through probiotic and prebiotic interventions. Indian J. Endocr. Metab. 16, 20–27. doi:10.4103/2230-8210.91178
Manning, P. J., Sutherland, W. H., Williams, S. M., Walker, R. J., Berry, E. A., De Jong, S. A., et al. (2013). The effect of lipoic acid and vitamin E therapies in individuals with the metabolic syndrome. Nutr. Metab. Cardiovasc Dis. 23 (6), 543–549. doi:10.1016/j.numecd.2011.11.006
Mansouri, M., Nayebi, N., Keshtkar, A., Hasani-Ranjbar, S., Taheri, E., and Larijani, B. (2012). The effect of 12 weeks Anethum graveolens (dill) on metabolic markers in patients with metabolic syndrome; a randomized double blind controlled trial. Daru 20 (1), 47. doi:10.1186/2008-2231-20-47
Matsumoto, K., Motoyasu, N., Sera, K., Fujii, T., Yoshikawa, Y., Yasui, H., et al. (2011). Effects of Zn(II) complex with vitamins C and U, and carnitine on metabolic syndrome model rats. Metallomics 3 (7), 683–685. doi:10.1039/c1mt00018g
Mayer, C., Côme, M., Ulmann, L., Chini Zittelli, G., Faraloni, C., Nazih, H., et al. (2019). Preventive effects of the marine microalga phaeodactylum tricornutum, used as a food supplement, on risk factors associated with metabolic syndrome in wistar rats. Nutrients 11 (5), 1069. doi:10.3390/nu11051069
Mayer, C., Côme, M., Ulmann, L., Martin, I., Zittelli, G. C., Faraloni, C., et al. (2022). The potential of the marine microalga diacronema lutheri in the prevention of obesity and metabolic syndrome in high-fat-fed wistar rats. Molecules 27 (13), 4246. doi:10.3390/molecules27134246
Mazur-Bialy, A. I., and Pocheć, E. (2016). Riboflavin reduces pro-inflammatory activation of adipocyte-macrophage Co-culture. Potential application of vitamin B2 enrichment for attenuation of insulin resistance and metabolic syndrome development. Molecules 21 (12), 1724. doi:10.3390/molecules21121724
McPherson, N. O., Fullston, T., Kang, W. X., Sandeman, L. Y., Corbett, M. A., Owens, J. A., et al. (2016). Paternal under-nutrition programs metabolic syndrome in offspring which can be reversed by antioxidant/vitamin food fortification in fathers. Sci. Rep. 6, 27010. doi:10.1038/srep27010
Melguizo-Rodríguez, L., Costela-Ruiz, V. J., García-Recio, E., De Luna-Bertos, E., Ruiz, C., and Illescas-Montes, R. (2021). Role of vitamin D in the metabolic syndrome. Nutrients 13 (3), 830. doi:10.3390/nu13030830
Mert, H., İrak, K., Çibuk, S., Yıldırım, S., and Mert, N. (2022). The effect of evening primrose oil (Oenothera biennis) on the level of adiponectin and some biochemical parameters in rats with fructose induced metabolic syndrome. Arch. Physiol. Biochem. 128 (6), 1539–1547. doi:10.1080/13813455.2020.1781900
Mirza, R., Chi, N., and Chi, Y. (2013). Therapeutic potential of the natural product mangiferin in metabolic syndrome. J. Nutr. Ther. 2 (2), 74–79. doi:10.6000/1929-5634.2013.02.02.2
Mizuno, H., Taketomi, A., and Nakabayashi, T. (2018). Potentially beneficial effects of st. John’s wort (Hypericum perforatum) in patients with metabolic syndrome. OBM Integr. Complementary Med. 3 (3). doi:10.21926/obm.icm.1803021
Mohammadifard, N., Sajjadi, F., and Haghighatdoost, F. (2021). Effects of soy consumption on metabolic parameters in patients with metabolic syndrome: a systematic review and meta-analysis. EXCLI J. 20, 665–685. doi:10.17179/excli2021-3348
