Tuesday, 23 February 2021

The Science of Legumes: An Overview of Black Bean Health Benefits

By Kyle Norton

I. Introduction
People who turn to alternative medicine for the treatment of disease in the avoidance of adverse effects induced by conventional medicine should be patient. Compared to herbal medicine, food therapy takes significantly longer times to ease symptoms, depending on the stages of the treatment which directly address the cause of the disease.

Black bean is a small roughly ovoid legume with glossy black shells, genus Phaseolus, belongings to the family Fabaceae. The legume was first domesticated in South America(1). Dried and canned forms of black beans can be bought in most grocery stores all around the year.


The bean also contains several nutrients including(1)(3)
* Carbohydrate
* Dietary fiber
* Protein
* Fat
* Vitamin A
* Vitamin B
* Folate
* Vitamin C
* Calcium
* Magnesium
* Manganese
* Phosphorus
* Molybdenum
* Iron

The major chemical compounds of black beans include anthocyanin, (-)-epicatechin, delphinidin, petunidin, flavonols, and malvidin(2).

In traditional Chinese medicine (TCM), the black bean has been used thousands of years for the treatment of disease associated with blood, and yin deficiency by regulating water in the body via the kidney channel(3).

In other words, TCM applies black beans for the treatment of diseases involved in kidney and yin deficiency such as lower back pain, knee pain, infertility, seminal emissions, blurry vision, ear problems, difficult urination(3).

In herbal medicine, black beans were used as a remedy to treat ear problems, including earache,  ear discharge, ear ringing... and remove wrinkles (4).

II. Health Benefits
1. Anti-Inflammation
Inflammation is a natural response of the immune system in which the white blood cells of the first line of defense destroy the foreign pathogens which try to enter the body through wound or tissue damage(5).

During the acute phase of infection, overproduction of proinflammatory cytokines may cause damage to nearby healthy cells, leading to the formation of scars(6).

Most cases of infection are stopped at the acute phase of infection as the immune system successfully kills off all invaders in a brief battle(5).

Some researchers suggested the immune system has evolved to protect our body over thousands of years to eradicate all pathogens within a period in the range of 3 to 8 weeks. Otherwise, it will adapt to the new change, leading to chronic inflammation(7).

In other words, chronic inflammation happens when the immune response lingers, causing low-grade inflammation. Chronic inflammation over time may damage the body tissues and organs(7).

In some cases, the infection may be latent in which the pathogen remains within the body for a long time without producing any symptoms, such as the hepatitis virus(7).

Diseases associated with chronic inflammation include cancer, heart disease, rheumatoid arthritis, type 2 diabetes, and obesity(7).

In a randomized, controlled, crossover trial of 12 adults with metabolic syndrome (MetS) consumed one of three meals (black bean (BB), fiber matched (FM), and antioxidant capacity matched (AM)) study, researchers found that blood sample collection before (fasting) and five hours after the meal, black bean intake group showed a significant expression of plasma antioxidant capacity and anti-inflammatory cytokines in response to meals differences over time(8).

This result showed strong support of black bean intake in reducing levels of oxidative stress-induced inflammation and enhancing the production of antioxidants.

Dr. Reverri EJ the lead researcher said, " Inclusion of black beans with a typical Western-style meal attenuates postprandial insulin and moderately enhances postprandial antioxidant endpoints"(8).

Therefore, adding a portion of black bean inti a daily diet regularly may improve insulin resistance and induced antioxidant activity to modify the risk and treatment of the inflammatory metabolic syndrome.

On colon inflammation triggered by high-fat diet (HD), -induced obesity in mice, mice fed with black bean showed a remarkable effect in a reduced pro-inflammatory expression such as tumor necrosis factor (TNF)-α, interleukin (IL)-1β, and IL-6, by attenuating changes associated with HD-induced colon inflammation(9).

Additionally, black bean-fed mice also demonstrated a significant improvement of antioxidants through modulated colon mRNA expression and reduced macrophage infiltration into adipose tissue, causing inflammation(9).

Dr. Yook JS, the lead author expressed, " BAB ameliorates HD-induced disorders such as obesity and colitis by improving mucosal barrier protection and reducing endotoxemia, as well as by inactivating NF-κB to decrease the production of proinflammatory cytokines".

Another study in support of the efficacy of black bean in ameliorated inflammation suggested that bean diets reduced not only mRNA expression of exhibited production of colonic inflammatory cytokines (IL-6, IL-9, IFN-γ, and IL-17A) and increased anti-inflammatory IL-10 (P< 0·05), but also systemically reduced circulating cytokines (IL-1β, TNFα, IFNγ, and IL-17A, P< 0·05) and dextran sodium sulfate-induced oxidative stress and colitis in an animal model(10).

The findings suggested that black beans may be used as a functional food for the prevention of inflammation after the body injure or damage by reduced levels of pro-inflammatory and increased levels of anti-inflammatory cytokines.

2. Antioxidants
Free radicals are highly reactive molecules. Internally, they are produced by our body cell metabolism. Externally, free radicals can enter our body from environmental sources, such as the air we breathe, the food we eat, and the water we drink(11).

In other words, free radicals are everywhere. Any chemicals compounds or molecules which process oxygen atom can be free radicals after chemical interaction(11).

Free radicals have been found epidemiologically to damage the lipid, and protein and induce the alternation of healthy cell DNA(11).

Out of all damages caused by overexpression of free radicals, some researchers suggested that lipid peroxidation induced by free radicals has a strong implication in the pathogenesis of various disorders and diseases(12).

Free radicals cause lipid peroxidation by oxidizing the free and ester forms of unsaturated fatty acids and cholesterol through three distinct mechanisms, including free radical-mediated chain reaction, enzyme-mediated oxidation, and nonradical, non-enzymatic oxidation. All of these chemical reactions cannot be stopped until the electrons on the outermost ring of free radicals are paired or inhibited by antioxidants(13).

Antioxidants, opposite to free radicals are substances that inhibit free radicals' activity in the induction of oxidation.

Antioxidants with the free radical scavenging property are atoms that process the function to prevent the free radicals from being formed or remove them before they can damage vital components of the cell (13).

Dr. Slemmer JE, the lead scientist in the examination of free radical scavengers for the treatment of stroke wrote, "The overproduction of reactive oxygen species (ROS) and reactive nitrogen species (RNS) is a common underlying mechanism of many neuropathologies, as they have been shown to damage various cellular components, including proteins, lipids, and DNA"(14).

And "several acute and chronic pharmacological therapies that have been extensively studied in order to reduce ROS/RNS loads in cells and the subsequent oxidative stress, so-called "free-radical scavengers"(14).

In a healthy individual, antioxidants produced by antioxidant enzymes, including superoxide dismutase (SOD), glutathione peroxidase, glutathione reductase, and catalases found in the tissue are more than enough to balance the ratio of ROS and antioxidant which in turn enhances the function of the body systems in protection against diseases associated to overexpression of free radicals(15)(16).

However, in the prevention of free radicals in the induction of diseases, some people may opt for supplementation, including free radical scavenging antioxidant vitamins, such as vitamins A, C, E, folic acid, and beta-carotene(15)(16).

Some researchers suggested, phytochemical produced by plants with a function to protect the plant to grow and defense against competitors, pathogens, or predators may also improve antioxidant status in the body if they are consumed by a human(16).

In the study to classify the maximum antioxidant effect of legumes including black and red varieties of adzuki beans, researchers found that Adzuki bean (black) contains high levels of antioxidants 2,2'-diphenyl-1-picrylhydrazyl and superoxide anion scavenger compared to other beans.
* Adzuki bean (black) also processes the hydrogen peroxide scavenging and metal chelating abilities, but lesser compared to adzuki bean (red) variety(17).

* Phenolic extracts found in black adzuki bean also showed distinct variations compared to other beans in the inhibition of enzymes associated with hyperglycemia and hyperlipidemia(17).

* α-glucosidase inhibitory activity was superior in the black variety of adzuki bean (IC(50,) 26.28 mg/mL), both adzuki bean varieties (black and red) with no significant difference in their IC(50) values (7.32 to 9.85 mg/mL)(17).

Dr. Sreerama YN, the lead scientist at the final report of the study wrote." Vigna species of legumes are a potential source of antioxidant phenolics and also great sources of strong natural inhibitors for α-glucosidase and lipase activities" and "Vigna species of legumes are good sources of phenolic antioxidants and strong natural inhibitors of enzymes associated with diabetes and obesity"(17).

