Background: Type 2 diabetes mellitus (T2DM) is commonly associated with hyperglycemia, dyslipidemia, oxidative stress and inflammation which are well known cardiovascular risk factors. Pomegranate peel polyphenols have a proven hypolipemic, antioxidant and anti-inflammatory activity. However, there is a lack of clinical studies that would confirm its antioxidant and anti-inflammatory effects in diabetic patients. The potential of pomegranate peel extract (PoPEx) to counteract inflammation and oxidative stress in T2DM patients was investigated. For this purpose, a randomized, double-blind placebo-controlled study involving adult T2DM patients treated with PoPEx or placebo for eight-weeks was conducted. Methods: Patients were randomly divided into two groups: the first group (n = 30) received capsules containing PoPEx 250 mg twice daily, while the placebo group (n = 30) received placebo capsules twice daily. Plasma concentration of inflammatory factors (interleukin 6 (IL-6), tumor necrosis factor α (TNF-α) and high sensitivity C reactive protein (hsCRP)), oxidative stress biomarkers (thiobarbituric acid reactive substances (TBARS), nitrites (NO2-), superoxide anion radical (O2-), hydrogen peroxide (H2O2), total antioxidant capacity (TAC)), homocysteine and lipid profile were analyzed. Results: The PoPEx treatment showed a significant reduction of inflammatory factors (IL-6, TNF-α, hsCRP), oxidative stress biomarkers (TBARS, NO2-, O2-) and homocysteine, while the TAC was increased. Moreover, a significant improvement in lipid profile was observed in the PoPEx group. Additional analysis showed a significant inverse correlation between the decrements of all measured inflammatory markers and TAC in the PoPEx group. Conclusions: The study demonstrated that eight-week-long PoPEx administration had favorable effects on inflammatory status and oxidative stress biomarkers in diabetic patients.

Body composition in childhood is not only a marker of the prevalence of obesity, but it can also be used to assess associated metabolic complications. Bioelectrical impedance analysis (BIA) shows promise as an easy to use, rapid, and non-invasive tool to evaluate body composition. The objectives of this study were to: (a) develop BIA prediction equations to estimate total body water (TBW) and fat-free mass (FFM) in European children and early adolescents and to validate the analysis with the deuterium dilution as the reference technique and (b) compare our results with previously published paediatric BIA equations. The cohort included 266 healthy children and adolescents between 7 and 14 years of age, 46% girls, in five European countries: Bosnia and Herzegovina, Latvia, Montenegro, North Macedonia, and Portugal. TBW and FFM were the target variables in the developed regression models. For model development, the dataset was randomly split into training and test sets, in 70:30 ratio, respectively. Model tuning was performed with 10-fold cross-validation that confirmed the unbiased estimate of its performance. The final regression models were retrained on the whole dataset. Cross-validated regression models were developed using resistance index, weight, and sex as the optimal predictors. The new prediction equations explained 87% variability in both TBW and FFM. Limits of agreement between BIA and reference values, were within ±17% of the mean, (-3.4, 3.7) and (-4.5, 4.8) kg for TBW and FFM, respectively. BIA FFM and TBW estimates were within one standard deviation for approximately 83% of the children. BIA prediction equations underestimated TBW and FFM by 0.2 kg and 0.1 kg respectively with no proportional bias and comparable accuracy among different BMI-for-age subgroups. Comparison with predictive equations from published studies revealed varying discrepancy rates with the deuterium dilution measurements, with only two being equivalent to the equations developed in this study. The small difference between deuterium dilution and BIA measurements validated by Bland-Altman analysis, supports the application of BIA for epidemiological studies in European children using the developed equations.

Background/Aim: Polyphenol compounds obtained from pomegranate have beneficial pharmacological activities in the treatment of diabetes mellitus type 2 (DMT2). Most of DMT2 patients are overweight or obese and obesity by itself is very much related to insulin resistance and abnormalities in insulin secretion. This clinical study aimed to evaluate the pomegranate peel extract (PoPEx) activity on anthropometric parameters and body composition of overweight patients with DMT2. Methods: Sixty patients with DMT2 on continuous metformin therapy were involved in this double-blind, placebo-controlled, randomised clinical trial. Patients from the study group (n=30) were treated with capsules containing PoPEx (250 mg) twice a day for 8-week period, while those ones from the placebo group (n=30) received placebo capsules for the same period. Anthropometric characteristics (body weight, waist circumference, fat mass percentage, visceral fat level) were measured at the beginning and at the end of the study. Results: Eight-week treatment with PoPEx resulted in significant changes in BMI (mean value ± standard deviation: 0.18 ± 0.30 kg/m2 ) and body mass (0.48 ± 0.93 kg). The intake of PoPEx produced a significant decrease in waist circumference (z = -4.613, p < 0.001, r = 0.60) indicating a large effect size using Cohen's d-test, and a non-significant decrease in the level of visceral fat. The results showed a non-significant reduction in fat mass percentage in PoPEx group (-0.58 ± 2.21 %, p = 0.159) compared with the placebo group (0.14 ± 1.24 %, p = 0.546). Conclusion: The eight-week supplementation with PoPEx had a beneficial effect on anthropometry and body composition of overweight diabetic patients.

Background: Fish is consumed as food worldwide and is considered as a rich source of essential nutrients required for a healthy life. Supplementation with fish oil has been adopted as a solution to prevent or cure many pathophysiological states and diseases by both the professionals and the civil population. The beneficial effects are, however, being questioned, as some controversial results were obtained in clinical and population studies. Methods: Critical evaluation of studies regarding known effects of fish oil, both in favour of its consumption and related controversies. Results: From the literature review, contradictory allegations about the positive action of the fish oil on human health emerged, so that a clear line about its beneficial effect cannot be withdrawn. Conclusion: Scientific results on the application of fish oil should be taken with caution as there is still no standardised approach in testing its effects and there are significantly different baselines in respect to nutritional and other lifestyle habits of different populations.