Articles published in 2018

The gastrointestinal microbiota plays a key role in human health. Over the past few decades, a lot of attention has been directed at improving health by modulating the gut microbial composition using probiotics. In vivo studies have limitations in providing mechanistic insights into the effect of probiotics and cannot be used to screen numerous test compounds. However, in vitro approaches can be used for mechanistic research under highly controlled environmental conditions. Here we describe how the Simulator of the Human Intestinal Microbial Ecosystem (SHIME®) can be used to produce data complementary to in vivo studies to help elucidate the mode-of-action of probiotics in the gastrointestinal tract.

Legumes are good sources of protein and are rich in lysine and tryptophan, which are limiting amino acids in cereals. Common legumes include sugar beans, soya beans and cowpeas. Although soya beans are an important commercial legume, cowpea (Vigna unguiculata L. Walp) varieties grown by some communities in developing countries have many food and non-food uses. The objective of this study was to determine the effect of soaking, dehulling and boiling on the protein, polyphenolic and antinutrient content of cowpea varieties, namely CBC2 and CBC4. Phenols, tannins, flavonoids, alkaloids and saponins were present in the cowpea varieties. Boiling caused a significant (p≤0.05) decrease in the protein content of both cowpea varieties. Soaking for 24 hours resulted in an insignificant (p>0.05) change in the protein content of CBC2, but significantly (p≤0.05) decreased the protein content of CBC4. On the other hand, dehulling seeds soaked for 6 hours resulted in a significant increase (p≤0.05) in the protein content of both varieties. Boiling caused a significant decrease (p≤0.05) in total phenolic content (TPC), total flavonoid content (TFC), and content of condensed tannins and saponins in both cowpea varieties. Also, soaking for 6, 12, 18 and 24 hours significantly (p≤0.05) decreased the content of these phytochemicals. The greatest losses in TPC, TFC, condensed tannins and saponins for both varieties were observed in seeds soaked for 6 hours and dehulled samples. The results of this study show that boiling, soaking and dehulling reduced the protein, polyphenolic and antinutrient content of the cowpea varieties.

There is plenty of evidence in the literature that vitamin D is essential for calcium homeostasis for optimal skeletal health. Type 2 diabetes mellitus is a syndrome with major long-term negative consequences. Efforts have been made to find innovative approaches for diabetes prevention and treatment, and a recent focus has been on vitamin D supplementation. The aim of this review was to evaluate the effect of vitamin D on insulin resistance.

The treatment of breast cancer is complex, with a wide variety of surgical, radiotherapeutic, chemotherapeutic, biological and endocrine options available. Although these therapies have improved survival rates, adjuvant treatment does have side-effects. The main adverse effects, such as vasomotor symptoms, classically represented by hot flushes and night sweats, are related to anti-hormone therapy, which aims to block the estrogen receptor or destroy estrogen-producing tissue. Options generally include selective estrogen receptor modulators (SERMs), GnRH analogues and aromatase inhibitors, which all cause climacteric symptoms in most breast cancer survivors and have a big impact on their quality of life and treatment compliance. Classically, hormone replacement therapy (HRT) has been the gold standard treatment for menopausal hot flushes. However, this treatment has risks, and should not be the first option in women with breast cancer or at high risk of developing the disease. Many alternatives to HRT such as tibolone, phytoestrogens and antidepressants have been proposed in recent decades, but results have been controversial regarding efficacy and safety, and consequently compliance is poor. Therefore, interventions to improve compliance with adjuvant hormonal therapy are required. Black cohosh or Cimicifuga racemosa isopropanolic extract (Remifemin®) is a herbal medication frequently used for alleviating menopausal symptoms. Several recent studies have shown that patients with mild menopausal symptoms usually experience spontaneous remission after taking black cohosh, while those with moderate to severe symptoms may experience some benefit. No adverse effects or estrogen activity were reported with this compound. This review examined the effectiveness of black cohosh extract for relieving symptoms and improving quality of life in breast cancer survivors and high-risk women with moderate to severe menopausal symptoms.

Gut microbiome variations have been described in several skin disorders, including atopic dermatitis in children and psoriasis in adults. In both pathologies, an increase in blood markers for oxidative stress and inflammation has also been detected. Taking these results into account, we have developed specific blends of probiotics for each of these skin conditions which have also been studied in clinical trials. The results have shown that nutritional supplementation with these functional ingredients can improve the treatment of such skin disorders.

