Nutraceuticals for metabolic syndrome management: From laboratory to benchside

Current Vascular Pharmacology

Volumn 12, Issue 4, 2014, Pages 565-571

  Cicero, Arrigo F ^a   Tartagni, Elisa ^a   Ertek, Sibel ^b  

^a UNIVERSITY OF BOLOGNA   (Italy)

^b Sanliurfa Education and Research Hospital   (Turkey)

Author keywords

Diabetes; Dyslipidemia; Hypertension; Insulin resistance; Metabolic syndrome; Nutraceuticals; Obesity

Indexed keywords

BERBERINE; CHROMIUM; CINNAMON EXTRACT; ISPAGULA; NUTRACEUTICAL; OMEGA 3 FATTY ACID; PICOLINIC ACID; PICOLINIC ACID DERIVATIVE; PLANT MEDICINAL PRODUCT;

DIABETES MELLITUS; DYSLIPIDEMIA; GASTROINTESTINAL DISEASE; HUMAN; HYPERLIPIDEMIA; HYPERTENSION; INSULIN RESISTANCE; METABOLIC SYNDROME X; NONHUMAN; OBESITY; REVIEW; ANIMAL; BODY WEIGHT; CARDIOVASCULAR DISEASES; CHEMISTRY; CINNAMOMUM ZEYLANICUM; DIET SUPPLEMENTATION; DRUG EFFECTS; LAGERSTROEMIA; MOMORDICA CHARANTIA;

ANIMALS; BERBERINE; BODY WEIGHT; CARDIOVASCULAR DISEASES; CINNAMOMUM ZEYLANICUM; DIETARY SUPPLEMENTS; FATTY ACIDS, OMEGA-3; HUMANS; LAGERSTROEMIA; METABOLIC SYNDROME X; MOMORDICA CHARANTIA; PICOLINIC ACIDS; PLANT PREPARATIONS; PSYLLIUM;

EID: 84904764401     PISSN: 15701611     EISSN: 18756212     Source Type: Journal    
DOI: 10.2174/15701611113119990120     Document Type: Review

References (107)

