Garlic contains a sulfur compound known as allicin that is formed when garlic cloves are crushed, chewed, or chopped. Allicin is responsible for most of the health benefits you reap from garlic. If you already have high cholesterol, supplementing with garlic could reduce your LDL and total cholesterol by as much as 10 to 15 percent.

Incorporating more garlic into your diet can be easy! Try adding chopped cloves to sautéed greens such as broccoli, kale, and spinach.

Potatoes can be roasted with whole garlic cloves and then sprinkled with your favorite seasoning, and crushed or chopped garlic goes great with almost all Italian dishes.

From reducing blood pressure to lowering levels of bad cholesterol, the health advantages of adding more garlic to your diet can aid in the prevention of heart disease and heart-related conditions, such as a heart attack.

Native to India and Southeast Asia, turmeric is a bright yellow spice that has long been used for both medicinal purposes and flavoring food. Curcumin ingestion and exercise training improve vascular endothelial function in postmenopausal women. Nutr Res.

Panahi Y, Khalili N, Sahebi E, et al. Curcuminoids modify lipid profile in type 2 diabetes mellitus: A randomized controlled trial.

Complement Ther Med. Santos-Parker JR, Strahler TR, Bassett CJ, Bispham NZ, Chonchol MB, Seals DR. Curcumin supplementation improves vascular endothelial function in healthy middle-aged and older adults by increasing nitric oxide bioavailability and reducing oxidative stress.

Aging Albany NY. Mortezaee K, Salehi E, Mirtavoos-Mahyari H, et al. Mechanisms of apoptosis modulation by curcumin: Implications for cancer therapy. J Cell Physiol. Yu C, Yang B, Najafi M.

T argeting of cancer cell death mechanisms by curcumin: Implications to cancer therapy. Basic Clin Pharmacol Toxicol. Mansouri K, Rasoulpoor S, Daneshkhah A, et al. Clinical effects of curcumin in enhancing cancer therapy: A systematic review.

BMC Cancer. Pivari F, Mingione A, Brasacchio C, Soldati L. Curcumin and type 2 diabetes mellitus: prevention and treatment.

Marton LT, Pescinini-E-Salzedas LM, Camargo MEC, et al. The effects of curcumin on diabetes mellitus: a systematic review. Front Endocrinol Lausanne. Hewlings SJ, Kalman DS. Curcumin: a review of its effects on human health.

Bahramsoltani R, Rahimi R, Farzaei MH. Pharmacokinetic interactions of curcuminoids with conventional drugs: A review. J Ethnopharmacol. Filardi T, Varì R, Ferretti E, Zicari A, Morano S, Santangelo C. Curcumin: could this compound be useful in pregnancy and pregnancy-related complications?.

Zuniega, J. Extending the storage life of fresh turmeric Curcuma longa L. rhizomes through light and temperature manipulation. April , 44 1 : Spices, ground, turmeric. How does turmeric spice compare to curcumin turmeric extract in supplements? I sprinkle it on my foods and wonder if that's equivalent to taking a supplement.

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List of Partners vendors. Dietary Supplements. By Lindsay Curtis. Medically reviewed by Elizabeth Barnes, RDN. Table of Contents View All. Table of Contents. Health Benefits. Possible Side Effects.

Selection, Preparation, and Storage. Firestein Answers This Question and More. Sue I have A-fib and take Xarelto.

Is it safe for me to take turmeric? January 23rd, am. Lynda How much turmeric SHOUKD be taken daily? January 25th, pm.

Mercy Health Hi Lynda, thanks for reaching out. Whatever powder, supplement or tea you purchase will likely include a serving size recommendation. January 26th, am. Mercy Health Hi Sue, thanks so much for your question! We encourage you to talk with your primary care physician or cardiologist about any potential interactions between turmeric and your medication based on their evaluation of your unique medical factors.

Helen Kane I bought a big container Costco size! of turmeric after reading about its health benefits. But I have never cooked with it. Do you have any recipes or suggestions you can share so I can incorporate it into my diet?

Thank you. January 26th, pm. Mercy Health Hi, Helen! Golden milk lattes are a very popular recipe that include turmeric. Many people also enjoy turmeric in curries and stir-fry dishes. We recommend searching "popular turmeric recipes" to see what fits your diet best!

Janet Schnieders This is great information! My husband and I read the health benefits about this spice a while ago and have a shaker of turmeric on our table along with black pepper.

We use them to flavor our cooked vegetables! We also enjoy making dishes with this spice. March 28th, am.

Research shows that curcumin may help alleviate oxidative stress and reduce inflammation, lowering the risk of metabolic diseases. Curcumin may help people with type 2 diabetes manage the condition. Research shows that curcumin improves insulin sensitivity and glucose metabolism in people with type 2 diabetes.

It also helps lower cholesterol levels in people with the condition. This suggests that curcumin supplementation may help maintain healthy blood sugar levels and prevent type 2 diabetes complications such as heart disease.

Turmeric curcumin is generally considered safe in doses up to 4, to 8, milligrams mg a day. While curcumin is usually well-tolerated, some people may experience side effects such as:.

Curcumin may have potential interactions with certain medications, such as blood thinners, antidepressants, antibiotics, antihistamines, and medications used to treat heart disease and cancer.

Pregnant and breastfeeding people should avoid taking high doses of turmeric and curcumin supplements, as there is limited information on their safety for a developing fetus and growing baby. Talk to a healthcare provider before taking any new supplements to confirm they are safe and suitable for you.

Turmeric is a common spice often used in Indian and southeast Asian cuisines and dishes, such as curries, rice dishes, and marinades.

Found in many spice cabinets in homes around the world, turmeric can also be used to make tea , smoothies , or golden milk. When buying fresh turmeric, looking for fresh and whole roots free of cuts, bruises, or mold is best.

