{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T17:04:17Z","timestamp":1790183057443,"version":"4.1.0"},"reference-count":48,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background\/Objectives: Overweight and obesity are major drivers of cardiometabolic dysfunction and increase the risk of type 2 diabetes (T2DM)and cardiovascular disease. Although lifestyle intervention remains the cornerstone of treatment, complementary strategies may provide additional benefits. The effects of Glucoerb\u00ae and Epavin\u00ae, administered individually or in combination, on cardiometabolic health in adults with overweight or obesity remain poorly characterized. Methods: In this prospective real-world study, 150 adults received Glucoerb\u00ae (n = 50), Epavin\u00ae (n = 50), or their combination (n = 50), alongside individualized nutritional counselling based on a moderately carbohydrate-restricted Mediterranean diet and standardized physical activity recommendations. Anthropometric, body composition, biochemical, and vascular parameters were assessed at baseline and after 3 months. Results: All groups showed significant improvements in body weight, body mass index (BMI), waist circumference, and fat mass (FM) (all p &lt; 0.001). Glucoerb\u00ae supplementation was associated with a significant reduction in HOMA-IR (\u221221%), whereas Epavin\u00ae supplementation improved the lipid profile (total cholesterol \u221213%, triglycerides\u221213%, LDL cholesterol \u221217%, HDL cholesterol +6%). Fatty Liver Index decreased across all groups (Glucoerb\u00ae \u221214%, Epavin\u00ae \u221219%, combination \u221217%). Combined supplementation was associated with reductions in body weight (\u22126%) and HOMA-IR (\u221232%), while endothelial function improved (+19%, p = 0.017). Conclusions: These findings support further investigation of complementary multi-target plant-based strategies for cardiometabolic risk management.<\/jats:p>","DOI":"10.3390\/jcm15197404","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T16:10:31Z","timestamp":1790179831000},"page":"7404","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effects of Glucoerb\u00ae and Epavin\u00ae on Cardiometabolic Profile in Adults with Overweight or Obesity: A Three-Month Real-World Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-2211-8482","authenticated-orcid":false,"given":"Viviana","family":"Maggio","sequence":"first","affiliation":[{"name":"School of Medicine, Department of Health Promotion, Maternal Childhood, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90142 Palermo, Italy"},{"name":"Unit of Diabetes and Cardiometabolic Prevention, University Hospital of Palermo, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6126-9435","authenticated-orcid":false,"given":"Francesca","family":"Vaccaro","sequence":"additional","affiliation":[{"name":"School of Medicine, Department of Health Promotion, Maternal Childhood, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90142 Palermo, Italy"},{"name":"Unit of Diabetes and Cardiometabolic Prevention, University Hospital of Palermo, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"}]},{"given":"Elena","family":"Muratore","sequence":"additional","affiliation":[{"name":"School of Medicine, Department of Health Promotion, Maternal Childhood, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90142 Palermo, Italy"},{"name":"Unit of Diabetes and Cardiometabolic Prevention, University Hospital of Palermo, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Felicia","family":"Di Falco","sequence":"additional","affiliation":[{"name":"School of Medicine, Department of Health Promotion, Maternal Childhood, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90142 Palermo, Italy"},{"name":"Unit of Diabetes and Cardiometabolic Prevention, University Hospital of Palermo, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"}]},{"given":"Angelo Maria","family":"Patti","sequence":"additional","affiliation":[{"name":"School of Medicine, Department of Health Promotion, Maternal Childhood, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90142 Palermo, Italy"},{"name":"Unit of Diabetes and Cardiometabolic Prevention, University Hospital of Palermo, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"conceptualization","vocabulary":"credit"}]},{"given":"Mario","family":"Manunta","sequence":"additional","affiliation":[{"name":"School of Medicine, Department of Health Promotion, Maternal Childhood, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90142 Palermo, Italy"},{"name":"Unit of Diabetes and Cardiometabolic Prevention, University Hospital of Palermo, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Vincenzo","family":"Geraci","sequence":"additional","affiliation":[{"name":"School