1. Malik S, Wong ND, Franklin SS, et al. Impact of the metabolic syndrome on mortality from coronary heart disease, cardiovascular disease and all causes in United States adults. Circulation 2004; 110: 1245-50.
2. Grundy SM, Cleeman JI, Daniels SR, et al. Diagnosis and management of metabolic syndrome. An American Heart Association/National Heart, Lung and Blood Institute Scientific Statement. Circulation 2005; 112: 2737-52.
3. Kris-Etherton PM, Harris WS, Appel LJ, for the Nutrition Committee. Fish Consumption, Fish Oil, Omega-3 Fatty Acids, and Cardiovascular Disease. Circulation 2002; 106: 2747-57.
4. Wei MY, Jacobson TA. Effects of eicosapentaenoic acid versus docosahexaenoic acid on serum lipids: a systematic review and meta-analysis. Curr Atheroscler Rep 2011; 13: 474-83.
5. Cicero AF, Ertek S, Borghi C. Omega-3 Polyunsaturated Fatty Acids: Their Potential Role in Blood Pressure Prevention and Management. Curr Vasc Pharmacol 2009; 7: 330-7.
6. Mohan IK, Das UN. Effect of L-arginine-nitric oxide system on the metabolism of essential fatty acids in chemical induced diabetes mellitus in experimental animals by polyunsaturated fatty acids. Nutrition 2001; 17: 126-51.
7. Morris MC, Sacks F, Rosner B. Does fish oil lower blood pressure? A meta-analysis of controlled trials. Circulation 1993; 88: 523-33.
8. Geleijnse JM, Giltay EJ, Grobbee DE, et al. Blood pressure response to fish oil supplementation: metaregression analysis of randomized trials. J Hypertens 2002; 20: 1493-9.
9. Mori TA, Watts GF, Burke V, et al. Differential effects of eicosapentaenoic acid and docosahexaenoic acid on vascular reactivity of the forearm microcirculation in hyperlipidemic, overweight men. Circulation 2000; 102: 1264-9.
10. Sanders TA, Gleason K, Griffin B, et al. Influence of an algal triacylglycerol containing docosahexaenoic acid (22: 6n-3) and docosapentaenoic acid (22: 5n-6) on cardiovascular risk factors in healthy men and women. Br J Nutr 2006; 95: 525-31.
11. Bays HE. Safety considerations with omega-3 fatty acid therapy. Am J Cardiol 2007; 99(6A): 35C-43C.
12. Friedberg CE, Janssen MJ, Heine RJ, et al. Fish oil and glycemic control in diabetes: a meta-analysis. Diabetes Care 1998; 21: 494-500.
13. The Origin Trial Investigators. Basal Insulin and Cardiovascular and Other Outcomes in Dysglycemia. N Engl J Med 2012 Jun 11 [Epub ahead of print].
14. Rischio and Prevenzione Investigators. Efficacy of n-3 polyunsaturated fatty acids and feasibility of optimizing preventive strategies in patients at high cardiovascular risk: rationale, design and baseline characteristics of the Rischio and Prevenzione study, a large randomised trial in general practice. Trials 2010; 11: 68.
15. Manson JE, Bassuk SS, Lee IM, et al. The VITamin D and OmegA-3 TriaL (VITAL): rationale and design of a large randomized controlled trial of vitamin D and marine omega-3 fatty acid supplements for the primary prevention of cancer and cardiovascular disease. Contemp Clin Trials 2012; 33: 159-71.
16. Cicero AF, Ertek S. Metabolic and cardiovascular effects of berberine, from preclinical evidences to clinical trial results. Clin Lipidol 2009; 4: 553-63.
17. Cameron R, Ranheim T, Kulseth MA, et al. Berberine decreases PCSK9 expression in HepG2 cells. Atherosclerosis 2008; 201: 266-73.
18. Brusq JM, Ancellin N, Grondin P, et al. Inhibition of lipid synthesis through activation of AMP kinase: an additional mechanism for the hypolipidemic effects of berberine. J Lipid Res 2006; 47: 1281-8.
19. Zhang Y, Li X, Zou D, et al. Treatment of type 2 diabetes and dyslipidemia with the natural plant alkaloid berberine. J Clin Endocrinol Metab 2008; 93: 2559-65.
20. Yin J, Xing H, Ye J. Efficacy of berberine in patients with type 2 diabetes mellitus. Metabolism 2008; 57: 712-7.
21. Zhang W, Xu YC, Guo FJ, et al. Antidiabetic effects of cinnamaldehyde and berberine and their impacts on retinol binding protein 4 expression in rats with type 2 diabetes mellitus. Chin Med J 2008; 121: 2124-8.
