Collagen supplementation (CS) has emerged as a promising therapeutic approach with potential benefits for managing metabolic syndrome (MetS)-related risk factors. This narrative review integrates human evidence with preclinical mechanistic insights into the metabolic actions of collagen. Anti-obesity effects are attributed to increased satiety, gastric distension, GLP-1 secretion, and enhanced fatty acid oxidation mediated by PPAR-α activation and AMPK signalling. In type 2 diabetes, collagen improves glucose homeostasis by enhancing insulin sensitivity, upregulating GLUT-4, and inhibiting DPP-IV, thereby prolonging incretin activity (GLP-1, GIP) and supporting β-cell function. The antihypertensive effect of collagen peptides (CP) is primarily linked to angiotensin-converting enzyme (ACE) inhibition, which reduces angiotensin II levels while promoting bradykinin-mediated vasodilation and nitric oxide release. Additionally, CP has shown potential in improving lipid profiles by modulating PPAR-γ and AMPK, increasing HDL-C and reducing LDL-C and triglycerides. Emerging evidence also supports a role for collagen in restoring gut microbiota balance, increasing short-chain fatty acid production, and reducing pro-inflammatory and oxidative pathways, contributing to systemic metabolic regulation. Overall, these findings suggest CS exerts multi-targeted benefits on MetS components through modulation of endocrine, inflammatory, and metabolic pathways. Nevertheless, larger, long-term clinical trials are warranted to determine optimal dosing regimens, evaluate long-term efficacy, and further elucidate microbiota-mediated effects.

Hypertension (HTN) is the primary cause of preventable cardiovascular-related deaths globally, representing the most important modifiable risk factor for preventing such deaths. Nearly 700 million of the 1.3 billion adults with HTN worldwide remain untreated, most of whom live in low-and middle-income countries, including East Africa. Barriers to the diagnosis of HTN also impact treatment adherence after diagnosis and the initiation of treatment. This scoping review used a qualitative synthesis method to describe studies examining the cultural and contextual factors influencing HTN treatment adherence in East Africa and the lived experiences of patients with HTN to gain a better understanding of these factors in the region. A total of 34 studies, 25 qualitative and 9 mixed-methods designs from five East African nations were included in the final review. Reported influencing factors are classified into individual, structural, and social factors. Lack of HTN literacy and limited risk perception were often cited as individual barriers to adherence, along with mental health challenges, including fear of stigma, while trust and HTN literacy enhanced adherence. Inconsistent healthcare delivery, lack of access, and financial constraints were the most reported structural factors. Social norms surrounding health behaviours and attitudes towards HTN treatment were identified as key determinants of adherence at the social level. The findings underscore the complex interplay of individual, structural, and social factors associated with HTN treatment adherence in East Africa, offering practical ways to enhance adherence in the region at all three levels.

A significant association between tomato consumption and a lower risk of developing hypertension has been reported. In this study, we aimed to investigate the relationship between tomato intake and prehypertension risk among Korean adults. Hypertension was defined according to the criteria established by the Korean Society of Hypertension. The study participants were selected from the Health Examinees cohort study. Tomato consumption was measured using an FFQ and categorised into quintiles based on the amount consumed. Higher tomato consumption was associated with a lower risk of prehypertension in men (hazard ratio (HR) 0·86, 95 % CI 0·80, 0·92, Pfor trend 0·0005). Women in the highest quintile also showed a similar trend (HR 0·94, 95 % CI 0·90, 0·99, Pfor trend 0·0091). Stratified analyses revealed a reduced risk of prehypertension across all subgroups, except underweight individuals and those with a history of alcohol consumption (all Pfor interaction < 0·05). These findings indicate that higher tomato intake may offer potential advantages for managing blood pressure levels.

