Abstract
Background: The use of nutraceutical products and functional foods in the cardiovascular and metabolic field is rising in several countries. Preparation and implementation of guidelines are pivotal for translating research-derived knowledge and evidence-based medicine to the clinical practice. Based on these considerations, the aim of this paper is to explore if and how nutraceutical products are discussed by the most recent international guidelines related to cardio-metabolic diseases (dyslipidaemia, obesity, type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD) prevention). Some, but not all, guidelines for dyslipidaemia mention nutraceutical products as potential useful options for the treatment of mild dyslipidaemia, but also indicate the low level of evidence associated to their effects on hard endpoints (myocardial infarction, stroke, CVD-related death). In the most recent guidelines on obesity, it is mentioned that no safe and effective dietary supplement nor nutraceutical product is available for the management of weight loss in this condition, and more high-quality studies are necessary in this field. The examined guidelines for T2DM do not mention any specific nutraceutical approach to this disease, nor to milder forms, such as insulin resistance and pre-diabetes. Conclusions: The focus on nutraceutical products in the main international guidelines for cardio-metabolic disease management remains limited. Since robust scientific evidence is the background of useful and effective guidelines, the implementation of high-quality clinical research is strongly needed in the field of nutraceutical products for cardio-metabolic diseases.
Highlights
Cardiovascular (CV) and metabolic diseases are the leading cause of morbidity, disability and mortality in the world [1] and their heterogenous causes are currently on the rise [2]
The current clinical practice in many fields and, in particular, in the CV disease (CVD) and metabolic disease area, is built on a body of knowledge and evidence, which is collected in guidelines focusing on specific medical issues [3,4]
This review is based upon the analysis of the international guidelines regarding CVDs, obesity, type 2 diabetes mellitus (T2DM) and metabolic syndrome, published in the last 20 years, in order to assess the relevance of this topic over time and in different regions of the world
Summary
Cardiovascular (CV) and metabolic diseases are the leading cause of morbidity, disability and mortality in the world [1] and their heterogenous causes are currently on the rise [2]. The current clinical practice in many fields and, in particular, in the CV disease (CVD) and metabolic disease area, is built on a body of knowledge and evidence, which is collected in guidelines focusing on specific medical issues [3,4] These guidelines are constructed according to a specific development process [5,6], which takes into consideration several aspects, including a systematic review of the available evidence, the inclusion of a multidisciplinary panel of representatives and experts from key affected groups (such as patients), and the identification of potential conflicts of interest. This review is based upon the analysis of the international guidelines regarding CVDs, obesity, T2DM and metabolic syndrome, published in the last 20 years, in order to assess the relevance of this topic over time and in different regions of the world
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