Furthermore, with an aim to reaffirm the antioxidant status of varieties of legume species, researchers at the Bhabha Atomic Research Center launched an investigation using number of different techniques, including Ferric Reducing Antioxidant Power (FRAP) and metal ion (Fe²⁺) chelation assays(18).

Thirty different varieties of commonly consumed legumes in India were screened for phenolic content and antioxidant in the study(18).

All 30 bean varieties process a high level of antioxidants. Beans with a dark coating such as black beans have higher levels of antioxidants compared to beans with a lighter coating(18).

Moreover, Antioxidant activity showed a positive correlation (r²>0.95) with phenolic contents(18).

3. Benign Prostatic Hyperplasia (Enlarged Prostate)
Prostatic hyperplasia is a medical condition associated with an enlarged prostate that impedes urinary flow(19).

The prostate is a gland that surrounds part of your urethra, the tube with a function to carry urine and semen out of men's penis(19).

The condition is found mostly in aging men, as a result of free testosterone converting to the hormone dihydrotestosterone (DHT). Overabundant DHT in the men's body is a major cause of an enlarged prostate(20).

Truly, DHT has been found to plays a beneficial role in the developing prostate but it can be detrimental in the adult prostate in facilitating pathologic prostate growth, including the enlarged prostate(20).


The role of DHT in other adult tissues is uncertain. DHT has not been shown to perform beneficial functions unique from testosterone in the adult male, and it is believed that its fundamental effect may amplify testosterone's weaker hormonal signal(20).

The 5alpha-reductase inhibitors play an important role in the protection of the prostate gland by blocking the process of prostate diseases, reducing the prostate volume, and reduce the risk of acute urinary retention and enlarged prostate(20).

5alpha-reductase inhibitors have been found in the low levels in aging males with prostate diseases.

Some researchers suggested that by targeting the conversion of testosterone to DHT, the enlarged prostate can be preventable(20).

Men who follow an unhealthy diet and lifestyle of the Western diet with a lot of saturated and trans fat, red meat, process and less in fruits and vegetable and whole-grain are associated with a substantial risk of the early onset of LUTS (lower urinary tract symptoms)  related to problems of the lower urinary tract (bladder, prostate, and urethra), including enlarged prostate(21).

Dr. Pao-Hwa Lin, the lead author in the study "Lifestyle and LUTS: what is the correlation in men?" reconfirm these statements said, "1) Epidemiological data repeatedly show a favorable relationship between healthy eating habits and regular physical activity level and a lower risk for LUTS or progression of LUTS, 2) certain specific nutrients or dietary factors may contribute to the link between diet and LUTS due to their anti-inflammatory potential, and 3) very little research has been conducted to test the epidemiological findings in randomized controlled trials"(21).

"A healthy lifestyle with a good quality diet and regular physical activity is beneficial not only for potentially improving or reducing LUTS but also for cardiovascular and overall health"(21).

In other words, an enlarged prostate can be preventable in the aging male, if they follow a healthy diet and lifestyle with moderate exercise.

In the examination to reconfirm the effect of black soybeans on benign prostatic hyperplasia (BPH), researchers launched an investigation to evaluate the anti benign prostatic hyperplasia (BPH) anthocyanin extracted from the legume on rat induced enlarged prostate(22).

The study included a total of male rats who were divided into five experimental groups: a control group, a BPH-induced group, and three BPH-induced groups that received oral doses of anthocyanin (40, 80, and 160 mg/kg)(22).

Prostate hyperplasia was induced by the administration of testosterone propionate for 4 weeks(22).

Anthocyanin-treated groups received the compound for 4 weeks after the induction of enlarged prostate.

The mean prostate weights for the rats receiving 40, 80, and 160 mg/kg anthocyanin were 323.00, 324.00, and 617.50 mg, respectively(22).

This assessment indicated the preferred dose of anthocyanin in the prevention of enlarged prostate is 40 mg(22).

In group comparison, the average prostate weight in the BPH-induced group was significantly higher than in the control group (p < 0.05), whereas the prostate weights in the anthocyanin-administered groups were significantly lower than in the BPH-induced group(22).

Furthermore, the anthocyanin administration helped to prevent the change of prostate weight caused by injecting testosterone to induce prostatic hyperplasia(22).

Moreover, apoptotic body counts were significantly higher in groups receiving anthocyanin than in the BPH-induced group(22).

These results suggested that anthocyanin may be effective in decreasing the volume and suppressing the proliferation of the prostate, by inhibiting the conversion of testosterone to the hormone dihydrotestosterone (DHT).

Additionally, in the testing to examine whether Seoritae extract (SE) from the black soybeans have beneficial effects on the reduction of prostate weight in a rat model of benign prostatic hyperplasia (BPH), researchers at the joint study led by The Catholic University of Korea College of Medicine conducted an experiment with BPH induced by intramuscular injections of testosterone enanthate once a week for 5 weeks in Sprague-Dawley rats, then rats were treated with or without daily oral doses of SE during BPH induction(23).

After 5 weeks, the SE treatment group showed a significant decrease in prostate weight, oxidative stress, apoptosis, and 5alpha-reductase activity compared to the nontreated BPH group(23).

These results coincidently showed that SE is effective in decreasing the weight and proliferation of the prostate similar to those of the above study(23)

Dr. Hoon Jang, the lead scientists suggest that SE may be an effective treatment for BPH(23).

4. Cancers
Cancer is a class of diseases associated with abnormal cell growth in a specific tissue of an organ, due to the alternation of DNA(24).

A primary tumor or original tumor is a tumor that is at the original site where it first arose where tumor progression began and proceeded to yield a cancerous mass(24).

Cancer cells that grow to their tumor size, can invade and kill their neighbor cells by producing abnormal or excessive signaling chemicals (hormones or cytokines) which upset the normal chemical balance of the body and alter the metabolic pathways, leading to disordered and violent cellular behavior(24).

Most cases of cancer begin in the cells on the surface of the inner lining of the tissue. At the early stage, due to the small size of the tumor, most patients are asymptomatic(24).

However, at the advanced stage, the oversize tumor can press on the nearby nerve cells and blood vessels, leading to bleeding and localized pain and symptoms accompanied by the general symptoms shared by other types of cancer, such as unintended weight loss(24).

Furthermore, at this stage, cancer cells can also travel a distance away from the originated site to infect other healthy cells and tissue, leading to secondary metastasis(24).

Localized symptoms are totally depending on the types of cancer(24).

In the cell cycle division perspective, under normal circumstances, cell growth is a natural process. Every day millions of cells grow to replace millions of dead cells and keep our body in balance and healthy(25).

Sometimes, acceleration of cell growth is necessary to prevent further damage to the body organ, such as cut, injure, etc., but after fulfilling their purposes, the growth of cells is back to a normal rate again(25).

However, if the DNA of a cell is altered, it can multiply indefinitely compared to limit cell cycle division in a normal cell(25).

 4.1. Liver Cancer
The liver is the largest internal organ and plays a critical role in filtering blood coming from the intestine before passing to the heart and other parts of the body(26).

The liver also produces bile that aids the digestive function in digesting lipids and absorbing the nutrients from food and cholesterol that is essential to build a strong cell membrane, production of steroid hormones, vitamin D(26).

However, overexpression of cholesterol in the blood has been found to induce plaque accumulated on the arterial wall, increasing the risk of cardiovascular disease(26).

Primary liver cancer is a medical condition caused by irregular cell growth in the liver tissue as a result of the alternation of cell DNA(27).

According to the statistics, in 2019, approximately, 42,030 adults (29,480 men and 12,550 women) in the United States will be diagnosed with primary liver cancer(27).

Believe it or not, since 1980, the incidence of liver cancer has tripled. Between 2006 and 2015, the number of people diagnosed with primary liver cancer is increased by approximately 3% annually(27).

Most cases of primary liver cancer begin in the cell on the surface of the inner lining of the liver tissue, before penetrating into the deeper layers and spreading to other nearby tissues and organs(27).

Epidemiologically, primary liver cancer has been found metastasizing to the lung (median 44%), portal vein (35%), and portal lymph node(s) (27%). Furthermore, the most common causes of liver cancer death are liver failure (34%), bleeding (30%), and advanced cancer (24%)(28).

Interestingly, the pattern of metastasis of primary liver cancer caused by the cirrhotic liver is somewhat different from that of the noncirrhotic(28).

Out of many risk factors associated with the onset of primary liver cancer, some researchers suggested accessive alcohol consumption may be the main culprit that causes the rise of liver cancer incidence in the Western world(29).

