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Nowadays despite conventional methods in colon cancer treatment, targeting vital molecular pathways and induction of various forms of cell death by safe probiotic components like exopolysaccharides (EPSs) are of great importance and are considered as potential therapeutic agents. This study aimed to investigate the inhibitory effect of the EPS of L. paracasei on different colon cancer cell lines (SW-480, HT-29, and HCT-116). For this purpose, several cellular and molecular experiments including MTS assay, DAPI staining, Annexin V/PI assay, quantitative real-time PCR (qPCR) and some important ferroptosis-related assays were performed. Based on the findings, L. paracasei EPS can induce apoptosis confirmed by all apoptosis-related assays and could not act through ferroptosis pathways. L. paracasei EPS could hinder the Akt1, mTOR, and Jak-1 mRNAs, and induces apoptosis through down-regulation of the anti-apoptotic gene (Bcl-2), up-regulation of pro-apoptotic genes (BAX, caspase-3, 8). The exploited EPS of an indigenous probiotic strain with anticancer potential with low/insignificant cytotoxicity to normal cells is proposed for future applications in molecular-targeted therapy of colon cancer treatment. Furthermore, in vivo and clinical trials should be performed to evaluate the applicability of this component besides conventional methods to increase the survival rate of colon cancer patients.

Available evidence substantiates a strong association between metabolic syndrome and elevated oxidative stress. This study was aimed to assess the effects of probiotic yogurt containing Lactobacillus acidophilus La5 and Bifidobacterium lactis Bb12 on the oxidative stress biomarkers in patients with metabolic syndrome. Furthermore, the association between uric acid levels and insulin resistance indexes was assessed.An 8-week randomized, double-blind, placebo-controlled, parallel study was designed. Forty-four patients, 22 males and 22 females aged 20-65 years, were assigned into two groups. Treatment (n = 22) and control (n = 22) groups consumed 300 g/d of probiotic and regular yogurt, respectively. The serum concentration of uric acid, oxidized Low-Density Lipoprotein (oxLDL), Malondialdehyde (MDA) and Total Antioxidant Capacity (TAC) were measured at the beginning and the end of the trial. This study was recorded at http://www.irct.ir (code: IRCT201608213140N17).Probiotic yogurt consumption resulted in a significant decrease in the level of serum uric acid and a significant increase in the level of TAC (p 0.05). A positive significant association between uric acid with insulin concentration and the homeostasis model assessment of insulin resistance (HOMA-IR) and an inverse significant relationship with insulin sensitivity (Quicki) were also found (p 0.05).Probiotic yogurt consumption through improvement in insulin sensitivity may exert positive effects on the oxidative stress and uric acid levels. However, further studies are needed to make concise conclusions.

Diabetes mellitus is a metabolic disorder defined as an increase in blood glucose levels (hyperglycaemia) and insufficient production or action of insulin produced by the pancreas. Chronic hyperglycaemia leads to increased reactive oxygen species (ROS) production and oxidative stress, which consequently results in insulin resistance, beta cell degeneration, dyslipidaemia, and glucose intolerance in diabetic patients. Chromium has an essential role in the metabolism of proteins, lipids, and carbohydrates through increasing insulin efficiency. This systematic review aimed to evaluate chromium supplementation's potential roles in oxidative stress indices in diabetes mellitus. A systematic search was performed in PubMed, Scopus, Google Scholar, Cochrane, and Science Direct databases until November 2020. All clinical trials and animal studies that assessed chromium's effect on oxidative stress indices in diabetes mellitus and were published in English-language journals were included. Finally, only 33 out of 633 articles met the required criteria for further analysis. Among 33 papers, 25 studies were performed on animals, and eight investigations were conducted on humans. Twenty-eight studies of chromium supplementation lead to reducing oxidative stress indices. Also, 23 studies showed that chromium supplementation markedly increased antioxidant enzymes' activity and improved levels of antioxidant indices. In conclusion, chromium supplementation decreased oxidative stress in diabetes mellitus. However, further clinical trials are suggested in a bid to determine the exact mechanisms.

Nahid Karamzad,1– 3 Esmaeil Faraji,4 Shaghayegh Adeli,2 Kristin Carson‐Chahhoud,5,6 Samaneh Azizi,2 Bahram Pourghassem Gargari2,3 1Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran; 2Department of Biochemistry and Diet Therapy, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran; 3Nutrition Research Center, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran; 4Endocrine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; 5Australian Centre for Precision Health, School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia; 6School of Medicine, University of Adelaide, Adelaide, South Australia, AustraliaCorrespondence: Bahram Pourghassem GargariDepartment of Biochemistry and Diet Therapy, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, IranEmail bahrampg@yahoo.comBackground: Type 2 diabetes mellitus (T2DM) is a prevalent disorder which accounts for 90– 95% of diabetic patients. The aim of this study was to assess the effects of menaquinone (MK-7) supplementation on glycemic indices, anthropometric indices and lipid profile, among patients with T2DM.Methods: In this double-blind placebo-controlled randomized clinical trial, 60 men and women with T2DM were allocated equally into either the MK-7 (200 μg/day) or the placebo group. Physical activity level and dietary intake were assessed using the international physical activity questionnaire-short form (IPAQ-SF) and a 3-day food record, pre- and post-intervention. Anthropometric measures, blood pressure, glycemic indices and lipid profile including fasting blood sugar (FBS), hemoglobin A1c (HBA1C), fasting insulin (FI), homeostatic model assessment insulin resistance index (HOMA-IR), triglycerides (TG), total cholesterol (TC), high-density lipoprotein (HDL-C) and low-density lipoprotein (LDL-C) were measured at baseline and after twelve weeks.Results: Forty-five patients completed the trial. There were no significant between-group differences for calorie intake, macronutrient intake, physical activity level or anthropometric measures at baseline and at the end of the study. Dietary vitamin K intake increased significantly at the end of the study in the MK-7 (p: 0.02) and placebo (p: 0.001) groups, but intergroup differences were not significant (p: 0.86). FBS (p: 0.01), HbA1c (p: 0.002), fasting insulin (p: 0.01) and HOMA-IR (p: 0.007) decreased significantly in the MK-7 group. Furthermore, after adjustment for the baseline values and changes of vitamin K intake at the end of study, FBS and HbA1C showed significant intergroup changes, and they were significantly lower in the MK-7 group compared to the placebo group. Lipid profile (TG, TC, LDL-C, HDL-C and LDL-C/HDL-C) did not change significantly within or between groups.Conclusion: MK-7 supplementation seems to be effective in the improvement of glycemic indices, but not the lipid profile of patients with T2DM.Clinical Trial Registration: The present study was prospectively registered at the Iranian Registry of Clinical Trials on May 2019 (ID: IRCT20100123003140N22).Keywords: diabetes, dyslipidemia, glycemic status, menaquinone, MK-7, phylloquinone, vitamin K, anthropometric indices

Colon cancer is one of the most prevalent cancers, and intestinal microbial community plays a pivotal role in colorectal tumor genesis. Probiotics as live microorganisms may be able to exert an anticancer effect in colon cancer. The aim of this study was to isolate and identify Lactobacillus spp. from traditional dairy products with probiotic properties and to investigate their anticancer effects through ErbB-2 and ErbB-3 gene expression in colon cancer cells. The isolated lactobacilli from yogurt and cheese samples were molecularly identified by blasting of 16-23s rDNA region PCR sequenced products. The probiotic properties, including acid and bile tolerance, antimicrobial activity, and antibiotic susceptibility, were assayed. The proliferation inhibition effects of lactobacilli secretion metabolites with probiotic potential on colon cancer cell lines (HT-29 and caco-2) were analyzed using MTT assay. The real-time PCR was used for assessment of ErbB-2 and ErbB-3 gene expression after being treated with probiotics. Four species of bacteria with the most probiotic properties, including Lactobacillus casei, Lactobacillus paracasei, Lactobacillus rhamnosus, and Lactobacillus plantarum, were characterized and their effects on different human cell lines were taken into consideration. Total bacterial secretions significantly reduced the viability of HT-29 and caco-2 cancer cells compared with untreated controls. The metabolites secreted by bacteria downregulated the expression of ErbB-2 and ErbB-3 genes in colon cancer cells. The present study indicated that probiotic bacteria isolated from traditional dairy products exert anticancer effect on colon cancer cells through the downregulation of ErbB-2 and ErbB-3 gene expression.