The complete and undisturbed healing of bone fractures is a key priority for surgeons and patients, so intensive efforts are made to improve bone healing with a variety of approaches. Oral therapies with collagen peptides are a relatively new therapeutic approach. In this observational study, the impact of collagen peptides on bone healing was investigated in a group of 28 (14 verum/14 placebo) patients of both genders with different fracture locations. Some patients underwent surgery, while others were treated conservatively. The patients who received bioactive collagen peptide treatment (FORTIBONE®) had a clearly better outcome regarding bone healing than the placebo group, half of whom showed suboptimal or bad results. No side effects or intolerance to the product were reported. The results of this investigation confirm the positive impact of collagen peptides on bone healing. The data suggest that FORTIBONE® can be used to improve fracture healing, even in cases where a normal outcome is expected, and to achieve faster healing.

Human milk oligosaccharides (HMOs) comprise a large family of extremely diverse oligosaccharides present in high concentrations and which generate a multitude of biological responses. They are generally considered to have a beneficial effect upon the establishment of the microbiota in infants, but they also exert this effect in adult humans. They can impede the attachment of pathogens and toxins such as Campylobacter jejuni, Escherichia coli, Vibrio cholerae, Salmonella fyris, Helicobacter pylori, bacterial toxins, Entamoeba histolytica and viruses, to the epithelial cells of the gastrointestinal tract. This in effect reduces their pathogenicity as binding to receptors on the epithelial cells is a prerequisite for infection by pathogens. If the pathogens or toxins bind to the HMOs they will be removed from the gastrointestinal tract and not cause disease. Therefore, HMOs are putative protective agents against enteric infections in adults as well as in infants. HMOs are also useful as therapeutic or preventive adjuncts in gut motility disorders and gut pain, and possibly also have beneficial effects in reducing food allergies. Hence, dietary manipulation by the use of HMOs represents a strategy to promote a beneficial gut microbiota and provide health benefits to human adults as well as to infants.

Many bifidobacterial strains are currently exploited as probiotic, or health-promoting, bacteria by the food and pharmaceutical industries. However, the molecular mechanisms responsible for these beneficial effects on human health are generally poorly investigated and not properly understood. Therefore, the health-promoting activities of probiotic bacteria must be clinically investigated in order to satisfy regulatory agencies and to address public demands for effective and scientifically supported probiotic therapies. Here, we describe the current situation regarding Bifidobacterium bifidum strain PRL2010, and discuss evidence supporting its use as an effective probiotic for infants and expectant mothers.

Bacterial CST (community state type) I is characterized by Lactobacillus crispatus dominance and is associated with a healthy vagina and a reduced risk of vaginosis, vaginitis, preterm birth, infertility and vaginal atrophy. On the other hand, CST IV is characterized by the absence of lactobacillus and is associated with unhealthy gynaecological conditions. Unfortunately, very few L. crispatus strains have been properly studied and documented for human use. Here we discuss the genetic, probiotic and vaginal colonization properties of strain M247, isolated in 1989 from infant faeces, and describe its possible gynaecological uses especially in woman characterized by CST IV.

Its high nutritive quality and ability to survive in harsh conditions makes pearl millet a suitable crop for arid and semi-arid regions, but anti-nutrient factors reduce the bioavailability and digestibility of its nutrients. Fermentation reduces anti-nutrients and hence increases protein digestibility and mineral bioavailability. Thus, the present work examines the effects of fermentation on the nutritive, physiochemical and functional properties and anti-nutrient composition of pearl millet flour. Natural fermentation at 20°C, 25°C and 30°C and pure culture fermentations with Saccharomyces cerevisiae, Saccharomyces diastaticus, Lactobacillus fermentum and Lactobacillus brevis were performed. Analysis revealed an increase in moisture and fat content and a decrease in protein content following all types of fermentation. Although the variation in protein levels in different fermentations was not significant, ranging from 10.29% to 9.83%, the effect on thiamine content was significant as it decreased with an increase in temperature in the range 20–30˚C in natural fermentation but was increased in pure culture yeast fermentations as compared with bacterial fermentations at their favourable temperatures, respectively. Total soluble sugar content decreased in pure culture fermentation but increased in natural fermentation. Fermentation decreased pH, thereby increasing titratable acidity. Oil and water absorption capacities were increased, while least gelation concentration was decreased in all types of fermentations. Also, anti-nutritional factors like tannins and phenolic compounds were significantly decreased in all fermentations. We conclude that fermentation is an efficient process to improve the quality of pearl millet flour.