Dr. F. Turati, the lead scientist wrote, "Compared with non-drinking, the pooled RRs were 0.91 (95% confidence interval, CI, 0.81–1.02) for moderate drinking (<3 drinks per day) and 1.16 (95% CI, 1.01–1.34) for heavy drinking (≥3 drinks per day), with significant heterogeneity among studies"(29).

And, "The dose–risk curve suggested a linear relationship with increasing alcohol intake in drinkers, with an estimated excess risk of 46% for 5g of ethanol per day and 66% for 10g per day. This systematic review suggests a moderate detrimental role of consumption of 3 or more alcoholic drinks per day on liver cancer and a lack of association with moderate drinking".Liver cancer is a condition of the abnormal growth of the cells in the liver's tissue. According to statistics approximately 40,710 adults (29,200 men and 11,510 women) in the United States will be diagnosed with primary liver cancer this year"(29).

According to the Stocking Hall, Cornell University, phytochemicals isolated from black beans such as triterpenoids, flavonoids, and other compounds exhibited antiproliferative activities against the HepG2 cells(3), the human liver cancer cell line(30).

The efficacy of black beans in ameliorating the growth of liver cancer may be attributed to the presence of some potent antioxidants in the expression of apoptosis(30).

Consumption of beans not only played a prominent role in gene expression(4) involved the regulation of gene Hspa8 in reduced risk of liver disease developed but also addressed the important issue of attenuated hepatic stress or toxicity in a rat model(31).

Increased bean consumption in rats exhibits changes indicative of hepatic damage, Dr. Daniell EL, the lead author said, "Dry bean (Phaseolus vulgaris L.) consumption is associated with reduced risk for a number of chronic diseases", such as liver cancer(31).

Dietary bean concentrations are found to associate with the cholesterol 7α hydroxylase and UDP-glucuronosyltransferase genes increased with connection to the development of liver cancer, in a dose-dependent manner(32).

4. 2. Breast Cancer
The women's breast is made up of specialized tissue that produces milk (glandular tissue) and fatty tissue. The size of the women's breasts is totally determined by the amount of fat(33).

Breast cancer is a medical and chronic condition associated with abnormal cell growth either in the inner lining of milk ducts (Ductal carcinoma) or the lobules (Lobular carcinoma) that supply the ducts with milk(33).

Most cases of breast cancer start in the cells on the surface of the inner lining tissues of the breast before growing into a tumor by invading the deeper layers of the organ(33).

According to the statistics, the lifetime risk of invasive breast cancer developing is 12%(34).

In 2019, approximately 268,600 new cases of invasive breast cancer will be diagnosed in the U.S., along with 62,930 new cases of non-invasive (in situ) breast cancer(34).

The 5 years survival rate of breast cancer diagnosed at the early stage is closed to 100%(34).

Epidemiologically, there are several factors that can reduce the risk of breast cancer including
* Breastfeeding
Researchers found that women who breastfeed their babies slightly lower the risk of developing breast cancer.

* Early age at first full-term pregnancy
Women who have their first full-term pregnancy at an early age slightly lower the risk of developing breast cancer later in life(35).

* An increasing number of births
The risk of breast cancer declines with the birth of a number of children(35).

* Preeclampsia
Women who have had pregnancy conditions of high blood pressure and protein in the urine develop after the 20th week may slightly decrease the risk of developing breast cancer(35).

* Longer duration of breastfeeding
Researchers found that breastfeeding for an extended period of over a year reduces the risk of developing breast cancer later in their life in both hormone receptor-positive and hormone receptor-negative breast cancer(35).

* Drinking more Coffee
In a new study, published in the journal Breast Cancer Research, women who drink five cups of coffee a day or more can reduce the risk of getting certain types of breast cancer. (How many women can do that without developing nervous tension)(35).

In the study of water-soluble condensed tannins isolated from black beans against Hs578T breast cancer cells, the preparation at 0.24-24 microM in dose-dependent induced cancer cell death by apoptosis but did not affect the growth of normal cells(5), as shown by observation assay(32).

The efficacy of water-soluble black bean condensed tannins at 24 microM in suppressed breast cancer cells(32) may be attributed to the phytochemicals in reduced coagulation of remained blood in stimulated cancer cell migration and regulated the growth of breast tumor in the formation of new blood vessels(32).

According to the National Taiwan University, a fermentation product of soybean, black bean, and green bean mixture (BN999) showed a significant effect in inhibiting the growth of human breast cancer AU565 cells in increased expression of multiple apoptotic regulators in induced apoptosis(36).

The fermentation product also exerted an impressive activity in induced apoptosis in various human cancer cells but not in normal human cells, Dr, Chia JS, the lead author insisted(36).

Dr. Dong M, the lead researcher at the Cornell University, in the finding of major phytochemicals of black bean which may have a powerful effect in the treatment of breast cancer, suggested, that out of newly found flavonoids, only 6 (5, 7, 8, 9, 11, 19, 20) of them showed potent antioxidant and antiproliferative activities. against MCF-7 human breast cancer cells(37).

4.3. Osteosarcoma
Osteosarcoma is a type of bone cancer found mostly in teenagers and people over age 60(38).

Most cases of osteosarcoma are associated with genetic syndromes. In other words, Osteosarcoma is associated with a genetic preposition inherited from the parent(38).

Dr. James J. Morrow wrote, "Osteosarcoma is the most common primary malignancy of bone, typically presenting in the first or second decade of life"(38).

And, " Increased risk of osteosarcoma is associated with a number of well-defined genetic syndromes: hereditary retinoblastoma (germline mutation of the Rb gene), Li-Fraumeni syndrome (germline mutation of the p53 gene), Bloom syndrome (germline mutation of the RECQL2 gene), Werner syndrome (germline mutation of the RECQL3 gene), and Rothmund-Thomson syndrome (germline mutation of the RECQL4 gene)"(38).

The exact causes of osteosarcoma are unidentified. However, epidemiologically, besides gene expression, an unhealthy lifestyle such as body weight, physical activity, diet, and tobacco, gender, age, height, ethnicity, and exposure to bone radiation are also some prevalent factors found in patients with the disease(38).

According to the statistic, in the US, osteosarcoma is rare and approximately 900 new cases of osteosarcoma are diagnosed each year. Children and teens are younger than 20 accounts for half of the numbers(38).

The overall 5-year survival rate for children and teens with osteosarcoma is 70%(39). If cancer has spread to the lung, the 5-year survival rate is only 40% compared to localized cancer between 60% to 80%(39).

Conventionally, most cases of osteosarcoma are o treated with a combination of surgery, chemotherapy, and radiation therapy(39).

In patients with high-grade tumors, before surgery, neo-adjuvant therapy may be necessary to shrink the tumor. Osteosarcoma is a condition of bone cancer caused by irregular cell growth in bone, affecting mostly adolescents and young adults(39).

According to The Chinese University of Hong Kong, hemagglutinin isolated from an edible legume, namely black bean, showed an anti-proliferative activity(40) against tumor cell lines MG-63(40) and HepG2(40) but not the normal cell line.

Malignant osteosarcoma cells treated with the phytochemical also exerted a significant effect in the shrinking of tumor cells as well as inducing apoptosis(40).

The study also stated that hemagglutinin also induced cell death by interfering with the first stage of tumor cell division in the expression of the protein, RNA, and DNA and inducing mitochondrial membrane depolarization(40) in controlling the plasma membrane of a muscle or nerve cell

Furthermore, the study also suggested that the efficacy of hemagglutinin in causing cell death may be attributed to the function of the protein in increased regulation of pro-inflammatory expressions(40)

Dr. Dan X, the lead author said, " a novel hemagglutinin from an edible legume (showed) a growth-inhibitory effect on osteosarcoma and liver cancer cells" and " The hemagglutinating activity of this hemagglutinin was demonstrated to be ion-dependent and stable over a wide range of temperature and pH values"(40).

4.4. Prostate Cancer
Prostate cancer is a medical condition associated with cell growth disorderly in the tissue of the prostate(41).

The prostate is a reproductive gland in men that have the shape and size of a walnut located between the bladder and the penis found in front of the rectum(41).

The gland has a unique function in the making of prostate fluid, one of the components of semen(41).

Prostate cancer is one of the slowest growth of cancer in men. Prostate cancer may take years to develop before affecting the patients with symptoms(41).

Most cases of prostate cancer are found in older men. However, the disease also affects men before the age of 40(42).

Believe it or not, about 1 man in 9 will be diagnosed with prostate cancer during his lifetime. According to the statistics, about 6 cases in 10 are diagnosed in men aged 65 or older(42).

In the US, approximately 1,700,000 new cases are diagnosed every year. Prostate cancer also causes the death of 609,640 patients(42).