Mohtashami, A. (2019). Effects of bread with Nigella sativa on blood glucose, blood pressure and anthropometric indices in patients with metabolic syndrome. Clin. Nutr. Res. 8 (2), 138–147. doi:10.7762/cnr.2019.8.2.138
Mollazadeh, H., and Hosseinzadeh, H. (2016). Cinnamon effects on metabolic syndrome: a review based on its mechanisms. Iran. J. Basic Med. Sci. 19 (12), 1258–1270. doi:10.22038/ijbms.2016.7906
Mopuri, R., Ganjayi, M., Meriga, B., Koorbanally, N. A., and Islam, M. S. (2018). The effects of Ficus carica on the activity of enzymes related to metabolic syndrome. J. Food Drug Anal. 26 (1), 201–210. doi:10.1016/j.jfda.2017.03.001
Morovati, A., Pourghassem Gargari, B., and Sarbakhsh, P. (2019). Effects of cumin (Cuminum cyminum L.) essential oil supplementation on metabolic syndrome components: a randomized, triple-blind, placebo-controlled clinical trial. Phytother. Res. 33 (12), 3261–3269. doi:10.1002/ptr.6500
Mostafa, D. K., Nasra, R. A., Zahran, N., and Ghoneim, M. T. (2016). Pleiotropic protective effects of Vitamin D against high fat diet-induced metabolic syndrome in rats: one for all. Eur. J. Pharmacol. 792, 38–47. doi:10.1016/j.ejphar.2016.10.031
Moukayed, M., and Grant, W. B. (2019). Linking the metabolic syndrome and obesity with vitamin D status: risks and opportunities for improving cardiometabolic health and well-being. Diabetes Metab. Syndr. Obes. 12, 1437–1447. doi:10.2147/DMSO.S176933
Nagata, Y., Goto, H., Hikiami, H., Nogami, T., et al. (2012). Effect of keishibukuryogan on endothelial function in patients with at least one component of the diagnostic criteria forMetabolic syndrome: a controlled clinical trial with crossover design. Evidence-Based Complementary Altern. Med., doi:10.1155/2012/359282
Nainu, F., Frediansyah, A., Mamada, S., Permana, A., Salampe, M., Chandran, D., et al. (2023). Natural products targeting inflammation-related metabolic disorders. A Compr. Rev. 9 (6), e16919. doi:10.1016/j.heliyon.2023.e
Najm, W., and Lie, D. (2010). Herbals used for diabetes, obesity, and metabolic syndrome. Prim. Care 37 (2), 237–254. doi:10.1016/j.pop.2010.02.008
Najmi, A., Nasiruddin, M., Khan, R., and Haque, S. F. (2013). Indigenous herbal product Nigella sativa proved effective as an antihypertensive in metabolic syndrome. Asian J. Pharm. Clin. Res. 6, 61–64.
Nasiri, E., Jafari, F., and Nasiri, R. (2023). Evaluation of attitude and use of complementary and alternative medicine in doctoral graduates of mazandaran university of medical science. Complement. Med. J. 13 (1), 52–59. doi:10.52547/cmja-13018
Nigussie, G. (2021). A review on traditionally used medicinal plants for scabies therapy in Ethiopia. Adv. Traditional Med. 21 (2), 199–208. doi:10.1007/s13596-020-00453-7
Nikaein, F., Babajafari, S., Mazloomi, S., Zibaeenezhad, M., and Zargaran, A. (2016). The effects of satureja hortensis L. Dried leaves on serum sugar, lipid profiles, hs-CRP, and blood pressure in metabolic syndrome patients: a double-blind randomized clinical trial. Iran. Red. Crescent Med. J., e34931. doi:10.5812/ircmj.34931
Nimrouzi, M., Ruyvaran, M., Zamani, A., Nasiri, K., and Akbari, A. (2020). Oil and extract of safflower seed improve fructose induced metabolic syndrome through modulating the homeostasis of trace elements, TNF-α and fatty acids metabolism. J. Ethnopharmacol. 254, 112721. doi:10.1016/j.jep.2020.112721