Fresh turmeric should be bright yellow or orange, and the roots should be firm and heavy. It can be stored in the refrigerator for up to two weeks or frozen for up to six months. When shopping for turmeric powder or supplements , look for an organic brand free of fillers or additives.

Dried turmeric powder should be stored in a cool, dry place away from light and moisture. You can also buy turmeric as a dietary supplement in capsule or tea form.

When selecting a turmeric supplement, look for a brand that uses a standardized curcumin extract, the most active turmeric compound. Check the label to ensure a third-party lab has tested the product for quality and purity.

While fresh turmeric may be more potent than supplements, it may be harder to find and less convenient since the yellow color can easily stain clothing and countertops. One teaspoon of dried turmeric powder contains:. Turmeric contains several micronutrients, including manganese, iron , vitamin B6, and potassium.

The nutritional value of turmeric varies based on its form. For example, fresh turmeric root has more nutritional value than dried turmeric powder. Turmeric supplements often contain dried turmeric powder, curcumin extract, or a combination.

Turmeric and its primary compound, curcumin, offer several health benefits. Thanks to its anti-inflammatory and antioxidant properties, turmeric may help reduce joint pain, boost cognitive function and mood, and support heart health.

Curcumin may also help protect against cancer and type 2 diabetes. To incorporate turmeric into your diet, add it to curries, soups, or smoothies, or take a turmeric supplement. As with any supplement, it is always best to consult your healthcare provider before taking turmeric.

National Center for Complementary and Integrative Health. Sharifi-Rad J, Rayess YE, Rizk AA, et al. Turmeric and its major compound curcumin on health: bioactive effects and safety profiles for food, pharmaceutical, biotechnological and medicinal applications.

Front Pharmacol. Daily JW, Yang M, Park S. Efficacy of turmeric extracts and curcumin for alleviating the symptoms of joint arthritis: a systematic review and meta-analysis of randomized clinical trials.

J Med Food. Calderón-Pérez L, Llauradó E, Companys J, et al. Acute effects of turmeric extracts on knee joint pain: a pilot, randomized controlled trial. Kotzaeroglou A, Tsamesidis I. The role of equilibrium between free radicals and antioxidants in depression and bipolar disorder.

Medicines Basel. Ionescu-Tucker A, Cotman CW. Emerging roles of oxidative stress in brain aging and Alzheimer's disease. Neurobiol Aging.

Fusar-Poli L, Vozza L, Gabbiadini A, et al. Curcumin for depression: a meta-analysis. Crit Rev Food Sci Nutr. Cox KHM, White DJ, Pipingas A, Poorun K, Scholey A. Further evidence of benefits to mood and working memory from lipidated curcumin in healthy older people: A week, double-blind, placebo-controlled, partial replication study.

Centers for Disease Control and Prevention. Heart disease facts. Li H, Sureda A, Devkota HP, et al. Curcumin, the golden spice in treating cardiovascular diseases. Pan et al.

evaluated a mouse model of obesity due to a high-fat diet and reported that ingestion of curcumin inhibited weight gain, reduced fat accretion due to a high-fat diet and significantly improved the serum lipid profile including serum levels of triglycerides, total cholesterol, LDL-cholesterol, HDL-cholesterol and free fatty acids.

Further, curcumin broke down lipids and improved glycolipid metabolism. Jazayeri-Tehrani et al. conducted a clinical trial involving 84 overweight or obese patients who were diagnosed with non-alcoholic steatohepatitis. There was also increased absorption efficiency in patients taking nanocurcumin compared to those taking placebo.

Nesfatin, an appetite-regulating protein, is significantly increased in patients taking nanocurcumin. When patients taking placebo were compared with those taking nanocurcumin, the two groups had a similar percentage decrease in BMI, but those taking nanocurcumin had a significantly greater percentage decrease in abdominal circumference.

In people with type 2 diabetes, trials have shown that curcumin decreased leptin and increased adiponectin in the blood and resulted in improved lipid metabolism.

Over the past few years, the role of inflammation has been recognised in the onset and progression of dementia. Research into the possible impact of curcumin on dementia is currently very limited.

However, Liu et al. found that curcumin significantly reduced spatial memory deficit and promoted the function of cholinergic neurons in mice; this improvement was associated with the inhibition of NF-kappaB signalling pathways and enhanced transcription by PPAR-gamma.

reported that highly absorbable curcumin reduced amyloid and tau accumulation in the brains of adults with no cognitive impairment and may consequently improve memory and attention. The anti-inflammatory effect of curcumin forms the basis for its potential clinical applications Figure 2.

A large body of clinical evidence is expected to accumulate in the future. Among trials registered at Clinicaltrials. gov, studies are related to the anti-inflammatory effect of curcumin.

Of these, 50 are currently on-going, 70 are complete and 42 have been withdrawn, have unknown status or have been terminated.

Of the 50 completed studies, the 10 randomised double-blind and placebo-controlled comparative studies are listed in Table 1. The results of eight of these studies were significant.

Curcumin has beneficial effects on the status of various diseases involving chronic inflammation. However, the absorption of curcumin is poor, and even if absorbed into the body it is rapidly metabolised and excreted in faeces.

These include polymer nanoparticles, chitosan nanoparticles, colloidal nanoparticles, nanoemulsion and ligand-targeted liposomes.

The beneficial effects of these drug delivery systems on curcumin bioavailability have been reported in streptozotocin-induced diabetic rats, a pulmonary fibrosis rat model, a dextran sulphate sodium-induced inflammatory bowel disease mouse model and a lipopolysaccharide-stimulated acute inflammation mouse model.

Moreover, Funamoto et al. reported that curcumin dispersed with colloidal nanoparticles Theracurmin ® suppressed an increase in alpha1-antitrypsin LDL levels in people with mild COPD. The Mechanisms of Curcumin Action on Inflammation.

A number of studies have reported the efficacy of curcurmin and the mechanisms by which its anti-inflammatory activity could treat various lifestyle-related conditions associated with chronic inflammation, including atherosclerosis, heart failure, obesity, diabetes and other related diseases, such as dementia.