Abstract. Some studies indicated poor vitamin D level in NAFLD which is independently correlated with severity of steatosis. Low 25(OH) D3 levels are associated with an impaired lipid profile. Impaired levels and function of vaspin and omentin, which are adipokines, have been demonstrated in NAFLD patients. This study determined the relationship between vitamin D and serum liver enzymes, ultrasound findings, some adipokines, atherogenic index of plasma (AIP) and visceral adiposity index (VAI) in patients with NAFLD in a cross-sectional study. This study was a cross-sectional study in eighty-three NAFLD patients (57 males and 26 females). Plasma levels of omentin-1e-1, vaspin were measured. Anthropometric indices metabolic status was assessed. Visceral adiposity index and atherogenic index of plasma were calculated according to suggested formula. Anthropometric indices, lipid profiles, liver enzymes as well as abdominal ultrasonography and the status of vitamin D were assessed. The results showed that aspartate aminotransferase (AST) (44.22 ± 8.5 IU/L vs. 40.19 ± 8.75 IU/L, p-value = 0.039) AIP (0.767 ± 0.142 vs. 0.6417 ± 0.139, p

Abstract. The present randomized, double-blind, placebo controlled study aimed to evaluate the effect of vitamin D supplementation on matrix metalloproteinases-2, -9 (MMP-2 and MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1) in subjects with metabolic syndrome. Forty-six eligible subjects were randomly assigned to either vitamin D or placebo groups for 16 weeks. The participants were asked to take 50,000 IU vitamin D or matching placebo every week. Metabolic and anthropometric indices, serum MMP-2, MMP-9, TIMP-1 and high-sensitivity C-reactive protein (hsCRP) were assessed before and after intervention. Moreover, dietary intake, sun exposure and physical activity were also determined. The trial was registered at http://www.irct.ir (No. IRCT201409033140N14). Participants were 40.20 ± 4.60 y and 45.50% males. Compared to the baseline values, MMP-9 and TIMP-1 concentrations were decreased after 16 weeks in the intervention group (p = 0.03 and p = 0.04, respectively). However, the changes of MMP-2, MMP-9, TIMP-1 and hsCRP in the intervention group were not significant compared to the placebo group (p > 0.05). Furthermore, the metabolic or anthropometric indices between two study groups remained unchanged (p > 0.05). The findings of the present study demonstrated no effect of vitamin D supplementation on MMP-2, MMP-9 and TIMP-1 concentrations in subjects with metabolic syndrome. However, there is a need for more longitudinal trials to investigate the role of vitamin D on atherosclerosis and cardiovascular diseases in subjects with metabolic syndrome.

Metabolic syndrome (MetS) is a cluster of interconnected serious disorders, which is a major health problem whose prevalence is increasing. Oxidative stress and inflammation contribute to the disease pathogenesis and its complications. The present study aimed to investigate the effect of Cuminum cyminum L. (which has antioxidant and anti-inflammatory properties) essential oil (CuEO) supplementation on inflammatory and antioxidant status in patients with MetS. In this clinical trial, 56 patients with MetS aged 18-60 years received either 75-mg CuEO or placebo soft gel, thrice daily, for 8 weeks. Data on anthropometric parameters, food consumption, tumor necrosis factor alpha, high-sensitivity C-reactive protein, superoxide dismutase (SOD), glutathione peroxidase, catalase, total antioxidant capacity (TAC), and malondialdehyde (MDA) were assessed at the beginning and at the end of the study. Compared with the placebo group, CuEO increased SOD (149.17; 95% CI, [67.93, 230.42]), TAC (0.24; 95% CI, [0.09, 0.38]) and decreased MDA (-0.36; 95% CI, [-0.66, 0.06]), (p < 0.01). In within-group analysis, CuEO led to 13.3% decrease in MDA and 6.7% increase in TAC levels (p < 0.04). The results indicated that CuEO supplementation can improve some antioxidative indices, as SOD and TAC, while decreasing MDA in patients with MetS.

This study aimed at determining the effects of coenzyme Q10 (CoQ10) supplementation on the inflammatory and endothelial dysfunction indices among overweight and obese women with polycystic ovary syndrome (PCOS).This randomized double-blind, placebo-controlled clinical trial was performed among overweight and obese women diagnosed with PCOS. Forty three PCOS women were randomly assigned to two groups: one group received 200 mg CoQ10 capsules per day (At the end of study, compared with pldacebo, CoQ10 supplementation resulted in significant decreases in serum levels of TNF-α (The present study showed that CoQ10 supplementation for 8 weeks had a beneficial effect on inflammatory and endothelial dysfunction markers in overweight and obese patients with PCOS.

Aims Diabetic nephropathy is one of the major microvascular complications of type 2 diabetes which insufficient vitamin D might -have a role in it's incidence. This study evaluated the effects of vitamin D supplementation on lipid profiles and oxidative/anti-oxidative indices in marginal vitamin D status patients with diabetic nephropathy. Methods For the current paralleled, randomized, double-blinded, placebo-controlled clinical trial, 50 diabetic nephropathy patients with marginal serum vitamin D were selected. Intervention group received 1,25-dihydroxycholecalciferol (50000 IU/week, n = 25), and placebo group (n = 25) received an identical placebo, for 8 weeks. Lipid profiles (LDL, HDL, TG and TC) and oxidative/anti-oxidative markers (TAC, SOD, CAT, GPX and MDA) were measured. Results Vitamin D supplementation significantly increased vitamin D status in the intervention group, compared to the control group (P = 0.001). The reductions in the serum levels of TG, LDL and TC were significant (P = 0.04, P = 0.006 and P = 0.02, respectively) in the intervention group. The changes in oxidative/anti-oxidative markers and HDL levels were not significant after intervention. Conclusion In conclusion, vitamin D supplementation for 8 weeks among diabetic nephropathy patients has beneficial effects on serum vitamin D status and dyslipidemia.

Abstract. Background: Rheumatoid arthritis (RA) is an inflammatory disorder in which the disease severity might be decreased by anti-inflammatory agents. There are several lines of evidence which support anti-inflammatory effects of vitamin K. The aim of this study was to examine whether vitamin K is a useful strategy for reducing inflammation in RA subjects. Materials and methods: In this double-blind placebo controlled trial, 58 patients with definitive RA were randomly allocated into two groups to receive vitamin K1 as phylloquinone [10 mg/day] or placebo pills for 8 weeks. Clinical status using disease activity score-28 (DAS-28) and serum concentrations of some inflammatory markers (IL-6, hs-CRP, TNFα) were assessed at baseline and at the end of intervention. Results: There were no significant differences between the two groups regarding any of the baseline characteristics. In the vitamin K1 group, a 27 % decrease in serum levels of IL-6 (P = 0.006) and a 13 % decrease in DAS-28 (P = 0.041) were observed. However, after adjusting for relevant confounders, i. e.; duration of RA, intake of folic acid supplements, energy intake, weight and baseline values of each variable, by comparing the two groups, we found no significant reduction in these markers. Conclusion: Vitamin K1 supplementation at 10 mg/day for 8 weeks had no significant effects on blood biomarkers of inflammation and disease severity of patients with rheumatoid arthritis compared with the placebo group.

