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Clinical research on berberine and French maritime pine bark extract
Perhaps it starts with realizing that belly bulge won’t go away. The next thing you know, your blood pressure reading is high during your annual checkup. Then, your doctor calls to talk about your cholesterol levels.
The health conditions associated with the umbrella term “metabolic syndrome” include excess belly fat, increased blood pressure, and elevated blood sugar and cholesterol levels. Whether we develop just one of these ailments, or a host of them, the condition tends to come on gradually as we age, and typically doesn’t resolve on its own. Metabolic syndrome increases the long-term risk of a cardiovascular disease and all-cause mortality, so it is important to address the problem at an early stage.[1]
Although much of the initial management focuses on a healthy diet and exercise regimen, certain supplements also may help tip the scales in our favor. In this article we will discuss two natural products: berberine and standardized pine bark extract.
Berberine: metabolic syndrome’s best friend
Berberine, an orangish-yellow compound found in several plants including Oregon grape (Mahonia aquifolium), goldenseal (Hydrastis canadensis), and barberry (Berberis vulgaris), is a botanical well recognized for its impact on metabolic function.[2] Interestingly, a major site of action of berberine is within the gastrointestinal tract.
Supplementation with berberine alters the gut microbial balance[3] and increases the abundance of Akkermansia muciniphila,[4] a beneficial microorganism linked to healthy body weight and a reduced risk of metabolic syndrome. On average, higher levels of A. muciniphila have been shown in athletes and individuals with a low body mass index (BMI), while lower levels of A. muciniphila have been observed in individuals with impaired glucose metabolism and obesity.[5],[6],[7]
Supplementation with berberine alters the gut microbial balance and increases the abundance of Akkermansia muciniphila, a beneficial microorganism linked to healthy body weight and a reduced risk of metabolic syndrome.
In addition, berberine helps reduce intestinal permeability (aka “leaky gut“) thereby decreasing the leakage of bacterial endotoxin into circulation.[8],[9] Endotoxin in circulation (endotoxemia) contributes to chronic inflammation and insulin resistance, and impairs detoxification pathways, liver, and gallbladder function.
Scientific studies suggest that berberine supplementation supports healthier glucose, cholesterol, and fat metabolism – each of these being challenges individuals with metabolic syndrome often face. Berberine has been evaluated in clinical studies of individuals with metabolic syndrome,[10] diabetes,[11] non-alcoholic fatty liver disease,[12] and mild hyperlipidemia.[13] The effects included reductions of waist circumference, body weight, systolic blood pressure, blood glucose, cholesterol (triglycerides, total cholesterol, and low-density lipoprotein (LDL) cholesterol), and improvements in other metabolic syndrome-related markers.
French maritime pine bark extract: a rich source of antioxidants
Standardized pine bark extract (SPBE), also known as maritime pine bark extract, is sourced from the French maritime pine (Pinus pinaster Aiton). SPBE is a rich source of proanthocyanidins and procyanidins, which serve as antioxidants and free radical scavengers in the body.[14] Excess free radicals contribute to the development of cardiovascular disease and the formation of atherosclerotic plaques, which may be improved by SPBE due to its antioxidant function.[15],[16]
Scientists have shown that SPBE promotes the development of brown adipose tissue, a type of fat that can boost metabolism and burn calories.
SPBE supplementation has been shown to help reduce blood pressure and improve blood vessel function in hypertensive subjects.[17],[18] In several studies, individuals who were supplemented with SPBE for three to four months experienced a reduction in total cholesterol and/or LDL cholesterol levels, while the protective high-density lipoprotein (HDL) levels were either unaffected or increased.[15],[19] In diabetics, the addition of SPBE to a standard treatment regimen further lowered plasma glucose levels within 12 weeks.[20]
In men and women with metabolic syndrome, SPBE supplementation was associated with a reduction in triglycerides, high blood pressure, and fasting blood glucose.[21] Moreover, both genders experienced a significant reduction in waist circumference (belly fat) over a six-month period. Scientists have shown that SPBE promotes the development of brown adipose tissue,[22] a type of fat that can boost metabolism and burn calories.[23]
SPBE has been shown to inhibit the formation of advanced glycation end products,[24] the sugar-carrying proteins or lipids in the blood that play a role in the development of diabetes-related complications such as eye, kidney, nerve, and cardiovascular disease.[25] Collectively, this helps protect all the organs of the body from oxidative damage leading to pathology downstream.
