{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:13:00Z","timestamp":1787026380167,"version":"build-2736575974"},"reference-count":60,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,1,27]],"date-time":"2023-01-27T00:00:00Z","timestamp":1674777600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>It is known that obesity has a multifactorial etiology that involves genetic and environmental factors. The WHO estimates the worldwide prevalence of 1.9 billion overweight adults and more than 650 million people with obesity. These alarming data highlight the high and growing prevalence of obesity and represent a risk factor for the development and aggravation of other chronic diseases, such as nonalcoholic fatty liver disease (NAFLD) that is frequently considered the hepatic outcome of type 2 diabetes. The use of non-pharmacological therapies such as food supplements, nutraceuticals, and natural integrative therapies has grown as an alternative tool for obesity-related diseases compared to conventional medications. However, it is a still little explored research field and lacks scientific evidence of therapeutic effectiveness. Considering this, the aim is to evaluate whether a new nutraceutical supplement composition can improve and supply essential mineral nutrients, providing an improvement of obesity-related metabolic and endocrine parameters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Sedentary volunteers (women and men) with body mass index (BMI) \u226434.9 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      were divided into two groups: Novel Nutraceutical Supplement_(S) (n = 30) and Novel Nutraceutical Supplement (n = 29), differing in the absence (S) or presence of silymarin, respectively. Volunteers were instructed to take two capsules in the morning and two capsules in the evening. No nutritional intervention was performed during the study period. The data (anthropometrics and anamneses) and harvest blood (biochemistry and hormonal exams) were collected at three different time points: baseline time [day 0 (T0)], day 90 (T90), and day 180 (T180) post-supplementation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In the anthropometric analysis, the waist circumference in middle abdomen (WC-mid) and waist circumference in iliac crest (WC-IC) were reduced. Also, the waist-to-height ratio (WHt R) and waist-to-hip ratio (WHR) seem to slightly decrease alongside the supplementation period with both nutraceutical supplements tested as well as transaminase enzyme ratio [aspartate aminotransferase (AST)\/alanine aminotransferase (ALT) ratio (AAR)], a known as a biomarker of NAFLD, and endocrine hormones cortisol and thyroid-stimulating hormone (TSH) at 90 and 180 days post-supplementation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In a condition associated with sedentary and no nutritional intervention, the new nutraceutical supplement composition demonstrated the ability to be a strong and newfangled tool to improve important biomarkers associated with obesity and its comorbidities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2022.1089938","type":"journal-article","created":{"date-parts":[[2023,1,27]],"date-time":"2023-01-27T08:46:24Z","timestamp":1674809184000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":28,"title":["Novel nutraceutical supplements with yeast \u03b2-glucan, prebiotics, minerals, and Silybum marianum (silymarin) ameliorate obesity-related metabolic and clinical parameters: A double-blind randomized trial"],"prefix":"10.3389","volume":"13","author":[{"given":"Victor","family":"Nehmi-Filho","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aline Boveto","family":"Santamarina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00e9ssica Alves","family":"de Freitas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ericka Barbosa","family":"Trarbach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela Rodrigues","family":"de Oliveira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fanny","family":"Palace-Berl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica","family":"de Souza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle Araujo","family":"de Miranda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Escamilla-Garcia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Pinhata","family":"Otoch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Fl\u00e1via Mar\u00e7al","family":"Pessoa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,1,27]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1079\/PHN2003584","article-title":"A life course approach to diet, nutrition and the prevention of chronic diseases","volume":"7","author":"Darnton-Hill","year":"2007","journal-title":"Public Health Nutr"},{"key":"B2","article-title":"The power of cities: tackling noncommunicable diseases and road safety. Geneva: World Health Organization; 2019 (WHO\/NMH\/PND\/2019.9). Licence: CC BY-NC-SA 3.0 IGO","year":""},{"key":"B3","doi-asserted-by":"publisher","first-page":"S5","DOI":"10.1017\/S0007114511005460","article-title":"Dietary factors and low-grade inflammation in relation to overweight and obesity","volume":"106","author":"Calder","year":"2011","journal-title":"Br J Nutr"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.2147\/DMSO.S267952","article-title":"Increased