Nna, V. U., McGrowder, D., and Nwokocha, C. (2023). Nutraceutical management of metabolic syndrome as a palliative and a therapeutic to coronavirus disease (COVID) crisis. Arch. Physiol. Biochem. 129 (5), 1123–1142. doi:10.1080/13813455.2021.1903041
Nyakudya, T., Tshabalala, T., Dangarembizi, R., Erlwanger, K., and Ndhlala, A., The potential therapeutic value of medicinal plants in the management of metabolic disorders. 2020;25:2669. doi:10.3390/molecules25112669
Ohkura, N., Atsumi, G., Uehara, S., Ohta, M., and Taniguchi, M. (2019). Ashitaba (angelica keiskei) exerts possible beneficial effects on metabolic syndrome. OBM Integr. Complementary Med. 4 (1). doi:10.21926/obm.icm.1901005
Olid, M. C., Hidalgo, M., Prieto, I., Cobo, A., Martínez-Rodríguez, A. M., Segarra, A. B., et al. (2023). Evidence supporting the involvement of the minority compounds of extra virgin olive oil, through gut microbiota modulation, in some of the dietary benefits related to metabolic syndrome in comparison to butter. Molecules 28 (5), 2265. doi:10.3390/molecules28052265
Owis, A. I., Abo-Youssef, A. M., and Osman, A. H. (2017). Leaves of Cordia boissieri A. DC. as a potential source of bioactive secondary metabolites for protection against metabolic syndrome-induced in rats. Z Naturforsch C J. Biosci. 72 (3-4), 107–118. doi:10.1515/znc-2016-0073
Pace, R., Pluye, P., Bartlett, G., Macaulay, A. C., Salsberg, J., Jagosh, J., et al. (2012). Testing the reliability and efficiency of the pilot Mixed Methods Appraisal Tool (MMAT) for systematic mixed studies review. Int. J. Nurs. Stud. 49 (1), 47–53. doi:10.1016/j.ijnurstu.2011.07.002
Padiya, R., Khatua, T. N., Bagul, P. K., Kuncha, M., and Banerjee, S. K. (2011). Garlic improves insulin sensitivity and associated metabolic syndromes in fructose fed rats. Nutr. Metab. (Lond). 8, 53. doi:10.1186/1743-7075-8-53
Palla, A. H., Amin, F., Fatima, B., Shafiq, A., Rehman, N. U., Haq, I., et al. (2021). Systematic review of polyherbal combinations used in metabolic syndrome. Front. Pharmacol. 12, 752926. doi:10.3389/fphar.2021.752926
Panchal, S. K., Wanyonyi, S., and Brown, L. (2017). Selenium, vanadium, and chromium as micronutrients to improve metabolic syndrome. Curr. Hypertens. Rep. 19 (3), 10. doi:10.1007/s11906-017-0701-x
Pandey, N., Mishra, P., and Tripathi, Y. (2021). Cyperus rotundus in the management of metabolic syndrome – benefit in the treatment of metabolic syndrome. Life Sci. Inf. Publ. 7 (3), 20. doi:10.26479/2021.0703.03
Papathanasopoulos, A., and Camilleri, M. (2010). Dietary fiber supplements: effects in obesity and metabolic syndrome and relationship to gastrointestinal functions. Gastroenterology 138 (1), 65–72. doi:10.1053/j.gastro.2009.11.045
Pastor, R., Bouzas, C., and Tur, J. A. (2021). Beneficial effects of dietary supplementation with olive oil, oleic acid, or hydroxytyrosol in metabolic syndrome: systematic review and meta-analysis. Free Radic. Biol. Med. 172, 372–385. doi:10.1016/j.freeradbiomed.2021.06.017
Patil, A. S., Mahajan, U. B., Agrawal, Y. O., Patil, K. R., Patil, C. R., Ojha, S., et al. (2020). Plant-derived natural therapeutics targeting cannabinoid receptors in metabolic syndrome and its complications: a review. Biomed. Pharmacother. 132, 110889. doi:10.1016/j.biopha.2020.110889
