Nutrition Metabolism and Cardiovascular Diseases最新文献

{"title":"Vegan diet, processed foods, and type 1 diabetes: A secondary analysis of a randomized clinical trial.","authors":"Hana Kahleova, Joseph Himmelfarb, Tatiana Znayenko-Miller, Arathi Jayaraman, Laura Chiavaroli, Richard Holubkov, Neal D Barnard","doi":"10.1016/j.numecd.2025.104197","DOIUrl":"https://doi.org/10.1016/j.numecd.2025.104197","url":null,"abstract":"<p><strong>Background and aims: </strong>Plant-based diets lead to weight loss and improved insulin sensitivity. However, some plant foods are highly processed, raising the question as to their effect on body weight and insulin sensitivity.</p><p><strong>Methods and results: </strong>Fifty-eight adults with T1D were randomly assigned to an ad libitum low-fat vegan (n = 29) or a portion-controlled group (n = 29) for 12 weeks. Three-day dietary records were analyzed using the NOVA system, which categorizes foods from 1 to 4, based on degree of processing. A repeated measure ANOVA, Spearman correlations, and a linear regression model were used for statistical analysis. In the vegan group, the consumption of animal foods decreased in all categories, significantly so in categories 1, 2, and 4. Animal foods in category 1 decreased in the vegan group; effect size: -192 g/day (95 % CI -297 to -88); p < 0.001. Concomitantly, the intake of plant-based foods in category 1 increased in the vegan group; effect size: +334 g/day (95 % CI -24 to +693); p = 0.07. No significant changes were observed in plant-based foods in categories 2, 3, and 4 in either group. Changes in animal foods in category 1 were positively associated with changes in body weight (r = +0.52; p = 0.001) and negatively with changes in insulin sensitivity (r = -0.46; p = 0.005). A 140-g/day reduction in the consumption of animal foods in category 1 was associated with a 1-kg weight loss.</p><p><strong>Conclusions: </strong>These findings suggest that replacing animal products with plant-based foods may be an effective weight-loss strategy in people with type 1 diabetes, even when processed foods are included.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov number, NCT04944316.</p>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":" ","pages":"104197"},"PeriodicalIF":3.3,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Which and how many screening tests for an accurate diagnosis of peripheral artery disease in patients with diabetic foot ulcers? A retrospective study.","authors":"Benedetta Ragghianti, Giulia Bandini, Gabriele Ciuti, Antonio Silverii, Edoardo Mannucci, Matteo Monami","doi":"10.1016/j.numecd.2025.104196","DOIUrl":"https://doi.org/10.1016/j.numecd.2025.104196","url":null,"abstract":"<p><strong>Background and aim: </strong>To retrospectively evaluate accuracy of screening tests for peripheral artery disease (PAD) in patients with diabetic foot ulcers (DFUs) and analyze the variation of these parameters when combining more tests together.</p><p><strong>Methods and results: </strong>PAD was diagnosed using Duplex-Ultrasound Scan (DUS). The following screening tests were evaluated: ankle systolic pressure, ABI (Ankle-Brachial Index), TP (Toe Pressure), TBI (Toe-Brachial Index), and wave-form analysis (WFA). Sensitivity, specificity, PLR, NLR (Positive and Negative Likelihood Ratio), and accuracy were calculated for each test and for multiple combinations (considering positive those cases in which at least one test was positive). Out of 97patients, 64 had PAD. TBI, TP, and WFA sensitivity (1.0, 1.0, and 0.83, respectively) and specificity (0.57, 0.43, and 1.0, respectively) were superior to those obtained with ABI (0.82 and 0.64). Among combination of two tests, those of pedal pulses with either TBI or WFA had a better performance than that with ABI. The combination of three tests further increased sensitivity, without reducing specificity.</p><p><strong>Conclusions: </strong>DUS is the golden standard for diagnosing PAD in patients with DFU. The use of combinations of tests (in particular, WFA + ABI or WFA + TBI) as a first-step can be a valid alternative in case of limited resources.