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Background: Previous experimental studies have reported that pistachios can elicit positive effects on lipid profile, blood pressure, and inflammation; however, a meta-analysis of the available evidence has yet to be performed., Objective: the aim of this study was to conduct systematic review and meta-analysis of the effect of pistachio enriched diets on cardiometabolic risk factors, such as weight, BMI, blood pressure, serum lipids, blood glucose, and inflammatory biomarkers., Design: A literature search was carried out for RCTs in medical databases, including PubMed/MEDLINE, Scopus, and Cochrane databases, with no time limitation up to August 2019, and conducted in accordance with the Preferred Reporting Items of Systematic Reviews and Meta-Analysis guidelines., Results: 11 RCTs, with 506 participants, that reported the effect of pistachios consumption on cardiometabolic risk factors were included in this systematic review and meta-analysis. Our findings indicated that pistachios consumption significantly reduced FBS (WMD: -3.73, 95 % CI: -6.99, -0.46, I 2 = 99 %), TC/HDL (WMD: -0.46, 95 % CI: -0.76, -0.15, I 2 = 95 %), LDL/HDL (WMD: -0.24, 95 % CI: -0.38, -0.11, I 2 = 96 %), HbA1C (WMD: -0.14, 95 % CI: -0.26, -0.02, I 2 = 60 %), Insulin (WMD: -2.43, 95 % CI: -4.85, -0.001, I 2 = 58 %), SBP (WMD: -3.10, 95 % CI: -5.35, -0.85, I 2 = 63 %), and MDA (WMD: -0.36, 95 % CI: -0.49, -0.23, I 2 = 0%). Importantly, we did not observe adverse effects of pistachios consumption on BMI or blood pressure., Conclusion: This systematic review and meta-analysis demonstrates that pistachios consumption can elicit a beneficial effect on some cardiometabolic risk factors. All previous clinical studies are well designed but some points have still remained unclear including the effects of different pistachios dosages on cardio metabolic risk factors and efficacy of pistachios consumption in preventing endothelial dysfunction. Further examination is required to determine the effect of pistachios consumption on further endothelial function risk factors., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Aims: This study aimed to summarize earlier studies on the effects of dairy consumption on inflammatory biomarkers in adults and to quantify these effects through meta-analysis., Data Synthesis: A comprehensive search of all relevant articles, published up to December 2019 indexed in PubMed, ISI (Institute for Scientific Information), EmBase, Scopus, and Google Scholar was done using relevant keywords. Randomized controlled trials (RCTs) that examined the effect of dairy products consumption, compared with low or no dairy intake, on inflammatory biomarkers in adults were included. Overall, 11 RCTs with 663 participants were included in this meta-analysis. We found that high consumption of dairy products, compared with low or no dairy intake, might significantly reduce CRP [weighed mean difference (WMD): -0.24 mg/L; 95% CI, -0.35, -0.14], TNF-α (WMD:- 0.66 pg/mL; 95% CI, -1.23, -0.09), IL-6 (WMD: -0.74 pg/mL; 95% CI, -1.36, -0.12), and MCP concentrations (WMD: -25.58 pg/mL; 95% CI, -50.31, -0.86). However, when the analyses were confined to cross-over trials, no such beneficial effects of dairy intake on inflammation were observed. In addition, high dairy intake might result in increased adiponectin levels (WMD: 2.42 μg/mL; 95% CI, 0.17, 4.66). No significant effect of dairy consumption on serum leptin (WMD: -0.32 ng/mL; 95% CI, -3.30, 2.65), ICAM-1 (WMD: -3.38 ng/ml; 95% CI, -15.57, 8.96) and VCAM-1 (WMD: 3.1 ng/mL; 95% CI, -21.38, 27.58) levels was observed., Conclusions: In summary, the current meta-analysis indicated that dairy intake might improve several inflammatory biomarkers in adults. In most subgroups without heterogeneity, effects tended to be null. Study design and participants' age were the main sources of heterogeneity. More research, with a particular focus on fat content of dairy foods, is recommended., Competing Interests: Declaration of Competing Interest Authors declared no personal or financial conflicts of interest., (Copyright © 2020 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.)