The antioxidant and peripheral blood vessel effects of SPBE also have been shown to support eye health and vision,[26],[27] kidney function,[28],[29],[30] healing of diabetic ulcers,[31] and nerve health,[32] with many of these benefits seen in clinical settings. Beyond this, the research on SPBE showing positive outcomes spans a broad array of conditions including arthritis,[33] cognitive health,[34] allergies and asthma,[35],[36] and even sexual function.[37]
Summary
Mechanistic and clinical studies suggest berberine and SPBE can help modulate cellular and gut pathways related to lipid and glucose metabolism and vascular health. Using these and other natural substances wisely can help protect the body from the many metabolic challenges it may face with age.
Click here to see References
[1] Mottillo S, et al. The metabolic syndrome and cardiovascular risk a systematic review and meta-analysis. J Am Coll Cardiol. 2010 Sep 28;56(14):1113-32.
[2] Lan J, et al. Meta-analysis of the effect and safety of berberine in the treatment of type 2 diabetes mellitus, hyperlipemia and hypertension. J Ethnopharmacol. 2015 Feb 23;161:69-81.
[3] Han J, Lin H, Huang W. Modulating gut microbiota as an anti-diabetic mechanism of berberine. Med Sci Monit 2011;17:RA164-167.
[4] Zhu L, et al. Berberine treatment increases Akkermansia in the gut and improves high-fat diet-induced atherosclerosis in Apoe-/- mice. Atherosclerosis. 2018 Jan;268:117-126.
[5] Clarke SF, et al. Exercise and associated dietary extremes impact on gut microbial diversity. Gut. 2014 Dec;63(12):1913-20.
[6] Dao MC, et al. Akkermansia muciniphila and improved metabolic health during a dietary intervention in obesity: relationship with gut microbiome richness and ecology. Gut. 2016 Mar;65(3):426-36.
[7] Escobar JS, et al. The gut microbiota of Colombians differs from that of Americans, Europeans and Asians. BMC Microbiol. 2014 Dec 14;14:311
[8] Li N, et al. Berberine attenuates pro-inflammatory cytokine-induced tight junction disruption in an in vitro model of intestinal epithelial cells. Eur J Pharm Sci. 2010 Apr 16;40(1):1-8.
[9] Gu L, et al. Berberine ameliorates intestinal epithelial tight-junction damage and down-regulates myosin light chain kinase pathways in a mouse model of endotoxinemia. J Infect Dis. 2011 Jun 1;203(11):1602-12.
[10] Pérez-Rubio KG, et al. Effect of berberine administration on metabolic syndrome, insulin sensitivity, and insulin secretion. Metab Syndr Relat Disord. 2013 Oct;11(5):366-9
[11] Yin J, Xing H, Ye J. Efficacy of berberine in patients with type 2 diabetes mellitus. Metabolism. 2008 May;57(5):712-7.
[12] Yan HM, et al. Efficacy of berberine in patients with non-alcoholic fatty liver disease. PLoS One. 2015 Aug 7;10(8):e0134172.
[13] Wang L, et al. [Therapeutic effects of berberine capsule on patients with mild hyperlipidemia]. Zhongguo Zhong Xi Yi Jie He Za Zhi. 2016 Jun;36(6):681-4.
[14] Devaraj S, et al. Supplementation with a pine bark extract rich in polyphenols increases plasma antioxidant capacity and alters the plasma lipoprotein profile. Lipids. 2002 Oct;37(10):931-4.
[15] Enseleit F, et al. Effects of Pycnogenol on endothelial function in patients with stable coronary artery disease: a double-blind, randomized, placebo-controlled, cross-over study. Eur Heart J. 2012 Jul;33(13):1589-97.
[16] Hu S, et al. Effects of Pycnogenol on endothelial dysfunction in borderline hypertensive, hyperlipidemic, and hyperglycemic individuals: the borderline study. Int Angiol. 2015 Feb;34(1):43-52.
[17] Hosseini S, et al. A randomized, double-blind, placebo-controlled, prospective, 16 week crossover study to determine the role of Pycnogenol in modifying blood pressure in mildly hypertensive patients. Nutr Res. 2001 Sep 1;21(9):1251-60.