of Medicine, Department of Health Promotion, Maternal Childhood, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90142 Palermo, Italy"},{"name":"Unit of Diabetes and Cardiometabolic Prevention, University Hospital of Palermo, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Marco","family":"Chiaramonte","sequence":"additional","affiliation":[{"name":"School of Medicine, Department of Health Promotion, Maternal Childhood, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90142 Palermo, Italy"},{"name":"Unit of Diabetes and Cardiometabolic Prevention, University Hospital of Palermo, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Carlotta","family":"Redavid","sequence":"additional","affiliation":[{"name":"School of Medicine, Department of Health Promotion, Maternal Childhood, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90142 Palermo, Italy"},{"name":"Unit of Diabetes and Cardiometabolic Prevention, University Hospital of Palermo, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Anna","family":"Masucci","sequence":"additional","affiliation":[{"name":"Department of Biomedicine, Neuroscience and Advanced Diagnostic (BIND), University of Palermo, 90133 Palermo, Italy"},{"name":"Institute of Clinical Biochemistry, Clinical Molecular Medicine, and Clinical Laboratory Medicine, University Hospital of Palermo, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9853-6329","authenticated-orcid":false,"given":"Marco","family":"Giammanco","sequence":"additional","affiliation":[{"name":"Unit of Diabetes and Cardiometabolic Prevention, University Hospital of Palermo, 90127 Palermo, Italy"},{"name":"Department of Precision Medicine in Medical, Surgical and Critical Care (MePreCC), University of Palermo, 90133 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"}]},{"given":"Luisa","family":"Agnello","sequence":"additional","affiliation":[{"name":"Department of Biomedicine, Neuroscience and Advanced Diagnostic (BIND), University of Palermo, 90133 Palermo, Italy"},{"name":"Institute of Clinical Biochemistry, Clinical Molecular Medicine, and Clinical Laboratory Medicine, University Hospital of Palermo, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6120-9041","authenticated-orcid":false,"given":"Marcello","family":"Ciaccio","sequence":"additional","affiliation":[{"name":"Department of Biomedicine, Neuroscience and Advanced Diagnostic (BIND), University of Palermo, 90133 Palermo, Italy"},{"name":"Institute of Clinical Biochemistry, Clinical Molecular Medicine, and Clinical Laboratory Medicine, University Hospital of Palermo, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"validation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9549-8504","authenticated-orcid":false,"given":"Manfredi","family":"Rizzo","sequence":"additional","affiliation":[{"name":"School of Medicine, Department of Health Promotion, Maternal Childhood, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90142 Palermo, Italy"},{"name":"Unit of Diabetes and Cardiometabolic Prevention, University Hospital of Palermo, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"validation","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"conceptualization","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1038\/s41580-023-00680-1","article-title":"White adipocyte dysfunction and obesity-associated pathologies in humans","volume":"25","author":"Hagberg","year":"2024","journal-title":"Nat. Rev. Mol. Cell Biol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1038\/s41574-024-01008-5","article-title":"Metabolically healthy obesity: From epidemiology and mechanisms to clinical implications","volume":"20","author":"Schulze","year":"2024","journal-title":"Nat. Rev. Endocrinol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"C375","DOI":"10.1152\/ajpcell.00379.2020","article-title":"Adipose tissue inflammation and metabolic dysfunction in obesity","volume":"320","author":"Kawai","year":"2021","journal-title":"Am. J. Physiol. Cell Physiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1038\/nature05482","article-title":"Mechanisms linking obesity to insulin resistance and type 2 diabetes","volume":"444","author":"Kahn","year":"2006","journal-title":"Nature"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2133","DOI":"10.1152\/physrev.00063.2017","article-title":"Mechanisms of Insulin Action and Insulin Resistance","volume":"98","author":"Petersen","year":"2018","journal-title":"Physiol. Rev."