Background: This study aimed to evaluate the safety and efficacy of 2 forms of vitamin D supplementation on oxidative stress and weaning from the ventilator in patients with traumatic injury and vitamin D deficiency., Methods: Seventy-two patients were randomly divided into 3 groups: receiving 50,000 IU pearl cholecalciferol daily for 6 days, 1 intramuscular injection of 300,000 IU of cholecalciferol, or a control group that did not receive any supplement. Duration of mechanical ventilation, body composition, and biochemical biomarkers were measured before and after the intervention., Result: At the end of the study, the mean serum 25(OH)D increased in the intervention groups compared with the control group (P < .05). The interleukin 6, erythrocyte sedimentation rate, C-reactive protein levels, Sequential Organ Failure Assessment score, duration of mechanical ventilation, and length of intensive care unit admission significantly decreased; however, total antioxidant capacity concentration did not differ significantly between the 2 intervention groups. Among the body composition variables, extracellular water ratio changes were statically different in oral vitamin D group compared with the control group (P = .001). No side effects were reported with the supplements., Conclusions: Vitamin D administration improved clinical signs and biochemical biomarkers in a small group of patients with traumatic injury. Well-designed multicenter clinical studies with longer intervention duration are necessary for this field., (© 2019 American Society for Parenteral and Enteral Nutrition.)

Purpose: Considering the present controversies on the association between green coffee supplementation and cardio metabolic risk factors, this systematic review and meta-analysis was conducted to evaluate the effect of green coffee supplementation on cardio metabolic risk factors., Method: A systematic literature search was performed throughout the PubMed, Embase, Scopus, and Web of Science databases up to October 2019. As a result, all randomized controlled trials over the effect of green coffee supplementation on fasting blood sugar (FBS), insulin, triglyceride, high-density lipoprotein (HDL), low-density lipoprotein (LDL), C - reactive protein (CRP), and homeostatic model assessment for insulin resistance (HOMA-IR) in adults were examined. Data were extracted from the relevant studies and analyzed using the random-effect or pooled model and standardized mean difference (SMD) with 95% confidence interval (CI)., Results: After excluding the irrelevant articles, 27 studies were included in the final analysis. Pooled results revealed that green coffee supplementation significantly reduced FBS (WMD = -2.28, 95% CI: -4.49 to -0.07, P  = 0.043), insulin (WMD = -0.53, 95% CI: -0.93 to -0.14, P  = 0.008), and triglyceride (WMD = -9.28, 95% CI: -14.93 to - 3.63, P  = 0.001). Furthermore, green coffee supplementation increased the HDL levels (WMD = 1.33, 95% CI: 0.08 to 2.58, P  = 0.037). However, the changes in HOMA-IR, LDL, and CRP levels were not significant ( P  > 0.05)., Conclusion: This meta-analysis indicated that green coffee supplementation significantly decreased FBS, insulin, and triglyceride, but improved HDL. No statistically significant improvement was found in HOMA-IR, LDL, and CRP indices following the green coffee supplementation., Competing Interests: Conflict of interestNo conflict of interest was declared., (© Springer Nature Switzerland AG 2020.)

Purpose: This study aimed to summarize earlier studies on the effects of RS consumption on the serum levels of inflammatory biomarkers., Methods: A comprehensive search was done in the electronic databases that published from 1988 up to May 2019. Two reviewers independently performed screening, data extraction, and risk-of-bias assessment. We used from the effect size, as estimated by the mean difference to perform the fixed method meta-analysis., Results: Overall, 13 studies with 14 effect sizes met the inclusion criteria and were included in the final analysis. Sample size of these studies ranged from 15 to 75 and intervention duration ranged from 4 to 14 weeks. Meta-analysis revealed that higher consumption of resistant starch caused a significant reduction in the interleukin 6 (weighted mean difference = - 1.11 pg/mL; 95% CI: - 1.72, - 0.5 pg/mL; P = < 0.001) and tumor necrosis factor alpha (weighted mean difference = - 2.19 pg/mL; 95% CI: - 3.49, - 0.9 pg/mL; P = 0.001) levels. However, no significant changes were found in C-reactive protein concentration (weighted mean difference = - 0.21 mg/L; 95% CI: - 1.06, 0.63 mg/L; P = 0.61). Moreover, the changes in interleukin 6 concentration was dependent on study quality and intervention duration., Conclusion: The current meta-analysis indicated that RS intake can improve some inflammatory biomarkers. More research, with a large sample sizes and accurate design is recommended.