</p>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":" ","pages":"104196"},"PeriodicalIF":3.3,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metformin is associated with low levels of vitamin B12 with no effect on other vitamin levels. A selective action of metformin.","authors":"Nicolò Vigolo, Anna Toffalini, Nicoletta Rolli, Elisa Paviati, Matteo Gelati, Maddalena Trombetta, Elisa Danese, Giacomo Zoppini","doi":"10.1016/j.numecd.2025.104193","DOIUrl":"https://doi.org/10.1016/j.numecd.2025.104193","url":null,"abstract":"<p><strong>Background and aims: </strong>Metformin is frequently used in type 2 diabetes. Long-term treatment is associated with low blood levels of vitamin B12. No studies have evaluated whether metformin affects the blood levels of other vitamins with different mechanisms of intestinal absorption. Thus, the aim of this study was to measure vitamin B12 and other vitamin levels in metformin treated type 2 diabetes patients.</p><p><strong>Methods and results: </strong>In 200 ambulatory patients with type 2 diabetes, vitamins B12, A, B1, B6, B9, C and E were measured. Subjects were divided into those taking and those not taking metformin. Vitamin levels were compared in these two groups. Metformin significantly reduced the levels of vitamin B12 compared to patients not taking the drug (227.1 ± 96.9 vs 325.6 ± 176.8 pmol/L, p < 0.001), without affecting the levels of all other measured vitamins. A deficiency of vitamin B12 was found in 21.1 % of patients. Metformin tripled the risk of vitamin B12 deficiency in the multivariate logistic regression model.</p><p><strong>Conclusions: </strong>To the best of our knowledge, this is the first study that shows a specific effect of metformin in reducing the level of vitamin B12 without affecting other vitamin levels.</p>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":" ","pages":"104193"},"PeriodicalIF":3.3,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between estimated pulse wave velocity trajectories and cardiovascular disease risk in patients with cardiovascular-kidney-metabolic syndrome stages 0-3.","authors":"Tingting Chen, Huangyi Yin, Yubo Zhou, Min Liang","doi":"10.1016/j.numecd.2025.104192","DOIUrl":"https://doi.org/10.1016/j.numecd.2025.104192","url":null,"abstract":"<p><strong>Background and aims: </strong>The incidence of cardiovascular events is markedly elevated in individuals diagnosed with cardiovascular-kidney-metabolic (CKM) syndrome. This study aims to examine the association between alterations in estimated pulse wave velocity (ePWV) over time and the onset of cardiovascular disease (CVD) in individuals with early CKM stages.</p><p><strong>Methods and results: </strong>This study included 6788 individuals with repeated ePWV measurements from the China Health and Retirement Longitudinal Study (CHARLS). Participants were categorized into four ePWV trajectory groups using group-based trajectory modeling: low, moderate-low, moderate-high, and high. The association between ePWV trajectories and CVD risk was assessed using Cox regression models. In comparison to the low ePWV group as the reference, the hazard ratios (HRs) with 95 % confidence intervals (CIs) for the moderate-low, moderate-high, and high ePWV groups were 1.287 (1.042-1.590), 1.891 (1.453-2.462), and 2.400 (1.660-3.469) for CVD, respectively. Additionally, the incorporation of ePWV trajectories to the basic risk model resulted in improved CVD risk prediction as indicated by receiver operating characteristic (ROC) curves, as well as improved risk reclassification as measured by net reclassification improvement (NRI) and integrated discrimination improvement (IDI).</p><p><strong>Conclusions: </strong>In middle-aged and older people with early CKM stages, elevated trajectories of ePWV are significantly associated with an increased risk of CVD. Monitoring ePWV over time may offer a valuable tool for early cardiovascular risk assessment and prevention in this population.</p>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":" ","pages":"104192"},"PeriodicalIF":3.3,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of different types of coffee consumption on the risk of cardiovascular complications and related mortality events in prediabetes: an analysis from NHANES.","authors":"Dan Yang, Yaqian Mao, Shuqian Chen, Wei Lin, Liantao Li, Jixing Liang, Huibin Huang, Junping Wen, Gang Chen","doi":"10.1016/j.numecd.2025.104113","DOIUrl":"https://doi.org/10.1016/j.numecd.2025.104113","url":null,"abstract":"<p><strong>Background and aims: </strong>This study aimed to investigate the association of different types of coffee consumption on mortality, cardiovascular outcomes and prevalence in adults with prediabetes.