Nutraceuticals in the Management and Prevention of Metabolic Syndrome

Review Article

Austin J Pharmacol Ther. 2015; 3(1).1063.

Nutraceuticals in the Management and Prevention of Metabolic Syndrome

Ginpreet Kaur*, Simi Mukundan, Vaidehi Wani and Maushmi S Kumar

Shobhaben Pratapbhai Patel School of Pharmacy and Technical Management, SVKM'S NMIMS, India

*Corresponding author: : Ginpreet Kaur, School of Pharmacy & Technology Management, SVKM'S NMIMS, V.L. Mehta Road, Vile Parle (W), Mumbai - 400056, India

Received: October 31, 2014; Accepted: January 12, 2015; Published: January 20, 2015


Metabolic syndrome has become a worldwide health problem and it affects a wide variety of population. It is a condition that includes a cluster of disorders such as obesity, diabetes, hypertension, hyperlipidemia etc. mainly due to poor nutrition. In order to deal with this syndrome, researchers have made various interventions in the treatment methods as well in terms of nutrition. The term nutraceutical include nutritional and pharmaceutical aspects that work for the prevention and treatment of diseases and provide health and medicinal benefits. Researchers have identified presence of a wide range of phytoconstituents present in various traditional plants and spices. Certain plants such as Lagenaria siceraria, Trigonella foenum graecum, Curcuma longa, Vigna mungo etc. shows excellent properties in curing hypertension, obesity, diabetes and hypercholestromia. The current article reviews the importance of various nutraceuticals that we consume in our daily diet and their contribution in curing the metabolic syndrome.

Keywords: Nutraceuticals; Diabetes; Hypertension; Obesity; Hyperlipidemia


Metabolic syndromes such as diabetes mellitus, obesity are rapidly increasing in the westernized world because of poor lifestyle habits favouring fat and sucrose enriched meals and low physical activity or sedentariness. Medical nutritional therapy is an integral component of diabetes mellitus, obesity and metabolic syndrome management. Pharmacological intervention is taken into consideration when diet associated physical exercise and healthy lifestyle is insufficient to control blood glucose, body weight and metabolic profile. In contrast, pharmacological intervention for obesity still remains a controversial issue because of only modest long term efficacy and concern about safety. Obesity is the major underline reason for metabolic syndrome. The worldwide incidence of obesity has been rapidly increasing in the last two decades. According to WHO report, obesity has been classified as a growing epidemic, and if immediate action is not taken, millions of people will suffer from serious weight related disorders. Obesity counts a major health problem and common chronic disease. In health surveys conducted in the United States in 2005, 24.2% of men and 23.5% of women or over onefifth of the respondents were classified as obese [1]. Obesity mainly arises when there is an imbalance between energy intake, principally stored as triglycerides (food consumption), and energy expenditure (basal metabolic rate and biochemical processes). The excess energy is primarily stored in adipose tissue in the form of triglycerides. When adipose tissue function is compromised during obesity, the excessive fat accumulation in adipose tissue, liver, and other organs predisposes the individual to the development of metabolic changes that increase overall morbidity risks [2]. Hence, the recent recognition of metabolic syndrome and its influence on health has led the researchers to consider the potential drug-food or nutrientdrug interaction here since nutrition therapy and pharmacological intervention are the major components in managing metabolic syndrome. An interaction is said to take place when the effects of one drug are changed by the presence of another food, drug, and drink or by some environmental chemical agents. Interactions between food and drug may inadvertently reduce or increase the effect of drug, resulting in therapeutic failure (i.e. hyperglycaemia in case of diabetes mellitus) or increased adverse effect (i.e. hypoglycaemia in case of diabetes mellitus). The conventional clinically relevant food-drug interactions are caused by food induced changes in the bioavailability of drugs. Thus, in the field of metabolic disorders where nutrition plays a major role in the overall treatment, the potential influence of food and nutrient intake on drug therapeutic effect may be crucial.

Nutraceutical is defined as a food (or a part of food) that provides medical or health benefits, including prevention or treatment of a disease. Nutraceuticals are found in number of products emerging from (a) food industry, (b) herbal and dietary supplements and (c) pharmaceutical industry. Nutraceuticals covers most of the therapeutic areas that includes disorders related to sleep, digestion, cold and cough, prevention of cancer, blood pressure, pain killers, depression, hyperglycaemia and hypoglycaemia [3].

