medtigo Journal of Pharmacology

|Literature Review

| Volume 1, Issue 1

A Comprehensive Review of Allium Cepa in Metabolic Syndrome Management

Author Affiliations

medtigo J Pharmacol. Published Date: Sep 17, 2024.

https://doi.org/10.63096/medtigo3061111

Abstract 

Allium cepa, also known as onion and is known for its therapeutic properties. This study synthesizes the evidence from studies conducted between 2010 and 2024 regarding the activity of Allium cepa. Research indicates that Allium cepa exhibits significant potential in managing diabetes through various mechanisms, including antioxidant activity, modulation of glucose metabolism, and improvement of insulin sensitivity. The chemical constituents of onions, such as quercetin, sulfur compounds, and flavonoids, have been shown to lower blood glucose levels, enhance insulin secretion, and reduce the complications associated with diabetes. Invitro and clinical studies support these findings, although results are heterogeneous and sometimes inconclusive. This review aims to provide a comprehensive overview of current evidence that highlights both the therapeutic potential and limitations of Allium cepa as an adjunct in diabetes management. Further research is needed to establish optimal dosages, mechanisms of action, and long-term efficacy.

Keywords

Allium cepa, Onion, Obesity, Antidiabetic effects, Glucose metabolism, Insulin sensitivity, Bioactive.

Introduction 

Metabolic syndrome increases the risk of developing cardiovascular disease, type 2 diabetes, and other chronic health issues. It is characterized by a combination of elevated blood glucose levels, high blood pressure, abnormal lipid profiles, and increased abdominal fat.[1] As the prevalence of metabolic syndrome rises globally, there is a growing need for effective management strategies that go beyond conventional treatments.[2]

Allium cepa has been utilized for centuries not only as a culinary ingredient but also for its medicinal properties.[3] Onions are rich in various bioactive compounds, including flavonoids (quercetin), sulfur-containing compounds (allicin), and phenolic acids.[4] These compounds are believed to contribute to the therapeutic effects of onions through their antioxidant, anti-inflammatory, and anti-lipidogenic properties.[5]

Recent studies have started to investigate Allium cepa effectiveness in controlling different aspects of metabolic syndrome, with a special focus on how it affects lipid profiles, obesity, and diabetes.[6] Onion extracts could impact oxidative stress reduction, lipid metabolism, and glucose uptake according to in vitro research.[7] Additional information regarding the potential benefits of onion intake for blood lipid levels, weight management, and glycemic control has been obtained through clinical trials.[8]

Methodology

Using PubMed, an extensive literature search was conducted to find appropriate studies published between January 2010 and September 2024. Allium cepa, onion, diabetes, lipid profile, obesity, in vitro research, and clinical trials were among the terms used in the search approach.

Inclusion Criteria
Study focused on the effects of Allium cepa on lipid profiles, obesity, and diabetes. Both in vitro and clinical studies were included. Articles published between January 2010 and September 2024. Only English-language articles were considered.

Exclusion Criteria
Studies not related to Allium cepa or its effects on metabolic syndrome. Review articles, meta-analyses, and editorial comments were excluded. Studies published in languages other than English were excluded.

Data Extraction
Information on study design, sample size, and intervention details was recorded.

Data were extracted by the impact of Allium cepa on lipid profiles (e.g., total cholesterol, LDL, HDL, and triglycerides), obesity measures (e.g., body weight, fat mass, and waist circumference), and diabetes parameters (e.g., fasting blood glucose, HbA1c, and insulin sensitivity).

Data Analysis
The extracted data were synthesized to provide the effects of Allium cepa on specified outcomes. Findings from in vitro and clinical studies were compared to highlight consistencies and discrepancies. The quality and methodological rigor of included studies were assessed based on study design, sample size, and reported outcomes.

Results

Data were extracted on study design, sample size, intervention details, outcomes related to lipid profile, obesity, and diabetes, as well as statistical values.

Effects on Hypertension
Brüll et al. (2015) conducted an RCT on the Effects of Quercetin-Rich Onion Skin Extract on Blood Pressure, in which findings showed Quercetin supplementation did not significantly affect 24-hour ambulatory blood pressure (ABP) or office blood pressure in the total study group. The subgroup analysis showed that for hypertensive participants, quercetin resulted in a significant reduction in 24-hour systolic blood pressure by 3.6 mmHg compared to placebo (P=0.022). There was also a decrease in daytime and nighttime systolic blood pressure in hypertensives, but not significant in inter-group comparisons.[9]

There were no significant effects of quercetin on vasoactive biomarkers, endothelial function, parameters of oxidation, inflammation, lipid, and glucose metabolism. Quercetin supplementation (162 mg/d) showed a cardioprotective effect on low blood pressure in patients with hypertension. However, the mechanisms underlying this effect remain unclear.