[18] Cesarone MR, et al. Kidney flow and function in hypertension: protective effects of Pycnogenol in hypertensive participants–a controlled study. J Cardiovasc Pharmacol Ther. 2010 Mar;15(1):41-6.
[19] Koch R. Comparative study of Venostasin and Pycnogenol in chronic venous insufficiency. Phytother Res. 2002 Mar;16 Suppl 1:S1-5.
[20] Liu X, et al. Antidiabetic effect of Pycnogenol French maritime pine bark extract in patients with diabetes type II. Life Sci. 2004 Oct 8;75(21):2505-13.
[21] Belcaro G, et al. Pycnogenol® supplementation improves health risk factors in subjects with metabolic syndrome. Phytother Res. 2013 Oct;27(10):1572-8.
[22] Cong H, et al. Pycnogenol® induces browning of white adipose tissue through the PKA signaling pathway in apolipoprotein E-deficient mice. J Diabetes Res. 2018;2018.
[23] Cypess AM, Kahn CR. Brown fat as a therapy for obesity and diabetes. Curr Opin Endocrinol Diabetes Obes. 2010 Apr;17(2):143-9.
[24] Zhang TM, et al. Inhibitory effect of pycnogenol on generation of advanced glycation end products in vitro. Chinese Pharmacol Bull. 2003;19(4):437-40.
[25] Singh VP, et al. Advanced glycation end products and diabetic complications. Korean J Physiol Pharmacol. 2014 Feb;18(1):1-14.
[26] Steigerwalt R, et al. Pycnogenol® improves microcirculation, retinal edema, and visual acuity in early diabetic retinopathy. J Ocular Pharm Therap. 2009 Dec 1;25(6):537-40.
[27] Kamuren ZT, et al. Effects of low-carbohydrate diet and Pycnogenol® treatment on retinal antioxidant enzymes in normal and diabetic rats. J Ocu Pharma Therap. 2006 Feb 1;22(1):10-8.
[28] Kim YJ, et al. Pycnogenol modulates apoptosis by suppressing oxidative stress and inflammation in high glucose-treated renal tubular cells. Food Chem Toxicol. 2011 Sep 1;49(9):2196-201.
[29] Stuard S, et al. Kidney function in metabolic syndrome may be improved with Pycnogenol®. Panminerva Med. 2010 Jun;52(2 Suppl 1):27-32.
[30] Muchová J, et al. The effect of natural polyphenols on the oxidative stress markers in patients with diabetic nephropathy. Free Radic Biol Med. 2014 Oct;75 Suppl 1:S42.
[31] Belcaro G, et al. Diabetic ulcers: microcirculatory improvement and faster healing with pycnogenol. Clin Appl Thromb Hemost. 2006 Jul;12(3):318-23.
[32] Jankyova S, et al. Pycnogenol® efficiency on glycaemia, motor nerve conduction velocity and markers of oxidative stress in mild type diabetes in rats. Phytother Res. 2009 Aug 1;23(8):1169-74.
[33] Farid R, et al. Pycnogenol supplementation reduces pain and stiffness and improves physical function in adults with knee osteoarthritis. Nutrition Res. 2007 Nov 1;27(11):692-7.
[34] Belcaro G, et al. The COFU3 Study. Improvement in cognitive function, attention, mental performance with Pycnogenol® in healthy subjects (55-70) with high oxidative stress. J Neurosurg Sci. 2015 Dec;59(4):437-46.
[35] Wilson D, et al. A randomized, double‐blind, placebo‐controlled exploratory study to evaluate the potential of pycnogenol® for improving allergic rhinitis symptoms. Phytotherapy Res. 2010 Aug 1;24(8):1115-9.
[36] Hosseini S, et al. Pycnogenol® in the management of asthma. J Med Food 2001 Dec 1;4(4):201-9.
[37] D̆uračková Z, et al. Lipid metabolism and erectile function improvement by Pycnogenol®, extract from the bark of Pinus pinaster in patients suffering from erectile Dysfunction-a pilot study. Nutr Res. 2003 Sep 1;23(9):1189-98.
The information provided is for educational purposes only. Consult your physician or healthcare provider if you have specific questions before instituting any changes in your daily lifestyle including changes in diet, exercise, and supplement use.
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Dr. Carrie Decker
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