22. Kim SH, Shin EJ, Kim ED, et al. Berberine activated GLUT-1-mediated glucose uptake in 3T3-L1 adipocytes. Bio Pharm Bull 2007; 30: 2120-5.
23. Wang ZQ, Lu FE, Leng SH, et al. Facilitating effects of berberine on rat pancreatic islets Through modulating hepatic nuclear factor 4 alpha expression and glucokinase activity. World J Gastroenterol 2008; 14: 6004-11.
24. Vuddanda PR, Chakraborty S, Singh S. Berberine: a potential phytochemical with multispectrum therapeutic activities. Expert Opin Investig Drugs 2010; 19(10): 1297-307.
25. Yin J, Gao Z, Liu D, et al. Berberine improves glucose metabolism through induction of glycolysis. Am J Physiol Endocrinol Metab 2008; 294: E148-56.
26. Yuan J, Shen XZ, Zhu XS. Effect of berberine on transit time of human small intestine. Zhongguo Zhong Xi Yi Jie He Za Zhi 1994; 14: 718-20.
27. Chan E. Displacement of bilirubin from albumin by berberine. Biol Neonat 1993; 63: 201-8.
28. Tan YZ, Wu AC, Tan BY, et al. Study on the interactions of berberine displace other drug from their plasma proteins binding sites. Chin Pharmacol Bull 2002; 18: 576-8.
29. Xin HW, Wu XC, Li Q, et al. The effects of berberine on the pharmacokinetics of cyclosporine A in healthy volunteers. Methods Find Exp Clin Pharmacol 2006; 28: 25-9.
30. Lin HL, Liu TY, Wu CW, et al. Berberine modulates expression of mdr1 gene product and the responses of the digestive tract cancers to Paclitaxel. Br J Cancer 1999; 81: 416-22.
31. NCEP expert panel. Expert Panel on detection, evaluation and treatment of high blood cholesterol in adults. Executive summary of the third report of the National Cholesterol Education Program (NCEP) (Adult Treatment Panel III). J Am Med Assoc 2001; 285: 2486-97.
32. Giacosa A, Rondanelli M. The right fiber for the right disease: an update on the psyllium seed husk and the metabolic syndrome. J Clin Gastroenterol 2010; 44 (Suppl 1): S58-60.
33. Vergara-Jimenez M, Conde K, Erickson SK, et al. Hypolipidemic mechanisms of pectin and pysllium in guinea pigs fed high fatsucrose diets: alterations on hepatic cholesterol metabolism. J Lipid Res 1998; 39: 1455-65.
34. Wei ZH, Wang H, Chen XY, et al. Time-and dose-dependent effect of psylium on serum lipids in mild-to-moderate hypercholesterolemia: a meta-analysis of controlled trials. Eur J Clin Nutr 2009; 63: 821-7.
35. Petchetti L, Frishman WH, Petrillo R, et al. Nutriceuticals in cardiovascular disease: psyllium. Cardiol Rev 2007; 15: 116-22.
36. Bajorek SA, Morello CM. Effects of dietary fiber and low glycemic index diet on glucose control in subjects with type 2 diabetes mellitus. Ann Pharmacother 2010; 44: 1786-92.
37. Cicero AF, Derosa G, Manca M, et al. Different effect of psyllium and guar dietary supplementation on blood pressure control in hypertensive overweight patients: a six-month, randomized clinical trial. Clin Exp Hypertens 2007; 29: 383-94.
38. Pal S, Khossousi A, Binns C, et al. The effects of 12-week psyllium fibre supplementation or healthy diet on blood pressure and arterial stiffness in overweight and obese individuals. Br J Nutr 2012; 107: 725-34.
39. Pittler MH, Ernst E. Dietary supplements for body-weight reduction: a systematic review. Am J Clin Nutr 2004; 79: 529-36.
40. Mechanick JI, Brett EM, Chausmer AB, et al. AACE Nutrition Guidelines Taskforce. American Association of Clinical Endocrinologists Medical Guidelines for the clinical use of dietary supplements and nutraceuticals. Endocrine Pract 2003; 9: 417-70.
41. Roberts KT. The potential of fenugreek (Trigonella foenumgraecum) as a functional food and nutraceutical and its effects on glycemia and lipidemia. J Med Food 2011; 14: 1485-9.
42. Jull AB, Ni Mhurchu C, Bennett DA, et al. Chitosan for overweight or obesity. Cochrane Database Syst Rev 2008; 3: CD003892.
43. Choi CR, Kim EK, Kim YS, et al. Chitooligosaccharides decreases plasma lipid levels in healthy men. Int J Food Sci Nutr 2012; 63: 103-6.
44. Hernández-González SO, González-Ortiz M, Martínez-Abundis E, et al. Chitosan improves insulin sensitivity as determined by the euglycemic-hyperinsulinemic clamp technique in obese subjects. Nutr Res 2010; 30: 392-5.