Five bar samples, including a control bar, prepared from different percentages of mahua flower syrup were investigated using fuzzy logic sensory analysis. These bar samples were ranked against each other: the quality attributes of the bars (colour, flavour, stickiness, overall acceptability and taste) were scored and the bars rated. A panel of 15 judges performed the sensory evaluation. Analysis indicated that taste, overall acceptability and flavour were the main quality attributes, while stickiness and colour were less important. Fuzzy logic sensory analysis determined that the bar with 100% replacement of sugar with mahua flower syrup was the most acceptable.

Silymarin, a flavanolignan-containing standardized extract obtained from the fruits of Silybum marianum, is a traditional phytotherapic product widely used for the treatment of liver diseases including hepatitis , cirrhosis and bile secretion dysfunction. Recent preclinical data and some clinical investigations also support its use in the management of non-alcoholic fatty liver disease (NAFLD). Despite this evidence, silymarin efficacy has not yet been supported by clear-cut dose-related pharmacokinetic data, although several attempts have been made to enhance the oral absorption of flavanolignans, its putative active principles. However, positive results have been obtained with lecithin-based formulations (Phytosome®) of silybin, the main flavanolignans in silymarin, which showed improved oral absorption in preclinical and clinical trials. The Phytosome® delivery system has also been applied to silymarin with promising preclinical results consistent with the oral bioavailability of most of the flavanolignans present in the extract. These data may help optimize the dose for clinical efficacy in liver protection and also pave the way for the use of silymarin in new therapeutic areas where recent findings indicate a major role for the entire phytocomplex.

Pyrroloquinoline quinone (PQQ) is a novel vitamin-like compound that acts as an essential active factor in the functioning of mitochondria. However, as higher organisms do not seem to biosynthesize PQQ, the major source in humans is the diet. In addition to its role in mitochondria, PQQ stimulates growth and serves as a cofactor for a special class of enzymes involved in cellular functions including cellular growth, development, differentiation and survival. It also has possible pharmacological effects via activation of AMP-kinase (AMPk). Given the nutritional importance and numerous physiological effects of PQQ, there are many possible clinical applications. The most obvious are those chronic degenerative conditions that revolve around low mitochondrial function and aging, including degenerative neurological disease (e.g., Alzheimer’s and Parkinson’s disease), chronic inflammation, metabolic syndrome and obesity. It also holds promise as a clinical aid for simply improving energy levels and cognition. This review will highlight the pharmacology, clinical applications and dosage recommendations for this promising natural product.

Human milk oligosaccharides (HMOs) are unique oligosaccharides found in mother’s milk. Collectively, HMOs constitute the third largest solute in human milk, after lactose and fat. The types and levels of HMO vary considerably among women, geographical regions and the stages of lactation. Over 130 different oligosaccharides have been identified in human milk, with 2’-fucosyllactose (2’-FL) being the most abundant (~2 g/l). Recent innovations and regulatory approvals have enabled infant formula companies to incorporate 2’-FL into their products, helping infant formulas to become more like mother’s milk. This article explores the latest research on HMOs and their role in supporting digestive, immune and cognitive development in infants.

Human milk is a rich source of components that contribute to shaping the infant gut microbiota through a variety of mechanisms. After lactose and lipids, human milk oligosaccharides (HMOs; Fig. 1) are the third most abundant components of human milk. One litre of mature human milk contains 5–20 g of these complex sugars, which often exceeds the amount of all human milk proteins combined. Oligosaccharide concentrations in colostrum are even higher [1]. To date, the molecular structures of more than 100 different HMOs have been characterized, but it is important to note that total amount and composition are highly variable between different women.