Most of these studies have involved animal experiments; however, there are several reports on the benefits of curcumin use in humans.

Because curcumin has extremely low bioavailability in humans, an appropriate drug delivery system is necessary for its clinical application. It is important to study the relationship between the structure and activity of curcumin and to develop novel compounds that are more effective than natural curcumin.

Additional clinical trials involving drug delivery systems for curcumin in humans need to be conducted to determine the benefits of curcumin treatment in conditions associated with inflammation.

ICR 3. ECR is the official journal of the. About ECR. Editorial Board. For Authors. Special Collections. Submit Article. Kana Shimizu ,. Masafumi Funamoto ,. Yoichi Sunagawa ,. Satoshi Shimizu ,. Yasufumi Katanasaka ,. Yusuke Miyazaki ,.

Hiromichi Wada ,. Koji Hasegawa ,. Tatsuya Morimoto ,. Register or Login to View PDF Permissions Permissions × For commercial reprint enquiries please contact Springer Healthcare: ReprintsWarehouse springernature.

For permissions and non-commercial reprint enquiries, please visit Copyright. com to start a request. For author reprints, please email rob. barclay radcliffe-group.

Average ratings No ratings. Your rating Sign in to rate. Keywords Inflammation , curcumin , lifestyle-related diseases , cardiovascular risk factor , natural product ,.

Citation ×. Select format. ris Mendeley, Papers, Zotero. enw EndNote. bibtex BibTex. txt Medlars, RefWorks. Open Access: This work is open access under the CC-BY-NC 4. Curcumin and Atherosclerosis Risk factors for atherosclerosis, including hypertension, diabetes and smoking, cause a chronic inflammatory response.

Curcumin and Chronic Obstructive Pulmonary Disease COPD is a family of diseases mainly characterised by airflow obstruction due to airway inflammation and remodelling.

Drug Delivery Systems Curcumin has beneficial effects on the status of various diseases involving chronic inflammation. Conclusion A number of studies have reported the efficacy of curcurmin and the mechanisms by which its anti-inflammatory activity could treat various lifestyle-related conditions associated with chronic inflammation, including atherosclerosis, heart failure, obesity, diabetes and other related diseases, such as dementia.

Libby P. Inflammatory mechanisms: the molecular basis of inflammation and disease. Nutr Rev ;S­6. Crossref PubMed Cheresh P, Kim SJ, Tulasiram S, et al. Oxidative stress and pulmonary fibrosis. Biochim Biophys Acta ;— Crossref PubMed Frangogiannis NG. The extracellular matrix in myocardial injury, repair, and remodeling.

J Clin Invest ;— Crossref PubMed Xu XY, Meng X, Li S, et al. Bioactivity, health benefits, and related molecular mechanisms of curcumin: current progress, challenges, and perspectives. Nutrients ;pii:E Crossref PubMed Aggarwal BB, Vijayalekshmi RV, Sung B. Targeting inflammatory pathways for prevention and therapy of cancer: short-term friend, long-term foe.

Clin Cancer Res ;— Crossref PubMed Pahwa R, Jialal I. Chronic inflammation. StatPearls Nojiri S, Daida H. Atherosclerotic cardiovascular risk in Japan. Jpn Clin Med ; Crossref PubMed Frostegård J. Immunity, atherosclerosis and cardiovascular disease.

BMC Med ; Crossref PubMed Zhao TX, Mallat Z. Targeting the immune system in atherosclerosis: JACC state-of-the-art review. J Am Coll Cardiol ;— Crossref PubMed Hansson GK. Inflammation and atherosclerosis: the end of a controversy. Circulation ;—7.

Crossref PubMed Tsuda T. Curcumin as a functional food-derived factor: degradation products, metabolites, bioactivity, and future perspectives. Food Funct ;— Crossref PubMed Rauf A, Imran M, Erdogan-Orhan I, et al. Health perspective of a bioactive compound curcumin: a review. Trends Food Sci Technol ;— Crossref Liu X, Zhu L, Gao X, et al.

Magnetic molecularly imprinted polymers for spectrophotometric quantification of curcumin in food. Food Chem ;— Crossref PubMed Hewlings SJ, Kalman DS.

Curcumin: a review of its effects on human health. The numbered test meals, whose appearances were identical, were prepared according to the planned study participations and distributed to each study facility.

After obtaining approval from the patients and upon completion of the study enrolment, the investigator assigned the test meals to each patient according to the number described on the test foods.

If patients were receiving diuretics, inotropic agents digitalis, etc. Changes or new additions to the underlying therapeutic agents were not made during the administration of the study sample. The safety outcome was the onset of adverse events. Underlying disease: stable patients i.

Patients with cardiac hypertrophy and moderate LV diastolic dysfunction attributable to hypertension. Patients or legally acceptable representatives who provided informed consent.

Patients using an antiplatelet agent must undergo head magnetic resonance imaging within 5 years before providing informed consent because they may meet the exclusion criteria 3. Patients who used multiple antithrombotic drugs experienced gastrointestinal bleeding in a previous study that used this high-absorption curcumin agent; thus, the following exclusion criteria were set.

Patients who used two or more antiplatelet agents or concomitant use of one antiplatelet agent and antithrombotic drugs e. anticoagulants, EPA eicosapentaenoic acid agents, and prostacyclin agents. Patients with a history of cerebral haemorrhage including slight bleeding who used antiplatelet agents.

Patients with unstable angina, acute myocardial infarction, or severe coronary artery disease at the left main coronary trunk or three-vessel coronary artery disease.

This included patients who experienced acute myocardial infarction within 3 months before providing informed consent; patients with unstable angina, vasospastic angina, or angina at rest; patients who underwent coronary artery bypass graft or percutaneous coronary intervention within 3 months before providing informed consent; and patients who were scheduled to undergo the above procedure.