45. Sood N, Baker WL, Coleman CI. Effect of glucomannan on plasma lipid and glucose concentrations, body weight, and blood pressure: systematic review and meta-analysis. Am J Clin Nutr 2008; 88: 1167-75.
46. Bandara T, Uluwaduge I, Jansz ER. Bioactivity of cinnamon with special emphasis on diabetes mellitus: A review. Int J Food Sci Nutr 2012; 63: 380-6.
47. Mohamed Sham Shihabudeen H, Hansi Priscilla D, Thirumurugan K. Cinnamon extract inhibits α-glucosidase activity and dampens postprandial glucose excursion in diabetic rats. Nutr Metab 2011; 8: 46.
48. Anand P, Murali KY, Tandon V, et al. Insulinotropic effect of cinnamaldehyde on transcriptional regulation of pyruvate kinase, phosphoenolpyruvate carboxykinase, and GLUT4 translocation in experimental diabetic rats. Chem Biol Interact 2010; 186: 72-81.
49. Kim SH, Choung SY. Antihyperglycemic and antihyperlipidemic action of Cinnamomi Cassiae (Cinnamon bark) extract in C57BL/Ks db/db mice. Arch Pharm Res 2010; 33: 325-33.
50. Cao H, Graves DJ, Anderson RA. Cinnamon extract regulates glucose transporter and insulin-signaling gene expression in mouse adipocytes. Phytomedicine 2010; 17: 1027-32.
51. Sheng X, Zhang Y, Gong Z, et al. Improved Insulin Resistance and Lipid Metabolism by Cinnamon Extract through Activation of Peroxisome Proliferator-Activated Receptors. PPAR Res 2008; 2008: 581348.
52. Huang B, Yuan HD, Kim do Y, et al. Cinnamaldehyde prevents adipocyte differentiation and adipogenesis via regulation of peroxisome proliferator-activated receptor-(PPAR) and AMP-activated protein kinase (AMPK) pathways. J Agric Food Chem 2011; 59: 3666-73.
53. Cao H, Polansky MM, Anderson RA. Cinnamon extract and polyphenols affect the expression of tristetraprolin, insulin receptor, and glucose transporter 4 in mouse 3T3-L1 adipocytes. Arch Biochem Biophys 2007; 459: 214-22.
54. Peng X, Cheng KW, Ma J, et al. Cinnamon bark proanthocyanidins as reactive carbonyl scavengers to prevent the formation of advanced glycation endproducts. J Agric Food Chem 2008; 56: 1907-11.
55. Kim W, Khil LY, Clark R, et al. Naphthalenemethyl ester derivative of dihydroxyhydrocinnamic acid, a component of cinnamon, increases glucose disposal by enhancing translocation of glucose transporter 4. Diabetologia 2006; 49: 2437-48.
56. Ranasinghe P, Perera S, Gunatilake M, et al. Effects of Cinnamomum zeylanicum (Ceylon cinnamon) on blood glucose and lipids in a diabetic and healthy rat model. Pharmacognosy Res 2012; 4: 73-9.
57. Lee JS, Jeon SM, Park EM, et al. Cinnamate supplementation enhances hepatic lipid metabolism and antioxidant defense systems in high cholesterol-fed rats. J Med Food 2003; 6: 183-91.
58. Ping H, Zhang G, Ren G. Antidiabetic effects of cinnamon oil in diabetic KK-Ay mice. Food Chem Toxicol 2010; 48: 2344-9.
59. Qin B, Polansky MM, Sato Y, et al. Cinnamon extract inhibits the postprandial overproduction of apolipoprotein B48-containing lipoproteins in fructose-fed animals. J Nutr Biochem 2009; 20: 901-8.
60. Khan A, Safdar M, Ali Khan MM, et al. Cinnamon improves glucose and lipids of people with type 2 diabetes. Diabetes Care 2003; 26: 3215-8.
61. Akilen R, Tsiami A, Devendra D, et al. Glycated haemoglobin and blood pressure-lowering effect of cinnamon in multi-ethnic Type 2 diabetic patients in the UK: a randomized, placebo-controlled, double-blind clinical trial. Diabet Med 2010; 27: 1159-67.
62. Mang B, Wolters M, Schmitt B, et al. Effects of a cinnamon extract on plasma glucose, HbA, and serum lipids in diabetes mellitus type 2. Eur J Clin Invest 2006; 36: 340-4.
63. Hlebowicz J, Darwiche G, Björgell O, et al. Effect of cinnamon on postprandial blood glucose, gastric emptying, and satiety in healthy subjects. Am J Clin Nutr 2007; 85: 1552-6.
64. Akilen R, Tsiami A, Devendra D, et al. Cinnamon in glycaemic control: Systematic review and meta-analysis. Clin Nutr 2012 May 12 [Epub ahead of print].