Payab, M., Hasani-Ranjbar, S., Shahbal, N., Qorbani, M., Aletaha, A., Haghi-Aminjan, H., et al. (2020). Effect of the herbal medicines in obesity and metabolic syndrome: a systematic review and meta-analysis of clinical trials. Phytother. Res. 34 (3), 526–545. doi:10.1002/ptr.6547
Pedersen, M. H., Mølgaard, C., Hellgren, L. I., and Lauritzen, L. (2010). Effects of fish oil supplementation on markers of the metabolic syndrome. J. Pediatr. 157 (3), 395–400. doi:10.1016/j.jpeds.2010.04.001
Pérez-Muñoz, E. P., Antunes-Ricardo, M., Martínez-Ávila, M., and Guajardo-Flores, D. (2022). Eryngium species as a potential ally for treating metabolic syndrome and diabetes. Front. Nutr. 9, 878306. doi:10.3389/fnut.2022.878306
Pérez-Torres, I., Torres-Narváez, J. C., Pedraza-Chaverri, J., Rubio-Ruiz, M. E., Díaz-Díaz, E., Del Valle-Mondragón, L., et al. (2016). Effect of the aged garlic extract on cardiovascular function in metabolic syndrome rats. Molecules 21 (11), 1425. doi:10.3390/molecules21111425
Perona, J. S. (2017). Membrane lipid alterations in the metabolic syndrome and the role of dietary oils. Biochim. Biophys. Acta Biomembr. 1859 (9 Pt B), 1690–1703. doi:10.1016/j.bbamem.2017.04.015
Pilar, B., Güllich, A., Oliveira, P., Ströher, D., Piccoli, J., and Manfredini, V. (2017). Protective role of flaxseed oil and flaxseed lignan secoisolariciresinol diglucoside against oxidative stress in rats with metabolic syndrome. J. Food Sci. 82 (12), 3029–3036. doi:10.1111/1750-3841.13964
Pinzon-Perez, H., and Pérez, M. (2016). Complementary, alternative, and integrative health: a multicultural perspective. Hoboken, New Jersey, United States: Wiley. ISBN: 978-1-118-88042-5.
Ponticelli, M., Russo, D., Faraone, I., Sinisgalli, C., Labanca, F., Lela, L., et al. (2021). The promising ability of humulus lupulus L. Iso-acids vs. Diabetes, inflammation, and metabolic syndrome: a systematic review. Molecules 26, 954. doi:10.3390/molecules26040954
Raja Kumar, S., Mohd Ramli, E. S., Abdul Nasir, N. A., Ismail, N. H. M., and Mohd Fahami, N. A. (2019). Preventive effect of Naringin on metabolic syndrome and its mechanism of action: a systematic review. Evidence-Based Complementary Altern. Med., doi:10.1155/2019/9752826
Ramírez-Higuera, A., Peña-Montes, C., Herrera-Meza, S., Mendoza-López, R., Valerio-Alfaro, G., and Oliart-Ros, R. M. (2020). Preventive action of sterculic oil on metabolic syndrome development on a fructose-induced rat model. J. Med. Food 23 (3), 305–311. doi:10.1089/jmf.2019.0177
Ramli, N. Z., Chin, K. Y., Zarkasi, K. A., and Ahmad, F. (2018). A review on the protective effects of honey against metabolic syndrome. Nutrients 10 (8), 1009. doi:10.3390/nu10081009
Razavi, B., and Hosseinzadeh, H. (2017). Saffron: a promising natural medicine in the treatment of metabolic syndrome. J. Sci. Food Agric. 97, 1679–1685. doi:10.002/jsfa.8134
Reshidan, N., Abd Muid, S., and Mamikutty, N. (2019). The effects of Pandanus amaryllifolius (Roxb.) leaf water extracts on fructoseinduced metabolic syndrome rat model. BMC Complementary Altern. Med. 19, 232. doi:10.1186/s12906-019-2627-0