The 5-year survival rate for diagnosed local or regional prostate cancer is nearly 100%(42).

Although there are many risk factors involved in the onset of the condition, some researchers suggested the widespread prostate cancer over the past few decades may correlate to the promotion of a high-fat diet in the US(43).

Dr. Amir Bagheri, the lead scientist in the cancer team wrote, "Prostate cancer is one of the most common types of cancer with a high mortality rate"(43).

And, "After adjustment for potential confounders, a healthy dietary pattern was associated with decreased risk of prostate cancer (highest versus lowest tertile OR:0.24; 95% CI: 0.07-0.81; trend p: 0.025). An unhealthy dietary pattern was related to increased risk of prostate cancer(highest versus lowest tertile OR:3.4; 95% CI: 1.09-10.32; trend p: 0.037)"(43).

The findings strongly suggested that men who follow the Western diet pattern are associated with an increased risk of prostate cancer compared to those who do not.

According to the National Taiwan University, fermentation products BN999, included black bean processed an anti-prostate cancer effect through the expression of prostate adenocarcinoma PC-3 cell line(44).

BN999, the product mixture induced cancer cell death by activating the protein gene involved pro-cancer cell apoptosis via cell mediatory activities(44), including a network of membranous anatomical structures and double membrane-bound organelle in energy conversion.

Most importantly, BN999 targets the prostate and other cancer cells without affecting the normal human cells and inducing obvious side effects(44).

In the investigation of water-soluble black bean condensed tannins isolated from black beans, researchers showed significant activity in induced cancer cell death by apoptosis without affecting the growth of normal cells, in a dose-dependent manner(45).

Additionally, the study also addressed that the efficacy of water-soluble in induced prostate cancer cell death may be attributed to a direct effect in decrease cancer cell energy molecule and formation of cell structure(45).

Dr. Bawadi HA(45), the lead author indicated, after 24 h of injection, water-soluble black bean condensed tannins showed strongly reduced coagulation of blood in stimulated cancer cell migration and regulated mechanisms involved the growth of prostate cancer in the formation of new blood vessels.

4.5. Colon Cancer
The colon is the 2nd part of the digestive system found in the large bowel which consists of the colon and rectum, with a function that absorbs water from the small bowel contents and breaks down certain materials in the feces into substances in which some of them are reabsorbed and reused by the body(46).

Colon cancer is a chronic condition characterized by irregular cell growth in the tissues of the colon tissues due to the alternation of the cell DNA(47).

Most cases of colon cancer begin in the cell on the surface of the inner lining of the colon tissue, before penetrating into deeper layers to form a tumor(47).

Colon cancer is relatively very common, slowly growing and progressing in a predictable way(47).

Together with rectal cancer, colorectal cancer is the third most commonly diagnosed cancer in Western countries, including the US and Canada(48).

According to the statistics, the lifetime risk of developing colon cancer is about one in 23. Colon cancer accounts for 71% of all cases of colorectal cancer. The overall 5 years survival rate of localized colon cancer is 90%(48).

Conventionally, the treatment of colon cancer is totally depending on the stage and grade of cancer, including surgery, radiotherapy, and chemotherapy(48).
* If the cancer is only limited to the mucosa such as a single layer of epithelial cells, a layer of connective tissue, and a thin muscle layer then it can be cured in most cases(48).

* If cancer has spread through the muscular layer of the bowel or the lymph node, the curable rate is lower(48).

* If cancer has spread to other organs, the curable rate is even lower. The grade of the cancer is calculated depending on how aggressive the cancer(48). Colon cancer is a medical condition of the abnormal proliferation of cells in the large intestine(48).

In a study of rats injected with azoxymethane (AOM)-induced colon cancer or saline and one week later administered an AIN, black bean (BB) and soy flour (SF)--based diet, researchers found that mice fed with black bean showed a significant expression in attenuated gene expression in colon carcinogenesis by modulating cellular kinetics and reducing inflammation(49).

Other experiments to test the prevalence of high bean intake and low incidence of colon cancer in many Latin American countries in 53-wk-old weanling male F344 rats randomly assigned by weight to the following groups: control (11 rats), casein diet (21 rats), and bean diet (21 rats), with animals, fed the casein and bean diets treated with the carcinogen azoxymethane (AOM) once weekly for 2 wk, the results returned showed a significantly fewer colon adenocarcinoma (P < 0.05) in rat fed with bean diet in compared control and rats fed the casein diet(50).

Rats fed with bean diet also expressed a lesser tumor multiplication observed by tumors per tumor-bearing rat than in casein-fed rats.

Dt. Hughes JS, the lead researcher said, "dry beans contain anticarcinogenic compounds capable of inhibiting AOM-induced colon cancer in rats. However, the specific anticarcinogenic components within dry beans have not been identified(50)".

But suggested that the efficacy of beans in reduced colon cancer risk may be results of the dietary fiber, phytochemicals, or other components within dry beans(50),...

Promisingly, the results of rats fed a modified AIN-93G diet (control) or diets containing 75% black beans or 75% navy beans for 4 wk, and then colon cancer initiated by the administration of two injections of azoxymethane 1 wk apart, also postulated a lower incidence of colon cancer in rats fed the black bean (9%) in compared navy bean (14%) diets than in rats fed the control diet (36%) at 31 weeks(51).

Rats fed the black bean also significantly lower total tumor multiplicity compared to control(52).

The findings suggested that black beans with abundant bioactive chemical compounds such as genistein, flavonols, and saponins may be considered as a functional food and integrated form of injection for reduced risk and treatment of various types of malignant tumors. However, raw black beans containing phytohemagglutinin can be toxic to the liver in high amounts (52).

5. Chronic Diseases
Chronic diseases are medical conditions that last more than 3 months depending on the type of diseases(53).

In other words, chronic diseases generally cannot be prevented or cured by medication, nor do they just disappear(53).

Chronic diseases, not prevented by vaccines or cured by medication are any diseases that last over 3 months or more(53).

According to the statistics, chronic diseases affect millions of people worldwide, leading to the death of 35 million people in 2005, including many young people and those in middle age(54).

The most common types of chronic diseases include cardiovascular diseases, stroke, cancer, chronic respiratory diseases, diabetes, and mental disorders(54).

From an inflammatory perspective, chronic inflammatory diseases are the result of the immune system response's inability to kill off all infectious pathogens during the acute phase of infection, leading to the immune adaptation to the new change(55).

In some cases, chronic diseases also are caused by the immune system mistakenly attacking the bodily tissue, leading to low-grade inflammation such as rheumatoid arthritis(55).

Out of many risk factors associated with the onset of chronic diseases, some researchers suggested that the widespread chronic diseases may be caused a long-term unhealthy diet(56).

The World Health Organization in the evaluation of noncommunicable diseases wrote, "An unhealthy diet is one of the major risk factors for a range of chronic diseases, including cardiovascular diseases, cancer, diabetes and other conditions linked to obesity. Specific recommendations for a healthy diet include: eating more fruit, vegetables, legumes, nuts, and grains; cutting down on salt, sugar, and fats. It is also advisable to choose unsaturated fats, instead of saturated fats"(56)

And, Improving dietary habits is a societal, not just an individual problem. Therefore it demands a population-based, multisectoral, multi-disciplinary, and culturally relevant approach"(56).

The results strongly suggested that if you follow a healthy diet such as a traditional diet, your risk of chronic disease is reduced compared to unhealthy diet individuals.

According to the University of Colorado Colorado Springs, the efficacy of legume in reduced chronic illness risk may be attributed to antioxidant phytochemical activities as well as other responses that influenced the classification of types of diseases such as diabetes, CVD, and cancer(57).

In protein and four synthesized pure peptides isolated Mexican black and Brazilian Carioca bean showed a potential and therapeutic effect in treating antidiabetic and antihypertensive mice regardless of their antioxidant capacity(58).

In fact, according to the Universidad Complutense de Madrid, types of carbohydrates found in black bean may be associated with a low glycemic response, low serum cholesterol levels, and a decrease of colon cancer risk factors as well as other forms of chronic diseases such as diabetes type II and cardiovascular diseases(59).

Collectively, black bean reduced risk and treatment of a chronic illness are the result of improved antioxidant status and other mechanisms, including reduction of glucose, triglycerides, total cholesterol, lower levels of LDL and Raised HDL as well as protecting pancreatic ß-cells, ...

6. Colitis
Colitis is chronic a condition associated with the inflammation of the large intestine, including the colon, caecum, and rectum(60).