Non-alcoholic fatty liver disease (NAFLD), the hepatic manifestation of insulin resistance, is the most common cause of chronic liver. The present study aimed to investigate the roles of vaspin and omentin-1 in the NAFLD-related pathology including IR, inflammation and elevated blood pressure.This cross-sectional study was conducted among 83 NAFLD patients in Jahrom, Iran. Plasma levels of omentin-1, vaspin, hs-CRP and IL-6 were measured. Anthropometric indices, lipid profiles, liver enzymes as well as abdominal ultrasonography were assessed.Partial correlations controlling for age and sex showed significant positive correlation between vaspin and fasting blood sugar (FBS), insulin, HOMA-IR, and hs-CRP. It has been observed that omentin negatively correlated with glucose levels. Moreover, a marginally significant association has been found between omentin levels and systolic blood pressure (SBP).This study shows that vaspin and omentin-1 are associated with inflammation, insulin resistance and serum glucose levels in patients with NAFLD.Oboljenje ne-alkoholna masna jetra (NAFLD) je posledica promene na jetri usled insulinske rezistencije je najčešći uzrok hroničnog oboljenja jetre. Ovaj rad ima za cilj ispitivanje uloge vaspina i ometina-1 u NAFLD-patologiji, inflamaciji i povećanom krvnom pritisku.Ispitivanja su izvedena na 83 NAFLD pacijenta u Jahrom-u, Iran. Mereni su nivoi ometina-1, vaspina, hs-CRP i IL-6. Ispitivani su antropometrijski parametri, profil lipida, jetreni enzimi i abdominalna ultrasonografija.Delimičnom korelacijom između pola i starosti ukazala su na pozitivnu korelaciju između vaspina i nivoa glukoze u krvi (FBS), insulina, HOMA-IR i hs-CRP. Nađeno je da je ometin u negativnoj korelaciji sa nivoima glukoze. Međutim, marginalno značajna veza je nađena između nivoa ometina i sistolnog krvnog pritiska (SBP).Rezultati su pokazali da vaspin i ometion-1 su praćeni inflamacijom, insulinskom rezistencijom u nivoima glukoze u serumu kod pacijenata sa NAFLD.

Aims The role of gut microbiota in the management of diabetes is shown. In this randomized clinical trial we assessed the effects of synbiotic supplementation on insulin, lipid profile and antioxidative status among women with gestational diabetes mellitus (GDM). Methods Ninety pregnant women with GDM were randomly assigned into two groups to receive either a daily synbiotic capsule – consisting of L. acidophilus, L. plantarum, L. fermentum, L. gasseri (1.5–7.0 × 109–10 CFU/g) – with fructooligosaccharide (38.5 mg), or placebo for 6 weeks. Fasting plasma glucose (FPG), insulin, homeostasis model assessment-insulin resistance (HOMA-IR), quantitative insulin sensitivity check index (QUICKI), high- and low density lipoprotein cholesterol (HDL-C, LDL-C), total cholesterol (TC), triglycerides (TG), total antioxidant capacity (TAC), and systolic and diastolic blood pressure (SBP, DSP) were assessed before and after the intervention. Results No significant changes in FPG, insulin resistance/sensitivity, lipid profile and TAC indices were seen in synbiotic group compared to the placebo one (p > 0.05). Significant within group increases for HDL-C and TAC levels in synbiotic group were observed (p Conclusions The results showed that, in women with GDM, synbiotic supplementation had no effect on FPG and insulin resistance/sensitivity indices. Lipid profile and TAC status may be affected by synbiotic supplementation. Synbiotic is effective in reducing of blood pressure in women with GDM.

Introduction Nonalcoholic fatty liver disease (NAFLD) is the most frequent liver disease. Vaspin may modulate the inflammatory process, insulin resistance, and NAFLD. Omentin-1 is independently associated with hepatocyte ballooning. There is evidence of improvement in the adipokines level and histological hepatic steatosis following energy intake restriction and weight loss. The aim of the study was to evaluate the effects of Ramadan fasting on various circulating adipokines in NAFLD patients. Methods This study was conducted on 83 NAFLD patients, 42 cases who declared that they would fast during the month of Ramadan fasted and 41 controls who decided not to fast during Ramadan. Anthropometric parameters including weight, body mass index (BMI), waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR) and body fat percentage were measured before and after Ramadan. Dietary intake and physical activity levels were assessed by 24-h recall questionnaire and International physical activity questionnaire-short form (IPAQ-S), respectively. Serum adipokines including vaspin and omentin-1 were measured using commercial ELISA kit. Results Patients who fasted displayed a lower mean hip circumference and body mass index and considerable changes in serum vaspin and omentin-1 (p-value Conclusion There is a potential for fasting in improving several anthropometric indices in NAFLD patients. Additionally, fasting during Ramadan resulted in decreased levels of adipokines including vaspin and omentin-1. Studies with longer follow-up periods are required.

Metabolic syndrome may predispose to cardiovascular diseases. Since, in recent studies, vitamin D is advocated for cardioprotective roles, this study was designed to investigate the effects of vitamin D supplementation on proatherogenic inflammatory markers and common carotid intima media thickness in subjects with metabolic syndrome.This randomized double blind clinical trial was conducted in Tabriz, Iran. Eligible subjects (n = 80) with metabolic syndrome were recruited thorough advertisement and randomized to receive either vitamin D (50,000 IU/week) or matching placebo for 16 weeks. Interlukin-6, high sensitivity C-reactive protein, vascular cell adhesion molecule-1, E-selectin, and common carotid intima media thickness were measured at the beginning and end of the study. The study was registered at http://www.irct.ir (code: IRCT201409033140N14).Sixteen weeks supplementation with vitamin D increased median of serum 25-hydroxy vitamin D [25(OH)D] and mean calcium levels (p 0.001) in the intervention group. There was also a significant difference in parathyroid hormone level at the end of the study (p 0.001). Vitamin D treatment reduced IL-6 level after 16 weeks (p = 0.027). Compared to baseline, vascular cell adhesion molecule-1 and E-selectin levels decreased significantly in vitamin D treated subjects; however, there were no significant differences between two groups. No effect of vitamin D supplementation was observed in either common carotid intima media thickness or high sensitivity C-reactive protein concentrations at the end of the study (p 0.05).Vitamin D supplementation improved some proatherogenic inflammatory markers in subjects with metabolic syndrome. No changes of high sensitivity C-reactive protein and carotid intima media thickness were shown after 16 weeks.

Evaluating the impact of chromium picolinate supplementation on glycemic status, lipid profile, inflammatory markers and fetuin-A in patients with non-alcoholic fatty liver disease (NAFLD).In present research, participants (N = 46) were randomized to (400 mcg/day, n = 23) chromium picolinate and placebo (n = 23) for 3 months.Glucose indices, and lipid profiles, inflammatory biomarker and fetuin-A were measured before and after the intervention. Chromium reduced triglyceride (TG), atherogenic index of plasma (AIP), very-low-density lipoprotein (VLDL), insulin, homeostatic model assessment for insulin resistance (HOMA-IR), high-sensitivity C-reactive protein (hs-CRP), interleukin (IL) -6, tumor necrosis factor-alpha (TNF-α) and fetuin-A significantly compared to placebo group (p 0.05). Furthermore, chromium significantly increased the quantitative insulin sensitivity check index (QUICKI). There were no significant differences in total cholesterol (TC), high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL), fasting blood sugar (FBS), Hemoglobin A1c (HbA1C), interleukin (IL)-17 between the two groups (p 0.05).Chromium picolinate significantly decreased TG, insulin, HOMA-IR, fetuin-A, the number of inflammatory factors, and increased QUICKI without changing FBS, HbA1C, TC, LDL, HDL, IL-17 levels and liver steatosis intensity in patients with NAFLD. Further studies by examining the effect of different doses of chromium and mechanisms of cellular action, would help further clarify the subject.