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Quirino-Vela, L.M., Mayoral-Ch\u00e1vez, M.A., Mat\u00edas-Cervantes, C.A., P\u00e9rez-Cervera, Y., Garc\u00eda-Montalvo, I.A., and Alpuche, J. (2026). The unified cardiometabolic disease continuum: Mechanistic stages of a single pathophysiological process. Front. Endocrinol., 17.","DOI":"10.3389\/fendo.2026.1897556"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Ionescu, V.A., Gheorghe, G., Bacalbasa, N., and Diaconu, C.C. (2025). Metabolic Dysfunction-Associated Steatotic Liver Disease: Pathogenetic Links to Cardiovascular Risk. Biomolecules, 15.","DOI":"10.3390\/biom15020163"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1038\/s41572-025-00599-1","article-title":"Metabolic dysfunction-associated steatotic liver disease in adults","volume":"11","author":"Huang","year":"2025","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1159\/000528083","article-title":"European Association for the Study of Obesity Position Statement on Medical Nutrition Therapy for the Management of Overweight and Obesity in Adults Developed in Collaboration with the European Federation of the Associations of Dietitians","volume":"16","author":"Hassapidou","year":"2023","journal-title":"Obes. Facts"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1038\/s41574-025-01114-y","article-title":"Insulin resistance in type 2 diabetes mellitus","volume":"21","author":"Accili","year":"2025","journal-title":"Nat. Rev. Endocrinol."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"American Diabetes Association Professional Practice Committee for Diabetes (2026). 2. Diagnosis and Classification of Diabetes: Standards of Care in Diabetes\u20142026. Diabetes Care, 49, S27\u2013S49.","DOI":"10.2337\/dc26-S002"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Fogacci, F., Borghi, C., and Cicero, A.F.G. (2024). Functional Foods and Nutraceuticals to Reduce the Risk of Cardiometabolic Disease: Where We Are, and Where We Are Going. Nutrients, 16.","DOI":"10.3390\/nu16183152"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"106944","DOI":"10.1016\/j.phrs.2023.106944","article-title":"Comparative effects of nutraceuticals on body weight in adults with overweight or obesity: A systematic review and network meta-analysis of 111 randomized clinical trials","volume":"196","author":"Shahinfar","year":"2023","journal-title":"Pharmacol. Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"678","DOI":"10.1080\/07853890.2017.1366042","article-title":"Nutraceutical approaches to metabolic syndrome","volume":"49","author":"Sirtori","year":"2017","journal-title":"Ann. Med."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Noce, A., Di Lauro, M., Di Daniele, F., Pietroboni Zaitseva, A., Marrone, G., Borboni, P., and Di Daniele, N. (2021). Natural Bioactive Compounds Useful in Clinical Management of Metabolic Syndrome. Nutrients, 13.","DOI":"10.3390\/nu13020630"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1987","DOI":"10.2147\/DMSO.S214550","article-title":"Potential role of phytochemicals in metabolic syndrome prevention and therapy","volume":"12","author":"Spinella","year":"2019","journal-title":"Diabetes Metab. Syndr. Obes."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.pcad.2021.06.010","article-title":"Impact of nutraceuticals on markers of systemic inflammation: Potential relevance to cardiovascular diseases\u2014A position paper from the International Lipid Expert Panel (ILEP)","volume":"67","author":"Ruscica","year":"2021","journal-title":"Prog. Cardiovasc. Dis."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"750","DOI":"10.1089\/jmf.2017.0001","article-title":"Effect of Gymnema sylvestre Administration on Metabolic Syndrome, Insulin Sensitivity, and Insulin Secretion","volume":"20","year":"2017","journal-title":"J. Med. Food"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"119756","DOI":"10.1016\/j.jep.2025.119756","article-title":"Bitter gourd (Momordica charantia L.) supplementation for twelve weeks improves biomarkers of glucose homeostasis in a prediabetic population","volume":"347","author":"Mes","year":"2025","journal-title":"J. Ethnopharmacol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"8983232","DOI":"10.1155\/2016\/8983232","article-title":"Evaluation of a Standardized Extract from Morus alba against \u03b1-Glucosidase Inhibitory Effect and Postprandial Antihyperglycemic in Patients with Impaired Glucose Tolerance: A Randomized Double-Blind Clinical Trial","volume":"2016","author":"Hwang","year":"2016","journal-title":"Evid. Based Complement. Altern. Med."