Rizvi, M. K., Rabail, R., Munir, S., Inam-Ur-Raheem, M., Qayyum, M. M. N., Kieliszek, M., et al. (2022). Astounding health benefits of jamun (syzygium cumini) toward metabolic syndrome. Molecules 27 (21), 7184. doi:10.3390/molecules27217184
Rochlani, Y., Pothineni, N. V., Kovelamudi, S., and Mehta, J. L. (2017). Metabolic syndrome: pathophysiology, management, and modulation by natural compounds. Ther. Adv. Cardiovasc Dis. 11 (8), 215–225. doi:10.1177/1753944717711379
Ruyvaran, M., Zamani, A., Mohamadian, A., Zarshenas, M. M., Eftekhari, M. H., Pourahmad, S., et al. (2022). Safflower (Carthamus tinctorius L.) oil could improve abdominal obesity, blood pressure, and insulin resistance in patients with metabolic syndrome: a randomized, double-blind, placebo-controlled clinical trial. J. Ethnopharmacol. 282, 114590. doi:10.1016/j.jep.2021.114590
Sabarathinam, S., Chandra, S. K. R., and Mahalingam Vijayakumar, T. (2022). “Necessity of herbal medicine in the management of metabolic syndrome,” in Lifestyle-related diseases and metabolic syndrome (London, UK: IntechOpen). doi:10.5772/intechopen.105199
Saha, S., and Pal, D. (2022). Impact of flax on metabolic syndrome and related environmental factors. Int. J. Pharm. Sci. Res. 13, 531–542. doi:10.13040/IJPSR.0975-8232
Salaramoli, S., Mehri, S., Yarmohammadi, F., Hashemy, S. I., and Hosseinzadeh, H. (2022). The effects of ginger and its constituents in the prevention of metabolic syndrome: a review. Iran. J. Basic Med. Sci. 25 (6), 664–674. doi:10.22038/IJBMS.2022.59627.13231
Salekzamani, S., Bavil, A. S., Mehralizadeh, H., Jafarabadi, M. A., Ghezel, A., and Gargari, B. P. (2017). The effects of vitamin D supplementation on proatherogenic inflammatory markers and carotid intima media thickness in subjects with metabolic syndrome: a randomized double-blind placebo-controlled clinical trial. Endocrine 57 (1), 51–59. doi:10.1007/s12020-017-1317-2
Salekzamani, S., Mehralizadeh, H., Ghezel, A., Salekzamani, Y., Jafarabadi, M. A., Bavil, A. S., et al. (2016). Effect of high-dose vitamin D supplementation on cardiometabolic risk factors in subjects with metabolic syndrome: a randomized controlled double-blind clinical trial. J. Endocrinol. Invest. 39 (11), 1303–1313. doi:10.1007/s40618-016-0507-8
Samakar, B., Mehri, S., and Hosseinzadeh, H. (2022). A review of the effects of Urtica dioica (nettle) in metabolic syndrome. Iran. J. Basic Med. Sci. 25 (5), 543–553. doi:10.22038/IJBMS.2022.58892.13079
Sanchez-Rodriguez, E., Lima-Cabello, E., Biel-Glesson, S., Fernandez-Navarro, J. R., Calleja, M. A., Roca, M., et al. (2018). Effects of virgin olive oils differing in their bioactive compound contents on metabolic syndrome and endothelial functional risk biomarkers in healthy adults: a randomized double-blind controlled trial. Nutrients 10 (5), 626. doi:10.3390/nu10050626
Scandar, S., Zadra, C., and Marcotullio, M. C. (2023). Coriander (coriandrum sativum) polyphenols and their nutraceutical value against obesity and metabolic syndrome. Molecules 28 (10), 4187. doi:10.3390/molecules28104187
Seong, E., Bose, S., Han, S. Y., Song, E. J., Lee, M., Nam, Y. D., et al. (2021). Positive influence of gut microbiota on the effects of Korean red ginseng in metabolic syndrome: a randomized, double-blind, placebo-controlled clinical trial. EPMA J. 12 (2), 177–197. doi:10.1007/s13167-021-00243-4