</p><p><strong>Methods and results: </strong>This study included 5979 patients with prediabetes from the 2003-2018 National Health and Nutrition Examination Survey (NHANES) who had follow-up information. Mortality status was obtained from the National Mortality Record (NMR). A total of 748 deaths were recorded in patients with follow-up prediabetes, including 250 cardiovascular causes of death. The coffee consumption of NHANES participants was assessed using the first 24-h dietary recall interview. Among the patients with prediabetes during follow-up, there were significant survival differences between the three levels of total coffee, sugar-free coffee, and caffeinated coffee consumption (log-rank test, p < 0.05). Only for sugar-sweetened coffee consumption were there significant survival differences in cardiovascular disease (CVD) mortality across the three levels (log-rank test, p < 0.001). After multivariable adjustment, when comparing the lowest and highest consumption categories of different types of coffee, the hazard ratio for all-cause mortality among patients with prediabetes for total coffee consumption was 0.68 (95% confidence intervals [CI]: 0.55-0.85). Consumption of sugar-sweetened, sugar-free, full-fat, and fat-free coffee was negatively associated with the risk of all-cause mortality among patients with prediabetes (p < 0.05). Similar results were observed between individual types of coffee consumption and CVD mortality. Additionally, the hazard ratio for CVD mortality among patients with prediabetes for caffeinated coffee consumption was 0.47 (95% CI: 0.27-0.80). Full-fat coffee consumption was negatively associated with the prevalence risk of CVD among patients with prediabetes (OR: 0.0002, 95 % CI: 0.00-0.001, p for trend = 1.91).</p><p><strong>Conclusions: </strong>In adult patients with prediabetes, different types of coffee consumption showed varying associations with all-cause mortality, CVD outcomes, and prevalence. Higher consumption of coffee, sugar-sweetened coffee, sugar-free coffee, full-fat coffee, and fat-free coffee was associated with reduced all-cause mortality and CVD mortality in patients with prediabetes. Additionally, caffeinated coffee consumption was linked to a lower CVD mortality risk, and full-fat coffee consumption was associated with a reduced risk of CVD prevalence. These findings highlighted the potential role of choosing different types of coffee in managing the risk of CVD and premature mortality in adult patients with prediabetes.</p>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":" ","pages":"104113"},"PeriodicalIF":3.3,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypothesis- and data-driven disease risk scores among young adults - An analysis in the German DONALD cohort study.","authors":"Michaela Mark, Samuel Muli, Ines Perrar, Christina-Alexandra Conzen, Ute Nöthlings","doi":"10.1016/j.numecd.2025.104168","DOIUrl":"https://doi.org/10.1016/j.numecd.2025.104168","url":null,"abstract":"<p><strong>Background and aims: </strong>Disease risk scores (DRSs) can identify individuals at risk for chronic diseases, yet little is known about their potential use in young adult populations. We derived DRSs using two approaches (hypothesis- and data-driven) to describe subgroups of young adults regarding their disease risk profile.</p><p><strong>Methods and results: </strong>In the DOrtmund Nutritional and Anthropometric Longitudinally Designed (DONALD) cohort study, we applied seven hypothesis-driven DRSs among 492 adult participants (20-47 years) and performed cluster analysis (hierarchical, k-means) with 12 continuous metabolic risk factors (n = 457). We compared the DRSs using age- and sex-adjusted linear regressions and chi-square tests. The importance of each score component was examined using forward selection and age- and sex-adjusted logistic regressions. Longitudinal tracking of DRSs was assessed via concordance in tertile and cluster membership. Two clusters (1: \"comparably high-risk\"; 2: \"comparably low-risk\") were identified. Participants in cluster 1 (41.1 %) compared to cluster 2 showed: higher median values in all hypothesis-driven DRSs, higher absolute type 2 diabetes risk (German Diabetes Risk Score), elevated liver parameters (Fatty Liver Index, Hepatic Steatosis Index), a more unfavourable cardiovascular health (Life's Simple 7), and higher absolute coronary heart disease risk (Framingham Risk Score - Adult Treatment Panel III (females)) (P < 0.05). Waist circumference and BMI were most important. The DRSs tracked considerably within a median follow-up of 4.9 years.