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Derosa, G., D\u2019Angelo, A., Romano, D., and Maffioli, P. (2017). Effects of a Combination of Berberis aristata, Silybum marianum and Monacolin on Lipid Profile in Subjects at Low Cardiovascular Risk; A Double-Blind, Randomized, Placebo-Controlled Trial. Int. J. Mol. Sci., 18.","DOI":"10.3390\/ijms18020343"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"4030476","DOI":"10.1155\/2016\/4030476","article-title":"The Effect of Artichoke Leaf Extract on Alanine Aminotransferase and Aspartate Aminotransferase in Patients with Nonalcoholic Steatohepatitis","volume":"2016","author":"Rangboo","year":"2016","journal-title":"Int. J. Hepatol."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Rondanelli, M., Riva, A., Petrangolini, G., Allegrini, P., Bernardinelli, L., Fazia, T., Peroni, G., Gasparri, C., Nichetti, M., and Faliva, M.A. (2020). The Metabolic Effects of Cynara Supplementation in Overweight and Obese Class I Subjects with Newly Detected Impaired Fasting Glycemia: A Double-Blind, Placebo-Controlled, Randomized Clinical Trial. Nutrients, 12.","DOI":"10.3390\/nu12113298"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Castellino, G., Nikolic, D., Mag\u00e1n-Fern\u00e1ndez, A., Malfa, G.A., Chianetta, R., Patti, A.M., Amato, A., Montalto, G., Toth, P.P., and Banach, M. (2019). Altilix\u00ae Supplement Containing Chlorogenic Acid and Luteolin Improved Hepatic and Cardiometabolic Parameters in Subjects with Metabolic Syndrome: A 6 Month Randomized, Double-Blind, Placebo-Controlled Study. Nutrients, 11.","DOI":"10.3390\/nu11112580"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"106679","DOI":"10.1016\/j.phrs.2023.106679","article-title":"Nutraceutical approaches to non-alcoholic fatty liver disease (NAFLD): A position paper from the International Lipid Expert Panel (ILEP)","volume":"189","author":"Rizzo","year":"2023","journal-title":"Pharmacol. Res."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1430","DOI":"10.1016\/j.clnu.2004.09.012","article-title":"Bioelectrical impedance analysis\u2014Part II: Utilization in clinical practice","volume":"23","author":"Kyle","year":"2004","journal-title":"Clin. Nutr."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"American Diabetes Association Professional Practice Committee for Diabetes (2026). 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes\u20142026. Diabetes Care, 49, S89\u2013S131.","DOI":"10.2337\/dc26-S005"},{"key":"ref_28","unstructured":"World Health Organization (2020). WHO Guidelines on Physical Activity and Sedentary Behaviour, World Health Organization."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Bedogni, G., Bellentani, S., Miglioli, L., Masutti, F., Passalacqua, M., Castiglione, A., and Tiribelli, C. (2006). The Fatty Liver Index: A simple and accurate predictor of hepatic steatosis in the general population. BMC Gastroenterol., 6.","DOI":"10.1186\/1471-230X-6-33"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2534","DOI":"10.1093\/eurheartj\/ehz350","article-title":"Expert consensus and evidence-based recommendations for the assessment of flow-mediated dilation in humans","volume":"40","author":"Thijssen","year":"2019","journal-title":"Eur. Heart J."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Peretz, A., Leotta, D.F., Sullivan, J.H., Trenga, C.A., Sands, F.N., Aulet, M.R., Paun, M., Gill, E.A., and Kaufman, J.D. (2007). Flow mediated dilation of the brachial artery: An investigation of methods requiring further standardization. BMC Cardiovasc. Disord., 7.","DOI":"10.1186\/1471-2261-7-11"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1481","DOI":"10.2337\/dc10-2415","article-title":"Benefits of modest weight loss in improving cardiovascular risk factors in overweight and obese individuals with type 2 diabetes","volume":"34","author":"Wing","year":"2011","journal-title":"Diabetes Care"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"100306","DOI":"10.1016\/j.metop.2024.100306","article-title":"Low muscle mass is associated with low insulin sensitivity, impaired pancreatic \u03b2 cell function, and high glucose excursion in nondiabetic nonobese Japanese women","volume":"23","author":"Honda","year":"2024","journal-title":"Metabol. Open"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Gitsi, E., Kokkinos, A., Konstantinidou, S.K., Livadas, S., and Argyrakopoulou, G. (2024). The Relationship between Resting Metabolic Rate and Body Composition in People Living with Overweight and Obesity. J. Clin. Med., 13.","DOI":"10.3390\/jcm13195862"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1038\/s41580-023-00606-x","article-title":"Exercise metabolism and adaptation in skeletal muscle","volume":"24","author":"Smith","year":"2023","journal-title":"Nat. Rev. Mol. Cell Biol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1007\/s10068-022-01214-9","article-title":"Momordica charantia (bitter melon) efficacy and safety on glucose metabolism in Korean prediabetes participants: A 12-week, randomized clinical study","volume":"32","author":"Kim","year":"2023","journal-title":"Food Sci. Biotechnol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1007\/s40292-015-0087-2","article-title":"Effects of a new combination of nutraceuticals with Morus alba on lipid profile, insulin sensitivity and endothelial function in dyslipidemic subjects. A cross-over, randomized, double-blind trial","volume":"22","author":"Trimarco","year":"2015","journal-title":"High Blood Press. Cardiovasc. Prev."