Interpretation: The study suggests that quercetin derived from onion skin extract can decrease blood pressure in hypertensive individuals. Despite the lack of significant changes in various biomarkers and endothelial function, the observed reduction in systolic blood pressure supports the potential antihypertensive benefits of quercetin. Further research is needed to elucidate the exact mechanisms by which quercetin exerts these effects.

Effects on cholesterol levels
Ebrahimi-Mamaghani et al. (2014) conducted an RCT on the Effects of Raw Red Onion Consumption on Metabolic Features in Women with Polycystic Ovary Syndrome.[10] This showed a significant reduction in both intervention groups. The high-onion group showed a greater reduction (Weighted Mean Difference [WMD]: -5.60, 95% Confidence Interval [CI]: -9.16, -2.03, P=0.003) compared to the low-onion group (WMD: -6.42, 95% CI: -11.97, -0.87, P=0.025).

Low-Density Lipoprotein Cholesterol (LDL-C): Significant decrease in the high-onion group (WMD: -5.13, 95% CI: -9.46, -0.81, P=0.022) and low-onion group (WMD: -2.90, 95% CI: -5.57, -0.21, P=0.035). Fasting Blood Sugar, Triglycerides, High-Density Lipoprotein Cholesterol (HDL-C), and Lipoprotein (a) showed no significant changes after 8 weeks of onion treatment. Baseline measurements for progesterone, prolactin, and 17-OH progesterone were conducted, but the study does not report significant changes in these hormones after treatment. Adjustments for confounders did not affect the significance of results for cholesterol levels. Raw red onion consumption appears to have a cholesterol-lowering effect in women with polycystic ovary syndrome (PCOS). The high-onion group experienced a more pronounced reduction in total cholesterol and LDL-C compared to the low-onion group. However, no significant effects were observed on fasting blood sugar, triglycerides, HDL-C, or lipoprotein (a). The study supports the potential use of raw red onions as a dietary intervention for managing cholesterol levels in PCOS, though further research is needed to confirm these findings and explore the underlying mechanisms.

Effects on Diabetes
Parham et al. (2020) indicated that upon completing a 12-week intervention, fasting blood glucose significantly dropped (P=0.0001) in a study on the effects of an herbal combination on blood insulin resistance and blood glucose. Additionally, there was a significant decline in 2-hour postprandial blood glucose (P=0.002).[11]

The study showed a significant reduction in glycated hemoglobin A1c (HbA1c) from 9.72% to 8.39% (P=0.0001). Insulin Resistance improved (P=0.001), reducing from 4.1 to 2.6. During the research, a variety of herbal combinations were utilized, including berry leaf, nettle leaf, walnut leaf, fenugreek seed, onion, garlic, and cinnamon bark. These combinations enabled individuals who have advanced type 2 diabetes to improve their insulin resistance and maintain their blood sugar levels. Significant decreases in insulin resistance, HbA1c, postprandial blood glucose, and fasting blood glucose indicated that the preceding herbal combination may be beneficial when used in conjunction with adjuvant medication for diabetes control.

The study illustrates that type 2 patients who battle to control the condition with conventional therapies alone may benefit from utilizing herbal remedies to improve their glycemic control. The effectiveness of the herbal combination is demonstrated by the 1.31% reduction in HbA1c and enhancements in other metabolic markers. To verify these results and assess the long-term safety and efficacy of this herbal medication, another study with larger sample sizes and longer follow-up times is necessary.