</p><p><strong>Conclusion: </strong>Differences in DRSs could be applied to a rather young adult population. These early disease risks are particularly shaped by anthropometric markers and are relatively stable over time.</p>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":" ","pages":"104168"},"PeriodicalIF":3.3,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A paradoxical association between A Body Shape Index and cardiometabolic multimorbidity: Findings from the English longitudinal study of ageing.","authors":"Setor K Kunutsor, Atanu Bhattacharjee, Sae Young Jae, Jari A Laukkanen","doi":"10.1016/j.numecd.2025.104167","DOIUrl":"https://doi.org/10.1016/j.numecd.2025.104167","url":null,"abstract":"<p><strong>Background and aims: </strong>A Body Shape Index (ABSI) is a novel metric designed to more accurately reflect abdominal adiposity and visceral fat distribution - factors more strongly associated with cardiometabolic risk than body mass index (BMI) and waist circumference (WC). The association between ABSI and cardiometabolic multimorbidity (CMM) is unclear. This study aimed to assess the prospective association between ABSI and CMM risk, and to directly compare this association with those of other adiposity measures (BMI, WC, height, and weight) on CMM risk within the same population.</p><p><strong>Methods and results: </strong>We analyzed data from 3408 participants (mean age: 63 years; 44.7 % male) who were free from hypertension, coronary heart disease, diabetes, and stroke at wave 4 of the English Longitudinal Study of Ageing. ABSI was calculated as WC/(BMI^2/3height^1/2). CMM was defined as the presence of at least two chronic conditions (hypertension, cardiovascular disease, diabetes, and stroke) at wave 10. Multivariable logistic regression models were used to estimate odds ratios (ORs) and 95 % confidence intervals (CIs). Over a 15-year follow-up period, 201 participants developed CMM. Spline analysis showed a U-shaped trend between ABSI and CMM risk. Compared with the middle tertile, the multivariable adjusted ORs (95 % CIs) for CMM were 1.57 (1.10-2.25) for the lowest tertile and .97 (.64-1.48) for the highest tertile. Increased levels of BMI, WC, height, and weight were each associated with an elevated CMM risk.</p><p><strong>Conclusion: </strong>There was a U-shaped relationship between ABSI and CMM risk, with low ABSI being associated with an increased CMM risk.</p>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":" ","pages":"104167"},"PeriodicalIF":3.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of endogenous erythropoietin with 10-year risk of all-cause and cardiovascular mortality.","authors":"Haotai Xie, Fangfang Fan, Jia Jia, Jianping Li, Yong Huo, Yanjun Gong, Yan Zhang","doi":"10.1016/j.numecd.2025.104157","DOIUrl":"https://doi.org/10.1016/j.numecd.2025.104157","url":null,"abstract":"<p><strong>Background and aims: </strong>Whether endogenous erythropoietin (EPO) levels are associated with all-cause and cardiovascular mortality in the general population is still unknown. This study investigated the relationship between the endogenous EPO level and the risks of all-cause and cardiovascular mortality in a community-based population.</p><p><strong>Methods and results: </strong>A total of 4870 community-dwelling Chinese participants with no history of stroke or myocardial infarction were enrolled. The association of endogenous EPO levels with all-cause and cardiovascular mortality was determined using smoothed fitting curves and Cox proportional hazards models. The mean age was 56.72 ± 8.78 years. During a mean follow-up of 9.68 years, 271 (5.56 %) died, of which 84 (1.72 %) experienced cardiovascular death. After adjustment for risk factors, the risk of all-cause mortality was significantly higher in the fourth quintile (hazard ratio [HR] 1.80, 95 % confidence interval [CI] 1.21-2.68, P = 0.012) and highest quintile (HR 1.67, 95 % CI 1.12-2.49, P = 0.004) for EPO than in the middle quintile. The lowest quintile (HR 1.47, 95 % CI 0.95-2.28, P = 0.083) and second quintile (HR 1.49, 95 % CI 0.98-2.28, P = 0.064) showed a non-significant increased risk. Additionally, the risk of cardiovascular mortality was significantly higher in the highest quintile than in the middle quintile (HR 2.18, 95 % CI 1.08-4.39, P = 0.029).