Table 5.

Role of nutraceuticals in MetS. ↑ signifies increase. ↓ signifies decrease.

Source	Action
Turmeric (Curcuma longa) Active ingredient: diferuloylmethane in curcumin	Suppress NF-kB activation-> ↓ expression of pro-inflammatory cytokines-↓ TNF-α expression, ↓ expression of plasminogen activator inhibitor type-1-> ↓ inflammation [202]—antioxidant effect [201]—curcumin hinders Wnt/β-catenin pathway associated with obesity [203]
Garlic (Allium sativum) Active ingredient: allicin	Anti-inflammatory effect from the organosulfur compounds in its derivatives. Antioxidant action due to thiol groups—Antithrombotic effect [201]—increases insulin sensitivity [204]
Cinnamon (Cinnamomum verum) Active ingredient: polyphenols	Antithrombotic–antioxidant–anti-inflammatory effects—increases insulin sensitivity—regulates blood glucose and blood pressure [201]
Rhizoma coptidis Active ingredient: berberine	Improves body weight, triglyceride levels—increases insulin sensitivity—downregulation of genes involved in lipogenesis [205]—reduction in blood pressure [206]
Neem (Azadirachta indica) Active ingredient: neem oil	Increases glucose tolerance via reduction of intestinal and pancreatic glucosidase activity → improves post-prandial hyperglycemia [207]—regenerates pancreatic beta cells → ↑ insulin secretion [201]
Bergamot orange (Citrus bergamia) Active ingredient: bergamot essential oil	Anticancer–anti-inflammatory–antimicrobial–antioxidant–antianxiety properties—↓ ROS formation—↓ lectin-like LDL receptor-1 expression [208]
Grapes (Vitus vinifera) Active ingredient: resveratrol, (3,5,4′-trihydroxystilbene)	↓ Adipogenesis—↑ lipolysis—inhibits cyclooxygenase → antioxidant action [209]—enhances insulin sensitivity, glucose tolerance, overall weight, and BMI—[210]
Onions (Allium cepa) Active ingredient: quercetin	Anti-inflammatory—antioxidant—↓ blood pressure—↓ cholesterol levels—↓ insulin resistance [211]
Fish oils (omega fatty acids) Active ingredient: polyunsaturated fatty acids	↓ Lipogenesis—↑ fatty acid oxidation in liver and adipose tissue—regulates peroxisome proliferator—activates receptor gamma [212]
Broccoli (Brassica oleracea) Active ingredient: sulforaphrane	Anti-inflammatory properties—activates nuclear factor erythroid 2-related factor 2, an antioxidant transcription factor → antioxidant properties—role against hypertension, hyperlipidemia, and diabetes [213]
Ginger Active ingredient: gingerols, shogaols, parasols	Anti-inflammatory—↓ cyclooxygenase-2—↓ 5-lipoxygenase—↓ systolic blood pressure [201]
Cumin (Cuminum cyaminum) Active ingredient: cuminaldehyde	↓ Lipid levels—↓ glycemia [201]
Cynara cardunculus (L.) subsp. scolymus Hayek-based Altilix®	Modulates the expression of PPAR-γ and inhibits fatty acid synthase activity—↓ in body weight, waist circumference, HbA1c, plasma lipids, hepatic transaminases, flow-mediated dilation, carotid intima-media thickness [214].
Monascus purpureus, red yeast rice	Reversible inhibition of 3-hydroxy-3-methyl-glutaryl-CoA reductase [215]