Patients with severe arrhythmia e. sustained ventricular tachycardia and ventricular fibrillation or bradycardia indicated for an implanted pacemaker and those with an implanted pacemaker. Patients with cardiomyopathy e. hypertrophic cardiomyopathy, dilated cardiomyopathy, or arrhythmogenic right ventricular cardiomyopathy or progressive myocarditis.

Patients with serious respiratory illnesses e. chronic obstructive pulmonary disease IV. Patients with severe renal dysfunction i. Patients who experienced cerebrovascular disease e.

cerebral bleeding, subarachnoid haemorrhage, or cerebral infarction within 3 months before providing informed consent. Diabetic patients with poor glycaemic control persistently high HbA1c despite treatment, i.

Lactating and pregnant women or women desiring to become pregnant within 6 months after providing informed consent. At the beginning of the formation of LV hypertrophy caused by hypertension, the systolic function is maintained, while the diastolic function is impaired.

Redfield et al. This study included patients with hypertensive cardiac hypertrophy who had LV hypertrophy and moderate LV diastolic dysfunction, although their systolic function was maintained. normal value , a representative index used for systolic function assessment. The onset of remarkable cardiac hypertrophy is rare at the beginning of LV hypertrophy.

Venous blood in a fasting state was collected from the cutaneous vein of the forearm by the investigator before, 12 weeks after, and 24 weeks after administration of the test meals. Specifically, the lower limit of the one-sided confidence interval CI; confidence coefficient: 0. The upper limit of the one-sided CI confidence coefficient: 0.

We estimated that we would need to enrol patients in the high-absorption curcumin group and placebo group to have 0. We then included patients patients in each group to account for the dropout rate. Comparing data between the two groups, parametric and non-parametric data were analysed using the non-paired t -test and Mann—Whitney U test, respectively.

Absolute values in each parameter at baseline and 6 months after initiating treatment were compared using the paired t -test for parametric data and Wilcoxon signed-rank test for non-parametric data. All statistical analyses were performed using SPSS version Patient enrolment for the study was concluded in March Even though the target patient sample size was not achieved, the study period was not extended.

This was a result of a delay in patient enrolment and limitations of the research grant. Of the patients enrolled, the following patients were excluded: six patients in the placebo group [withdrawal of consent five patients and discontinuation of treatment by themselves one patient ] and three patients in the high-absorption curcumin group [discontinuation of treatment by themselves two patients and deemed unfit as a subject by the primary physician one patient ].

Therefore, a total of patients were included in this study. During the follow-up period, 2 patients in the high-absorption curcumin group discontinued treatment because of adverse events; therefore, patients completed the follow-up period Figure 1.

Echocardiography data and plasma BNP levels were obtained 6 months after study entry, and analyses were performed. There were 69 patients in the placebo group [56 male and 13 female patients with a mean age of Table 1 shows the baseline patient characteristics of the two groups.

No differences in the following parameters were observed between the two groups: sex, age, body mass index BMI , systolic blood pressure, diastolic blood pressure, pulse, plasma BNP levels, echocardiography e.

left axis deviation, LV end-diastolic diameter, EF, IVS, and PWT , and Doppler echocardiography e. Baseline characteristics of the participants in the placebo and curcumin groups. BMI, body mass index; BNP, brain natriuretic peptide; COPD, chronic obstructive pulmonary disease; Cre, creatinine; DBP, diastolic blood pressure; DcT, deceleration time; EF, ejection fraction; IVS, interventricular septum; LAD, left axis deviation; LVDd, left ventricular end-diastolic diameter; PWT, posterior LV wall thickness; SBP, systolic blood pressure.

Table 2 shows the percentage change in each parameter from baseline to 6 months after treatment initiation in the two groups. The percentage change in systolic blood pressure was significantly lower in the high-absorption curcumin group than in the placebo group.

The percentage change in plasma BNP levels was significantly lower in the high-absorption curcumin group than in the placebo group. Abbreviations used in this table are the same as in Table 1.

After stratification, no significant difference was found in the per cent change in the plasma BNP levels between the placebo and high-absorption groups.

In addition, no significant difference was noted in the effects of increased absorption of curcumin between the two groups.

Per cent change in brain natriuretic peptide divided by baseline age in each group. Bold line indicates the median and lower and upper lines of the box indicate the lower and upper quartiles, respectively.

Per cent change in brain natriuretic peptide divided by baseline value in each group. Supplementary material online , Table S2 shows the baseline data for the placebo group and high-absorption curcumin groups after stratification.

The per cent changes in plasma BNP levels and systolic blood pressure were significantly lower in the high-absorption curcumin group than in the placebo group.

Two patients in the high-absorption curcumin group discontinued the treatment because of adverse events. Specifically, one patient was hospitalized due to epididymitis, but the patient had a history of this disease; thus, this adverse event was assessed as unrelated to the study meal.

The other patient discontinued treatment because of mild adverse events soft stools and heartburn. The relationship between these adverse events and study meal high-absorption curcumin was unknown.

However, this patient likely had diarrhoea as blood test results, including liver enzymes, renal function, and blood cells, were unremarkable. This study aimed to examine whether a high-absorption curcumin agent possesses preventable effects in addition to blood pressure control.

The percentage change in plasma BNP levels from baseline to 6 months after initiating treatment was significantly lower in the high-absorption curcumin group than in the placebo group. Blood pressure control is the first priority to prevent the future development of HFpEF in patients with hypertension.

The results of this study might provide a novel strategy in addition to blood pressure control for the prevention of HFpEF development in the future.

However, long-term studies are needed to examine this hypothesis. Brain natriuretic peptide is a hormone secreted primarily by the LV in response to increased cardiac wall stretching and stress.

Blood BNP levels increase sharply when a load is exerted on the LV. Due to these characteristics, BNP levels have been widely used as indicators for heart failure diagnosis.