65. Davis PA, Yokoyama W. Cinnamon intake lowers fasting blood glucose: meta-analysis. J Med Food 2011; 14: 884-9.
66. Baker WL, Gutierrez-Williams G, White CM, et al. Effect of cinnamon on glucose control and lipid parameters. Diabetes Care 2008; 31: 41-3.
67. Altschuler JA, Casella SJ, MacKenzie TA, et al. The effect of cinnamon on A1C among adolescents with type 1 diabetes. Diabetes Care 2007; 30: 813-6.
68. Rafehi H, Ververis K, Karagiannis TC. Controversies surrounding the clinical potential of cinnamon for the management of diabetes. Diabetes Obes Metab 2012; 14: 493-9.
69. Kirkham S, Akilen R, Sharma S, et al. The potential of cinnamon to reduce blood glucose levels in patients with type 2 diabetes and insulin resistance. Diabetes Obes Metab 2009; 11: 1100-13.
70. Bagchi D, Bagchi M, Stohs SJ. Chromium (VI)-induced oxidative stress, apoptotic cell death and modulation of p53 tumor suppressor gene. Mol Cell Biochem 2001; 222: 149-58.
71. Sharma S, Agrawal RP, Choudhary M, et al. Beneficial effect of chromium supplementation on glucose, HbA1C and lipid variables in individuals with newly onset type-2 diabetes. J Trace Elem Med Biol 2011; 25: 149-53.
72. Preuss HG, Echard B, Perricone NV, et al. Comparing metabolic effects of six different commercial trivalent chromium compounds. J Inorg Biochem 2008; 102: 1986-90.
73. Broadhurst CL, Domenico P. Clinical studies on chromium picolinate supplementation in diabetes mellitus--a review. Diabetes Technol Ther 2006; 8: 677-87.
74. Sundaram B, Singhal K, Sandhir R. Ameliorating effect of chromium administration on hepatic glucose metabolism in streptozotocin-induced experimental diabetes. Biofactors 2012; 38: 59-68.
75. Wang YQ, Dong Y, Yao MH. Chromium picolinate inhibits resistin secretion in insulin-resistant 3T3-L1 adipocytes via activation of amp-activated protein kinase. Clin Exp Pharmacol Physiol 2009; 36: 843-9.
76. Bahijri SM, Alissa EM. Increased insulin resistance is associated with increased urinary excretion of chromium in non-diabetic, normotensive Saudi adults. J Clin Biochem Nutr 2011; 49: 164-8.
77. Drake TC, Rudser KD, Seaquist ER, et al. Chromium infusion in hospitalized patients with severe insulin resistance: a retrospective analysis. Endocr Pract 2012; 18: 39439-48.
78. Martin J, Wang ZQ, Zhang XH, et al. Chromium picolinate supplementation attenuates body weight gain and increases insulin sensitivity in subjects with type 2 diabetes. Diabetes Care 2006; 29: 1826-32.
79. Hummel M, Standl E, Schnell O. Chromium in metabolic and cardiovascular disease. Horm Metab Res 2007; 39: 743-51.
80. Ali A, Ma Y, Reynolds J, et al. Chromium effects on glucose tolerance and insulin sensitivity in persons at risk for diabetes mellitus. Endocr Pract 2011; 17: 16-25.
81. Pattar GR, Tackett L, Liu P, et al. Chromium picolinate positively influences the glucose transporter system via affecting cholesterol homeostasis in adipocytes cultured under hyperglycemic diabetic conditions. Mutat Res 2006; 610: 93-100.
82. Preuss HG, Grojec PL, Lieberman S, et al. Effects of different chromium compounds on blood pressure and lipid peroxidation in spontaneously hypertensive rats. Clin Nephrol 1997; 47: 325-30.
83. Moore JW, Maher MA, Banz WJ, et al. Chromium picolinate modulates rat vascular smooth muscle cell intracellular calcium metabolism. J Nutr 1998; 128: 180-4.
84. Abebe W, Liu JY, Wimborne H, et al. Effects of chromium picolinate on vascular reactivity and cardiac ischemia-reperfusion injury in spontaneously hypertensive rats. Pharmacol Rep 2010; 62: 674-82.
85. Komorowski JR, Greenberg D, Juturu V. Chromium picolinate does not produce chromosome damage. Toxicol In vitro2008; 22: 819-26.
86. Yeghiazaryan K, Peeva V, Shenoy A, et al. Chromium-picolinate therapy in diabetes care: molecular and subcellular profiling revealed a necessity for individual outcome prediction, personalised treatment algorithms and new guidelines. Infect Disord Drug Targets 2011; 11: 188-95.