Diabetes mellitus and pre-diabetes are prevalent endocrine disorders associated with substantial morbidity and premature mortality. Vitamin K is known to have several beneficial effects on complications of diabetes and pre-diabetes. However, systematic consolidation of evidence is required to quantify these effects in order to inform clinical practice and research. A systematic search in PubMed, Scopus, Embase, ProQuest, and Google Scholar databases was undertaken from database inception up to October 2018 to evaluate functional roles of different forms of vitamin K on diabetes and pre-diabetes. From 3,734 identified records, nine articles met the inclusion criteria and were evaluated. Vitamin K supplementation was found to be associated with significant reductions in blood glucose (six studies), increased fasting serum insulin (four studies), reduced hemoglobin A1c (three studies), reduced homeostatic model assessment-insulin resistance index (HOMA-IR) (two studies), and increased ß-cell function (two studies) in diabetic animal studies. Following 2-hour oral glucose tolerance test, vitamin K supplementation was observed to be effective in reducing blood glucose and insulin levels in the pre-diabetic population. However, no evidence of effect was observed for fasting blood sugar, insulin, HOMA-IR, and homeostatic model assessment-β-cell function index (two studies). A statistically significant effect was also noted with vitamin K in improving dyslipidemia (three studies) as well as oxidative stress and inflammatory markers (five studies) in diabetic animals. In conclusion, clinical trials and animal studies confirm that vitamin K supplementation may improve both clinical features and complications of diabetes and pre-diabetes. However, quantification of clinical efficacy in the pre-diabetic population and among individuals with comorbidities requires further investigation. Refereed/Peer-reviewed

Cancer is a globally challenging health problem threatening mankind. Despite therapeutic advances in dealing with this malignancy, heterogeneous response and resistance to chemotherapeutic agents remain the hallmarks of cancer therapy. On the other hand, the involvement of the microbiota in affecting human health is well defined. An ever-growing body of evidence implicates the potential link between the microbiome and the efficacy of cancer therapies. Gut microbiota can modulate the metabolism of drugs in a number of ways. The presence of bacteria within the tumor environment can also impact the responses to cancer therapies; changing the chemical structure of chemotherapeutic drugs, affecting their activity, and local concentration. However, the underlying mechanisms by which gut and tumor microbial communities affect the response to cancer therapy are poorly understood and deciphering these mechanisms is of paramount importance. This review provides an overview of how gut and tumor microbiota might affect the efficacy of chemotherapy, radiotherapy, and immunotherapy and alleviate the adverse side effects of these therapies for the development of personalized and effective anticancer therapy.

Prevalence of metabolic syndrome (MetS), as a major health problem, is increasing. Very limited data exist on the effect of Cuminum cyminum L. essential oil (CuEO) on MetS components. Accordingly, this study aimed to examine the effect of CuEO supplementation on anthropometric indices, glycemic control, blood pressure, lipid profile, and insulin resistance in patients with MetS. In a randomized, triple-blind, placebo-controlled clinical trial, 56 patients with MetS aged 18-60 years received either 75 mg CuEO or placebo soft gel thrice daily for 8 weeks. Anthropometric indices and biochemical measurements were assessed at baseline and end of the study. At the end of study, except for diastolic blood pressure (DBP), the other assessed variables were not significantly different between two groups. In intra group analysis, placebo and CuEO groups both had nonsignificant decrements in DBP (mean difference [MD] with 95% CI: -3.31 [-7.11, 0.47] and -1.77 [-5.95, 2.40] mmHg, respectively). However, DBP was significantly lower in CuEO compared with the placebo group at the end of study (81.41 ± 5.88 vs. 84.09 ± 5.54 mmHg, MD with 95% CI: -3.98 [-7.60, -0.35] mmHg, p < .05). The results indicated that CuEO does not have any effect on MetS components, except for DBP in patients with MetS.

Abstract. Background: Nonalcoholic fatty liver disease (NAFLD) is a serious global health problem, thus the prevention and management of the disease is necessary. This study aimed to determine the effects of Ramadan Fasting (RF) on liver function, Visceral Adiposity Index (VAI) and Atherogenic Index of Plasma (AIP) in these patients. Methods: Eighty-three NAFLD patients (57 males and 26 females) were enrolled in the study, 42 patients who practiced RF, between Jun 18 through July 17, 2015 and 41 patients in non-fasting groups. Anthropometric parameters and Ultrasound grading were measured before and after Ramadan. The biochemical parameters including lipid profiles (total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides), liver enzymes (Aspartate aminotransferase, SGOT and Alanine aminotransferase, SGPT) were evaluated before and after Ramadan. AIP and VAI were calculated based on formula. Results: The mean decreases in anthropometric indices were significantly different between groups. Similarly, the mean decrease in the total cholesterol values in the fasting group was remarkably greater than in the control group (p = 0.02). The values of AIP and VAI decreased at the end of the study in both group and the mean of changes showed no differences between groups (p = 0.79 and p = 0.65 for AIP and VAI, respectively). The changes in the concentrations of liver enzymes, as well as the severity of hepatic steatosis, showed remarkable differences between groups (p = 0.03, p = 0.05, and p = 0.02 for SGOT and SGPT, and Liver steatosis, respectively). Conclusion: RF improved liver steatosis in NAFLD patients and might be useful in the management of NAFLD.

Diabetes, as a low-grade chronic inflammatory disease, causes disruption in proper function of immune and metabolic system. Chromium is an important element required for normal lipid and glucose metabolism. Chromium deficiency is correlated with elevation in cardiometabolic risk, which results from increased inflammation. This systematic review was conducted to discover the potential roles of chromium on inflammatory biomarkers. Eligible studies were all in vitro, animal and human studies published in English-language journals from inception until October 2018. PubMed, Scopus, Embase, ProQuest and Google Scholar databases were searched to fined interventional studies from the effects of chromium on inflammatory biomarkers such as tumour necrosis factor a (TNF-a), C-reactive protein (CRP), interleukins, monocyte chemoattractant protein-1 (MCP-1), intercellular adhesion molecule-1 (ICAM-1) and adipocytokines in hyperglycaemia and diabetes. Out of 647 articles found in the search, only 14 articles were eligible for analysis, three in vitro studies, eight animal studies and three human studies. Twelve of the 14 studies included in this review, chromium significantly decreased inflammatory factors. The findings of this review indicate, based on in vitro and in vivo studies, that chromium might have potential anti-inflammatory properties, but some of the studies did not show anti-inflammatory effects for chromium (two studies). There are only three studies in humans with controversial results. Therefore, more consistent randomized double-blind controlled trials are needed to reach relevant clinical recommendations, as well as to determine the precise mechanism, of chromium on inflammation in diabetes.

Introduction Dyslipidemia is one of the most important risk factors for cardiovascular disease. Previous studies have shown that pomegranate and its polyphenols may have hypolipidemic effects. The objective of this study was to evaluate the effects of pomegranate peel extract on some cardiovascular risk factors in patients with dyslipidemia. Methods Thirty eight obese women (30 35 kg/m2) with dyslipidemia were allocated into two groups receiving two 500 mg pomegranate peel extract (n = 19) or placebo (n = 19) daily for 8 weeks. Serum lipid profile (total cholesterol (TC), HDL-cholesterol (HDL-C), LDL-cholesterol (LDL-C), triglycerides (TG)), Blood Pressure(BP), serum high sensitive-C reactive protein (hs-CRP) and BMIwere measured. Results Pomegranate peel extract significantly decreased post treatment levels of serum TC (p = 0.014), LDL-C (p = 0.021), and TG (p = 0.036) and increased HDL-C (p = 0.020)compared to baseline. There was a significant decrease in Systolic Blood Pressure (SBP) levels and hs-CRP in pomegranate peel group whereas Diastolic Blood Pressure (DBP) levels and BMI remained unchanged after intervention. No significant changes were seen in terms of all post treatment values for the placebo group at the end of trial (p > 0.05). After adjusting for the baseline values, energy intake and weight changes, there were significant differences in post-treatment values between the two groups except in serum concentrations of HDL-C, DBP and BMI. Conclusions Current study showed a positive effect of pomegranate peel extract in improving cardiovascular risk factors in obese women with dyslipidemia.