Although numerous clinical studies suggest that ginseng supplementation may benefit CVD risk factors, results remain inconclusive. This systematic review and meta-analysis evaluated the effects of ginseng supplementation on CVD-related risk factors. Relevant studies were identified through electronic searches in Embase, Web of Science, Scopus, PubMed and CENTRAL up to August 2024. Statistical analyses, including a random effects model, meta-regression and non-linear modelling, were used to assess heterogeneity, dose–response relationships and the overall effects of ginseng supplementation. A total of 70 studies, published between 1998 and 2024 and involving 4506 participants, were included. Ginseng supplementation significantly affected several biochemical markers, including high-sensitivity C-reactive protein (standardised mean difference (SMD): −0·23; 95 % CI: −0·38, −0·08; P = 0·002), gamma-glutamyl transferase (SMD: −0·20; 95 % CI: −0·36, −0·04; P = 0·015), glutathione reductase (SMD: 0·90; 95 % CI: 0·38, 1·42; P = 0·001), reactive oxygen species (SMD: −0·94; 95 % CI: −1·27, −0·60; P < 0·001) and superoxide dismutase (SMD: 0·48; 95 % CI: 0·10, 0·87; P = 0·014). Meta-regression analysis showed significant linear associations between ginseng dosage and Homeostatic Model Assessment for Insulin Resistance (P = 0·044) and between supplementation duration and malondialdehyde (P = 0·007). Dose–response analysis revealed significant associations between ginseng dose and fasting blood glucose (P < 0·001), high-sensitivity C-reactive protein (P = 0·043), IL-6 (P = 0·041), diastolic blood pressure (P = 0·022), IL-10 (P = 0·048), fasting insulin (P = 0·012) and total protein (P = 0·010). Supplementation duration was positively associated with malondialdehyde levels (P = 0·008). Ginseng supplementation was associated with improvements in inflammatory markers, liver function and oxidative stress parameters. No significant effects were observed on anthropometric indices, blood pressure, glycaemic profile, lipid profile, adipokines or heart rate.

Passive smoking is associated with an increased risk of hypertension in children. Antioxidant nutrients are known to alleviate oxidative stress, a key factor in the development of hypertension. Riboflavin, with its antioxidant properties, may help mitigate oxidative damage caused by passive smoke exposure. This study aimed to examine whether riboflavin intake could influence the relationship between passive smoking and hypertension in children and adolescents aged 6–19 years. Data were extracted from the 2007–2018 National Health and Nutrition Examination Survey. Weighted logistic regression models were used to identify potential covariates, and weighted multiple logistic regression models assessed the associations between passive smoking, riboflavin intake and hypertension. The association was also investigated in diverse age, gender and race subgroups. Results were presented as OR and 95 % CI. A total of 11 445 children and adolescents with a mean age of 12·89 (0·06) years were included. After adjusting covariates, cotinine ≥ 0·05 ng/ml was associated with increased odds of hypertension (OR = 1·20, 95 % CI: 1·06, 1·36). When individuals had a riboflavin intake < 1·87 mg, passive smoking (OR = 1·98, 95 % CI: 1·25, 3·13) and active smoking (OR = 1·69, 95 % CI: 1·14, 2·51) were both related to higher odds of hypertension. When individuals had a riboflavin intake ≥ 1·87 mg, no association was observed between passive smoking (OR = 0·83, 95 % CI: 0·48, 1·44) and active smoking (OR = 1·05, 95 % CI: 0·68, 1·62) and hypertension. Riboflavin intake may modulate the association between smoking status and hypertension in children and adolescents aged 6–19 years. The moderating effect was also found in age < 13 years old, ≥ 13 years old, males and non-Hispanic Whites.

Comorbidities, which are additional health conditions that occur alongside diabetes, can have a significant effect on blood sugar control. These conditions often complicate the management of diabetes and worsen overall health. Malnutrition, on the other hand, is a common concern for people with diabetes due to difficulties with food intake and metabolism. Proper nutrition is crucial for maintaining general health and effectively managing the disease. However, the extent of comorbidities and malnutrition within this group is not well understood in the study area. A cross-sectional study was conducted at Hawassa governmental hospitals between April and May 2023, involving 422 adult outpatients living with diabetes. The study aimed to evaluate their comorbidities, nutritional status, and associated factors. The required data were collected using structured and semi-structured questionnaires. Bivariate and multivariate logistic regression analyses were conducted using SPSS version 25.0. Undernutrition and concordant comorbidities were prevalent in the study population, occurring at rates of 15.2% and 57.8%, respectively. Additionally, 18.5% of participants were classified as overweight and obese with a BMI greater than 25 kg/m2. Three significant predictors of undernutrition among adult outpatients living with diabetes were identified: alcohol intake (P < 0.05), comorbidities (P < 0.01), and educational status (P < 0.05). Concordant comorbidity was notably common in these patients. It is recommended that the healthcare system consider comorbid conditions when managing diabetes. A longitudinal study is suggested to provide stronger evidence on these findings.