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1111\/j.1748-1716.2007.01783.x","article-title":"Exercise training-induced improvements in insulin action","volume":"192","author":"Hawley","year":"2008","journal-title":"Acta Physiol."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Galbo, T., Olsen, G.S., Quistorff, B., and Nishimura, E. (2011). Free Fatty Acid-Induced PP2A Hyperactivity Selectively Impairs Hepatic Insulin Action on Glucose Metabolism. PLoS ONE, 6.","DOI":"10.1371\/journal.pone.0027424"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Makarova, E., Makrecka-Kuka, M., Vilks, K., Volska, K., Sevostjanovs, E., Grinberga, S., Zarkova-Malkova, O., Dambrova, M., and Liepinsh, E. (2019). Decreases in Circulating Concentrations of Long-Chain Acylcarnitines and Free Fatty Acids During the Glucose Tolerance Test Represent Tissue-Specific Insulin Sensitivity. Front. Endocrinol., 10.","DOI":"10.3389\/fendo.2019.00870"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Terzo, S., Amato, A., Mag\u00e1n-Fern\u00e1ndez, A., Castellino, G., Calvi, P., Chianetta, R., Giglio, R.V., Patti, A.M., Nikolic, D., and Firenze, A. (2023). A Nutraceutical Containing Chlorogenic Acid and Luteolin Improves Cardiometabolic Parameters in Subjects with Pre-Obesity: A 6-Month Randomized, Double-Blind, Placebo-Controlled Study. Nutrients, 15.","DOI":"10.3390\/nu15020462"},{"key":"ref_42","first-page":"13","article-title":"A Study on Pharmacognostical Approach on Taraxacum officinale","volume":"13","author":"Verma","year":"2023","journal-title":"J. Drug Deliv. Ther."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Tian, W., Cao, S., Guan, Y., Zhang, Z., Liu, Q., Ju, J., Xi, R., and Bai, R. (2024). The effects of low-carbohydrate diet on glucose and lipid metabolism in overweight or obese patients with T2DM: A meta-analysis of randomized controlled trials. Front. Nutr., 11.","DOI":"10.3389\/fnut.2024.1516086"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1016\/j.cmet.2018.01.005","article-title":"An Integrated Understanding of the Rapid Metabolic Benefits of a Carbohydrate-Restricted Diet on Hepatic Steatosis in Humans","volume":"27","author":"Mardinoglu","year":"2018","journal-title":"Cell Metab."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"7479","DOI":"10.1080\/10408398.2025.2472882","article-title":"Anti-inflammatory and antioxidant effects of anthocyanins in Nonalcoholic fatty liver disease (NAFLD): A systematic review of in vivo studies","volume":"65","author":"Dias","year":"2025","journal-title":"Crit. Rev. Food Sci. Nutr."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1080\/09540105.2021.1986471","article-title":"Anthocyanins profiling of bilberry (Vaccinium myrtillus L.) extract that elucidates antioxidant and anti-inflammatory effects","volume":"32","author":"Bayazid","year":"2021","journal-title":"Food Agric. Immunol."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Ikonomidis, I., Pavlidis, G., Tsoumani, M., Kousathana, F., Katogiannis, K., Tsilivarakis, D., Thymis, J., Kountouri, A., Korakas, E., and Pliouta, L. (2022). Endothelial Dysfunction Is Associated with Decreased Nitric Oxide Bioavailability in Dysglycaemic Subjects and First-Degree Relatives of Type 2 Diabetic Patients. J. Clin. Med., 11.","DOI":"10.3390\/jcm11123299"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"134677","DOI":"10.1016\/j.foodchem.2022.134677","article-title":"The mechanistic insights into the role of pH and solvent on antiradical and prooxidant properties of polyphenols\u2014Nine compounds case study","volume":"407","author":"Spiegel","year":"2023","journal-title":"Food Chem."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/19\/7404\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T16:19:45Z","timestamp":1790180385000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/19\/7404"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,23]]},"references-count":48,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2026,10]]}},"alternative-id":["jcm15197404"],"URL":"https:\/\/doi.org\/10.3390\/jcm15197404","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,23]]}}}