BACKGROUND/OBJECTIVES Vitamin D plays an important role in the etiology of gestational diabetes mellitus (GDM). This study evaluated the effect of vitamin D supplementation on metabolic indices and hs-C-reactive protein (CRP) levels in GDM patients. SUBJECTS/METHODS The study was a randomized, placebo-controlled, double-blinded clinical trial. Seventy-six pregnant women with GDM and gestational age between 24-28 weeks were assigned to receive four oral treatments consisting of 50,000 IU of vitamin D3 (n = 38) or placebo (n = 38) once every 2 weeks for 2 months. Fasting blood glucose (FG), insulin, HbA1c, 25-hydroxyvitamin D, lipid profile, hs-CRP, and homeostasis model assessment-insulin resistance (HOMA-IR) were measured before and after treatment. Independent and paired t-tests were used to determine intra- and intergroup differences, respectively. ANCOVA was used to assess the effects of vitamin D supplementation on biochemical parameters. RESULTS Compared with the placebo group, in the vitamin D group, the serum level of 25-hydroxyvitamin D increased (19.15 vs. -0.40 ng/ml; P < 0.01) and that of FG (-4.72 vs. 5.27 mg/dl; P = 0.01) as well as HbA1c (-0.18% vs. 0.17%; P = 0.02) decreased. Improvements in the lipid profiles were observed in the vitamin D group, but without statistical significance. Significant increases in concentrations of hs-CRP, FG, HbA1c, total cholesterol, and LDL cholesterol were observed in the placebo group. No significant change in fasting insulin and HOMA-IR was observed in either group. CONCLUSIONS In GDM patients, vitamin D supplementation improved FG and HbA1c but had no significant effects on lipid profile or hs-CRP.

Eating disorders are rapidly increasing in young adults. But, a few studies have examined the risk of eating disorders and body image in university students of non-Western societies. The current study aimed to assess eating disorders risk in relation to body image and self-esteem among Iranian university students. The participants were 430 students from Tabriz, between April and May 2015. The 26-item Eating Attitude Test (EAT-26), Multidimensional Body-Self Relations Questionnaire (MBSRQ) and Rosenberg’s Self-Esteem Questionnaires were used. EAT-26 score of 20 or more was considered as eating disorders risk cutoff. Majority of the students (68 %) were females. The overall eating disorders risk was 9.5 % (7.5 and 10.5 % in men and women, respectively). Further, the prevalence of poor body image and low self-esteem was 34.2 and 16 %, respectively. Neither of the gender differences was statistically significant (p > 0.05). In simple logistic regression, there were significant associations between self-esteem, body image, parental education and eating disorders risk (p

The roles of vitamin K in inflammation, the lipid profile, and glucose homeostasis are under investigation. It appears that vitamin K may be an adjuvant therapy in some diseases. There are documents showing the beneficiary effects of vitamin K in the biochemical and clinical changes in rheumatoid arthritis. However, the clinical trials aimed at investigating the effect of any form of vitamin K in pathological pathways involved in rheumatoid arthritis reached different conclusions. The contradictory findings in such studies are the result of their different methodologies, including differences in the dose and form of vitamin K, the duration of intervention, the severity of the disease, the status of vitamin K, etc. Therefore, it is hard to reach any definitive consensus about the efficacy of vitamin K in rheumatoid arthritis. Many questions remain unsolved. Altogether, given the determined role of vitamin K in molecular interactions, the necessity for further clinical trials in this regard becomes evident.

This randomised, double blind study was conducted on 44 subjects with metabolic syndrome (MetS). Participants were randomly assigned to receive 300 g daily regular yoghurt or 300 g probiotic yoghurt for 8 weeks. Serum lipid profiles, blood pressure, anthropometric measurements, and serum inflammatory factors were evaluated before and after the intervention. The inflammatory factors, low-density lipoprotein-cholesterol, total cholesterol, body fat percentage and waist to hip ratio, were not significantly different within and between the groups after intervention. A significant decrease in weight, body mass index, waist circumference, hip circumference, systolic blood pressure, diastolic blood pressure, triglyceride, and a significant increase in high-density lipoprotein cholesterol were found in probiotic yoghurt group after intervention compared with baseline. Consuming probiotic yoghurt in MetS patients did not affect the inflammatory markers and cardiometabolic risk factors significantly.

Context: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in reproductiveage women. The hormonal and metabolic effects of coenzyme Q10 (CoQ10) and/or vitamin E in patients with PCOS have not been studied, to our knowledge. Objective: To evaluate the effects of CoQ10 and/or vitamin E on glucose homeostasis parameters and reproductive hormones in women with PCOS. Design, Setting, Participants: Randomized, double-blind, placebo-controlled clinical trial among 86 women with PCOS. Intervention: CoQ10 or vitamin E or combination for 8 weeks. Main Outcome Measures: Glucose homeostasis parameters and sex hormone concentrations. Results: After adjustment for potential confounders, supplementation with CoQ10 alone or in combination with vitamin E, compared with placebo, had significant effects on fasting blood sugar (FBS); vitamin E’s effect on FBS was not significant. A significant reduction in homeostasis model assessment of insulin resistance (HOMA-IR) was observed in the CoQ10 and combined groups. CoQ10, vitamin E, and cosupplementation led to decreased serum total testosterone levels (P , 0.001) compared with those of the placebo group. CoQ10 supplementation in combination with vitamin E significantly improved in sex hormone–binding globulin (SHBG) levels compared with other groups (P = 0.008). Linear regression analysis revealed that changes in FBS, insulin, and HOMAIR were predictors of change in free androgen index (P , 0.05). Conclusion: CoQ10 with or without vitamin E supplementation among women with PCOS had beneficial effects on serum FBS and insulin levels, as well as HOMA-IR and total testosterone levels. However, only cosupplementation affected SHBG concentrations.

Objectives The relationship between gut microflora and metabolic syndrome components such as obesity, low-grade chronic systemic inflammation, dyslipidemia, and altered glucose metabolism is now acknowledged. The aim of this study was to assess the effects of probiotic yogurt on glycemic indexes and endothelial dysfunction markers in patients with metabolic syndrome. Methods This was a randomized, double-blind, placebo-controlled clinical trial of 44 patients with metabolic syndrome (22 men and 22 women), who were 20 to 65 y of age. The patients were assigned to either a treatment or control group and consumed 300g/d of probiotic yogurt containing Lactobacillus acidophilus La5 and Bifidobacterium lactis Bb12 or a regular yogurt for 2 mo, respectively. Each group contained 22 participants. Fasting blood glucose and serum insulin was performed to derive homeostasis model assessment of insulin resistance (HOMA-IR), insulin sensitivity (Quicki), and HOMA of β-cell function (HOMA- β). In addition, markers of vascular cell adhesion molecule cell (VCAM)-1, intercellular adhesion molecule cell (ICAM)-1, and plasminogen activator inhibitor (PAI)-1 were measured to evaluate endothelial function at the beginning and at the end of the study. Results Consumption of probiotic yogurt resulted in a significant reduction in the level of blood glucose and VCAM-1. Significant changes in PAI-1, VCAM-1, insulin, HOMA-IR, and Quicki were observed in the probiotic yogurt group after intervention compared with baseline. Conclusion Consumption of probiotic yogurt improved fasting blood glucose and partly modified serum endothelial function markers. These results suggest that regular intake of probiotic yogurt may exert positive effects on the treatment of metabolic syndrome.

Purpose: This trial was conducted to evaluate the effects of oligofructose-enriched inulin on some of cardiovascular disease risk factors in women with type 2 diabetes. Methods: 52 females (25

Colorectal cancer is the most common malignancy of the gastrointestinal tract and it seems the colonic microbiota plays a significant role in the aetiology of colorectal cancer because it can influence many aspects of intestinal tract health including its physiology, metabolism, development, and immune homeostasis. Hence, all factors modulating the gut microflora and their metabolism are very interesting in cancer prevention. Probiotic bacteria have been examined for anti-cancer effects and different mechanisms were suggested about their anti-tumour functions. This study reviewed some of the possible cellular and molecular mechanisms of probiotics such as influencing intestinal microbial composition and pathogenic bacteria, the production of biological substance like short chain fatty acids and conjugated linoleic acid, inactivation of carcinogenic compounds especially those derived from food, improvement of intestinal barrier function, modulation of immune responses, apoptosis and anti-proliferative effects and antioxidant function.

