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Amidst the growing concern of antimicrobial resistance as a significant health challenge, research has emerged, focusing on elucidating the antimicrobial potential of polyphenol-rich extracts to reduce reliance on antibiotics. Previous studies explored the antifungal effects of extracts as potential alternatives to conventional therapeutic strategies. We aimed to assess the antibacterial and antifungal effects of standardised pomegranate extract (PE) and lemon extract (LE) using a range of Gram-negative and Gram-positive bacteria and two yeast species. Additionally, we assessed the antimicrobial activities of common antibiotics (Ciprofloxacin, Imipenem, Gentamicin, and Ceftazidime), either alone or in combination with extracts, against Staphylococcus aureus and Escherichia coli. PE displayed substantial antibacterial (primarily bactericidal) and antifungal effects against most pathogens, while LE exhibited antibacterial (mostly bacteriostatic) and antifungal properties to a lesser extent. When compared with antibiotics, PE showed a greater zone of inhibition (ZOI) than Ciprofloxacin and Ceftazidime (p < 0.01) and comparable ZOI to Gentamicin (p = 0.4) against Staphylococcus aureus. However, combinations of either PE or LE with antibiotics exhibited either neutral or antagonistic effects on antibiotic activity against Staphylococcus aureus and Escherichia coli. These findings contribute to the existing evidence regarding the antimicrobial effects of PE and LE. They add to the body of research suggesting that polyphenols exert both antagonistic and synergistic effects in antimicrobial activity. This highlights the importance of identifying optimal polyphenol concentrations that can enhance antibiotic activity and reduce antibiotic resistance. Further in vivo studies, starting with animal trials and progressing to human trials, may potentially lead to recommendation of these extracts for therapeutic use.

Polyphenols are widely known for their putative antioxidant and anti-inflammatory effects and their potential protective role in several diseases such as type 2 diabetes, cardiovascular disease and cancer. They have also attracted significant interest as ‘anti-obesity’ agents, although with mechanisms of action that have been exclusively demonstrated in animal and in vitro studies. This umbrella review aims to evaluate current evidence surrounding the role of polyphenols in obesity and weight management and to establish the usefulness of these agents in combatting obesity. A search of systematic reviews and meta-analyses of randomised controlled trials was carried out. Nine systematic reviews (of which eight included a meta-analysis) were included. Evidence of polyphenols' effects on reducing bodyweight is mixed, and where the effects are significant, they are numerically small and unlikely to be of help in reducing bodyweight or preventing weight gain. Future research should focus on establishing the anti-inflammatory and antioxidant effects of polyphenols through well-designed randomised controlled trials. Such research could be more valuable and cost-effective since it has shown potential to improve human health.

People from South Asian heritage are at high risk of type 2 diabetes, but there are limited specific strategies to prevent and manage this condition. The aim was to assess the effectiveness of culturally bespoke lifestyle programmes in South Asians that target weight loss for the prevention or remission of type 2 diabetes mellitus (T2DM). We performed a systematic review and meta-analysis of intervention trials. PubMed, Scopus, MEDLINE (EBSCOhost), CINAHL, PsycINFO and CENTRAL were searched. Human intervention trials (randomised controlled trials and quasi-experimental) investigating the effect of lifestyle interventions on the prevention and remission of T2DM in South Asians were included. Studies including participants at risk of T2DM (prevention trials) and having the disease (remission trials) with duration ≥12 weeks were eligible. For prevention trials, the primary outcome was change in weight (kg) from baseline; for remission trials, it was decrease in HbA1c to non-diabetic levels (HbA1c ≤ 6.5%) without diabetes medications. Prevention trials were separated into (i) lifestyle modification advice and (ii) lifestyle modification advice including a supervised physical activity programme. Twenty-four trials were eligible (21 prevention trials and 3 remission trials). In T2DM prevention trials involving only lifestyle modification advice, the mean postintervention difference in weight between intervention and control groups was -0.65 kg (95% confidence interval [CI]: -1.04, -0.26; p = 0.01). Lifestyle modification advice including a physical activity programme was associated with greater decreases in weight: -1.13 kg (95% CI: -2.04, -0.21; p = 0.02). Fasting blood glucose levels were slightly lower in intervention groups for both intervention subtypes, although there was no significant change in HbA1c levels or 2-h plasma glucose levels. Diabetes remission trials showed potential acceptability but were limited in number and involved a small sample size, and some di