metabolic burden among blacks: A putative mechanism for disparate covid-19 outcomes","volume":"13","author":"Jean-Louis","year":"2020","journal-title":"Diabetes Metab Syndr Obes Targets Ther"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.3390\/ijms222413424","article-title":"It is high time physicians thought of natural products for alleviating nafld","volume":"22","author":"Tarantino","year":"2021","journal-title":"Is there sufficient evidence to Use them? Int J Mol Sci"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3390\/ijms22084193","article-title":"Activation of insulin signaling by botanical products","volume":"22","author":"Rosenzweig","year":"2021","journal-title":"Int J Mol Sci"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.3390\/medicines6030094","article-title":"Functional foods and bioactive compounds: A review of its possible role on weight management and obesity\u2019s metabolic consequences","volume":"6","author":"Konstantinidi","year":"2019","journal-title":"Medicines"},{"key":"B8","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1016\/j.intimp.2016.02.005","article-title":"Modulation of toll-like receptor signaling in innate immunity by natural products","volume":"37","author":"Chen","year":"2016","journal-title":"Int Immunopharmacol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1016\/j.joim.2021.05.002","article-title":"A novel supplement with yeast \u03b2-glucan, prebiotic, minerals and silybum marianum synergistically modulates metabolic and inflammatory pathways and improves steatosis in obese mice","volume":"19","author":"Nehmi","year":"2021","journal-title":"J Integr Med"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3390\/antiox11030447","article-title":"The symbiotic effect of a new nutraceutical with yeast \u03b2-glucan, prebiotics, minerals, and silybum marianum (Silymarin) for recovering metabolic homeostasis via pgc-1\u03b1, il-6, and il-10 gene expression in a type-2 diabetes obesity model","volume":"11","author":"Santamarina","year":"2022","journal-title":"Antioxidants"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1111\/ijcp.12041","article-title":"Is the neck circumference an emergent predictor for inflammatory status in obese adults","volume":"67","author":"Jamar","year":"2013","journal-title":"Int J Clin Pract"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1590\/S0104-42302009000600015","article-title":"Raz\u00e3o cintura\/estatura comparado a outros indicadores antropom\u00e9tricos de obesidade como preditor de risco coronariano elevado","volume":"55","author":"Haun","year":"2009","journal-title":"Rev Assoc Med Bras"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1590\/S0066-782X2010005000073","article-title":"Associa\u00e7\u00e3o entre a raz\u00e3o cintura-estatura e hipertens\u00e3o e","volume":"95","author":"Rodrigues","year":"2010","journal-title":"Arq Bras Cardiol"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.3945\/jn.114.20610202","article-title":"Environmental, dietary, and behavioral factors distinguish Chinese adults with high waist-to-Height ratio with and without inflammation","volume":"145","author":"Thompson","year":"2015","journal-title":"J Nutr"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1007\/s10787-018-0458-0","article-title":"IL-6 signalling pathways and the development of type 2 diabetes","volume":"26","author":"Akbari","year":"2018","journal-title":"Inflammopharmacology"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.27.8.2057","article-title":"Approach to the pathogenesis and treatment of nonalcoholic steatohepatitis","volume":"27","author":"Medina","year":"2004","journal-title":"Diabetes Care"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-immunol-031210-101322","article-title":"Inflammatory mechanisms in obesity","volume":"29","author":"Gregor","year":"2011","journal-title":"Annu Rev Immunol"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1079\/BJN2003000968","article-title":"Effect of high-fat feeding on metabolic efficiency and mitochondrial oxidative capacity in adult rats","volume":"90","author":"Iossa","year":"2003","journal-title":"Br J Nutr"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.3390\/nu10040432","article-title":"Obesity, inflammation, toll-like receptor 4 and fatty acids","volume":"10","author":"Rogero","year":"2018","journal-title":"Nutrients"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1038\/nri1937","article-title":"Adipocytokines: Mediators linking adipose tissue, inflammation and immunity","volume":"6","author":"Tilg","year":"2006","journal-title":"Nat Rev Immunol"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.3390\/ijms12053117","article-title":"Inflammation, oxidative stress, and obesity","volume":"12","author":"Fern\u00e1ndez-S\u00e1nchez","year":"2011","journal-title":"Int J Mol Sci"},{"key":"B22","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3390\/nu12020334","article-title":"Defining a healthy diet: Evidence for the role of contemporary dietary patterns in health and disease","volume":"12","author":"Cena","year":"2020","journal-title":"Nutrients"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1007\/BF03180584","article-title":"Dietary fructooligosaccharides and potential benefits on