Nutraceuticals can be organized in several ways depending upon its easier understanding and applications i.e. for academic instruction, clinical trial design, and functional foods. Classification of nutraceuticals on the basis of food sources are as follows [4]:-

More broadly, they can be classified as:

  1. Potential nutraceuticals
  2. Established nutraceuticals

A potential nutraceutical can only become an established one after sufficient data on its medicinal and clinical aspects are obtained. Pharmacokinetic interferences often occur as a result of change in drug metabolism. Cytochrome- P450 (CYP-450) system oxidises a broad spectrum of drugs by a number of metabolic processes that can be enhanced or reduced by various drugs (known as inducers or inhibitors). Other factors involved in drug interaction also involve age, sex, patient and administration [5,6].


Curcumin [1, 7- bis (4-hydroxy-3-methoxyphenyl)-1, 6- heptadiene-3,5dione], being an active component of turmeric is responsible for the yellow colour and is known to posses multiple pharmacological effects. It is used in the treatment for a wide variety of inflammatory ailments, including obesity and other metabolic diseases. Curcumin is the principal curcuminoid of the popular Indian spice turmeric, which belongs to the family Zingiberaceae. The yellowish compound, curcumin, is known to possess multiple pharmacological effects [7]. Obesity comes with one of the major component and that is inflammation. The chronic and subclinical inflammation is recognized, as being a part in the development of diabetes, and obesity- related atherosclerosis. Adipose tissue is an important initiator of inflammatory response, and which is involved in energy regulation and homeostasis.

Mechanism of Action

Curcumin interacts directly with cyclooxygenase-2 (COX- 2), DNA polymerase, lipoxygenase (LOX), glycogen synthase kinase- 3b (GSK-3b), and cytokines (TNF-a). It interacts indirectly with several transcription factors, activator protein1 (AP-1), b-catenin, signal transducer and activator of transcription (STAT) proteins, and peroxisome proliferator - activated receptor c (PPARc) [8]. Adipose tissue is not simply a storage depot for excess calories but it also actively secretes fatty acids and a variety of polypeptides. The adipose tissue consists of adipocytes, immune cells and pre-adipocytes. They secrete leptin, adiponectin and other inflammatory cytokines such as TNF, interleukins 1, 6 [9]. These factors are critically involved in obesity-induced insulin resistance and chronic inflammation.

Safety and Efficacy

Various clinical trials (phase1 and phase 2) dealing with curcumin safety has shown that curcumin is safe and is well tolerated. Doses (500-1200mg/day) were administered in capsules form by patients and safety was assessed. Few developed adverse reactions such as diarrhea, headache, skin rashes and yellow stool. Curcumin has also been reported to inhibit the activity of drug metabolizing enzymes such as CYP-450, glutathione S- transferase, UDP -glucuronosyltransferase [10].

The major obstacle for the clinical development of curcumin is its poor absorption, rapid execration, and low systemic bioavailability which suggest that the therapeutic potential of oral curcumin is limited.

Lagenaria siceraria

Lagenaria siceraria also known as bottle gourd belonging to the family Curcurbitaceae is extensively grown in India and other tropical and sub tropical regions of the world. Bottle gourd has certain potent nutraceutical and therapeutic functions and they include phytoconstituents, minerals, vitamins, fibre etc. Certain parts of the plant is used to treat disorders such as headache, baldness etc. L. siceraria is reported to exhibit cardio protective, antihyperlipidemic, antioxidant, and antihyperglycemic, analgesic, anti-inflammatory, immnuomodulatory and hepatoprotective functions in humans [11]. Different varieties of L. Siceraria are known to exist; the sweet variety is generally used as vegetable and for the preparation of sweets and pickles, while the wild variety is preferred for medicinal use. Drinking one or two glasses of raw bottle gourd juice in the morning on an empty stomach is one particular practise in India to deal with obesity associated disorders. Table 1 enlists the Ethanopharmacological uses of Lagenaria siceraria