Objective Although many studies have considered alpha-lipoic acid (ALA) as a potent antioxidant with anti-inflammatory functions in oxidative stress-associated inflammatory diseases, few studies have evaluated its efficacy in rheumatoid arthritis (RA). Therefore, we aimed to examine the effects of ALA on serum biomarkers of joint damage and inflammation in women with RA. Methods We performed a randomized, double-blind, placebo-controlled clinical trial in which RA patients (n = 70) aged 20-50 years were randomly assigned 1:1 to receive either ALA (1200 mg/day) or placebo for 8 weeks. Fasting blood samples were taken before and after the study to analyze inflammatory biomarkers including serum high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and serum matrix metalloproteinase-3 (MMP-3) as a marker of joint erosion. Moreover, 3-day dietary records, the International Physical Activity Questionnaire (IPAQ), and the Spielberger State-Trait anxiety inventory form Y (STAI-Y) were assessed before and after the intervention. Results Sixty-five RA patients completed the trial. No statistically significant differences were observed in serum levels of hs-CRP, TNF-α, IL-6, and MMP-3 within and between the ALA and placebo groups (p > 0.05). There were no statistically significant differences in dietary intakes, physical activity, and anxiety levels between groups at baseline and they remained statistically unchanged during the study period (p > 0.05). Conclusion Although in theory ALA supplementation could serve as a beneficial nutraceutical in RA patients, in the present study serum inflammatory biomarkers and MMP-3 were not significantly affected by 8 weeks of ALA supplementation.

This randomized clinical trial was conducted to evaluate the effects of silymarin supplementation on glycemic indices and serum lipid profile in type 2 diabetes mellitus (T2DM) patients.40 T2DM patients (twenty male and twenty female), 25-50 years of age and on stable medication, were recruited for the present paralleled, randomized, triple-blinded, placebo-controlled clinical trial. The participants were randomly assigned to the silymarin or placebo groups, in which the patients either received 140 mg of silymarin, thrice daily (n = 20) or placebo (n = 20) for 45 days. Anthropometric and dietary intake data were collected at the baseline and end of the trial. Fasting blood samples were collected, and glycemic indices and lipid profile were determined at baseline, as well as the end of the study.Silymarin supplementation led to significant reduction in fasting blood sugar, serum insulin, homeostatic model assessment for insulin resistance, serum triglyceride and triglyceride to high-density lipoprotein cholesterol ratio as compared to the placebo, by 11.01, 14.35, 25.92, 23.7 and 27.67% respectively. There was significant increase in high-density lipoprotein cholesterol levels and quantitative insulin sensitivity check index in the silymarin group as compared to the placebo group, by 6.88 and 5.64% respectively, (p 0.05). Total cholesterol and low-density lipoprotein cholesterol concentrations significantly decreased in the silymarin group as compared to the baseline, by 7.93 (p = 0.001) and 7.15% (p = 0.02), respectively.Silymarin supplementation may improve the glycemic indices and lipid profiles of T2DM patients. More studies are needed to validate the adjunct use of silymarin for metabolic control of T2DM patients.

Nonalcoholic fatty liver disease (NAFLD) is a chronic liver disease and is a serious global health problem. Regarding the increasing prevalence of NAFLD, finding various strategies to prevent and manage the disease is of great importance. The aim of this study was to determine the effects of caloric restriction during Ramadan fasting on anthropometric indices, fasting glucose, plasma insulin, insulin resistance, and inflammatory cytokines (C-reactive protein and interleukin 6) in patients with NAFLD.We conducted this study with 83 patients with NAFLD, 42 of whom decided to fast and 41 controls who decided not to fast for Ramadan, between June 18 and July 17, 2015. Anthropometric parameters were measured and a sample of venous blood was obtained for biochemical assays before and after Ramadan.There was a significant decrease in all anthropometric parameters as well as fasting glucose, plasma insulin, and insulin resistance. Relative to the nonfasting group, fasting significantly reduced circulating inflammatory, but changes in blood pressure after Ramadan were not significant.This study shows significant effects on parameters during Ramadan fasting such as anthropometric indices, fasting glucose, plasma insulin, and inflammatory cytokines in patients with NAFLD. The results of this study suggest that Ramadan fasting may be useful to improve NAFLD, so further studies are needed in this area.

Background: Oral administration of pro- and prebiotics has recently been considered as an effective way for nonalcoholic fatty liver disease (NAFLD) recovery. Objectives: The current study aimed at evaluating the effect of supplementation with probiotics and/or prebiotics on liver function tests in patients with NAFLD. Methods: In this double blind, placebo-control clinical trial, 75 subjects with NAFLD were voluntarily recruited from May 2013 to March 2014, in Iran. Participants were randomly assigned to 1 of 4 groups using a block randomization procedure. Group 1 received probiotic capsules (Bifidobacterium longum (BL) and Lactobacillus acidophilus (LA): 2 × 107 CFU/day), group 2 received prebiotic inulin high performance (HP): 10 g/day, group 3 received probiotic and the prebiotic, and group 4 received a placebo for 3 months. The sample size was determined on the basis of a primary outcome of a change in aspartate aminotransferase (AST) level. Results: An intergroup comparison indicated that the AST (P = 0.006) and alanine aminotransferase (ALT) (P = 0.04) levels decreased at the end of the study. Aspartate Aminotransferase (mean difference of group1 versus placebo with P value of 0.001, group2 versus placebo with P value of 0.045, group3 versus placebo with P value of 0.015) and ALT (mean difference of group 1 versus placebo with P value of 0.009, group 2 versus placebo with P value of 0.041, and group 3 versus placebo with P value of 0.046) serum levels decreased significantly in all of the intervention groups compared to the placebo. The grade of fatty liver in group 1 (P of 0.027, and number needed to treat (NNT) = 3) and group 3 (P = 0.019 and NNT = 3) decreased compared to the placebo group with no significant changes in group 2. Conclusions: Supplementation with probiotics and/or prebiotics improved aminotransferase enzymes, and supplementation with probiotics or pro- and prebiotics recovered the grade of fatty liver in NAFLD patients.

Colorectal cancer (CRC) is a widespread and lethal cancer throughout the world. Nowadays there is considerable debate about the efficacy of conventional methods in CRC treatment. Though targeting vital molecular pathways, as well as induction of various forms of cell death by safe probiotic yeast components are regarded as potential therapeutic modalities against CRC. Hence, here we aimed to investigate the inhibitory role of the EPSs of Kluyveromyces marxianus and Pichia kudriavzevii on different colon cancer cell lines. In this regard, several cellular and molecular experiments were performed. Here, we found that both EPSs can induce apoptosis which were confirmed by DAPI and Annexin V/PI assays. Further, our data showed that the EPSs could not act via ferroptotic pathways, however, they could hinder the AKT-1, mTOR, and JAK-1 pathways, and induce apoptosis. Therefore, the probiotic yeast EPSs present beneficial effects and may provide as a novel molecular-targeted therapeutics for combating CRC.

Background The purpose of this study was to evaluate the effects of high performance inulin supplementation on blood glycemic control and antioxidant status in women with type 2 diabetes. Methods In a randomized, triple-blind controlled trial, 49 females (fiber intake

It is known that markers of oxidative stress and nitrite/nitrate anion (NOThis double-blind, randomized, controlled clinical trial was conducted on 83 patients with DM aged 30-60 years. Forty-two of the subjects had taken 400 IU/day vitamin E and 41 were given placebo over 8 weeks. Fasting blood samples, anthropometric measurements, and dietary intake data were collected at the baseline and at the end of the trial.Vitamin E significantly increased serum vitamin E level, paraoxonase-1 activity, and total antioxidant status (TAS) and decreased fasting blood sugar (FBS) compared to the control group (p0.05). Hemoglobin A1c, serum insulin, and insulin resistance significantly decreased in the vitamin E group compared to baseline values (p0.05). Alterations in serum levels of malondialdehyde and NOVitamin E improved serum vitamin E level, paraoxonase-1 activity, TAS, and FBS in patients with type 2 diabetes. Longitudinal studies are warranted to assess the outcome of these results in reducing complications of diabetes in patients with type 2 diabetes.