Effects on antioxidant and antibacterial properties
Islam et al. (2024) conducted on Green Synthesis of Zinc Oxide Nanoparticles Using Allium cepa L. Waste Peel Extracts where the nanoparticle Formation like Zinc oxide nanoparticles (ZnO-NPs) was successfully synthesized using onion waste peel extract. The nanoparticles were characterized using multiple techniques by UV-Vis Spectroscopy, and the Sharp absorption peaks at 318 and 322 nm confirmed ZnO-NP formation.[12] While the X-ray Powder Diffraction (XRD) has revealed a crystallite size of 57.38 nm with a hexagonal shape. Field Emission Scanning Electron Microscopy (FE-SEM) provided visual confirmation of nanoparticle shape. Fourier Transform Infrared Spectroscopy (FTIR) identified bioactive functional groups responsible for stabilizing and capping the nanoparticles. Energy Dispersive X-ray (EDX) confirmed the presence of zinc and oxygen in nanoparticles. Antioxidant Properties by DPPH Assay, synthesized ZnO-NPs exhibited significant antioxidant activity, indicating their ability to scavenge free radicals.

Antibacterial Properties by Zone of Inhibition showed Pseudomonas aeruginosa has a maximum inhibition zone of 13.17 mm. Escherichia coli has a maximum inhibition zone of 22.00 mm. Staphylococcus aureus has a maximum inhibition zone of 12.35 mm.

Minimum Inhibitory Concentration (MIC): P. aeruginosa and S. aureus had MIC of 50 μg/mL, and E. coli had an MIC of 100 μg/mL.

This study successfully demonstrated the green synthesis of ZnO-NPs using Allium cepa L. waste peel extracts. The synthesized nanoparticles showed promising antioxidant and antibacterial properties. The ZnO-NPs exhibited effective free radical scavenging activity and were capable of inhibiting the growth of pathogenic bacteria, including P. aeruginosa, E. coli, and S. aureus.

Interpretation: The results suggest that ZnO-NPs derived from onion waste peels have significant potential for applications in agricultural and food safety due to their antimicrobial properties. Additionally, their antioxidant activity supports their potential use in biomedical applications. Further in vivo studies are recommended to explore the full scope of their efficacy and safety.

Study Phytoconstituent Study Design Sample Size Intervention Key Findings
Ebrahimi-Mamaghani et al. (2014) Raw Red Onion Randomized Controlled Trial 54 High-onion vs. low-onion (2 × 40-50 g/day vs. 2 × 10-15 g/day) Significant reduction in total cholesterol and LDL-C in high-onion group. No significant effects on fasting blood sugar, triglycerides, HDL-C, or lipoprotein (a).
Parham et al. (2020) Herbal Combination (includes onion) Double-Blind Clinical Trial 76 Herbal capsules (750 mg) containing nettle leaf, berry leaf, onion, garlic, fenugreek seed, walnut leaf, cinnamon bark Significant reductions in fasting blood glucose, 2-hour postprandial glucose, HbA1c, and insulin resistance.
Islam et al. (2024) Onion Waste Peel Extract Green Synthesis & Characterization Not specified ZnO-NPs synthesized using onion peel extract ZnO-NPs showed significant antioxidant and antibacterial activities. Effective against Pseudomonas aeruginosa, Escherichia coli, and Staphylococcus aureus.

Table 1: A Summary of Onion and Its Phytoconstituents Effects in Metabolic Syndrome

Table 1 consolidates the effects of onion and its derivatives on various aspects of metabolic syndrome and related health conditions.

Discussion 

Onions or Allium cepa, constitute a widely utilized vegetable that has long been valued for its taste and medicinal properties.[13] It has been a part of food for many thousands of years, and multiple studies have investigated its potential health benefits.[14] Garlic, leeks, and chives are among plant species that belong to the Amaryllidaceae family, which comprises onions. There are various uses of Allium cepa, in addition to its medicinal properties, nutritional advantages, and potential underlying mechanisms.[15]

Nutritional Profile: Allium cepa is rich in essential nutrients and bioactive compounds. Onions are a good source of vitamins C, Vit B6, folate, potassium, and dietary fiber.[16] They contain various antioxidants, including flavonoids like quercetin, which add to their health advantages. By lowering inflammation and oxidative stress in the body, onion antioxidants assist in the elimination of free radicals. Onions are also low in fat and calories, which makes them a useful part for a balanced nutritional plan.[17]

Medicinal Properties: The medicinal properties of Allium cepa have been recognized in traditional medicine systems for their potential benefits in treating a wide range of health conditions. Research has supported several uses, although the extent of their efficacy varies.[18]

Cardiovascular Health: The possible cardiovascular advantages of onions are well documented. The quercetin and sulfur-containing components have been connected to better heart health.[19] These substances might assist in managing blood pressure, cholesterol, and stopping platelet aggregation. Based on research examining its effects in hypertensive patients, quercetin has been shown to have antihypertensive benefits by improving endothelial function and lowering systolic blood pressure.[20]