This increase may be attributed to the presence of hypertensive cardiac hypertrophy and spontaneous increase with age. Curcumin has been reported to exhibit vasodilating effects through the following possible mechanisms: i inhibition of angiotensin-converting enzyme via nuclear factor-kappa B activation and ii nitric oxide production via endothelial nitric oxide synthase activation.

Therefore, the improvement in peripheral circulation by curcumin may be associated with the inhibition of an increase in BNP levels in patients with hypertension. Moreover, our previous study demonstrated that curcumin reduced phenylephrine-induced BNP mRNA levels in cultured cardiomyocyte hypertrophy.

We believe that the mechanism of curcumin-induced suppression of blood BNP levels in these patients may be associated with inhibition of BNP expression in the myocardium.

In addition to the suppression of myocardial pathological growth, curcumin possesses various bioactive effects, such as anti-inflammatory inhibiting nuclear factor-kappa B , anti-growth antagonizing platelet-derived growth factor , and antioxidant actions scavenging reactive oxygen species, inhibiting lipid peroxidation.

In fact, many patients with HFpEF have complications such as diabetes, hypertension, and obesity, which cause systemic inflammatory and oxidative stress. This study did not evaluate an inflammatory marker; however, previous studies that used the same high-absorption curcumin agent have shown that this drug reduces oxidized low-density lipoprotein.

It is well known that compliance of the heart and blood vessels decreases with aging. Once age-related phenomena such as calcification and fibrosis occur in the cardiovascular system, it is difficult to completely restore them with drug interventions.

This study is the first to examine the cardiac effects of high-absorption curcumin in a double-blind, randomized controlled trial. Currently, the precise mechanisms that explain the lack of curcumin-induced reduction in BNP levels in elderly patients are unclear.

Further studies are needed to clarify these mechanisms. Curcumin did not significantly affect the echocardiographic parameters.

Generally, changes in blood BNP levels are more sensitive to drug interventions compared with echocardiographic parameters. One patient in the high-absorption curcumin group developed mild adverse events soft stools and heart burn. A previous study using the same high-absorption curcumin agent reported the occurrence of soft stools.

Curcumin is a less soluble compound and this may be the cause of the soft stools. Further studies are required to evaluate the relationship between curcumin and soft stool. This study has some limitations. First, the sample size of this study was small, and the follow-up period was 6 months.

The endpoint was an examination index i. plasma BNP levels , not death or hospitalization due to heart failure. To examine whether a high-absorption curcumin agent prevents future onset of HFpEF in patients with hypertensive heart disease, a large and long-term study is needed.

Moreover, this study included patients exhibiting initial signs of hypertensive heart disease, which was diagnosed based on echocardiographic findings. Therefore, plasma BNP levels were normal or only minimally elevated in these patients.

Further studies are required to evaluate whether curcumin improves the prognosis of HFpEF patients. This effect was apparent in non-elderly individuals aged 65 years.

The P -values for the interactions and subgroups were not adjusted for multiple testing, and therefore, the reported age-based differences should be viewed as hypothesis-generating only. Further long-term studies are needed to clarify whether a high-absorption curcumin agent will prevent future HFpEF development in this patient population.

Koji Hasegawa, MD, PhD, is currently, Director at Division of Translational Research in National Hospital Organization NHO Kyoto Medical Center and Leader of NHO Cardiovascular Clinical Research Network. He is also serving as Clinical Professor, Faculty of Medicine, at Kyoto University as well as Visiting Professor at the University of Shizuoka.

He has been widely involved in the study of cardiology, covering areas ranging from prevention to intervention and from translational science to clinical medicine. Professor Koji Hasegawa is internationally active as an executive board director at the International Society of Cardiovascular Pharmacotherapy ISCP and a member of the Tobacco Expert Group at the World Heart Federation WHF.

The data that support the findings of this study are available from the corresponding author K. upon reasonable request.

In coxsackievirus B3-induced myocarditis, curcumin inhibited the phosphatidylinositol-3 kinase—Akt—NF-kappaB signalling pathway and inhibited the expression of inflammatory cytokines, such as TNF-alpha, IL-6 and IL-1beta, both systemically and in the myocardium; thus, reducing the inflammatory response.

evaluated a mouse model of myocarditis caused by the protozoan parasite Trypanosoma cruzi and reported that curcumin inhibited the expression of cyclooxygenase-2 and microsomal prostaglandin E synthase-1 in the myocardium as well as inhibiting inflammation in the myocardium and increased the survival rate of mice.

Curcumin inhibited the expression of TNF-alpha and IL-6 and increased the expression of IL-4 and IL in autoimmune acute myocarditis induced by cardiac myosin. Morimoto et al.

studied two rat models of heart failure caused by hypertension and MI and showed that curcumin inhibits p histone acetyltransferase activity, thus inhibiting the development of left ventricular hypertrophy and left ventricular systolic dysfunction. COPD is a family of diseases mainly characterised by airflow obstruction due to airway inflammation and remodelling.

Several clinical studies have demonstrated the relationship between COPD and an increase in inflammatory markers, such as TNF-alpha, IL-6 and CRP. The most common comorbidity in patients with mild-to-moderate COPD is cardiovascular disease. One study suggested that chronic inflammation due to COPD exacerbates atherosclerosis, both directly and indirectly, and promotes thrombosis by weakening plaque.

Several studies have demonstrated the possible benefits of curcumin in COPD. Moghaddam et al. used a mouse model of K-ras-induced lung cancer in which Haemophilus influenzae induced COPD-like airway inflammation and showed that curcumin inhibited neutrophil migration to the lungs.

studied a mouse model of COPD induced by lipopolysaccharide and cigarette smoke, reporting that curcumin inhibited the degradation of IkappaB-alpha protein and the expression of cyclooxygenase-2, thus reducing airway inflammation and remodelling.

conducted a clinical trial including patients with mild COPD in which the oxidised LDL — alphaantitrypsin LDL — was significantly decreased in those taking highly absorbable curcumin compared with those taking a placebo.