Insulin resistance is one of the most common features of polycystic ovary syndrome (PCOS). Some studies suggest that vitamin D deficiency may have a role in insulin resistance; thus, the aim of the current study was to determine the effect of vitamin D supplementation on insulin resistance in women with PCOS and a vitamin D deficiency. We hypothesized that vitamin D supplementation would lower the glucose level and insulin resistance in women with PCOS and a vitamin D deficiency. The current study was a randomized, placebo-controlled, double-blinded trial with 50 women with PCOS and a vitamin D deficiency, 20 to 40 years old, assigned to receive 3 oral treatments consisting of 50,000 IU of vitamin D₃ or a placebo (1 every 20 days) for 2 months (vitamin D, n = 24; placebo, n = 26). The fasting blood glucose, insulin, 25-hydroxyvitamin D, and parathyroid hormone levels, as well as the homeostasis model assessment of insulin resistance and quantitative insulin sensitivity check index were measured at baseline and after treatment. In the vitamin D group, the serum level of 25-hydroxyvitamin D increased (6.9 ± 2.8 to 23.4 ± 6.1 ng/mL, P < .0001), and the parathyroid hormone level decreased (70.02 ± 43.04 to 50.33 ± 21.99 μ IU/mL, P = .02). There were no significant changes in the placebo group. There was a significant increase in insulin secretion in the vitamin D group (P = .01), but this was not significant compared with the placebo group. The fasting serum insulin and glucose levels and the insulin sensitivity and homeostasis model assessment of insulin resistance did not change significantly by the end of the study. We were not able to demonstrate the effect of vitamin D supplementation on insulin sensitivity and insulin resistance in women with PCOS and vitamin D deficiency.

a b s t r a c t Aims: This study performed to determine the effects of folate supplementation on indices of glycemic control, insulin resistance and lipid profile in overweight and obese men with type 2 diabetes under metformin (at least 1500 mg daily) treatment. Methods: The study was a double-blind randomized controlled clinical trial. Forty-eight overweight and obese men (aged 58.2 � 8.9 years; BMI = 28.6 � 2.9 kg/m 2 ) with type 2 diabetes participated in the study. Patients were divided randomly into two groups of folic acid (5 mg/d) and placebo. All patients received the tablets for eight weeks. Results: Supplementation with folic acid led to 8% decrease in HbA1C ( p = 0.048), 7.5% in fasting blood glucose ( p = 0.051), 16.2% in serum insulin ( p = 0.021), 20.5% in insulin resistance ( p = 0.041) and 21.2% in plasma homocysteine ( p = 0.000). A significant increase in serum folate and B12 levels (19% and 17.3%, p = 0.000, respectively) were observed in the folic acid group, whereas no significant changes occurred in the placebo group. Also, in the folic acid and placebo groups, there were no significant changes in body weight. Conclusions: Folic acid supplementation lowered plasma level of homocysteine, improved glycemic control and insulin resistance in patients with type 2 diabetes.

Metformin is widely used in patients with type 2 diabetes, but it may decrease vitamin B12 and folate levels and increase levels of homocysteine (Hcy). Hyperhomocysteinemia (HHC) and hyperglycemia induce oxidative stress in type 2 diabetes. Thus, this study was performed to determine the effects of folate supplementation on the concentration of homocysteine, total antioxidant capacity (TAC), and malondialdehyde (MDA).This was a double-blind randomized controlled clinical trial. Sixty-eight men with type 2 diabetes participated in the study with written consent. Patients were divided randomly into 2 groups: folic acid 5 mg/d and placebo. All patients received the tablets for 8 weeks. Anthropometric and nutrient intake data were obtained from each patient. Baseline and eighth-week homocysteine, total antioxidant capacity, malondialdehyde, folate, and B12 levels were measured.After folate supplementation in the folic acid group, homocysteine was significantly decreased (15.1 ± 3.2 to 12.1 ± 3.1 μmol/L, p0.001) and folate and B12 levels were significantly increased (p0.001). A significant increase in total antioxidant capacity (0.96 ± 0.2 to 1.14 ± 0.3 mmol Fe2+/L, p0.001) and a significant decrease in malondialdehyde (2.6 ± 0.7 to 1.7 ± 0.2 μmol/L, p0.001) were observed in the folic acid group, whereas no significant changes occurred in the placebo group (p0.05).Pharmacological doses of folate supplementation lowered plasma homocysteine and serum malondialdehyde levels and improved serum total antioxidant capacity and folate and B12 levels in patients with type 2 diabetes.

Zinc deficiency is one of the most prevalent nutritional problems. In a food, phytic acid to zinc mole ratio is the main factor for determination of zinc bioavailability, therefore we measured phytic acid and its mole ratio to zinc in flour and various breads – including: Lavash, Mashini, Sangak, Oskoo, Barbari, Roghani and Baggett – which are consumed in Tabriz, Iran. The study was a descriptive, cross-sectional investigation. Mean of phytic acid and its mole ratio to zinc in flour was 262.75 (CI with 95%: 210.38–315.11 mg/100) and 19.36 (CI with 95%: 14.93–23.79), respectively. For the breads above indices were 108.53 (CI with 95%: 93.75–123.31 mg/100) and 8.91 (CI with 95%: 7.76–10.06), respectively. The differences between breads’ phytic acid and its mole ratio to zinc with those of flours were significant (p

Background: Abnormal eating behavior, unhealthy weight control methods, and eating disordered symptoms have risen among college students. Objectives: The aim of this study was to examine disordered eating attitudes and their relationship with anthropometric and body composition indices in physical education students in Tabriz, the capital of East Azerbaijan province, Iran. Patients and Methods: This cross-sectional study was conducted on 210 physical education students, 105 males and 105 females aged 18 to 25, who were selected by systematic random sampling from physical education faculty of Tabriz University in Tabriz, Iran, in 2013. Eating attitude test (EAT-26) was used for the assessment of disordered eating attitudes. In addition, anthropometric and body composition indices were assessed. Results: About 10% of the studied subject had disturbed eating attitudes; significantly more males (15.4%) reported an EAT-26 ≥ 20 (disordered eating attitudes) than females (4.8%) (P < 0.05). In males, the EAT-26 score was positively correlated with weist perimeter (WP) (r = 0.21, P < 0.05) and the waist-to-hip ratio (r = 0.26, P < 0.01). In females, the EAT-26 score was positively correlated with weight (r = 0.19, P < 0.05) and the WP (r = 0.28, P < 0.01). In females, weight (P < 0.05), body mass index (BMI) (P < 0.05), WP (P < 0.01), and waist-to-hip ratio (P < 0.05) were significantly different between disordered eating attitude and healthy subjects, while in males there was no significant difference between the two groups regarding the anthropometric and body composition indices. Conclusions: Abnormal eating attitude was notable among physical education students in Tabriz, Iran. It seems that some anthropometric indices such as BMI and central obesity indices were related to the increase of disordered eating attitude.

Aims: This trial aims to determine the effects of resistant starch (RS) subtype 2 (RS2) on glycemic status, metabolic endotoxemia and markers of oxidative stress. Methods: A randomized, controlled, parallel-group clinical trial group of 56 females with type 2 diabetes mellitus (T2DM) was divided to 2 groups. The intervention group (n = 28) and control group (n = 28) received 10 g/day RS2 or placebo for 8 weeks, respectively. Fasting blood samples were taken to determine glycemic status, endotoxin, high sensitivity C-reactive protein (hs-CRP), malondialdehyde (MDA), total antioxidant capacity (TAC), antioxidant enzymes concentrations as well as uric acid at baseline and after the intervention. Results: After 8 weeks, RS2 caused a significant decrease in the levels of MDA (-34.10%), glycosylated hemoglobin (-9.40%), insulin (-29.36%), homeostasis model of insulin resistance (-32.85%) and endotoxin (-25.00%), a significant increase in TAC (18.10%) and glutathione peroxidase (11.60%) as compared with control. No significant changes were observed in fasting plasma glucose, quantitative insulin sensitivity check index, hs-CRP, superoxide dismutase, catalase and uric acid in the RS2 group as compared with the control group. Conclusion: Supplementation with RS2 may be improved glycemic status, endotoxemia and markers of oxidative stress in patients with T2DM.