Aim: The present study aimed to compare the effects of the Dietary Approaches to Stop Hypertension (DASH) diet and American Diabetes Association (ADA) guidelines on the lipid profiles of patients with type 2 diabetes., Methods: In a 12-week clinical trial, 80 patients with type 2 diabetes aged 18-65 years were randomly allocated into the case (n = 40) and control (n = 40) groups. The case group received the DASH diet and the control group consumed a dietary pattern in accordance with the ADA guidelines. Fasting blood samples were measured for triglyceride (TG), low-density lipoprotein (LDL), total cholesterol (TC), high-density lipoprotein (HDL), very low-density lipoprotein (VLDL) and free fatty acid (FFA). Moreover, physical activity and 24-hour dietary recall (24 hours) were assessed at baseline and end of the study., Results: The DASH diet and diabetic diet (in accordance with the ADA guidelines) for 12 weeks significantly decreased TG, TC and VLDL (P < 0.05). FFA showed a significant decrease in both the groups, which was greater in the cases compared with the control group (P = 0.049)., Conclusions: Compliance with any DASH or diabetic diet for 12 weeks in patients with type 2 diabetes had beneficial effects on cardiometabolic risks., (© 2019 Dietitians Association of Australia.)

Purpose: Vitamin D and calcium insufficiency has been related to elevated blood pressure (BP) and cardiovascular complications. This systematic review and meta-analysis investigates the effect of calcium and vitamin D co-supplementation on BP., Methods: A systematic search was conducted of electronic databases, including Web of Sciences, MEDLINE, Scopus, EMBASE, and the Cochrane Library, along with searches of gray literature and reference lists from included trials. There were no language restrictions, and the databases were searched from inception to October 2019. Randomized controlled trials, using calcium and vitamin D co-supplementation and reporting mean systolic BP and/or diastolic BP (DBP) with SDs, were included in the systematic review. Articles were evaluated independently by 2 researchers based on inclusion and exclusion criteria. A random effects model was conducted to synthesize the data., Findings: Eight trials were included in the meta-analysis. Meta-analysis of these 8 trials indicated a nonsignificant reduction in systolic BP in the calcium and vitamin D co-supplementation group compared with control (standardized mean difference, -0.23; 95% CI, -0.52 to 0.06). Conversely, there was a statistically significant decrease in DBP (standardized mean difference, -0.29; 95% CI, -0.55 to -0.02). Subgroup analysis suggested that young adults achieve a greater reduction in DBP than other age groups., Implications: Calcium and vitamin D co-supplementation can modulate DBP and should be investigated more specifically in large, well-designed trials of hypertensive populations. (Clin Ther. 2020;42:XXX-XXX) © 2020 Elsevier HS Journals, Inc., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Background & Aims: Several randomized clinical trials (RCTs) have investigated the effect of l-carnitine supplementation on lipid profile and glycaemic control in adults with cardiovascular risk factors; however, the results were conflicting. Therefore, a meta-analysis was performed to assess the effect of l-carnitine on lipid profile and glycaemic control in adults with cardiovascular risk factors., Methods: We searched PubMed, Scopus, Cochrane Databases, Google Scholar, ProQuest, Web of Science and Embase for randomized, placebo-controlled human trials that investigated the effect of l-carnitine supplementation on lipid profile and glycaemic control up to April 2017. From the eligible trials, 24 articles were selected for the meta-analysis. The meta-analysis was performed in a random-effects model. Heterogeneity was determined by I 2 statistics and Cochrane Q test., Results: The result showed significant effect of l-carnitine on TC (WMD: -13.73 [95% CI: -22.28, -5.17] mg/dL; P < 0.001), LDL-C (WMD = - 7.70 [95% CI: - 11.80, -3.61]mg/dL; p < 0.001), HDL-C (WMD = 0.82 [95% CI: 0.44, 1.21] mg/dL; P > 0.001), Lp(a) (WMD = - 7.13 [95% CI: -9.82,- 4.43]mg/dL; P < 0.001), FPG (WMD = -6.25 [95% CI: -10.35, -2.16] mg/dL; P < 0.001), HbA1C (WMD (%) = - 0.35 [95% CI: -0.65,- 0.05]; p = 0.02) and HOMA-IR (WMD (%) = - 0.94 [95% CI: -1.89, -0.00]; P = 0.05). No effect of l-carnitine was detected in TG, Apo A-I and Apo B 100 on pooled effect size. Additionally, sensitivity analysis showed l-carnitine supplementation could improve glycaemic control, particularly along with hypocaloric diet., Conclusion: This meta-analysis showed that l-carnitine supplementation could improve lipid profile levels, particularly in doses more than 1500 mg/day. More RCTs with large sample sizes, focusing on gut microbiome profiles and dietary patterns are needed to better understand the effect of l-carnitine on patients with cardiovascular risk factors., (Copyright © 2019 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.)