Anti-inflammatory and Antioxidant Effects: Onions have high flavonoid and sulfur component composition, which is primarily responsible for their anti-inflammatory and antioxidant properties.[21] These characteristics have the capacity to reduce chronic inflammation, which is associated with a number of diseases such as cancer, diabetes, and cardiovascular disease. Onions improve general health and prevent disease by lowering oxidative stress and inflammatory marker levels.[22]

Antimicrobial Activity: Due to their antibacterial qualities, onions may prevent a variety of germs and fungus from developing. It is believed that the sulfur-containing chemicals in onions, such as allicin, are responsible for this action. Potential effects of this antimicrobial action include infection prevention and immune system support.[23]

Cancer Prevention: According to certain investigations, consuming onions may lower your risk of developing stomach, colon, and prostate cancer, among other cancers. Organosulfur compounds are believed to hold the potential anticancer properties as they can stop cancer cells from proliferating and cause it to undergo apoptosis.[24]

Mechanisms of Action: The health benefits of Allium cepa can be attributed to its complex array of bioactive compounds. Quercetin is a prominent flavonoid in onions that plays a crucial role in reducing inflammation and oxidative stress.[25] Sulfur compounds, including diallyl disulfide and allyl propyl disulfide, are known for their antioxidant and antimicrobial properties. These compounds may modulate various signaling pathways, including those involved in inflammation, oxidative stress, and cellular proliferation.

Allium cepa offers a wide range of health benefits from its nutritional value to its medicinal properties. Its active compounds, such as quercetin and sulfur compounds, contribute to its cardiovascular, anti-inflammatory, antioxidant, antimicrobial, and potential anticancer effects. Despite the promising evidence, further research is needed to fully understand the mechanisms underlying these effects and to establish optimal intake levels for health benefits. Incorporating onions into the diet can be a practical and beneficial approach to enhancing overall health and preventing disease.[26]

Limitations and Future Directions for Research on Allium cepa
Limitations:
Variability in Bioactive Compound Content: One significant limitation in studying Allium cepa is the variability in the concentration of bioactive compounds such as quercetin and sulfur compounds. This variability can arise from differences in onion varieties, growing conditions, and processing methods. Such inconsistency can impact the reproducibility of study results and the ability to draw definitive conclusions about the health benefits of onions. Standardization of onion extracts and products used in research could help address this issue.[27]

Bioavailability and Metabolism: The bioavailability of bioactive compounds in onions can be affected by their metabolism and absorption in the human body. Compounds such as quercetin are known to have low bioavailability, which may limit their effectiveness. Additionally, the metabolism of these compounds can vary among individuals due to genetic differences and interactions with other dietary components. Research on the bioavailability and metabolism of onion-derived compounds is essential for understanding their potential health effects.[28]

Clinical Study Design: Many studies investigating the health benefits of onions are observational or involve small sample sizes, which can limit the generalizability of the findings. Randomized controlled trials (RCTs) with larger sample sizes and longer follow-up periods are needed to provide more robust evidence regarding the efficacy of onions in preventing or managing specific health conditions. Moreover, many studies use onion extracts rather than whole onions, which may not fully represent the effects of consuming onions as part of a normal diet.[29]

Complexity of Health Outcomes: The health benefits attributed to Allium cepa are often complex and multifactorial. For example, the potential cardiovascular benefits of onions involve multiple pathways and mechanisms, including blood pressure regulation, cholesterol levels, and endothelial function. Isolating the effects of onion consumption on specific health outcomes can be challenging due to the interplay of various factors that influence other dietary and lifestyle habits.[30]

Mechanistic Understanding: While there is evidence supporting the health benefits of onions, the underlying mechanisms through which bioactive compounds exert their effects are not fully understood. Research into the specific molecular pathways and interactions of compounds like quercetin and sulfur compounds is necessary to elucidate their roles in health and disease.[31]

Future Research Directions
Standardization and Optimization: Future studies should keep focus on standardizing the preparation and concentration of onion extracts to ensure consistency in research findings. Additionally, research should investigate the optimal forms and dosages of onions or their extracts for achieving specific health benefits.

Enhanced Bioavailability Studies: Research into enhancing the bioavailability of key bioactive compounds in onions could improve their therapeutic potential. Strategies such as nanoparticle formulations and combination with other foods or compounds help in understanding the impact of food preparation methods, which could increase the effectiveness of onions as functional foods.