87. Bailey MM, Sturdivant J, Jernigan PL, et al. Comparison of the potential for developmental toxicity of prenatal exposure to two dietary chromium supplements, chromium picolinate and [Cr3O(O2CCH2CH3)(6(H2O)3]+, in mice. Birth Defects Res B Dev Reprod Toxicol 2008; 83: 27-31.
88. Bailey MM, Boohaker JG, Sawyer RD, et al. Exposure of pregnant mice to chromium picolinate results in skeletal defects in their offspring. Birth Defects Res B Dev Reprod Toxicol 2006; 77: 244-9.
89. Stohs SJ, Miller H, Kaats GR. A review of the efficacy and safety of banaba (Lagerstroemia speciosa L.) and corosolic acid. Phytother Res 2012; 26: 317-24.
90. Liu X, Kim JK, Li Y, et al. Tannic acid stimulates glucose transport and inhibits adipocyte differentiation in 3T3-L1 cells. J Nutr 2005; 135: 165-71.
91. Klein G, Kim J, Himmeldirk K, et al. Antidiabetes and Antiobesity Activity of Lagerstroemia speciosa. Evid Based Complement Alternat Med 2007; 4: 401-7.
92. Saumya SM, Basha PM. Antioxidant effect of Lagerstroemia speciosa Pers (banaba) leaf extract in streptozotocin-induced diabetic mice. Indian J Exp Biol 2011; 49: 125-31.
93. Kakuda T, Sakane I, Takihara T, et al. Hypoglycemic effect of extracts from Lagerstroemia speciosa L. leaves in genetically diabetic KK-AY mice. Biosci Biotechnol Biochem 1996; 60: 204-8.
94. Suzuki Y, Unno T, Ushitani M, et al. Antiobesity activity of extracts from Lagerstroemia speciosa L. leaves on female KK-Ay mice. J Nutr Sci Vitaminol 1999; 45: 791-5.
95. Liu F, Kim J, Li Y, et al. An extract of Lagerstroemia speciosa L. has insulin-like glucose uptake-stimulatory and adipocyte differentiation-inhibitory activities in 3T3-L1 cells. J Nutr 2001; 131: 2242-7.
96. Judy WV, Hari SP, Stogsdill WW, et al. Antidiabetic activity of a standardized extract (Glucosol™) from Lagerstroemia speciosa leaves in type II diabetics: A dose-dependence study. J Ethnopharmacol 2003; 87: 115-7.
97. Fukushima M, Matsuyama F, Ueda N, et al. Effect of corosolic acid on postchallenge plasma glucose levels. Diabetes Res Clin Pract 2006; 73: 174-7.
98. Stohs SJ, Miller H, Kaats GR. A review of the efficacy and safety of banaba (Lagerstroemia speciosa L.) and corosolic acid. Phytother Res 2012; 26: 317-24.
99. Tsai CH, Chen EC, Tsay HS, et al. Wild bitter gourd improves metabolic syndrome: a preliminary dietary supplementation trial. Nutr J 2012; 11: 4.
100. Fuangchan A, Sonthisombat P, Seubnukarn T, et al. Hypoglycemic effect of bitter melon compared with metformin in newly diagnosed type 2 diabetes patients. J Ethnopharmacol 2011; 134: 422-8.
101. Inayat-ur-Rahman, Malik SA, Bashir M, et al. Serum sialic acid changes in non-insulin-dependant diabetes mellitus (NIDDM) patients following bitter melon (Momordica charantiaL) and rosiglitazone (Avandia) treatment. Phytomedicine 2009; 16: 401-5.
102. Kasbia GS, Arnason JT, Imbeault P. No effect of acute, single dose oral administration of Momordica charantiaLinn., on glycemia, energy expenditure and appetite: a pilot study in non-diabetic overweight men. J Ethnopharmacol 2009; 126: 127-33.
103. Banegas JR, López-García E, Dallongeville J, et al. Achievement of treatment goals for primary prevention of cardiovascular disease in clinical practice across Europe: the EURIKA study. Eur Heart J 2011; 32: 2143-2152.
104. Saha S, Gerdtham UG, Johansson P. Economic evaluation of lifestyle interventions for preventing diabetes and cardiovascular diseases. Int J Environ Res Public Health 2010; 7: 3150-3195.
105. King DE, Mainous AG 3rd, Matheson EM, Everett CJ. Impact of healthy lifestyle on mortality in people with normal blood pressure, LDL cholesterol, and C-reactive protein. Eur J Cardiovasc Prev Rehabil 2011 Sep 30. [Epub ahead of print].
106. Cicero AFG, Derosa G, D'angelo A, et al. Gender-specific haemodynamic and metabolic effects of a sequential training programme on overweight-obese hypertensives. Blood Press 2009; 18: 111-116.
107. Davì G, Santilli F, Patrono C. Nutraceuticals in diabetes and metabolic syndrome. Cardiovasc Ther 2010; 28(4): 216-26.