There have been various clinical studies on the effect of flaxseed-derived products on circulating inflammatory biomarkers, but the findings from these are contradictory. The aim of the present study was to clarify any association. A comprehensive literature search was conducted from inception to May 2018. From the eligible trials, 32 articles describing studies conducted on adults aged 18-70 y were selected for the meta-analysis. Meta-analyses using the random-effects model were performed to investigate the data and results showed significant effects of flaxseed intake on circulating high-sensitivity CRP (hs-CRP) [weighted mean difference (WMD) = -0.75; 95% CI: -1.19, -0.30; P < 0.001] and TNFα (WMD = -0.38; 95% CI: -0.75,-0.01; P = 0.04). However, no significant changes were found in IL6 concentration (WMD = -0.24; 95% CI: -0.70, 0.21; P = 0.28) and C-reactive protein (CRP) (WMD = -0.34; 95% CI:-0.89, 0.20; P = 0.22). Moreover, by eliminating 1 of the studies from the sensitivity analysis, changes in IL6 concentration were significant (WMD = -0.44; 95% CI: -0.81, -0.08). The changes in inflammatory biomarkers were dependent on study design (parallel or crossover), supplement type (flaxseed, flaxseed oil, or lignan), study quality (high or low), and participants' age and BMI. According to this meta-analysis, flaxseed significantly reduced circulating concentrations of hs-CRP and TNFα, but did not affect IL6 and CRP. Further research is needed to examine the effect of different doses and long-term benefits of flaxseed and its derivatives on inflammatory factors., (Copyright © American Society for Nutrition 2019.)

Flaxseed is one of the rich sources of α-linolenic acid and lignan. Flaxseed and its components have antioxidant, hypolipidemic and hypoglycemic effects. The study aimed to investigate the effect of flaxseed enriched yogurt on glycemic control, lipid profiles and blood pressure in patients with type 2 diabetes. A randomized, open-labeled, controlled clinical trial was conducted on 57 patients with type 2 diabetes. Participants were assigned to receive 200 g 2.5% fat yogurt containing 30-g flaxseed or plain yogurt daily for 8 weeks. Anthropometrics and biochemical parameters were evaluated at the beginning and end of the study. After 8 weeks of supplementation, Hemoglobin A1c was significantly decreased in the intervention group compared to control (p = 0.007). Also, at the end of the study, significant differences were seen between the flaxseed enriched yogurt and control groups in triglycerides and total cholesterol concentrations (p = 0.04 and p = 0.01), systolic blood pressure and diastolic blood pressure (p = 0.02 and p = 0.002, respectively). However, we did not find any difference between 2 groups in low-density lipoprotein, high-density lipoprotein, body weight and waist circumference (p > 0.05). Our results showed that the addition of flaxseed to yogurt can be effective in the management of type 2 diabetes., Trial Registration: ClinicalTrials.gov Identifier: NCT02436369., Competing Interests: Conflict of Interest: The authors declare that they have no competing interests., (Copyright © 2019. The Korean Society of Clinical Nutrition.)