Colitis can be classified into microscopic colitis, ischemic colitis, segmental colitis associated with diverticula, radiation colitis, diversion colitis, eosinophilic colitis, and Behcet's colitis, according to the Catholic University of the Sacred Heart(61).

The most common symptoms of colitis are totally depending on the types. However, the general symptoms include
* Adnominal pain and diarrhea
There is a report of a 25-year-old Iranian gentleman who was admitted to the hospital with severe bloody diarrhea and abdominal pain as a result of herbal-induced weight loss adverse effects. On flexible sigmoidoscopy, a continuous length of congested mucosa with multiple small ulcers was seen extending up to the mid-transverse colon, in keeping with ulcerative colitis, according to the study by
Homerton University Hospital NHS Foundation Trust(62).

* Bleeding per rectum
Acute ischaemic colitis (AIC) has been found to be an uncommon cause of abdominal pain associated with fresh bleeding per rectum and diarrhea, according to the study by University Central Hospital(63).

* Distention with bloody diarrhea
The typical clinical presentation is acute sudden abdominal pain and distention with bloody diarrhea(64).

* Abdominal bloating and flatulence
In the study to estimate the prevalence of microscopic colitis and SIBO in patients with IBS, to evaluate the symptoms and the efficacy of treatment found that out of the 132 patients initially diagnosed with IBS 3% (n=4) had microscopic colitis and 43.9% (n=58) had SIBO. Diarrhea was the main symptom in patients with microscopic colitis and SIBO (p=0.041), while abdominal pain, abdominal bloating, and flatulence were prominent in IBS patients (p=0.042; p=0.039; p=0.048)(65).

* Changes in bowel habits
Abdominal pain, bloating, early satiety, and changes in bowel habits are common presenting symptoms in individuals with functional GI disorders(66).

* Fever and severe dehydration
There is a report of a 19-year-old man with a 1-year history of ulcerative colitis presented with fever, bloody diarrhea, and severe dehydration. He was on po.48 mg methylprednisolone and 3 g mesalazine daily and has recently finished taking clarithromycin for Campylobacter jejuni infection(67).

* Urgency
The study to examine the differing perspectives and perceptual gaps relating to ulcerative colitis (UC) symptoms and their management between patients and healthcare professionals (HCPs), indicated that fifty-five percent of patients stated that UC symptoms over the past year had affected their quality of life, while physicians and nurses estimated that 35% to 37% of patients would have a reduced quality of life over the same period. Patients ranked urgency and pain as the most bothersome symptoms(68)

* Other symptoms
There is a report of a case of a 51-year-old Caucasian male who was evaluated for abdominal pain, elevated liver enzymes, leukopenia, thrombocytopenia, severe peripheral arthralgias, and chronic watery diarrhea as a result of granulomatous enterocolitis. due to Sarcoidosis(69). Another study conducted by Anhui University of Traditional Chinese Medicine, with rats in the model group, showed lethargy, poor appetite, loss of energy, diarrhea, and bloody stool(70).

According to the joint study led by the University of Guelph, in vivo, cooked whole-bean flours, with differing phenolic compound levels and profiles, showing a completed inhibition of colitis in a mouse model(71).

In C57BL/6 mice fed a 20 % navy bean or black bean flour-containing diet or an isoenergetic basal diet (BD) for 2 weeks before the induction of experimental colitis via 7 d dextran sodium sulfate (DSS, 2 % (w/v) in the drinking water) exposure, coincidentally, both groups exerted similarly a beneficial and adverse effects in induced locally and systemically while aggravating colonic mucosal damage with unknown identity and systemic inflammation(71).

In the bean treatment group, the efficacy in ameliorated colitis may be a result of the inhibition of pro-inflammatory expressions, such as colonic inflammatory cytokines (IL-6, IL-9, IFN-γ, and IL-17A) and increased anti-inflammatory IL-10(71).

In mice with colon inflammation triggered by high-fat diet (HD)-induced obesity, injection of black bean expressed significantly decreased concentrations of lipid and various circulating proinflammatory cytokines(71) such as tumor necrosis factor (TNF)-α, interleukin (IL)-1β, and IL-6 in mice with HD-induced obesity, in attenuated change associated to colon inflammation(72).

Furthermore, mice treated with black bean also improved antioxidant status in reduced progression
of reactive oxygen species (ROS) in the induction of oxidative stress(72).

Dr. Yook JS, the lead researcher said, "BAB ameliorates HD-induced disorders such as obesity and colitis by improving mucosal barrier protection and reducing endotoxemia, as well as by inactivating NF-κB to decrease the production of proinflammatory cytokines"(72).

7. Diabetes
Diabetes is a medical condition caused by not enough insulin entering the bloodstream as a result of the loss of beta cells in the pancreas or insulin receptor sites clogged by plaques that are responsible for the production of insulin(73).

The insulin receptor sites processed a function that binds the insulin and passes the message into the cell, leading to the transformation of glucose from the blood to energy(73).

The hallmark of diabetes is insulin resistance. The condition has been found to increase the risk of cardiovascular disease even without the presence of diabetes(73).

According to the statistics, in the US, between 60 to 70 million individuals are affected by insulin resistance. More than 40% of individuals older than 50 years may be at risk of insulin resistance(75).

The exact causes of insulin resistance are unknown. However, some researchers suggested that genetic preposition and lifestyle are major risk factors that cause the onset of the syndrome(74).

Some researchers suggested that the widespread insulin resistance in the US may be a result of the promotion of the Western diet over the past few decades(74).

Dr. Merat S, in the examination of the Western-type diets in the risk of insulin resistance, said, "the Western diets commonly used in LDLR-/- mice may not only induce atherosclerosis, but also IR, potentially complicating the interpretation of results"(74).

According to the University of Illinois at Urbana-Champaign, bioactive peptides protein isolated from black bean (Phaseolus vulgaris L.) exhibited anti-diabetic activity by inhibiting important molecular markers, a particular sequence of DNA related to diabetes(76).

The study also stressed that certain types of peptides showed some degrees of different inhibitory potential on α-glucosidase, compared to others(76).

In C57BL/6J Mice fed by a High-Fat Diet, black adzuki bean (BAB) extract exerted significantly anti-diabetic effects in improved pancreatic β cells function in maintained mediation of normal glucose(77).

Furthermore, mice fed with dietary supplementation of black bean extract also significantly enhanced hyperglycemia and homeostasis measured by insulin resistance index, observed by expression of glucose intolerance, and regulated insulin secretion(77).

More importantly, in the comparison of protective effects of black bean peel extract (BBPE), pomegranate peel extract (PPE), and a combination of the two (PPE + BBPE) on streptozotocin-induced DM mice(78), mice treated with black bean or combination of black bean showed a strong improvement of fasting blood glucose and insulin levels, and pancreas weight index exerted through antioxidant in reduced oxidative expression(78).

Mice treated with PPE + BBPE also indicated a positive influence in ameliorated oxidative stress-against damage of pancreatic islets(78).

8. Diabetics Complications
Diabetic complications in most cases are caused by long-term unmanaged hyperglycemia, a hallmark of diabetes(79).

Hyperglycemia occurs in diabetics due to uncontrolled diet, skip diabetes medication, and improper use of insulin injection(79).

A most common complication of diabetes is associated with the damage of tiny blood vessels that nourish the related organ and tissues, leading to the risk of developing microvascular and macrovascular complications(80). includes
* Cardiovascular disease(80)
* Nerve damage(80)
* Kidney damage(80)
* Eye damage(80)
* Foot damage(80)
And skin problems(80)

Dr. Waqas Sami, in the evaluation of the effect of diet and type 2 diabetes wrote, "Dietary habits and sedentary lifestyle are the major factors for the rapidly rising incidence of DM among developing countries"(81).

And, "In type 2 diabetics, recently, elevated HbA1c level has also been considered as one of the leading risk factors for developing microvascular and macrovascular complications. Improvement in the elevated HbA1c level can be achieved through diet management; thus, the patients could be prevented from developing diabetes complications"(81).

According to the University of Colorado Colorado Springs, individuals who eat more beans in promoted less glycaemic stress (hyperglycemia and hyperinsulinemia) may have a reduced risk of CVD. (82)

The study also addressed the importance of bean efficacy on glycaemic response and the impact that relationship may have on the risk of developing diabetes and CVD(82).

In the Sprague-Dawley rats model and C57Bl/6 mice induced obesity by a diet, both bean diet, groups showed a significant in reduced plasma total cholesterol and LDL-cholesterol without affecting HDL-cholesterol or total TAG in short-term(83). And bean-fed obese mice not only induced weight loss but also improved plasma lipid profile within a 12 d time frame in comparison to other groups(83).