Shafiee, M., Aghili Moghaddam, N. S., Nosrati, M., Tousi, M., Avan, A., Ryzhikov, M., et al. (2017). Saffron against components of metabolic syndrome: current status and prospective. J. Agric. Food Chem. 65 (50), 10837–10843. doi:10.1021/acs.jafc.7b03762
Shah, A. S., Khan, G. M., Badshah, A., Shah, S. U., Shah, K. U., Mirza, S. A., et al. (2012). Nigella sativa provides protection against metabolic syndrome. Afr. J. Biotechnol. 11 (48), 10919–10925. doi:10.5897/AJB12.890
Shakib, Z., Shahraki, N., Razavi, B. M., and Hosseinzadeh, H. (2019). Aloe vera as an herbal medicine in the treatment of metabolic syndrome: a review. Phytotherapy Res. 33, 2649–2660. doi:10.1002/ptr.6465
Shen, H. H., Alex, R., Bellner, L., Raffaele, M., Licari, M., Vanella, L., et al. (2020). Milk thistle seed cold press oil attenuates markers of the metabolic syndrome in a mouse model of dietary-induced obesity. J. Food Biochem. 44 (12), e13522. doi:10.1111/jfbc.13522
Shen, Y., Jia, L. N., Honma, N., Hosono, T., Ariga, T., and Seki, T. (2012). Beneficial effects of cinnamon on the metabolic syndrome, inflammation, and pain, and mechanisms underlying these effects - a review. J. Tradit. Complement. Med. 2 (1), 27–32. doi:10.1016/s2225-4110(16)30067-0
Singh, R. K., Lui, E., Wright, D., Taylor, A., and Bakovic, M. (2017). Alcohol extract of North American ginseng (Panax quinquefolius) reduces fatty liver, dyslipidemia, and other complications of metabolic syndrome in a mouse model. Can. J. Physiol. Pharmacol. 95 (9), 1046–1057. doi:10.1139/cjpp-2016-0510
Strange, R. C., Shipman, K. E., and Ramachandran, S. (2015). Metabolic syndrome: a review of the role of vitamin D in mediating susceptibility and outcome. World J. Diabetes 6 (7), 896–911. doi:10.4239/wjd.v6.i7.896
Suganya, M., Vikneshan, M., and Swathy, U. (2017). Usage of complementary and alternative medicine: a survey among Indian dental professionals. Complement. Ther. Clin. Pract. 26, 26–29. doi:10.1016/j.ctcp.2016.11.005
Taghipour, Y. D., Hajialyani, M., Naseri, R., Hesari, M., Mohammadi, P., Stefanucci, A., et al. (2019). Nanoformulations of natural products for management of metabolic syndrome. Int. J. Nanomedicine 14, 5303–5321. doi:10.2147/IJN.S213831
Tamel Selvan, K., Goon, J. A., Makpol, S., and Tan, J. K. (2023). Effects of microalgae on metabolic syndrome. Antioxidants (Basel) 12 (2), 449. doi:10.3390/antiox12020449
Tamtaji, O. R., Milajerdi, A., Reiner, Ž., Dadgostar, E., Amirani, E., Asemi, Z., et al. (2020). Effects of flaxseed oil supplementation on biomarkers of inflammation and oxidative stress in patients with metabolic syndrome and related disorders: a systematic review and meta-analysis of randomized controlled trials. Clin. Nutr. ESPEN 40, 27–33. doi:10.1016/j.clnesp.2020.09.017
Tan, Y., Kamal, M. A., Wang, Z. Z., Xiao, W., Seale, J. P., and Qu, X. (2011). Chinese herbal extracts (SK0506) as a potential candidate for the therapy of the metabolic syndrome. Clin. Sci. (Lond). 120 (7), 297–305. doi:10.1042/CS20100441
Tenorio-Jiménez, C., Martínez-Ramírez, M. J., Gil, Á., and Gómez-Llorente, C. (2020). Effects of probiotics on metabolic syndrome: a systematic review of randomized clinical trials. Nutrients 12 (1), 124. doi:10.3390/nu12010124