While the traditional Japanese diet has been suggested to increase blood pressure due to its high Na content, whether the contemporary Japanese diet is associated with blood pressure remains elusive. We developed a traditional Japanese diet score (nine items: white rice, miso soup, soy products, vegetables, mushrooms, seaweeds, fish, salty food and green tea) and a modified version by substituting white rice with whole-grain rice, reverse scoring for salty food and adding fruits, raw vegetables and dairy products using data from 12 213 employees from Japanese companies. Hypertension was defined as a blood pressure of 140/90 mmHg or more or the use of antihypertensive drugs. A multi-level Poisson regression model with a robust variance estimator was used to calculate prevalence ratios (PR) and 95 % CI while adjusting for covariates. The adjusted PR (95 % CI) of hypertension for the lowest through highest quartiles of the traditional Japanese diet score were 1·00 (reference), 0·94 (0·88, 1·02), 0·98 (0·90, 1·06) and 0·96 (0·90, 1·02), respectively (P for trend = 0·29), while those for the modified Japanese diet score were 1·00 (reference), 0·96 (0·94, 0·99), 0·95 (0·85, 1·05) and 0·94 (0·87, 1·01), respectively (P for trend = 0·10). In this cross-sectional study, close adherence to the traditional Japanese diet was not associated with the prevalence of hypertension, whereas there was a suggestion of an inverse association between the modified Japanese diet and the prevalence of hypertension.

We conducted a pilot study of implementing community health workers (CHWs) to assist patients with hypertension and social needs. As part of clinical care, patients identified as having an unmet need were referred to a CHW. We evaluated changes in blood pressure and needs among 35 patients and conducted interviews to understand participants’ experiences. Participants had a mean age of 54.1 years and 29 were Black. Twenty-six completed follow-up. Blood pressure and social needs improved from baseline to 6 months. Participants reported being accepting of CHWs, but also challenges with establishing a relationship with a CHW and being unclear about their role.

This study was designed to explore the mediating role of serum 25-hydroxyvitamin D (25(OH) D) in Triglyceride–glucose (TyG) index and hypertension (HTN). Study participants were selected from the 2001 to 2018 National Health and Nutrition Examination Survey. Firstly, we estimated the association between TyG index and serum 25(OH)D with HTN using a weighted multivariable logistic regression model and restricted cubic spline. Secondly, we used a generalised additive model to investigate the correlation between TyG index and serum 25(OH)D. Lastly, serum 25(OH)D was investigated as a mediator in the association between TyG index and HTN. There were 14 099 subjects in total. TyG index was positively and linearly associated with HTN risk, while serum 25(OH)D had a U-shaped relationship with the prevalence of HTN. When the serum 25(OH)D levels were lower than 57·464 mmol/l, the prevalence of HTN decreased with the increase of serum 25(OH)D levels. When serum 25(OH)D levels rise above 57·464 mmol/l, the risk of HTN increases rapidly. Based on the U-shaped curve, serum 25(OH)D concentrations were divided into two groups: < 57·464 and ≥57·464 mmol/l. According to the mediation analysis, when serum 25(OH)D levels reached < 57·464 mmol/l, the positive association between the TyG index and incident HTN was increased by 25(OH)D. When serum 25(OH)D levels reached ≥ 57·464 mmol/l, the negative association between the TyG index and incident HTN was increased by 25(OH)D. There was a mediation effect between the TyG index and HTN, which was mediated by 25(OH)D. Therefore, we found that the association between serum 25(OH)D levels and TyG index may influence the prevalence of HTN.