Background & Aims: Several randomized clinical trials (RCTs) have investigated the effect of Alpha - Lipoic Acid (ALA) supplementation on metabolic parameters, with conflicting results. Therefore, the present study assessed the effect of ALA on some glycemic and inflammatory parameters., Methods: A comprehensive literature search was conducted up from inception to July 2018 on PubMed, Scopus, Cochrane databases, Google Scholar, ProQuest, Web of Science, and Embase. From among eligible trials, 41 articles were selected for the meta-analysis. Two reviewers independently assessed the risk of bias and extracted data from the included studies. Meta-analyses using the random-effects model were performed to analyze the data., Results: Based on the Cochrane risk of bias tool, 19 articles had a good quality, 16 trials had a poor quality and 6 trials had a fair quality. The results demonstrated the significant effect of ALA on Fasting Blood Sugar (FBS) (weighted mean difference (WMD)) = -6.57, 95% confidence interval (CI: -11.91 to -1.23, P = 0.016), Hemoglobin A1c (HbA1c) (WMD = -0.35, 95% CI: -0.55 to -0.15, P = 0.004), Tumor Necrosis Factor Alpha (TNF-α) (WMD = -1.57, 95% CI: -2.29 to -0.85, P < 0.05), Interleukin 6 levels (IL-6) (WMD = -1.15, 95% CI: -1.58 to -0.72, P < 0.001), and C-reactive protein (CRP) (WMD = -0.31, 95% CI: -0.47 to -0.16, P > 0.001). No effect was detected for ALA on insulin and the homeostatic model assessment of insulin resistance (HOMA-IR)., Conclusions: These findings suggest that ALA is a viable supplement to improve some of the glycemic and inflammatory biomarkers., (Copyright © 2019 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.)

The objective of this study was to assess the association between dietary antioxidant intake and semen quality parameters in infertile men. In this cross-sectional study, dietary antioxidant intake was evaluated in 175 infertile Iranian men by a validated dish-based 106-item semi-quantitative food frequency questionnaire. Men were asked to abstain from ejaculation for at least 72 hours before sample collection. Semen parameters were assessed by a sperm counting chamber and Terminal deoxynucleotidyl transferase dUTP nick end labeling assay methods. Linear quantile regression was used to determine the associations between antioxidant nutrient intake and semen quality parameters (including total sperm count, sperm density, total motility, DNA damage and DNA fragmentation). Mean age of study participants was 32.19 ± 2.34 years. Compared with the lowest quartile, men in the highest quartile of dietary β-carotene and vitamin C intake had lower sperm DNA fragmentation index (P trend = 0.042 and P trend = 0.03, respectively). Also, dietary intake of beta-cryptoxanthin had a positive association with sperm density (P trend = 0.02), and dietary lutein was associated with total sperm count (P trend = 0.045). Dietary intake of other antioxidants did not significantly correlate with the indicators related to the quantity and quality of sperm (p > 0.05). These data suggest that dietary intake of some of the antioxidants is associated with semen related parameters., Competing Interests: Conflict of Interest: The authors declare that they have no competing interests.

Background: Metabolic syndrome (MetS) is one of the worldwide most chronic endocrine disorders. The disease can also lead to several other chronic disorders such as type 2 diabetes mellitus, cardiovascular diseases, renal diseases and cancers. This study aimed to evaluate the safety and efficacy of ginger powder on biochemical and anthropometric parameters in patients with MetS., Methods: This randomized controlled clinical trial was conducted on 37 patients with MetS. We supplemented the individuals with MetS with either 2 g per day ginger powder or placebo for 12 weeks. Biochemical and anthropometric parameters before and after the intervention were compared between the two groups., Results: After 12 weeks of treatment, the levels of triglyceride (TG), FBS, and insulin resistance were significantly improved in the patients receiving ginger in compare to the placebo group ( P  < 0·05). Moreover, significant changes were observed in terms of weight, waist circumference, LDL, HDL, total cholesterol, systolic and diastolic blood pressure and energy intake between the groups., Conclusion: In general, our findings demonstrated that the ginger supplementation offers beneficial effects on patients with MetS, at least, in part due to the modulatory effects on TG, FBS, and insulin resistance., Competing Interests: Conflict of interestThe authors disclose no conflicts of interest.