</p><p><strong>Conclusion: </strong>The risks of cardiovascular and all-cause mortality were significantly increased in individuals with elevated endogenous EPO. Lower endogenous EPO levels were also associated with a non-significant increased risk. Further research is needed to elucidate the mechanisms underlying these findings.</p>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":" ","pages":"104157"},"PeriodicalIF":3.3,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Independent effect of body fat content on inflammatory biomarkers in children and adolescents: The GENOBOX study.","authors":"Aizaz Anwar Khalid, Ayesha Parvaiz Malik, Javed Iqbal, Brijesh Sathian","doi":"10.1016/j.numecd.2025.104122","DOIUrl":"https://doi.org/10.1016/j.numecd.2025.104122","url":null,"abstract":"","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":" ","pages":"104122"},"PeriodicalIF":3.3,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144183356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impacts of supplementation with pomegranate on cardiometabolic risk factors: A systematic review and dose-response meta-analysis.","authors":"Shooka Mohammadi, Javad Heshmati, Nima Baziar, Somayeh Ziaei, Farnaz Farsi, Sara Ebrahimi, Tofigh Mobaderi, Tanin Mohammadi, Hassan Mir","doi":"10.1016/j.numecd.2025.104154","DOIUrl":"https://doi.org/10.1016/j.numecd.2025.104154","url":null,"abstract":"<p><strong>Aims: </strong>It has been suggested that supplementation with pomegranate (PO) may improve the risk factors related with cardiometabolic syndrome (CMS). This systematic review and dose-response meta-analysis of randomized controlled trials (RCTs) was conducted to assess the impacts of PO supplementation on cardiovascular risk factors and CMS.</p><p><strong>Data synthesis: </strong>A comprehensive search of major databases including PubMed, Scopus, and Web of Science was implemented to identify appropriate RCTs that were published until January 2024. A random-effects model was applied for the meta-analysis and I² was used to report the heterogeneity between included studies. After the screening of the search results a 53 RCTs with 2306 participants included in this meta-analysis. The findings revealed that PO supplementation substantially reduced body weight (standardized mean difference (SMD): -0.14 kg, 95 % CI: -0.25, -0.03; P = 0.01), diastolic blood pressure (DBP) (SMD: -0.39 mmHg, 95 % CI: -0.59, -0.18; P < 0.001), body mass index (BMI) (SMD: -0.17 kg/m², 95 % CI: -0.30, -0.04; P = 0.01), systolic blood pressure (SBP) (SMD: -0.49 mmHg, 95 % CI: -0.68, -0.31; P < 0.001), serum fasting blood glucose (FBG) (SMD: -0.15 mg/dL, 95 % CI: -0.26, -0.04; P = 0.01), and total cholesterol (TC) (SMD: -0.12 mg/dL, 95 % CI: -0.24, -0.00; P = 0.04) while elevating high-density lipoprotein (HDL) levels (SMD: 0.27 mg/dL, 95 % CI: 0.08, 0.47; P < 0.001) compared to control groups. No substantial changes were observed in waist-to-hip ratio (WHR), homeostatic model assessment of insulin resistance (HOMA-IR), waist circumference (WC), serum values of hemoglobin A1c (HbA1c), alanine transaminase (ALT), triglycerides (TG), low-density lipoprotein (LDL), insulin, and aspartate transferase (AST) levels between PO and placebo groups.</p><p><strong>Conclusion: </strong>PO consumption may improve specific risk factors associated with CMS. Further RCTs with extended durations and larger sample sizes are suggested to corroborate these findings.</p><p><strong>Prospero registration number: </strong>CRD42024557368.</p>","PeriodicalId":49722,"journal":{"name":"Nutrition Metabolism and Cardiovascular Diseases","volume":" ","pages":"104154"},"PeriodicalIF":3.3,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144568047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}