health","volume":"65","author":"Sabater-Molina","year":"2009","journal-title":"J Physiol Biochem"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1111\/j.1541-4337.2010.00119.x","article-title":"Galacto-oligosaccharides: Production, properties, applications, and significance as prebiotics","volume":"9","author":"Torres","year":"2010","journal-title":"Compr Rev Food Sci Food Saf"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.3390\/nu8120792","article-title":"Exercise and beta-glucan consumption (Saccharomyces cerevisiae) improve the metabolic profile and reduce the atherogenic index in type 2 diabetic rats (HFD\/STZ)","volume":"8","author":"Andrade","year":"2016","journal-title":"Nutrients"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.3305\/nh.2015.32.1.9013","article-title":"Metabolic effects of \u03b2-glucans (Saccharomyces cerevisae) per os administration in rats with streptozotocin-induced diabetes","volume":"32","author":"Lobato","year":"2015","journal-title":"Nutr Hosp"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1111\/j.1753-4887.2010.00293.x","article-title":"Magnesium, inflammation, and obesity in chronic disease","volume":"68","author":"Nielsen","year":"2010","journal-title":"Nutr Rev"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1007\/s12011-013-9885-3","article-title":"Effect of zinc supplementation on inflammatory markers and adipokines in young obese women","volume":"157","author":"Kim","year":"2014","journal-title":"Biol Trace Elem Res"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)61452-9","article-title":"Selenium and human health","volume":"379","author":"Rayman","year":"2012","journal-title":"Lancet"},{"key":"B30","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1002\/ptr.6171","article-title":"Milk thistle (silybum marianum): A concise overview on its chemistry, pharmacological, and nutraceutical uses in liver diseases","volume":"32","author":"Izzo","year":"2018","journal-title":"Journal title: Phytotherapy Research"},{"key":"B31","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/s41598-017-10722-2","article-title":"Fructooligosaccharide (FOS) and galactooligosaccharide (GOS) increase bifidobacterium but reduce butyrate producing bacteria with adverse glycemic metabolism in healthy young population","volume":"7","author":"Liu","year":"2017","journal-title":"Sci Rep"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.2100107","article-title":"\u03b2-glucan induces distinct and protective innate immune memory in differentiated macrophages","volume":"207","author":"Stothers","year":"2021","journal-title":"J Immunol"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.3390\/nu10091203","article-title":"Selenium, selenoproteins, and immunity","volume":"10","author":"Avery","year":"2018","journal-title":"Nutrients"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1016\/j.aohep.2020.08.072","article-title":"Silymarin is an ally against insulin resistance: A review","volume":"23","author":"MacDonald-Ramos","year":"2021","journal-title":"Ann Hepatol"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(03)00239-3","article-title":"Silibinin protects mice from T cell-dependent liver injury","volume":"39","author":"Sch\u00fcmann","year":"2003","journal-title":"J Hepatol"},{"key":"B36","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3390\/ijms21197306","article-title":"The association between excess body mass and disturbances in somatic mineral levels","volume":"21","author":"Banach","year":"2020","journal-title":"Int J Mol Sci"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.3758\/BF03193146","article-title":"G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences","volume":"39","author":"Faul","year":"2007","journal-title":"Behav Res Methods"},{"key":"B38","doi-asserted-by":"publisher","first-page":"5","DOI":"10.12820\/rbafs.v.6n2p5-18","article-title":"Question\u00e1rio internacional de atividade f\u00edsica (Ipaq): Estupo de validade e reprodutibilidade no brasil","volume":"6","author":"Matsudo","year":"2012","journal-title":"Rev Bras Atividade F\u00edsica Sa\u00fade"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2010.09.006","article-title":"CONSORT 2010 statement: Updated guidelines for reporting parallel group randomized trials","volume":"4","author":"Schulz","year":"2010","journal-title":"Open Med"},{"key":"B40","article-title":"Serum gamma-glutamyltranspeptidase distinguishes non-alcoholic fatty liver disease at high risk","volume":"55","author":"Tahan","year":"2008","journal-title":"Hepatogastroenterology"},{"key":"B41","doi-asserted-by":"publisher","first-page":"e3843","DOI":"10.1097\/md.0000000000003843","article-title":"The AST\/ALT (De-ritis) ratio","volume":"95","author":"Rief","year":"2016","journal-title":"Med (Baltimore)"},{"key":"B42","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1177\/2048004016633371","article-title":"A clinical perspective of obesity, metabolic syndrome and cardiovascular disease","volume":"5","author":"Han","year":"2016","journal-title":"JRSM Cardiovasc Dis"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.1016\/j.pharmthera.2016.06.005","article-title":"Phytochemicals in regulating fatty acid \u03b2-oxidation: Potential underlying mechanisms and their involvement in obesity and weight