The weight loss and reduced levels of blood cholesterol in tested subjects provided significant information on dried bean function in the ameliorated risk of cardiovascular disease(83).

The study of the risk of development of cardiovascular complications in patients with diabetes suggested that the imbalance between reactive oxygen species and antioxidant systems in patients with type 2 diabetes may be leading causes of heart complications involving high cardiac collagen content(84).

Therefore, increased intake of bean diet may play a prevalent role in reduced risk of CVD by increased total antioxidant activity and reduced the expression of hyperglycaemic state, catalase, and superoxide dismutase activity and tissue damage caused by lipid peroxidation(84).

Dr. Oliveira RJ, the lead author said, "The phaseolamin treatment attenuated the collagen levels compared to non-treated diabetic rats. Thus, the short-term anti-hyperglycemic effect of the phaseolamin treatment may prevent the initial changes caused by oxidative stress and the deposition of collagen, as well as reduce the incidence of heart complications"(84).


9. Heart Disease
Heart disease is a class of diseases associated with interruption of blood flow in the blood vessel or damage of the heart tissue, including coronary artery diseases (CAD) such as angina and myocardial infarction(85).

According to the statistics, heart disease is a leading cause of death in the US. Over 2000 people in the general population die of heart disease every day(86).

Coronary heart disease (CHD) is the most common type of heart disease, that kills over 370,000 people annually(85).

The most common risk factors associated with heart disease are aging, family history with heart disease, metabolic syndrome, high blood pressure and cholesterol, obesity, smoking, and stress epidemiologically(87).

However, most people with some of the above risk factors have never developed heart disease. Symptoms of heart disease completely depend on the infected location(87).

Some researchers suggested that by making a change in lifestyle accompanied by moderate physical activity such as walking, the risk of heart disease can be prevented(88).

The American College of Cardiology wrote in the article of Heart Disease: Lifestyle Changes to Lower Risk. "Start slowly, and go at a pace you can manage. Try to do at least 2½ hours of moderate exercise a week. One way to do this is to be active 30 minutes a day, at least 5 days a week"(88).

"Healthy eating starts with learning new ways to eat, such as adding more fresh fruits, vegetables, and whole grains and cutting back on foods that have a lot of saturated fat, sodium, and sugar"(88)

"Getting active and eating a healthy diet can help you lose extra weight and quit smoking"(88)

Finally, the article continued, "Even though you are taking medicine, it is always important to make lifestyle changes that keep your heart and your body healthy"(88).

In the study to assess the antioxidant activity in the family legumes, researchers at the North Dakota State Univ. launched an investigation to examine whether the hydrophilic extracts from 9 selected legumes have potency against copper-induced human LDL oxidation model in vitro(89).

After assessing the antioxidant activity on the early and later stage markers of LDL oxidation using the formation of conjugated dienes (lag time of oxidation) and thiobarbituric acid reactive substances (TBARS), researchers found that(89)
* There is no significant lag-time lengthening of all legume extracts(89). On the other hand,

* Black beans exhibited higher antioxidant capacities (Trolox equivalents) in both LDL-conjugated dienes assay and LDL-TBARS assay(89).

* The antioxidant activities of these legumes against LDL-lipid peroxidation are correlated very significantly with their phenolic substances, and DPPH radical scavenging activity, and ORAC (oxygen radical absorbance capacity(89().

These results suggested that consuming black beans may have the potential in preventing the development of atherosclerosis from the perspective of inhibiting LDL oxidation, the major source of plaque accumulation.

Furthermore, in the study to reaffirm that the inhibitory effect of black soybeans on low-density lipoprotein (LDL) oxidation, researchers conducted an experiment to compare the efficacy of black and yellow soybean extracts in reducing the risk of low-density lipoprotein(90).

At the final report of the study, researchers indicated that although the lacked time for LDL oxidation is found in both beans, the antioxidant effects of the extract are similar in both soybeans(90).

Additionally, the mixture of the germ and cotyledon hydrolyzed by beta-glucosidase in both beans showed a stronger inhibitory effect on LDL oxidation than that before being hydrolyzed by beta-glucosidase(90).
Moreover, black soybeans are found more effective in inhibiting LDL oxidation than yellow soybeans because of the total polyphenols contents in their seed coat(90).

Dr. Takahashi R, the lead author after taking into account co and confounders said, "aglycones, which are rich in soybeans fermented or hydrolyzed by beta-glucosidase, may play a crucial role in the prevention of oxidation-related diseases"(90).

10. Hypercholesterolemia
Hypercholesterolemia is a chronic condition associated with abnormally high blood cholesterol in the blood(91).

In other words, hypercholesterolemia is a result of overexpression of low-density lipoprotein compared to low levels of high-density lipoprotein(91).

Low-density cholesterol also is known as bad cholesterol produced by the liver or dietary saturated and trans fat in moderate amount plays a critical role in building a strong cell wall, production of steroid hormones and vitamin D, and aiding the gastrointestinal tract in the absorption of nutrients(91).

However, high levels of bad cholesterol have been found to induce hypercholesterolemia, a leading cause of heart disease and stroke(91).

High-density lipoprotein or good cholesterol, on the other hand, returns the amount of excess cholesterol back to the liver for future use(91).

High-density lipoprotein is also produced by the liver and dietary sources found mostly in nuts and fish(91).
The healthy ratio of LDL/HDL is any number less than 4(92).

Although there are many risk factors that cause the onset of hypercholesterolemia, some researchers suggested the introduction of a high-fat diet in North American over the past few decades may accelerate the rise of the condition(93).

Dr. Cole TG, the lead scientist, in a randomized controlled parallel-designed intervention study to evaluate the effects of a diet with less than 20 g carbohydrates per day (LCHF) on plasma low-density lipoprotein cholesterol (LDL-C) in young and healthy adults wrote, "There was a significant increase in apolipoprotein B, total cholesterol, high-density lipoprotein cholesterol, free fatty acids, uric acid and urea in the LCHF group versus controls"(93).

Included a portion of black beans in your diet may have a potential impact on reduced levels of high blood cholesterol, a renowned institute study proposed.

According to the joint study led by the University of Illinois at Urbana-Champaign, black bean peptides (-7.2 to -7.0kcal/mol) after injection showed a significant disrupt interactions between NPC1L1,(essential for intestinal sterol absorption) and membrane proteins (regulate cholesterol contains) in cholesterol absorption(94).

The efficacy of black bean peptides in reduced levels of cholesterol in the bloodstream may be attributed to the binding cholesterol receptor Niemann-Pick C1 Likeability in cholesterol transport, found on the gastrointestinal tract epithelial cells(94).

In compared primary rat hepatocytes and C57BL/6 mice study, methanol extract of black bean seed coats, exhibited anti hyper cholesterol activity by significantly reduced the expression of SREBP1c, involved glucose metabolism and fatty acid and lipid production, and FAS and HMGCR, involved inflammation and stimulated the expression of the reverse cholesterol transporters(95).

The result in reducing hyper cholesterol levels also was observed in the decrease in hepatic lipid depots and a significant increase in bile acid secretion with some portion of lipids used for energy generation(95).

Dr. Chavez-Santoscoy RA, the lead author said, "the extract of black bean seed coats may decrease hepatic lipogenesis and stimulate cholesterol excretion, in part, via bile acid synthesis"(95).

Additionally, other researchers also in the study of black bean (Phaseolus vulgaris L.) seed coat extracts, expressed a similar effect in reduced risk of high blood cholesterol but with phytochemicals mechanism(96).

Dr. the lead author said, "Contrary to the flavonoid content, saponins were correlated to the inhibitory effect of cholesterol micelle(lipid molecules) solubility as an approach to a potential reduction of cholesterol absorption"(96).

Indeed, the high concentration of saponin in the extract showed significant activity against cholesterol expression in fed mice(96),


11. Hyperglycemia
Hyperglycemia is a condition of abnormally high levels of glucose in the bloodstream(97).

Postprandial blood glucose is the levels taken after 2 hours of a meal, generally at the approximate peak value in patients with diabetes(97).

Management of postprandial blood glucose has become an important feature for diabetics against the risk of microvascular (retinopathy, nephropathy, and neuropathy) and cardiovascular disease (CVD)(98).

Diabetes is a medical and chronic disease characterized by insufficient insulin entering the bloodstream to regulate glucose as a result of the cells in the pancreas died off or receptor sites clogged up by fat and cholesterol(97).

Insulin resistance is a hallmark of diabetes(97). The exact causes of insulin resistance are unknown. Researchers do not know why people with the same health conditions in the same family, some are susceptible to the onset of diabetes while others do not(99).