Adipose tissue is a multifunctional endocrine organ that releases various inflammatory and anti-inflammatory cytokines and physiologically active peptides.

In obese patients, the secretion of inflammatory adipocytokines, such as TNF-alpha and IL-6, is increased and the secretion of anti-inflammatory adipocytokines is inhibited in enlarged mast cells in the visceral adipose tissue.

Several rodent studies have assessed the effects of curcumin in models of obesity. In a mouse model of obesity due to a high-fat diet and in a model of genetic obesity, curcumin reduced macrophage invasion of adipose tissue, increased adiponectin production which has anti-inflammatory and anti-atherosclerotic actions and inhibited adipose tissue inflammation.

Pan et al. evaluated a mouse model of obesity due to a high-fat diet and reported that ingestion of curcumin inhibited weight gain, reduced fat accretion due to a high-fat diet and significantly improved the serum lipid profile including serum levels of triglycerides, total cholesterol, LDL-cholesterol, HDL-cholesterol and free fatty acids.

Further, curcumin broke down lipids and improved glycolipid metabolism. Jazayeri-Tehrani et al. conducted a clinical trial involving 84 overweight or obese patients who were diagnosed with non-alcoholic steatohepatitis.

There was also increased absorption efficiency in patients taking nanocurcumin compared to those taking placebo. Nesfatin, an appetite-regulating protein, is significantly increased in patients taking nanocurcumin. When patients taking placebo were compared with those taking nanocurcumin, the two groups had a similar percentage decrease in BMI, but those taking nanocurcumin had a significantly greater percentage decrease in abdominal circumference.

In people with type 2 diabetes, trials have shown that curcumin decreased leptin and increased adiponectin in the blood and resulted in improved lipid metabolism. Over the past few years, the role of inflammation has been recognised in the onset and progression of dementia.

Research into the possible impact of curcumin on dementia is currently very limited. However, Liu et al. found that curcumin significantly reduced spatial memory deficit and promoted the function of cholinergic neurons in mice; this improvement was associated with the inhibition of NF-kappaB signalling pathways and enhanced transcription by PPAR-gamma.

reported that highly absorbable curcumin reduced amyloid and tau accumulation in the brains of adults with no cognitive impairment and may consequently improve memory and attention. The anti-inflammatory effect of curcumin forms the basis for its potential clinical applications Figure 2.

A large body of clinical evidence is expected to accumulate in the future. Among trials registered at Clinicaltrials. gov, studies are related to the anti-inflammatory effect of curcumin. Of these, 50 are currently on-going, 70 are complete and 42 have been withdrawn, have unknown status or have been terminated.

Of the 50 completed studies, the 10 randomised double-blind and placebo-controlled comparative studies are listed in Table 1. The results of eight of these studies were significant.

Curcumin has beneficial effects on the status of various diseases involving chronic inflammation. However, the absorption of curcumin is poor, and even if absorbed into the body it is rapidly metabolised and excreted in faeces. These include polymer nanoparticles, chitosan nanoparticles, colloidal nanoparticles, nanoemulsion and ligand-targeted liposomes.

The beneficial effects of these drug delivery systems on curcumin bioavailability have been reported in streptozotocin-induced diabetic rats, a pulmonary fibrosis rat model, a dextran sulphate sodium-induced inflammatory bowel disease mouse model and a lipopolysaccharide-stimulated acute inflammation mouse model.

Moreover, Funamoto et al. reported that curcumin dispersed with colloidal nanoparticles Theracurmin ® suppressed an increase in alpha1-antitrypsin LDL levels in people with mild COPD. The Mechanisms of Curcumin Action on Inflammation.

A number of studies have reported the efficacy of curcurmin and the mechanisms by which its anti-inflammatory activity could treat various lifestyle-related conditions associated with chronic inflammation, including atherosclerosis, heart failure, obesity, diabetes and other related diseases, such as dementia.

Most of these studies have involved animal experiments; however, there are several reports on the benefits of curcumin use in humans. Because curcumin has extremely low bioavailability in humans, an appropriate drug delivery system is necessary for its clinical application.

It is important to study the relationship between the structure and activity of curcumin and to develop novel compounds that are more effective than natural curcumin. Additional clinical trials involving drug delivery systems for curcumin in humans need to be conducted to determine the benefits of curcumin treatment in conditions associated with inflammation.

ICR 3. ECR is the official journal of the. About ECR. Editorial Board. For Authors. Special Collections. Submit Article. Kana Shimizu ,. Masafumi Funamoto ,. Yoichi Sunagawa ,.

Satoshi Shimizu ,. Yasufumi Katanasaka ,. Yusuke Miyazaki ,. Hiromichi Wada ,. Koji Hasegawa ,. Tatsuya Morimoto ,. Register or Login to View PDF Permissions Permissions × For commercial reprint enquiries please contact Springer Healthcare: ReprintsWarehouse springernature.

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Keywords Inflammation , curcumin , lifestyle-related diseases , cardiovascular risk factor , natural product ,. Citation ×. Select format. ris Mendeley, Papers, Zotero. enw EndNote. bibtex BibTex. txt Medlars, RefWorks. Open Access: This work is open access under the CC-BY-NC 4.

Curcumin and Atherosclerosis Risk factors for atherosclerosis, including hypertension, diabetes and smoking, cause a chronic inflammatory response.

Curcumin and Chronic Obstructive Pulmonary Disease COPD is a family of diseases mainly characterised by airflow obstruction due to airway inflammation and remodelling. Drug Delivery Systems Curcumin has beneficial effects on the status of various diseases involving chronic inflammation.

Conclusion A number of studies have reported the efficacy of curcurmin and the mechanisms by which its anti-inflammatory activity could treat various lifestyle-related conditions associated with chronic inflammation, including atherosclerosis, heart failure, obesity, diabetes and other related diseases, such as dementia.