Background and Objectives: Prehypertension in people with type 2 diabetes is associated with increased risk of cardiovascular disease and lower extremity damages compared to people with normal blood pressure. On the other hand, limited studies have conducted to investigate the effect of DASH diet on blood pressure and prehypertension in patients with type 2 diabetes. Therefore, in this study, we aimed to evaluate the effect of DASH diet on blood pressure and prehypertension in patients with type 2 diabetes., Materials and Methods: In this clinical trial, 80 patients with diabetes type 2 and prehypertension in the age range of 18-65 years were randomly allocated to intervention (n = 40) and control (n = 40) groups for 12 weeks. The intervention group had DASH diet and the control group received diabetic diet in accordance with the recommendations of the American Diabetes Association (ADA) with 24-h dietary recall; systolic and diastolic blood pressures were measured before and after study., Results: Taking DASH diet and diabetic diet for 12 weeks caused significant reduction in systolic blood pressure in the intervention group (P value = 0.003). Diastolic blood pressure showed no significant change in none of the two groups., Conclusion: Following the DASH diet in patients with prehypertension has beneficial effects in improving systolic blood pressure and can be effective to prevent the development of hypertension. Hence, there are needs for long-term interventions with larger sample size in future studies., (Copyright © 2018 Diabetes India. Published by Elsevier Ltd. All rights reserved.)

Background: A combination of genetic and environmental factors is involved in depression etiology. During the last years, the prevalence of depression has increased in both developed and developing countries. Several studies indicated an association between dietary glycemic index (GI) and glycemic load (GL) with risk of depression. This systematic review was undertaken to summarize the effect of these diet indicators in depression pathogenesis., Methods: A comprehensive search strategy was performed in the Pubmed, Embase, Cochrane Library and Scopus databases from 1966 to March 2017. Finally, six studies (three prospective cohort studies and three cross-sectional) were ultimately selected for inclusion in the systematic review., Results: 75298 adults and elderly entered the reviewed studies. All of the included studies had high methodological quality. The present study indicated that the intake of foods with higher GI is associated with disease risk. However, the relationship was found to be inverse for GL, though the association was rather weak., Conclusions: Overall, the findings indicated that a diet with lower dietary glycemic index may be effective to reduce the risk or risk of depression.

Background: A combination of genetic and environmental factors is involved in the etiology of inflammatory bowel disease (IBD). Recent studies have shown that adipocytes play a crucial role, by actively participating in systemic immune responses in IBD patients. But findings remain controversial. To the best of our knowledge, no systematic review has evaluated the roles of adipokines in IBD, considering which this systematic review was undertaken to summarize the effects of these adipokines in IBD pathogenesis., Methods: For this review, articles published between 1980 and 2016 were identified from the PubMed, EMBASE, Scopus, and Cochrane and Google scholar databases. Thirteen articles were ultimately selected for inclusion in this systematic review., Results: Findings of the present study indicate that some of the adipokines such as leptin, adiponectin and resistin are associated with disease severity, body composition and glucose hemostasis in IBD patients, although some of these associations are stronger than others., Conclusions: Overall findings indicate that some adipokines may play a crucial role in IBD severity or other IBD related outcomes. Further studies are recommended to confirm the results.

The aim of this study was to evaluate the efficacy of flaxseed supplementation plus lifestyle modification in comparison with lifestyle modification alone in the management of metabolic syndrome (MetS). A randomized controlled clinical trial was conducted on 44 patients with MetS. Participants were assigned to receive either the lifestyle advice and 30-g brown milled flaxseed daily or only the lifestyle advice as the control group. The percentage of individuals with MetS decreased from baseline by 50% and 82% in the control and intervention group, respectively. The reversion rate of central obesity was higher in the flaxseed group (36%) than control group (13%). Moreover, greater reduction in insulin resistance was observed in flaxseed group in comparison with control group (p < 0.001). Body weight, waist circumference, and body mass index decreased significantly in both groups with a significantly greater reduction in flaxseed group in comparison with controls (p < 0.05). There were no significant changes in blood pressure in any groups. Our results indicate that co-administration of flaxseed with lifestyle modification is more effective than lifestyle modification alone in management of MetS; whether these effects will be sustained with longer treatment durations remains to be determined. Copyright © 2016 John Wiley & Sons, Ltd., (Copyright © 2016 John Wiley & Sons, Ltd.)