However, some researchers suggested that an unhealthy diet with high saturated and trans fat, red meat, and processed foods is one of the major risk factors associated with the onset of the disease in the Western world compared to a traditional diet(100).

In other words, if you follow the Western diet, you are at an increased risk of diabetes development.

Dr. David Hefner in the concern of the risk of diabetes in patients who are fans of the Western diet wrote, "The typical Western diet-red meat, high-fat dairy products, refined grains and desserts-may increase your chances for Type 2 diabetes"(101) and "That's what researchers at the Harvard School of Public Health have found and reported in the Annals of Internal Medicine. (101)"

The doctor continued, "The news isn't particularly shocking but offers a new view on the health risks of a typical Western diet as a whole, rather than simply attacking elements within the diet such as fatty foods"(101).

The finding argued the risk of diabetes is reduced if you change your Western diet pattern to a traditional diet with high fruits and vegetables and whole-grain with a limited intake of saturated and trans fat, processed foods, and red meat.

In high-fat diet-induced glucose-intolerant obese C57BL/6J mice, black adzuki bean (BAB) extract injection showed an improved function of pancreatic β cells in inhibiting tolerance of the high glucose-induced glucotoxicity at a concentration of 0.2 mg/mL(102). The dietary supplementation BAB extract also expressed significantly (P < .05) improved hyperglycemia and homeostasis model, using an insulin resistance index (HOMA-IR)(102).

Furthermore, mice fed with the extract also stimulated gene expression in regulated glucose metabolism and insulin response(102).

Dr. Kim M, the lead researcher said, "BAB extract ameliorates hyperglycemia and glucose intolerance, and lowers HOMA-IR (assessment) by regulating insulin secretion and response, and by maintaining the integrity of pancreatic β cells exposed to hyperglycemic conditions"(102).

Additionally, in the investigated possible protective effects of black bean peel extract (BBPE), pomegranate peel extract (PPE), and a combination of the two (PPE + BBPE) on streptozotocin-induced DM mice, researchers at the Xuzhou Medical College, indicated that black bean fed mice showed different degrees, in decreased blood glucose, increased insulin secretion, pancreas weight index, and antioxidative activity(103).

Dr. Wang JY, the lead author said, "PPE and BBPE, particularly the combination of the two, have the ability to ameliorate hyperglycemia by inhibiting oxidative stress-induced pancreatic damage"(103).

The results of these experiments not only displayed the positive and effects of black beans in reducing hyperglycemia risk regardless of types of preparation but also addressed the important issue in the contribution of higher outcome in risk control(103).

Promisingly, compared glycemic response of bean and rice in traditional meals and rice alone in adults with type 2 diabetes of 17 men and women, group injection of traditional meal showed lower a postprandial net glucose values in contrast to the rice control at 90, 120, and 150 minutes(104).

Collectively, the black bean may be used as a functional food in ameliorating the risk and treatment of hyperglycemia, thus reducing the risk of early onset of diabetes.


12. Hypertension
Hypertension is a medical condition caused by abnormally high pressure that presses against the wall of the arteries, affecting the heart function in pumping blood to the body(105).

Hypertension is a member of the cluster of metabolic syndrome that facilitates the risk of cardiovascular disease and types 2 diabetes(105)

Epidemiologically, uncontrolled high blood pressure has been found to induce the risk of heart attack and stroke(105).

Most patients with high blood pressure are asymptomatic. However, the long-term elevated force of the blood against your artery walls may result in symptoms of headache, dizziness, and shortness of breath, early signs of heart disease and stroke(105).

According to the statistics provided by the CDC, approximately 75 million American adults (32%) have high blood pressure. In other words, 1 in every 3 American adults is affected by high blood pressure(106).

Believe it or not, the actual numbers of high blood pressure are substantially higher if people with the stage of prehypertension are also taking into account(106).

Sadly, only half of the people with high blood pressure in the US are under control(106).

There are 2 types of hypertension, including primary hypertension that takes years to develop and secondary hypertension associated with other medical conditions, such as kidney and thyroid disease(107).

Out of many prevalent factors, some researchers suggested that the promotion of a high-fat diet over the past few decades may have a direct implication on the onset of hypertension in American adults(108).

Dr. Dixon W. Wilde, the lead scientist wrote, "Dietary fat contributes to the elevation of blood pressure and increases the risk of stroke and coronary artery disease"(108).

And, "an elevation of plasma FAs may contribute to the development of hypertension via a process involving the elevation of Ca2+ current density and alteration of channel kinetics in the vascular smooth muscle membrane"(108).


The results strongly suggested the high-fat diet-induced elevated FAs associated with the alternation of vascular smooth muscle membrane in the initiation of hypertension.

Therefore, adding a portion of cooked black bean to your diet may substantially reduce risk and enhanced treatment of hypertension, a respectable university study suggested.

According to the joint study led by the University of Illinois at Urbana-Champaign, Mexican black bean isolated proteins peptidase-IV (DPP-IV), after pepsin/pancreatin digestion, showed a significant effect in reduced hypertension at a dose with IC50 = 0.03-0.87 mg and dry weight and inhibited α-glucosidase, a protein related to early onset of diabetes, ranged from 36.3 to 50.1% mg-1 DW(109).

The efficacy of the anti-hypertension of the black bean is attributed to the elevation of antioxidant capacity fighting against the forming of reactive oxygen species (ROS), Dr. Mojica L, the lead author insisted(109).

In an article published in the Research Journal of Pharmaceutical, Biological, and Chemical Sciences,
black bean crude extract decreased both systolic as well as diastolic BP in a dose-dependent manner (1-100 mg/kg)(110).

The article also indicated that the fall of both pressures may be attributed to the presence of phytochemicals saponin fraction and mediagenic acid glucoside in the crude extract(110).

Furthermore, azuki bean (Vigna angularis) seed coats (ABSC) with different colors, containing a high amount of polyphenols attenuated vascular oxidative stress and inflammation associated with hypertension in the experiment of hypertensive rats (SHR) and control normotensive Wistar-Kyoto (WKY) rats(111).

More importantly, treated mice with azuki bean (Vigna angularis) seed coats (ABSC), suppressed the elevation of SBP throughout the treatment period of 8 weeks, by decreasing NADPH pxidase in the activation of free radical expression and increasing antibody p47phox and Nox4 against radical formation through mRNA expression(111).

Dr. Mukai Y, the lead researcher said, " polyphenol-containing ABSC could attenuate vascular oxidative stress and inflammation during the progression of hypertension, and this may lead to an improvement in hypertension"(111).

13. Liver fibrosis
Hepatic fibrosis is a condition caused by scars tissue buildup on the liver which limits the function of the liver (112).

Most cases of hepatic fibrosis are a result of an imbalance of production and dissolution of collagen in the extracellular matrix caused by the overproduction of proinflammatory cytokines in the acute phase of infection or interruption in the stages of healing (112).

Hepatic fibrosis is an early stage of cirrhosis, a leading cause of liver failure and liver cancer(112).

Patients with hepatic fibrosis are asymptomatic. However, long-term accumulated of liver scar induced cirrhosis can cause symptoms of jaundice, variceal bleeding, ascites, a condition of the accumulation of protein-containing fluid within the abdomen, and portosystemic encephalopathy(113)

According to the statistics provided by the CDC, cirrhosis and other chronic liver diseases are common disease-related causes of death in the U.S. Approximately 31,000 people in the U.S. die each year from cirrhosis(114).

From the hepatitis C virus perspective, approximately 3.5 to 4.6 million people in the U.S. are chronically infected with the virus, leading to the death of 2,000 people annually(115).

Most cases of the advanced stages of liver fibrosis are treated by liver transplantation. However, according to the University of California in the development of new therapy for the treatment of liver fibrosis, targeting the steps in HSC activation may be a therapeutic target for liver fibrosis(116).

A list of the targets can be found by clicking the link to the reference area. Please read Fig. 5 Proposed therapies for liver fibrosis(116).

According to the Tecnológico de Monterrey, School of Medicine, Basic Research Laboratory, oral administrated black bean extract exerted a significantly decreased type I and type IV collagen gene expression(117).

In eight weeks of carbon tetrachloride (CCl4)induced liver injury in a rat model, black bean extract of 70 mg/kg treatment showed a reduced hepatic fibrosis index by 18% compared to positive controls(117).

The study also indicated that the efficacy of black bean extract in ameliorating the risk of liver fibrosis due to injury may be attributed to legume strong antifibrotic compounds in the treatment of diseases with the increase in inflammation and oxidative burst in their pathogenesis, including liver fibrosis(117).