BACKGROUND: People from South Asian heritage are at high risk of type 2 diabetes, but there are limited specific strategies to prevent and manage this condition. The aim was to assess the effectiveness of culturally bespoke lifestyle programmes in South Asians that target weight loss for the prevention or remission of type 2 diabetes mellitus (T2DM). METHODS: We performed a systematic review and meta-analysis of intervention trials. PubMed, Scopus, MEDLINE (EBSCOhost), CINAHL, PsycINFO and CENTRAL were searched. Human intervention trials (randomised controlled trials and quasi-experimental) investigating the effect of lifestyle interventions on the prevention and remission of T2DM in South Asians were included. Studies including participants at risk of T2DM (prevention trials) and having the disease (remission trials) with duration ≥12 weeks were eligible. For prevention trials, the primary outcome was change in weight (kg) from baseline; for remission trials, it was decrease in HbA1c to non-diabetic levels (HbA1c ≤ 6.5%) without diabetes medications. Prevention trials were separated into (i) lifestyle modification advice and (ii) lifestyle modification advice including a supervised physical activity programme. RESULTS: Twenty-four trials were eligible (21 prevention trials and 3 remission trials). In T2DM prevention trials involving only lifestyle modification advice, the mean postintervention difference in weight between intervention and control groups was -0.65 kg (95% confidence interval [CI]: -1.04, -0.26; p = 0.01). Lifestyle modification advice including a physical activity programme was associated with greater decreases in weight: -1.13 kg (95% CI: -2.04, -0.21; p = 0.02). Fasting blood glucose levels were slightly lower in intervention groups for both intervention subtypes, although there was no significant change in HbA1c levels or 2-h plasma glucose levels. Diabetes remission trials showed potential acceptability but were limited in number and involved a

Glycaemic control is the basis of type 2 diabetes mellitus (T2DM) management and is crucial for preventing diabetes microvascular and macrovascular complications. The South Asian population is at higher risk of T2DM and resultant cardiovascular disease, peripheral vascular disease and death compared to Caucasians. Effective diabetes care has been deemed challenging in this population, but little is known about the usefulness of lifestyle interventions in improving glycaemic control and reducing complications. This narrative review aims to explore the efficacy of lifestyle interventions targeted to South Asians with T2DM in inducing clinically relevant improvements in HbA1c levels at such levels that reduce the risk of diabetes complications. A search of the literature using six databases (MEDLINE (EBSCOhost), PubMed, CINAHL, PsycINFO, Cochrane Central Register of Controlled Trials and Scopus) identified dietary-based, physical-activity-based and education-based interventions that aimed to manage T2DM in South Asians. Results showed that dietary and physical activity interventions (duration 3-12 months) have been effective in generating a clinically relevant decrease in HbA1c levels (≥0.5%) in South Asians with T2DM and could potentially assist in reducing diabetes complications. Education-based interventions produced small effects on glycaemic control. These outcomes support the development of comparable longer-term randomised clinical trials combining dietary and physical activity interventions with the aim to provide further evidence on specific interventions that can lower complications and ensure effective diabetes care in a high-risk population.

The aim of the present study was to investigate whether ingestion of polyphenol-rich dark chocolate improved salivary cortisol levels and subjective mood states in adults recruited from a health and social care setting. Twenty-six participants ingested 25 g/day of a high polyphenol dark chocolate (containing 500 mg of total flavonoids) or a similar amount of a control dark chocolate containing negligible flavonoids for four weeks. Twenty-four-hour salivary glucocorticoid levels (cortisol and cortisone) were measured by an enzyme-linked immunosorbent assay, and subjective mood was assessed using a validated Positive Affect and Negative Affect Schedule. Total daily cortisol, morning cortisol, and the cortisol/cortisone ratio were significantly reduced (p < 0.001) after ingestion of only the high polyphenol dark chocolate. There were no significant differences between groups for overall scores for positive affect and negative affect. No changes were observed after the control dark chocolate, or any other parameter measured. In conclusion, the findings from this small-scale study indicate lowering of salivary cortisol levels following polyphenol-rich dark chocolate in adults recruited from a health and social care setting. Such changes may be attributable to their ability to inhibit 11β-hydroxysteroid dehydrogenase type 1 activity and warrant further investigation. Keywords: polyphenols; flavonoids; mood; stress; glucocorticoid; cortisol; Positive Affect and Negative Affect Schedule; dark chocolate