Even though cinnamon oil (CO) has functional and health effects in humans because of the presence of the antioxidant cinnamaldehyde (CIA), its food applications have been limited due to its poor water solubility. Encapsulation of CO in stable nanodroplets is a unique strategy to enhance the stability and bioavailability of hydrophobic molecules in the CO structure. A literature review has been conducted on the formation of stable nanoscale droplets using low- and high-energy nanoemulsification methods, physicochemical and antimicrobial characterization, and the food application efficiency of CO micro/nanoemulsions. Although high-energy emulsification technologies are more commonly used to produce CO nanoemulsions, there is considerable interest in the fabrication of these delivery systems using the low-energy techniques of spontaneous emulsification and phase-inversion temperature. Processing and formulation (oil phase composition and surfactant content) variables were optimized to produce the smallest droplet size and slowest CIA release rate. Cinnamon and CIA nanoemulsions can effectively control pathogens in functional foods during processing and storage. A strong inhibitory effect on many microorganisms can also be exerted by small nanodroplets encapsulating these bioactive compounds into edible films to significantly decrease the synthetic preservative content. The antibacterial and antifungal activity, nutritional value and physicochemical quality of foods can be improved by adding CO-enriched nanoemulsions.

Osteo-articular diseases affect many elderly people, resulting in worse quality of life and a substantial public health cost. Osteoarthritis, inflammatory articular diseases and conditions associated with cartilage disruption are the most frequently diagnosed. Non-steroidal anti-inflammatory drugs, glucocorticoids and physiotherapy are used to treat affected patients, while some nutraceutical products containing chondroprotective and osteotropic substances have been shown to improve their signs and symptoms. However, the true absorption and efficacy of these substances in humans is largely unknown. The absorption of hyaluronans and chondroitin sulfate is likely negatively affected by their high molecular weight. Nevertheless, many published papers have reported significant improvements in symptoms and articular functionality in patients taking these compounds. This paper attempts to clarify the apparent dichotomy between absorption and efficacy, and compare the clinical evidence for the bioavailability of hyaluronic acid with that of its precursor N-acetyl glucosamine.

Functional dyspepsia (FD), a gastrointestinal disorder characterized by pain or a burning sensation in the epigastrium, postprandial fullness, early satiety, bloating and nausea, used to be treated with prokinetics such as metoclopramide, cisapride and domperidone. Unfortunately, these drugs have severe side effects, including cardiac and sudden death, and consequently are now rarely used or have been withdrawn from the market. However, botanicals could be a source of natural prokinetics which do not have these adverse effects. Perilla frutescens leaf extract is a possible candidate, with some data indicating a clinical role in FD. As with any botanical, perilla extract normally consists of a complex mixture of active ingredients characterized by different chemical and physical properties, including varying degrees of solubility in water and/or alcohol. Consequently, selection of the correct solvents is very important for the preparation of standardized botanical extracts. We have therefore evaluated which solvents, and in which order, should be used. Our findings show that a first extraction step performed in ethanol (80%) followed by a second extraction step using warm water results in standardized quantities of both lipophilic and hydrophilic perilla leaf actives such as rosmarinic acid, vicenin-2, perilla ketone, apigenin, luteolin, and apigenin and luteolin glycosides.

Beta vulgaris subsp. cicla (BVc, leaf beet) and Beta vulgaris var. rubra (BVr, red beetroot) belong to the Amaranthaceae family and have been used for centuries as food and medicinal plants. The main bioactive phytochemicals of BVr are the betalains, a group of water-soluble pigments derived from betalamic acid, which are divided into two classes: the yellow/orange-coloured betaxanthins (BX) and the red/ violet-coloured betacyanins (BC). The seeds, leaves and roots of BVc are rich in phenolic acids and apigenin-derived flavonoids, namely vitexin, vitexin-2-O-rhamnoside (VOR) and vitexina-2-O-xyloside (XVX). We isolated BVc and BVr phytochemicals in our laboratory and tested them individually and in combination for their anticancer and anti-inflammatory activity. In cancer cells, vitexin flavonoids were able to induce intrinsic apoptosis, while betalains induced extrinsic apoptosis. Combinations of two or three molecules exhibited synergistic antioxidant, anti-inflammatory and anticancer activity, particularly towards hepatic, intestinal and urinary bladder tumours.