loss","volume":"165","author":"Rupasinghe","year":"2016","journal-title":"Pharmacol Ther"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.1590\/S0102-86502012000300013","article-title":"Fructo-oligosaccharide effects on blood glucose. an overview [Efeitos dos fruto-oligossacar{\u00ed}deos no controle glic{\u00ea}mico. revis{\u00e3}o]","volume":"27","author":"Costa","year":"2012","journal-title":"Acta Cir Bras"},{"key":"B45","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1007\/s12602-016-9206-1","article-title":"Effect of prebiotic galacto-oligosaccharides on serum lipid profile of hypercholesterolemics","volume":"8","author":"Hashmi","year":"2016","journal-title":"Probiotics Antimicrob Proteins"},{"key":"B46","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2016.01.004","article-title":"Effects of a beverage rich in (poly)phenols on established and novel risk markers for vascular disease in medically uncomplicated overweight or obese subjects: A four week randomized trial","volume":"246","author":"Mullan","year":"2016","journal-title":"Atherosclerosis"},{"key":"B47","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/07315724.2016.1194236","article-title":"Short-term effects of green tea on blood pressure, endothelial function, and metabolic profile in obese prehypertensive women: A crossover randomized clinical trial","volume":"5724","author":"Nogueira L de","year":"2016","journal-title":"J Am Coll Nutr"},{"key":"B48","doi-asserted-by":"publisher","DOI":"10.1210\/en.2014-1880","article-title":"Diets containing alfa-linolenic (omega-3) or oleic (omega-9) fatty acids rescues obese mice from insulin resistance","volume":"156","author":"Oliveira","year":"2015","journal-title":"Endocrinology"},{"key":"B49","doi-asserted-by":"publisher","DOI":"10.1017\/S000711451100599X","article-title":"An extract of chokeberry attenuates weight gain and modulates insulin, adipogenic and inflammatory signalling pathways in epididymal adipose tissue of rats fed a fructose-rich diet","volume":"108","author":"Qin","year":"2012","journal-title":"Br J Nutr"},{"key":"B50","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2014\/403041","article-title":"Evaluation of beneficial metabolic effects of berries in high-fat fed C57BL\/6J mice","volume":"2014","author":"Heyman","year":"2014","journal-title":"J Nutr Metab"},{"key":"B51","doi-asserted-by":"publisher","DOI":"10.1017\/S0007114512005090","article-title":"Freeze-dried jaboticaba peel powder improves insulin sensitivity in high-fat-fed mice","volume":"110","author":"Dragano","year":"2013","journal-title":"Br J Nutr"},{"key":"B52","doi-asserted-by":"publisher","first-page":"44","DOI":"10.3945\/an.115.009639","article-title":"Red raspberries and their bioactive polyphenols: Cardiometabolic and neuronal health links","volume":"7","author":"Burton-Freeman","year":"2016","journal-title":"Adv Nutr Int Rev J"},{"key":"B53","volume-title":"Liver function tests","author":"Lala","year":"2022"},{"key":"B54","doi-asserted-by":"publisher","DOI":"10.1002\/mnfr.201600032","article-title":"Hypoglycemic activity of the baker\u2019s yeast \u03b2-glucan in obese\/type 2 diabetic mice and the underlying mechanism","volume":"60","author":"Cao","year":"2016","journal-title":"Mol Nutr Food Res"},{"key":"B55","doi-asserted-by":"publisher","DOI":"10.1016\/j.metabol.2021.154925","article-title":"Insights into the molecular targets and emerging pharmacotherapeutic interventions for nonalcoholic fatty liver disease","volume":"126","author":"Negi","year":"2022","journal-title":"Metabolism"},{"key":"B56","doi-asserted-by":"publisher","DOI":"10.1016\/j.lfs.2016.02.002","article-title":"Oxidative stress and metabolic disorders: Pathogenesis and therapeutic strategies","volume":"148","author":"Rani","year":"2016","journal-title":"Life Sci"},{"key":"B57","doi-asserted-by":"publisher","DOI":"10.1172\/JCI29069","article-title":"Inflammation and insulin resistance","volume":"116","author":"Shoelson","year":"2006","journal-title":"J Clin Invest"},{"key":"B58","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1007\/s11684-013-0262-6","article-title":"Mechanisms of insulin resistance in obesity","volume":"7","author":"Ye","year":"2013","journal-title":"Front Med"},{"key":"B59","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1017\/S0029665113001249","article-title":"Ectopic fat, insulin resistance and non-alcoholic fatty liver disease","volume":"72","author":"Byrne","year":"2013","journal-title":"Proc Nutr Soc"},{"key":"B60","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.27438","article-title":"A review of COVID-19 in relation to metabolic syndrome: Obesity, hypertension, diabetes, and dyslipidemia","volume":"14","author":"Makhoul","year":"2022","journal-title":"Cureus"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2022.1089938\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,27]],"date-time":"2023-01-27T08:46:29Z","timestamp":1674809189000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2022.1089938\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,27]]},"references-count":60,"alternative-id":["10.3389\/fendo.2022.1089938"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2022.1089938","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,27]]},"article-number":"1089938"}}