A two-arm randomized open labeled controlled clinical trial was conducted on 50 patients with non-alcoholic fatty liver disease (NAFLD). Participants were assigned to take either a lifestyle modification (LM), or LM +30 g/day brown milled flaxseed for 12 weeks. At the end of the study, body weight, liver enzymes, insulin resistance and hepatic fibrosis and steatosis decreased significantly in both groups (p< 0.05); however, this reduction was significantly greater in those who took flaxseed supplementation (p < 0.05). The significant mean differences were reached in hepatic markers between flaxseed and control group, respectively: ALT [-11.12 compared with -3.7 U/L; P< 0.001], AST [-8.29 compared with -4 U/L; p < 0.001], GGT [-15.7 compared with -2.62 U/L; p < 0.001], fibrosis score [-1.26 compared with -0.77 kPa; p = 0.013] and steatosis score [-47 compared with -15.45 dB/m; p = 0.022]. In conclusion, flaxseed supplementation plus lifestyle modification is more effective than lifestyle modification alone for NAFLD management.

Background: Nonalcoholic fatty liver disease (NAFLD) is one of the most common chronic liver diseases worldwide. The pathogenesis of this disease is closely associated with obesity and insulin resistance. Ginger can have hypolipidemic and antioxidant effects, and act as an insulinsensitizer., Objectives: The aim of this study was to evaluate the effects of ginger supplementation in NAFLD management., Patients and Methods: In a randomized, double-blind, placebo-controlled clinical trial, 44 patients with NAFLD were assigned to take either two grams per day of a ginger supplement or the identical placebo, for 12 weeks. In both groups, patients were advised to follow a modified diet and physical activity program. The metabolic parameters and indicators of liver damage were measured at study baseline and after the 12 week intervention., Results: Ginger supplementation resulted in a significant reduction in alanine aminotransferase, γ-glutamyl transferase, inflammatory cytokines, as well as the insulin resistance index and hepatic steatosis grade in comparison to the placebo. We did not find any significant effect of taking ginger supplements on hepatic fibrosis and aspartate aminotransferase., Conclusions: Twelve weeks of two grams of ginger supplementation showed beneficial effects on some NAFLD characteristics. Further studies are recommended to assess the long-term supplementation effects.

Aim: Previous studies have shown that circulating adipokines may play an important role in the pathogenesis of some obesity related chronic disease such as dyslipidemia and type2 diabetes mellitus. The aim of the present study was to investigate the association between vaspin, omentin-1 and retinol binding protein-4 levels with metabolic dyslipidemia (MD) criteria in obese and non-obese individuals., Method: The study was conducted on 170 obese and 81 non-obese individuals. After collecting the blood samples, serum levels metabolic parameters as well as three circulating adipokines and body composition were measured., Results: No significant difference was noted regarding the mean serum levels of omentin-1 and vaspin between the obese and non-obese groups, while, serum level of RBP4 was significantly higher in the non-obese group. We found the 0.22 increased risk of MD in obese individuals with higher RBP4 concentration. After the adjustment for confounding factors, this association was still significant. No significant association was noted between MD and its components relative risks with omentin-1 and vaspin levels., Conclusion: Our study demonstrated that circulating RBP4 was significantly higher in the obese individuals which may increase the risk of MD in them. Further researches are needed to address this association., (Copyright © 2015 Diabetes India. Published by Elsevier Ltd. All rights reserved.)

Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in children. High prevalence of pediatric obesity and sedentary lifestyle has augmented the incidence of NAFLD in children. Obesity is associated with an increased risk of NAFLD through various mechanisms such as intensification of insulin resistance and increased levels of inflammatory markers. There is no approved medical intervention for treatment of pediatric NAFLD; the only proven strategy in management of pediatric NAFLD is lifestyle modification. Recently, the effects of nutritional supplements have been examined in the management of pediatric NAFLD. The purpose of this review is to summarize the studies evaluating the effects of nutritional supplements on pediatric NAFLD and explain the future direction in this field.