Introduction: Overweight and obesity increase the risk of mortality following the onset of several diseases generally characterized by oxidative stress. The levels of advanced glycation end-products (AGEs), a consequence of metabolic disorder and oxidative stress, play an important role in the process, and their quantification, based on skin autofluorescence (skin AF), could be used for non-invasive assessment of AGEs. Aim: To evaluate in overweight subjects the diagnostic use of AGE determination (skin AF detected by an AGE Reader) for assessing possible correlation between AGEs and some anthropometric/oxidative indices. Patients and methods: 51 consecutive overweight participants in a nutritional education programme were enrolled in this observational cross-sectional study: 39 women (aged 49.69±13.71; BMI 33.12±5.44 kg/m²) and 12 men (aged 56.84±17.84; BMI 33.12±3.11 kg/m²). Glycometabolic and oxidative parameters were measured using routine laboratory analyzers. Pearson’s correlation coefficient was used for statistical analysis. Results: Significant correlations were found between the Cardiovascular Risk Index and age (r=0.65; p<0.0001), AGEs (r=0.41; p<0.0001) and glycosylated haemoglobin (r=0.38; p<0.05); ageing and AGEs (r=0.50; p<0.0001) and glycosylated haemoglobin (r=0.40; p<0.0001); and C-reactive protein and fibrinogen (r=0.52; p<0.0001), homocysteine and fasting glucose (r=0.47; p<0.0001). Discussion: Oxidative stress can be assessed by AGE determination. Our findings in overweight subjects highlight interesting correlations between metabolic-oxidative parameters. Age emerged as the most important indicator of cardiovascular risk and AGE formation. Notably, skin AF, detected by the AGE Reader (a simple non-invasive clinical tool), can be a useful marker for rapid assessment of dysmetabolic-oxidative risk in overweight subjects.

The consumption of dietary proteins from vegetable sources can be very helpful in the dietary management of hypercholesterolemia. While it is well established that soy proteins can reduce LDL-cholesterol, particularly in patients with high cholesterolemia, novel protein sources have lately attracted much interest. Recent studies have clearly established the nutraceutical properties of eggs and egg peptides, which have significant effects on both cholesterolemia and blood pressure. In the last few years, extensive studies have shown that lupin and hempseed proteins have good cholesterol-lowering properties. Lupin, particularly Lupinus angustifolius, is characterized by peptides that can significantly raise LDL-receptor activity and also reduce PCSK9 levels, thus providing very effective treatment for hypercholesterolemic patients when used as substitutes or additives for standard drugs. More recently, hempseed, a protein source rarely evaluated clinically, has been shown to reduce cholesterolemia in animal models, by inhibiting HMG-CoA reductase activity, upregulating LDL receptors and, surprisingly, also increasing PCSK9 levels, with an overall profile similar to that of statins. These novel additions to the nutraceutical armamentarium for treating raised cholesterol may lead to exciting progress in the management of hypercholesterolemic patients.

In 2017, I wrote an editorial on the possible inefficacy of curcumin [1]. Recently, the possible effect of curcumin on the gut microbiota has been discussed. Curcumin is a polyphenolic compound with a long history of use as a dietary spice, food-colouring agent and herbal remedy. Curcumin exhibits anti-inflammatory, antioxidant, anticancer, antiviral and neurotrophic activity and therefore holds promise as a therapeutic agent to prevent and treat several disorders. However, a major barrier to curcumin’s clinical efficacy is its poor bioavailability. Efforts have therefore been made to develop curcumin formulations that have greater bioavailability and systemic tissue distribution. Nevertheless, curcumin’s potential as a therapeutic agent may not solely rely on its bioavailability but also on its positive influence on gastrointestinal health, function and structure.

Background: Since barley possesses various components beneficial to health, replacement of wheat flour with barley flour in bakery products could be an attractive approach. Hence, the objective of this study was to replace wheat flour with barley flour for the preparation of cakes. Materials and methods: Test blends were obtained by incorporating barley flour into wheat flour at 20%, 30%, 40% and 50% levels of substitution and the physiochemical and pasting properties of the blended flour were studied. The study also investigated the physical, baking and sensory characteristics of the cakes. Results: There was a slight increase in protein content from 8.4% to 9.6% and a reduction in moisture content from 13.57% to 11.27% with increasing levels of barley flour. Pasting properties showed significant differences among the samples, with a slight increase in pasting temperature and significant variations in stirring number. The baking time, symmetry index and volume index of cakes decreased with increased barley flour content, but there was no change in organoleptic properties. Conclusion: Wheat flour can be replaced with up to 50% barley flour with little decline in the quality parameters of cakes.