Theik, N. W. Y., Raji, O. E., Shenwai, P., Shah, R., Kalluri, S. R., Bhutta, T. H., et al. (2021). Relationship and effects of vitamin D on metabolic syndrome: a systematic review. Cureus 13 (8), e17419. doi:10.7759/cureus
Thomaz, F. S., Tan, Y. P., Williams, C. M., Ward, L. C., Worrall, S., and Panchal, S. K. Wasabi (eutrema japonicum) reduces obesity and blood pressure in diet-induced metabolic syndrome in rats. Foods 2022, 11, 3435. doi:10.3390/foods11213435
Tola, M. A., Ibrahim, F., Melak, H., Tafesse, T., Alemayehu, M., and Nigussie, G. (2023). Traditional herbal remedies in the management of metabolic disorders in Ethiopia: a systematic review of ethnobotanical studies and pharmacological activities. Evidence-Based Complementary Altern. Med., 1413038. doi:10.1155/2023/1413038
Ullah, H., De Filippis, A., Khan, H., Xiao, J., and Daglia, M. (2020). An overview of the health benefits of Prunus species with special reference to metabolic syndrome risk factors. Food Chem. Toxicol. 144, 111574. doi:10.1016/j.fct.2020.111574
Usui, T., Tochiya, M., Sasaki, Y., Muranaka, K., Yamakage, H., Himeno, A., et al. (2013). Effects of natural S-equol supplements on overweight or obesity and metabolic syndrome in the Japanese, based on sex and equol status. Clin. Endocrinol. (Oxf) 78 (3), 365–372. doi:10.1111/j.1365-2265.2012.04400.x
van der Pal, K. C., Koopman, A. D. M., Lakerveld, J., van der Heijden, A. A., Elders, P. J., Beulens, J. W., et al. (2018). The association between multiple sleep-related characteristics and the metabolic syndrome in the general population: the New Hoorn study. Sleep. Med. 52, 51–57. doi:10.1016/j.sleep.2018.07.022
Verhoeven, V., Van der Auwera, A., Van Gaal, L., Remmen, R., Apers, S., Stalpaert, M., et al. (2015). Can red yeast rice and olive extract improve lipid profile and cardiovascular risk in metabolic syndrome? a double blind, placebo controlled randomized trial. BMC Complementary Altern. Med. 15, 52. doi:10.1186/s12906-015-0576-9
Vílchez, L., Ascencios, J., and Dooley, T. (2022). GlucoMedix®, an extract of Stevia rebaudiana and Uncaria tomentosa, reduces hyperglycemia, hyperlipidemia, and hypertension in rat models without toxicity: a treatment for metabolic syndrome. BMC Complementary Med. Ther. 22, 62. doi:10.1186/s12906-022-03538-9
Villarroel-Vicente, C., Gutiérrez-Palomo, S., Ferri, J., Cortes, D., and Cabedo, N. (2021). Natural products and analogs as preventive agents for metabolic syndrome via peroxisome proliferator-activated receptors: an overview. Eur. J. Med. Chem. 221, 113535. doi:10.1016/j.ejmech.2021.113535
Waltenberger, B., Mocan, A., Šmejkal, K., Heiss, E., and Atanasov, A. (2016a). Natural products to counteract the epidemic of cardiovascular and metabolic disorders. Molecules 21, 807. doi:10.3390/molecules21060807
Waltenberger, B., Mocan, A., Šmejkal, K., Heiss, E. H., and Atanasov, A. G. (2016b). Natural products to counteract the epidemic of cardiovascular and metabolic disorders. Molecules 21, 6. doi:10.3390/molecules21060807
Wang, J., Ke, W., Bao, R., Hu, X., and Chen, F. (2017). Beneficial effects of ginger Zingiber officinale Roscoe on obesity and metabolic syndrome: a review. Ann. N. Y. Acad. Sci. 1398 (1), 83–98. doi:10.1111/nyas.13375