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Bioactivity, health benefits, and related molecular mechanisms of curcumin: current progress, challenges, and perspectives. Nutrients ;pii:E Crossref PubMed Aggarwal BB, Vijayalekshmi RV, Sung B. Targeting inflammatory pathways for prevention and therapy of cancer: short-term friend, long-term foe.

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Shock ;— Crossref PubMed Feldman AM, McNamara D. N Engl J Med ;— Thus, we conducted a meta-analysis of published clinical trials to assess the efficacy and safety of turmeric and cucumin in lowering lipid levels in patients with risk factors for CVD. An online search was carried out for clinical studies published in English language in the following electronic databases: PubMed, Embase, Ovid, Medline and Cochrane Library.

All studies published as of November were eligible for inclusion. Medical Subject Heading MeSH terms were used for PubMed, and comparable terms were used for other databases.

In addition, we used various synonyms. Primary outcome measures included serum levels of LDL-C, high-density lipoprotein cholesterol HDL-C , TG, and total cholesterol TC. Treatment safety, measured by adverse effects due to turmeric and curcumin, was defined as a secondary outcome.

Two independent investigators SQ and LFH screened the titles and abstracts of articles initially retrieved on online search of databases, and extracted essential data from eligible full-text articles. Data on study design, patient characteristics, number of patients, treatment regimen, duration of treatment, year of publication, and daily dose of curcumin or turmeric powder were extracted, as were the mean ± SD or mean ± SE of all efficacy measures specified earlier.

To control relative heterogeneity, only data of efficacy measures pertaining to the study period between 4 weeks and 3 months were extracted. For studies with missing data, authors were sent emails requesting details of these data.

Risk of bias was assessed independently by 2 reviewers SQ and LFH using the Cochrane Handbook for Systematic Reviews of Interventions [ 30 ]. This tool allows for assessment of the study quality with respect to 6 domains: random sequence generation, allocation concealment, blinding, incomplete outcome data, selective reporting, and other bias.

For each domain, the risk of bias was marked as low, unclear, or high. The meta-analysis was conducted by using Stata version In this analysis, only continuous variables were extracted. With use of relevant formulae [ 32 ], these values were also calculated from medians and ranges.

Statistical heterogeneity between trials was detected by the Chi-squared and I -square I 2 tests. Subgroup analyses were conducted to explore heterogeneity among studies with respect to underlying disease and form of intervention turmeric or curcumin used.

As only a single study had reported efficacy measures disaggregated by gender [ 27 ], subgroup analyses by gender could not be undertaken. Of the articles retrieved on initial literature search, a detailed evaluation of 11 full-text articles resulted in the elimination of 2 studies [ 33 , 34 ], due to the use of the same patient groups, and another 2 studies [ 35 , 36 ], owing to incomplete data Fig.

Consequently, 7 randomized controlled trials RCTs , including a total of subjects, met the inclusion criteria and were selected for a qualitative analysis.

Basic characteristics of the included RCTs are summarized in Table 1 , and the pre- and post-intervention serum lipid parameters are presented in Additional file 1 : Table S1. Of the 7 eligible studies, only studies that enrolled patients with T2DM [ 15 , 24 , 25 , 28 ] or MetS [ 23 , 26 , 27 ] were included.

All studies were conducted in a double-blind manner with the exception of the trials by Selvi et al. Two of the studies were performed in Iran [ 23 , 24 ] and 2 [ 15 , 25 ] were conducted in India. The remaining studies were conducted in Pakistan [ 26 ], Taiwan [ 27 ], and Thailand [ 28 ], respectively.

The duration of these studies ranged from 4 weeks to 6 months. Specified outcomes were reported from all studies, with the exception of the study by Chuengsamarn et al. The form of intervention and serum lipid parameters of studies at baseline and after intervention differed.

The risk of bias in the individual studies is shown in Additional file 2 : Table S2. Overall, these selected studies varied in terms of quality: of the 7 RCTs, 4 were classified as high quality [ 24 , 26 , 27 , 28 ] and 3 were judged to be of moderate quality [ 15 , 23 , 25 ].

Four studies used appropriate randomization methods, such as a random number table [ 25 , 27 ] or a computer-generated list of random numbers [ 24 , 28 ]. Allocation concealment was only used in 4 studies [ 23 , 25 , 26 , 28 ].

Five trials used double-blinding of patients and practitioners [ 23 , 24 , 26 , 27 , 28 ]. All studies reported dropout rates and specific reasons for dropout with the exception of the trial by Chuengsamarn et al. Forest plot of the meta-analysis for comparison of plasma LDL-C concentrations between experimental and control groups.

Forest plot of the meta-analysis for comparison of plasma HDL-C concentrations between experimental and control groups. Forest plot of the meta-analysis for comparison of plasma TG concentrations between experimental and control groups.

Forest plot of the meta-analysis for comparison of plasma TC concentrations between experimental and control groups. To assess sources of potential bias, we conducted subgroup analyses by underlying diseases and forms of intervention—namely, studies in patients with hyperglycemia pre-diabetes and T2DM and MetS Table 2.

Five RCTs reported adverse effects in both the control and experimental groups. Rahmani et al. Amin et al. Chuengsamarn et al. Moreover, 4 patients experienced side effects in the placebo group: vertigo and itching, constipation, and hot flashes in 1 patient each.

Selvi et al. None of the remaining studies reported any adverse reactions of turmeric and curcumin therapy. No serious adverse reaction induced by turmeric and curcumin was reported in any of the studies included in this meta-analysis. The epidemic of obesity has contributed to a growing burden of CVD risk factors such as T2DM and MetS [ 37 ] defined as the presence of at least 3 out of the 4 criteria: central obesity, increased blood pressure, high blood sugar levels, and dyslipidemia [ 38 ].