The preference for healthier and convenience food products has resulted in a demand for reducedcalorie chocolate which has 20% fewer calories than conventional chocolate but the same brightness, aroma, flavour and hue. The fat replacers used in reduced-calorie chocolate are usually derived from vegetable oils and/or polysaccharides. The vegetable oils include palm oil, corn oil and soybean oil, while the polysaccharides include carrageenan, guar gum and locust bean gum. Gums are considered healthier than vegetable oils but result in a weaker texture. Therefore, vegetable oils are often used in combination with gums to improve the rheological characteristics of reduced-calorie chocolate. Sucrose substitutes include sugar alcohols, dietary fibres, syrups and natural/artificial sweeteners. Sucralose is by far the preferred artificial sweetener because of its stability at higher temperatures. The incorporation of fat and sugar replacers increases the viscosity and slipperiness of reduced-calorie chocolate. Also, reduced-calorie chocolate is more bitter and less sweet than conventional chocolate.

Introduction: Autism is a neurodevelopmental condition of unknown aetiology which is usually diagnosed in the first 3 years of life. Several studies have linked reduced intake of some nutrients with autism and autism spectrum disorder (ASD). Objective: To identify nutritional risk factors that predispose to autism among preschool and school children living in Al-Madinah Al-Monawarah city in Saudi Arabia. Method: Thirty children with autism/ASD aged 2–12 years and 36 matched control children were compared regarding BMI and food intake, using 24-hour recall and a food frequency questionnaire. Results: Both groups consumed similar amounts of carbohydrates, protein and other nutrients, many of which were below the international recommendations for children of their age. However, children with autism/ASD also consumed significantly less omega-3 and iron than the control group. Conclusions: Children with ASD, like other children in Saudi Arabia, consume less than the recommended amounts of some nutrients. Autistic children have reduced intake of omega-3 and iron, together with limited intake of many food varieties which could be linked to autism in susceptible children.

Background: Nutrition during pregnancy affects the health of the mother and the health and development of the fetus. The aim of this study was to evaluate the effect of a nutrition education program on the diet of pregnant women. Methods: A total of 120 pregnant women (intervention group: 62, control group: 58) attending our centre at 16–35 weeks of pregnancy were enrolled in our study. A pretested questionnaire was used to collect data on demographics, job, age, medication use and educational level, and food records were collected weekly. Three similar educational sessions were held each week for 12 weeks. Data analysis was performed using SPSS software (version 16). Results: There were significant improvements in diet diversity (p=0.0001) and nutrient intake (p≤0.05) in the intervention group after the educational program. Conclusion: Nutrition education can improve the diet of pregnant women.

Vitamins are key to human health. Although vitamins are involved in several metabolic pathways, humans cannot biosynthesize them except for vitamin D and vitamin B3, so adequate intake in the diet is crucial. Vitamins are classified as fat-soluble or water-soluble. Fat-soluble vitamins include vitamins A, D, E and K, while water-soluble vitamins include vitamins B and C. Avitaminosis due to imbalanced nutrition, disease or genetic impairment leads to disease, but consumption of vitamin supplements or fortified foods can counteract vitamin deficiency. However, their absorption depends on the type of meal and food matrix composition. Vitamins A, D and E are mainly influenced by lipid content which promotes intestinal uptake. Surprisingly, the fat-soluble vitamin K seems to be unaffected by type of diet, although it has better bioavailability as a food supplement. Water-soluble vitamin absorption is not significantly affected by prandial status or dietary composition. No data are reported for vitamin C, while the vitamin B group needs evaluation by coenzyme.

High-dose omega-3 fatty acids rich in eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) can have significant benefits in the management of cardiovascular disease due to their formation of specialized hormones known as resolvins. The appropriate dose can be determined by the ratio of arachidonic acid (AA) to EPA in the blood. This review will summarize the recent data on reducing the AA/EPA ratio and its effects on cardiovascular outcomes.

A recently published paper in Nature [1] stated that 27% of 835 non-antimicrobial drugs have a significative impact on gut microbiota. It is likely that a similar or greater proportion of botanicals have comparable effects. For instance, we know that curcumin increases the abundance of butyrateproducing bacteria and faecal butyrate level [2]. This could explain why, despite its very poor oral bioavailability, curcumin acts as an anti-inflammatory agent and why it is a promising therapeutic option for the treatment of inflammatory bowel disease. Berberine is another excellent example of a botanical which acts by modulating the microbiota. Knowledge of the mechanism by which berberine modulates the microbiota could lead to better understanding of the role of berberine in metabolic diseases.