Wang, Y. Y., Hsieh, Y. H., Kumar, K. J. S., Hsieh, H. W., Lin, C. C., and Wang, S. Y. (2020). The regulatory effects of a formulation of cinnamomum osmophloeum kaneh and taiwanofungus camphoratus on metabolic syndrome and the gut microbiome. Plants (Basel) 9 (3), 383. doi:10.3390/plants9030383
Wenclewska, S., Szymczak-Pajor, I., Drzewoski, J., Bunk, M., and Śliwińska, A. (2019). Vitamin D supplementation reduces both oxidative DNA damage and insulin resistance in the elderly with metabolic disorders. Int. J. Mol. Sci. 20 (12), 2891. doi:10.3390/ijms20122891
Wimalawansa, S. J. (2018). Associations of vitamin D with insulin resistance, obesity, type 2 diabetes, and metabolic syndrome. J. Steroid Biochem. Mol. Biol. 175, 177–189. doi:10.1016/j.jsbmb.2016.09.017
Wong, S. K., Chin, K. Y., and Ima-Nirwana, S. (2020). Vitamin C: a review on its role in the management of metabolic syndrome. Int. J. Med. Sci. 17 (11), 1625–1638. doi:10.7150/ijms.47103
Xavier-Santos, D., Bedani, R., Lima, E., and Isay, S. S. (2019). Impact of probiotics and prebiotics targeting metabolic syndrome. J. Funct. Foods. doi:10.1016/j.jff.2019.103666
Xia, X., and Weng, J. (2010). Targeting metabolic syndrome: candidate natural agents. J. Diabetes 2 (4), 243–249. doi:10.1111/j.1753-0407.2010.00090.x
Yahyazadeh, R., Ghasemzadeh Rahbardar, M., Razavi, B. M., Karimi, G., and Hosseinzadeh, H. (2021). The effect of Elettaria cardamomum (cardamom) on the metabolic syndrome: narrative review. Iran. J. Basic Med. Sci. 24 (11), 1462–1469. doi:10.22038/IJBMS.2021.54417.12228
Yang, C., Xu, Z., Deng, Q., Huang, Q., Wang, X., and Huang, F. (2020). Beneficial effects of flaxseed polysaccharides on metabolic syndrome via gut microbiota in high-fat diet fed mice. Food Res. Int. 131, 108994. doi:10.1016/j.foodres.2020
Yousefi, R., Saidpour, A., and Mottaghi, A., The effects of Spirulina supplementation on metabolic syndrome components, its liver manifestation and related inflammatory markers: a Systematic Review, Complementary Ther. Med. (2018), doi:10.1016/j.ctim.2018.11.013
Youssef, F. S., Ovidi, E., and Rai, M., Editorial: natural product based drugs that control obesity and other disorders that trigger and provoke inflammation. Front. Pharmacol.2022;13:891496. doi:10.3389/fphar.2022.891496
Zhu, J., Chen, H., Song, Z., Wang, X., and Sun, Z. (2018). Effects of ginger (zingiber officinale roscoe) on type 2 diabetes mellitus and components of the metabolic syndrome: a systematic review and meta-analysis of randomized controlled trials. Evidence-Based Complementary Altern. Med., doi:10.1155/2018/5692962
Keywords: natural products, plants, complementary and alternative medicine, metabolic syndrome, scoping review
Citation: Abdulghani MF and Al-Fayyadh S (2024) Natural products for managing metabolic syndrome: a scoping review. Front. Pharmacol. 15:1366946. doi: 10.3389/fphar.2024.1366946
Received: 17 January 2024; Accepted: 11 April 2024;
Published: 30 April 2024.
Edited by:
Luca Rastrelli, University of Salerno, ItalyReviewed by:
Marion Mackonochie, Pukka Herbs Ltd., United KingdomAlberto J. Nunez Selles, Universidad Nacional Pedro Henríquez Ureña, Dominican Republic
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*Correspondence: Mohammed Faris Abdulghani, bW9oYW1tZWQuYWJkMjEwMnBAY29udXJzaW5nLnVvYmFnaGRhZC5lZHUuaXE=