Longitudinal and Large-Scale Trials: To establish more robust evidence of the health benefits of onions, future studies should include large-scale and long-term RCTs. These studies should investigate the effects of whole onions rather than just extracts and should evaluate various health outcome,s including cardiovascular health, cancer prevention, and metabolic disorders.

Mechanistic Research: Future research should aim to elucidate the specific mechanisms through which onion-derived compounds exert their health effects. This includes studying their impact on cellular and molecular pathways, interactions with other dietary components, and potential synergistic effects.

Population-Specific Studies: Investigating the effects of onions in different populations, including various age groups, genders, and individuals with specific health conditions, which could provide insights into personalized dietary recommendations and interventions.

The study by Ebrahimi-Mamaghani et al. (2014) demonstrated that raw red onion effectively lowers total cholesterol and LDL-C in women with PCOS, which is consistent with the known effects of quercetin and other onion-derived compounds on lipid metabolism. These findings suggest that onions can be a valuable dietary component for managing dyslipidemia.

The findings from Parham et al. (2020) highlight the potential of herbal combinations, including onion, to improve glycemic control and reduce insulin resistance in patients with type 2 diabetes. This is attributed to the combined effect of onion and other herbs on glucose metabolism and insulin sensitivity.

The research by Islam et al. (2024) showed that zinc oxide nanoparticles synthesized from onion peel have significant antioxidant and antibacterial properties. This suggests that onion waste, often discarded, can be repurposed into valuable nanomaterials with potential applications in health and food safety.

 Figure 1: Allium cepa properties in obesity, lipid profiles, and diabetes 

Conclusion

Onions and their derivatives, including raw forms, supplements, and synthesized nanoparticle,s can offer a range of benefits for managing metabolic syndrome and related conditions:

In metabolic health, the onions have shown efficacy in improving cholesterol levels, reducing body fat, and managing blood glucose levels, making them useful for metabolic syndrome and related disorders. The use of onion waste to produce zinc oxide nanoparticles is an innovative approach that highlights the potential of utilizing natural resources for developing effective antioxidant and antibacterial agents. The observed benefits of onions in various forms underscore their potential as functional foods and therapeutic agents. Further research is needed to fully understand their mechanisms to optimize their use in clinical settings and explore their long-term effects.

Future directions are more extensive, where the long-term clinical trials are required to confirm benefits observed in smaller studies and assess the safety and efficacy of onion-based interventions. Mechanistic research involves further studies that should explore precise mechanisms through which  the compounds exert their effects on metabolic parameters. The development and application of nanomaterials derived from onion waste should be expanded to explore their potential in various biomedical and industrial fields.

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Acknowledgments

Not reported

Funding

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Author Information

Corresponding Author:
Samatha Ampeti
Department of Pharmacology
Kakatiya University, University College of Pharmaceutical Sciences, Warangal, TS, India
Email: ampetisamatha9@gmail.com

Co-Authors:
Sonam Shashikala B V
Independent Researcher, Department of Content
medtigo India Pvt Ltd, Pune, India
Email: venkateshsonams@gmail.com

Mansi Srivastava
Independent Researcher, Department of Content
medtigo India Pvt Ltd, Pune, India
Email: srivastavamansi811@gmail.com

Raziya Begum Sheikh
Independent Researcher, Department of Content
medtigo India Pvt Ltd, Pune, India
Email: raziya.pharma@gmail.com

Shubham Ravindra Sali
Independent Researcher, Department of Content
medtigo India Pvt Ltd, Pune, India
Email: shubhamsali42@gmail.com

Authors Contributions

All authors contributed to the conceptualization, investigation, and data curation by acquiring and critically reviewing the selected articles. They were collectively involved in the writing – original draft preparation, and writing – review & editing to refine the manuscript. Additionally, all authors participated in the supervision of the work, ensuring accuracy and completeness. The final manuscript was approved by all named authors for submission to the journal.

Not applicable

Conflict of Interest Statement

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Guarantor

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DOI

https://doi.org/10.63096/medtigo3061111

Cite this Article

Samatha A, Sonam SBV, Mansi S, Raziya BS, Shubham RS. A Comprehensive Review of Allium Cepa in Metabolic Syndrome Management. medtigo J Pharmacol. 2024;1(1):e3061111. doi:10.63096/medtigo3061111 Crossref

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