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The prevalence of cardiometabolic diseases, a major subset of noncommunicable diseases (NCDs), continues to rise, claiming 17 million lives annually under the age of 70. Predictions indicate that by 2030, 77% of the global disease burden will be due to NCDs, with a significant portion attributed to cardiometabolic diseases. These illnesses encompass both cardiovascular and metabolic conditions, including cardiovascular disease (CVD), type 2 diabetes mellitus (T2DM), and metabolic syndrome.
Common risk factors for cardiometabolic diseases
Common risk factors for cardiometabolic diseases include dyslipidemia, impaired blood glucose control, hypertension, visceral obesity, and elevated liver enzymes. These factors often operate through interconnected pathways, leading to a spectrum of related health outcomes. Notably, elevated liver enzymes, previously thought to indicate impaired liver function, are now recognized as markers of developing T2DM and associated CVD risk factors.
Lifestyle choices such as smoking, sedentary behavior, and unhealthy diets are primary contributors to the increasing incidence of cardiometabolic diseases. Adopting an active lifestyle and making dietary modifications are essential strategies to counter this trend. In this context, the exploration of herbal and alternative medicine, such as the cornelian cherry (Cornus mas L.), offers promising potential in mitigating these health issues.
Bioactivity of Cornelian Cherry
Cornelian cherries have a long history of use in traditional medicine across Central Asia, Eastern Europe, and Iran, treating ailments ranging from sore throats to liver and kidney diseases. Recent scientific interest in the cornelian cherry stems from its rich composition of bioactive compounds, particularly anthocyanins and iridoids like organic acid. These compounds exhibit anti-inflammatory, anti-diabetic, and cardioprotective properties, alongside benefits for liver health and cholesterol reduction.
Anthocyanins, found in abundance in cornelian cherries, promote nitric oxide release from the endothelium, inhibit vasoconstrictor levels, and induce vasodilation. They also activate adenosine monophosphate (AMP)-activated kinase (AMPK), reducing the synthesis of cholesterol and triglycerides, thus lowering LDL and HDL cholesterol levels. Iridoids, on the other hand, help reduce serum lipid levels and prevent atheromatous changes. Animal studies have shown a significant reduction in triglycerides following cornelian cherry supplementation, highlighting its potential in improving lipid profiles.
Additionally, these bioactive compounds contribute to improved glycemic control. Anthocyanins enhance insulin sensitivity and suppress the breakdown of complex carbohydrates into simple sugars, while ursolic acid works through multiple pathways to restore insulin sensitivity, increase glycogen levels, and stimulate glucose uptake by muscle cells, thereby addressing metabolic syndrome. Loganic acid, another component, boosts antioxidant activity and reduces the formation of glycation and oxidation products.
Meta-Analysis of Cornelian Cherry Supplementation
A recent meta-analysis published in Nutrients examined several randomized controlled trials (RCTs) to assess the cardiometabolic benefits of cornelian cherry supplementation. The analysis included six RCTs involving adults who consumed cornelian cherry in various forms, such as fruit, powder, and extract, over periods ranging from six to twelve weeks. Participants included individuals with metabolic-dysfunction-associated fatty liver disease (MAFLD), type 2 diabetes mellitus (T2DM), insulin resistance, and postmenopausal women. The dosages of cornelian cherry varied from 500mg per day to 20-30g per day of dried powder.
The meta-analysis evaluated outcomes such as triglycerides, total cholesterol, LDL, HDL, fasting blood glucose (FBG), insulin, glycated hemoglobin (HbA1c), insulin resistance, liver enzyme levels, body weight, body mass index (BMI), and waist circumference (WC). The findings indicated a favorable impact of cornelian cherry supplementation on several parameters. Notably, there was a significant reduction in body weight and BMI, though waist circumference remained unchanged after accounting for inter-study differences.
Glycemic control showed marked improvement, with reductions in FBG and HbA1c levels, although insulin levels remained unaffected. HDL cholesterol levels increased, but no significant changes were observed in total plasma triglycerides, total cholesterol, or LDL cholesterol. Liver size and function also showed no post-intervention effects. Among the studies, only one involving MAFLD patients reported reductions in both systolic and diastolic blood pressure.
Overall, the meta-analysis suggests that cornelian cherry supplementation could positively influence anthropometric measurements, lipid profiles, and glycemic parameters, warranting further research to develop concentrated commercial formulations for broader use in cardiometabolic health management.