Dyslipidemia is a well-established modifiable cardiovascular risk factor. All of the currently available antilipemic therapies have their own inherent shortcomings and disadvantages. Therefore, natural treatments have been investigated as potential therapies for lowering blood lipid levels.

This systematic review of 7 randomized trials of turmeric and curcumin in patients at risk of CVD identified evidence of their beneficial effects on serum TG and LDL-C levels, although no significant difference was found with respect to serum HDL levels. When the analysis was restricted to more homogenous studies based on underlying disease in subjects hyperglycemia and MetS , a beneficial effect of turmeric and curcumin on serum TC levels was observed in subjects with MetS; however, in subjects with hyperglycemia, this beneficial effect on serum TC levels was not observed.

It seems that the natural form turmeric and curcumin have more positive effects on patients suffering from MetS. With regard to the forms of intervention, turmeric extract may have a greater beneficial effect on serum TC levels, as compared to that of turmeric in its natural form. However, owing to the limited number of studies, definitive conclusions may not be drawn in this respect.

Furthermore, larger scale trials are required among patients with MetS to explore the effect of turmeric extract, even in novel forms, in lowering plasma TC concentrations. Sahebkar conducted a meta-analysis of 5 RCTs to assess the effects of curcumin on blood lipid levels and found no significant improvements in the lipid profile in any aspect [ 22 ].

Several explanations could be tendered to explain why the results of their study were contrary to those of the present study.

Firstly, both parallel and crossover randomized trials were selected, and these may have adversely influenced the final results. Secondly, most of the selected studies were conducted with unformulated curcumin, which is considered to have low bioavailability.

Curcumin has poor bioavailability owing to its poor absorption, fast metabolism, and rapid elimination from the body. Some attempts have been made to overcome these deficits, including the use of a piperine black pepper adjuvant, liposomal curcumin, nanoparticles, phospholipid complexes, and an amorphous form [ 39 , 40 ].

Therefore, a hypothesis could be proposed that these novel dosage forms of curcumin may achieve greater clinical effects.

To verify this theory, forest plots were conducted initially. Nevertheless, in our present review, only two trials [ 23 , 24 ] used novel forms, and the preparations used in these studies were dissimilar amorphous forms were used in one study [ 23 ] and nanoparticles were used in the other [ 24 ].

Therefore, further research on newer dosage forms of curcumin is required to confirm the hypothesis. Finally, differences with respect to underlying diseases in the study population may also explain this discrepancy. The authors included healthy participants and patients with various chronic diseases i.

Even on performing a subgroup analysis in patients with high cardiovascular risk acute coronary syndrome, T2DM, or concomitant dyslipidemia and obesity , no significant difference could be identified because coronary artery disease is an end event rather than a risk factor for CVD.

The article by Mohammadi et al. Unlike this study, in a trial among patients with coronary artery disease, although curcumin supplementation decreased serum levels of TC, LDL-C, and TG, there was no obvious difference when compared to placebo [ 41 ], possibly due to the small size of the study.

Subsequently, a study by Soare et al. found that mg of curcumin did not influence plasma lipid levels in non-obese relatively healthy individuals [ 42 ]. Therefore, we tentatively propose that the antilipemic effect of curcumin is evident only in patients who are at a higher risk of cardiovascular morbidity, such as those with MetS, T2DM, and obesity.

Some molecular mechanisms could potentially explain these results. Insulin resistance IR is the basic underlying pathology in both T2DM and MetS. Neerati et al. reported that curcumin could counter IR [ 43 ]. Through amelioration of metabolic derangement and potential binding of curcumin with peroxisome proliferator-activated receptor gamma PPAR-γ as agonist, curcumin could play a preventive role in diet-induced insulin resistance [ 44 ].

Moreover, curcumin was shown to increase activation of PPAR-γ [ 45 ], which suppressed expression of the LDL-C receptor gene, and could thereby reduce plasma LDL-C concentrations [ 46 ]. Because it interacts with multiple targets, including peroxisome proliferator-activated receptor alpha PPAR-α , PPAR-γ, cholesteryl ester transfer protein CETP , and lipoprotein lipase, curcumin could probably play a role in reduction of triglyceride levels [ 47 , 48 , 49 ].

Furthermore, curcumin is expected to affect both synthesis and catabolism of triglyceride-rich lipoproteins [ 47 , 48 , 49 ].

Thus, curcumin supplementation may lower plasma triglycerides and cholesterol concentrations by mitigating the expressions of lipogenic genes [ 48 , 49 , 50 ]. Additionally, the lipid-lowering effect of turmeric and curcumin is related to statins. Panahi et al. found that curcumin affected all pathways of cholesterol metabolism that are affected by statin therapy; it also reduced the effective doses of statins, which helped reduce the incidence of serious adverse reactions [ 51 ].

Furthermore, curcumin might serve as a valuable adjunct to statin therapy in patients with disordered lipid metabolism [ 51 ]. In our meta-analysis, we found that consumption of turmeric and curcumin was safe and well-tolerated in general.

Several potential limitations of this review need mention. First, the most important limitation may pertain to the interpretability of outcomes. Third, all subjects in the included studies were Asians. Lastly, some data were obtained indirectly, and those could have affected the accuracy of both the overall effects and the results of subgroup analyses.

Subjects who received turmeric and curcumin experienced a natural cardioprotective effect, with lowering of serum LDL-C and TG levels, as compared to subjects who did not. The efficacy of turmeric and curcumin on serum TC levels remains inconclusive, despite their superior efficacy observed in patients with MetS.

A greater effect of turmeric extract in reducing serum TC levels may be observed in patients who are at risk of CVD; however, this finding needs to be confirmed in future studies. No significant change in serum HDL levels was observed. Due to uncertainties related to dosage form, dose and medication frequency, it is premature to recommend the use of turmeric or curcumin in clinical settings.

Nonetheless, the analysis does provide a synthesis of the currently available evidence and supports larger scale clinical trials of curcumin.

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