Background: There are few studies on the vitamin D status in preeclamptic women. The objective of this case-control study was to determine vitamin D status, in preeclamptic women and compare it with that of healthy pregnant controls. Methods: Forty preeclamptic women, aged 18 to 45yr and forty age- and pregnancy weight-matched healthy controls participated in the study. Serum 25-hydroxy vitamin D (25(OH)D) levels were meas­ured and its levels of 90 nanogram per milliliter (ng/ml) were considered as vitamin D deficiency, insufficiency, sufficiency, and toxicity, respectively. Results: Sixty and forty percent of preeclamptic women were vitamin D deficient and insufficient, while in the control group they were 10% and 90%, respectively. No significant difference was found in the median intake of vitamin D between preeclamptic and non preeclamptic women (1.45 and 1.20µg/day respectively), but serum 25(OH)D concentration was significantly lower in preeclamptic cases compared to controls (10.09 ± 6.66 and 15.73 ± 5.85ng /ml respectively, P= 0.002). Conclusion: Vitamin D deficiency is common among preeclamptic and non-preeclamptic pregnant women in the north-west of Iran. Preeclampsia can cause decreasing of serum level of 25(OH)D.

The aim of the present study was to determine effects of Resistant Starch (RS2) on metabolic parameters and inflammation in women with type 2 diabetes (T2DM).In this randomized controlled clinical trial, 60 females with T2DM were divided into intervention (n = 28) and placebo groups (n = 32). They received 10 g/d RS2 or placebo for 8 weeks, respectively. Fasting blood sugar (FBS), glycated hemoglobin (HbA1c), lipid profile, high-sensitive C-reactive protein (hs-CRP), interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) were measured at baseline and at the end of the trial. Paired t test, unpaired t-test and ANCOVA were used to compare the quantitative variables. The data were analyzed using SPSS software version 13.0.RS2 decreased HbA1c (-0.3%, -3.6%), TNF-α (-3.4 pg/mL, -18.9%), triglyceride (-33.4 mg/dL, -15.4%), and it increased HDL-c (+9.4 mg/dL, +24.6%) significantly compared with the placebo group (p0.05). Changes in FBS, total cholesterol, low-density lipoprotein, hs-CRP and IL-6 were not significant in the RS2 group compared with the control group. RS2 can improve glycemic status, inflammatory markers and lipid profile in women with T2DM.Although findings of the present study indicated positive effects of RS2 on inflammation and metabolic parameters, more studies are needed to confirm efficacy of RS2 as an adjunct therapy in diabetes.

Overweight and obesity are among the most prevalent nutritional problems in developed and developing countries. In this descriptive study, we attempted to determine the prevalence of overweight and obesity in Iranian adolescent girls attending high school in Tabriz. A sample of 1,650 (final study group, 1,518) high-school girls aged 14 to 20 years was selected by stepwise random sampling from five districts of Tabriz. Overweight and obesity were defined according to body mass index (BMI) percentiles from the First National Health and Nutrition Examination Survey (NHANES I) and the International Obesity Task Force (IOTF) BMI cutoffs. According to the NHANES I criteria, 14.6% of the study subjects were overweight or obese. Overweight and obesity was seen in 11.1% and 3.6% of the students, respectively. By the IOTF cutoffs, 14% of the subjects were overweight or obese. Overweight and obesity were seen in 10.1% and 3.9% of the students, respectively. Of the study subjects, 8% had a BMI below the 15th percentile of NHANES I, an indicator of underweight. The prevalence of overweight and obesity in Tabriz high-school girls is higher than in many, but not all, parts of Iran, but lower than in some neighboring countries such as Saudi Arabia. In this age group, in addition to overweight and obesity, underweight (BMI ≤ 15th percentile) is also present.

Background/Aims: Pre-eclampsia (PE) is associated with unfavorable metabolic profiles. Oxidative stress and inflammation have been increasingly postulated as major contributors to PE. Research suggests that vitamin D status is disturbed in women with PE. The aims of this study were to compare the serum levels of vitamin D and oxidative stress status in women with PE vs. women with normal pregnancies, and to evaluate the relationship between these 2 factors in women with PE. Methods: In this case-control study, 40 women with PE and 40 healthy pregnant women were selected, and high-sensitivity C-reactive protein, malondialdehyde (MDA), total antioxidant capacity (TAC) and 25-hydroxyvitamin D (25(OH)D) levels were assessed. We compared the biochemical indicators between the 2 groups by analysing the data using the independent t test, Mann-Whitney U test, chi-square and logistic regression. Results: Compared with the controls, the serum levels of MDA in women with PE were significantly higher (p = 0.001) and TAC and 25(OH)D levels were significantly lower (p < 0.05). TAC concentration was positively associated with 25(OH)D levels in cases of PE (β = 0.428, p = 0.01). Conclusion: Our findings show lower levels of TAC and 25(OH)D in women with PE in comparison to controls, while having similar vitamin D intakes. In addition, our results suggest a positive relationship between TAC concentration and 25(OH)D levels in PE cases.

Diabetes is a serious metabolic disorder and oxidative stress and inflammation contribute to its pathogenesis and complications. Since Silybum marianum (L.) Gaertn. (silymarin) extract is an antioxidant with anti-inflammatory properties, this randomized clinical trial was conducted to evaluate the effects of silymarin supplementation on oxidative stress indices and hs-CRP in type 2 diabetes mellitus patients.For the present paralleled, randomized, triple-blinded, placebo-controlled clinical trial, 40 type 2 diabetes patients aged 25-50 yr old and on stable medication were recruited from the Iranian Diabetes Society and endocrinology clinics in East Azarbayjan (Tabriz, Iran) and randomly assigned into two groups. Patients in the silymarin treatment group received 140 mg, thrice daily of dried extracts of Silybum marianum (n = 20) and those in the placebo group (n = 20) received identical placebos for 45 days. Data pertaining to height, weight, waist circumference and BMI, as well as food consumption, were collected at base line and at the conclusion of the study. Fasting blood samples were obtained and antioxidant indices and hs-CRP were assessed at baseline, as well as at the end of the trial.All 40 patients completed the study and did not report any adverse effects or symptoms with the silymarin supplementation. Silymarin supplementation significantly increased superoxide dismutase (SOD), glutathione peroxidase (GPX) activity and total antioxidant capacity (TAC) compared to patients taking the placebo, by 12.85%, 30.32% and 8.43%, respectively (p0.05). There was a significant reduction in hs-CRP levels by 26.83% (p0.05) in the silymarin group compared to the placebo group. Malondialdehyde (MDA) concentration significantly decreased by 12.01% (p0.05) in the silymarin group compared to the baseline.Silymarin supplementation improves some antioxidant indices (SOD, GPX and TAC) and decrease hs-CRP levels in T2DM patients.

BACKGROUND/OBJECTIVES: Rheumatoid arthritis (RA) is associated with an excess mortality from cardiovascular disease which is likely attributed to an atherogenic lipid profile. Among nutritional factors vitamin K has been recently focused as a pivotal nutrient in improvement of lipid related markers. Thus, this study was designed to determine the effects of vitamin K on lipid profile in this disease. SUBJECTS/METHODS: Fifty eight patients with definitive RA were participated in the present double blind placebo controlled study. They were randomly allocated into two groups to receive vitamin K1 as phylloquinone [10 mg/day] (n = 30) or placebo pills (n = 28), for eight weeks. In order to control the effects of probable confounders dietary intakes, anthropometric measurements including weight and height, clinical status using disease activity score-28 (DAS-28), physical activity and anxiety status were evaluated at baseline. Moreover, serum levels of lipid related markers including total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglyceride (TG) were measured at baseline and at the end of intervention. RESULTS: There were no significant differences between the two groups regarding any of the baseline characteristics. After adjusting for some relevant confounders, in comparison between two groups, we observed no significant changes in lipid related markers at the end of intervention. Also, there was no significant difference between before and after intervention values within groups (P > 0.05). CONCLUSIONS: Function of vitamin K1 in lipid profile modification remains still controversial. This study showed that vitamin K1 has no effect on lipid profile in women with rheumatoid arthritis. Further studies with a longer follow-up are required to determine the effects of vitamin K on atherogenic lipid profile.