Furthermore in the application of 0.1 g of crude biomass obtained from seed coats of Perla black bean dissolved in 400 mL of H2 O, and 100 g of NaCl added in liver injure mice model, the back bean treatment group expressed evidence of improvement of pathological changes(117), including interstitial fibrosis, inflammatory infiltration, collagen deposition and steatosis in compared to normal group(117).

Histological analysis showed that the test group presented a significant reduction of collagen deposition of which exhibited a reduced risk of developed liver scarring in the recovery phase(117).

The study also insisted that antioxidant effect against liver intoxication, a widely use laboratory application in induced lipid peroxidation and trichloromethyl radical (CCl3 ), to cause severe liver cell damage in an animal model, may represent a new perspective in liver injury and fibrosis prevention, the researcher concluded(117).

14. Oxidative Stress
Free radical scavengers are antioxidants that inhibit free radicals before they can cause damage to the tissues and organs(118).

Free radicals are unstable and high reactive atoms with a single electron in the outermost ring(118). Therefore, in order to maintain stability, free radicals are ready to steal or donate a single electron from other stable atoms in the body, leading to a cascade that cannot be stopped until all single electron is paired or inhibited by antioxidants(118).

In the body, free radical is produced by cell metabolism that provides energy for body needs. Outside of the body, free radicals can be anywhere including the air we breathe and the foods we eat(118).

In other words, any chemical compound containing oxygen atoms can be free radicals during the process of a chemical reaction.

Oxidative Stress is the imbalance between free radical and antioxidant expression.

The most common types of free radical scavengers include
* Bilirubin
Bilirubin is a prosthetic group that breaks down molecules into smaller units to release energy, excrete them through bile and urine(119).

* Carotenoids
Carotenoids are organic pigments, occurring in the chloroplasts and chromoplasts of plants and some other photosynthetic organisms like algae, some bacteria(120).

* Flavonoids
Flavonoids neutralize many reactive oxygen species (ROS), including singlet oxygen, hydroxyl, and superoxide radicals(121).

* Thiols (R-SH)
Chemically, thiol, an organosulfur compound has strong odors resembling that of garlic plays an important in the functioning of enzyme regulation, control of gene expression, protein trafficking, and receptor signaling(122).

* Coenzyme Q10
Coenzyme Q10 enhances energy production by promoting the process of the production of ATP then serving as fuel for the cells and acts as an antioxidant to prevent the generation of free radicals during this process(123).

* Vitamin A, C, E., and D (124)
**Vitamin A
Vitamin A plays an important role that scavenges free radicals in the lining of the mouth and lungs. The vitamin also boosts the immune system in controlling free radicals, preventing oxidation of LDL, and enhances the productions of insulin pancreas(124).

** Vitamin C
Vitamin C, an antioxidant and water-soluble vitamin, vitamin C can be easily carried in the blood, The vitamin not only restores the vitamin E but also fights against the forming of free radicals(124).

** Vitamin E
Vitamin E not only protects muscle weakness, repairs damaged tissues, lowers blood pressure and induce blood clotting in healing wound, but also moves into the fatty medium to prevent lipid peroxidation (124).

** Vitamin D
vitamin D, a group of fat-soluble secosteroids is also a membrane antioxidant with the ability to inhibit iron-dependent lipid peroxidation in liposomes compared to cholesterol.
Black beans may be used as a functional food to counter the overexpression of free radicals through improved antioxidant activity, a university study postulated(124).

According to the University of Illinois at Urbana-Champaign, the use of common bean peptides may contribute to a reduced risk of complications associated with chronic diseases, including oxidative stress(125).

Proteins and synthesized pure peptides from Mexican black and Brazilian Carioca bean, all showed a significant rate in reduced oxidative stress through overexpression of antioxidant activity(125).

In a randomized, controlled, crossover trial, 12 adults with metabolic syndrome (MetS) consumed one of three meals (black bean (BB), fiber matched (FM), and antioxidant capacity matched (AM)) on three occasions, then the blood of participants is collection before (fasting) and five hours postprandially, oxidized LDL (oxLDL) showed a trend of declining observed after the Back Bean and antioxidant capacity matched meals at five hours compared to the FM group(126).

Dr. Reverri EJ, the lead author said, " black beans with a typical Western-style meal attenuates postprandial insulin and moderately enhances postprandial antioxidant endpoints in adults with MetS, which could only be partly explained by fiber content and properties of antioxidant capacity"(126).

In the comparison of black bean peel extract (BBPE), pomegranate peel extract (PPE), and a combination of the two (PPE + BBPE), on streptozotocin-induced diabetic mice study conducted by the Xuzhou Medical College, after 4 weeks of injection, researchers found that PPE, BBPE or PPE + BBPE, DM mice showed in some different degrees, a decrease in blood glucose, increases in insulin secretion and the pancreas weight index, and an increase in antioxidative activity(127).

The result indicated that mice treated with black bean or a combination of black bean showed a significant in reduced levels of oxidative stress through enhanced antioxidant activities(127).

15. Weight Loss
Weight loss is a decrease in body weight regardless of circumstances. However, healthy weight loss is a gradual weight reduction through exercise, change of diet, and lifestyle without affecting the nutrients intake(133).

Obesity is a medical and chronic condition caused by long-term excessive body fat accumulated. Overweight is a condition of excess body weight relative to height(128).

According to the Body Mass Index(BMI), people who have a BMI between 25 to 29.9 are considered overweight and a BMI of over 30 is an indication of obesity(128).

The formula of the BMI indexBMI= weight (kg)/ height (m2)(128)

According to the statistic, 68% of the American population is either overweight or obese(130). However,
in 2016, more than 1.9 billion adults, 18 years and older, were overweight, including over 650 million were obese worldwide(129).

The most common causes of obesity are associated with
* An increased intake of energy-dense foods that are high in saturated and trans fat, processed foods, and red meat(129).

* An increase in physical inactivity(129).

The WHO in the explanation of the causes of obesity wrote, "Changes in dietary and physical activity patterns are often the result of environmental and societal changes associated with the development and lack of supportive policies in sectors such as health, agriculture, transport, urban planning, environment, food processing, distribution, marketing, and education"(129).

Certain medical conditions such as hypothyroidism, polycystic ovary syndrome, Cushing's syndrome,..., genetic preposition, and use of certain medications that can cause weight gain or water retention, such as corticosteroids, antidepressants, or some seizure medications, also increases the risk of overweight and obesity(131).

Epidemiologically, obese people are associated with an increased risk of diseases and health problems, including heart disease, diabetes, and high blood pressure(131).

Some researchers suggested that dietary changes, increased physical activity, and behavior changes have been found to enhance weight loss in obesity. In extremely obese subjects, prescription medications and weight-loss surgery may be the only options(132).

Losing weight is not easy, and it takes commitment. Even 5% or 10% of weight loss may have a significant effect on improving your health. A step-by-step guide is also necessary to get you on the right track(133).

The CDC said,, " if you weigh 200 pounds, a 5 percent weight loss equals 10 pounds, bringing your weight down to 190 pounds. While this weight may still be in the “overweight” or “obese” range, this modest weight loss can decrease your risk factors for chronic diseases related to obesity"(133).

In the review of the literature database, researchers at the University of Exeter found that injection of black bean exerted a statistically significant weight loss through the reduction of body fat in compared placebo groups(134).

In the study of dried bean in reduced risk of cardiovascular disease in obese subjects, researchers found that black bean fed Sprague-Dawley rats and diet-induced obesity model in C57Bl/6 mice treated groups experienced significant weight loss through improved plasma lipid profile within a 12 d time frame(135).

Dr. Zhu Z, the lead author said, "These findings support the use of short-term (7-14 d) assays to investigate mechanisms that account for the cardioprotective and weight regulatory effects of dry bean and to screen dry bean germplasm resources for types of bean with high protective activity'(135).

In fact, review literature obtained from the electronic databases PubMed, SpringerLink, Google Scholar, ScienceDirect, and MEDLINE with full text (via EBSCOHost) during late 2012 - early January 2013, showed that botanical ingredients from part of Phaseolus vulgaris and extract isolated from plants exhibited a potentially promising therapeutic effect in appetite controlled and weight loss(136).

Also, a high amount of intake of dietary fiber has shown statistically significant benefits for the reduction of body weight and risk factors in developed complications, such as gallstones(137).

III. Conclusion
Based on the findings, healthy food black beans may be used for the treatment of the aforementioned health problems, pending the large sample and multicenter human study.

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