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Background: Little is known about the association of plant-based diet indices with metabolic syndrome (MetS) and its novel predictive biomarkers, including the atherogenic index of plasma (AIP) and adropin. We aimed to investigate the association of plant-based diets with adropin, atherogenic index of plasma, and MetS and its components in adults., Methods: The present population-based cross-sectional study was conducted on a representative sample of adults aged 20-60 years in Isfahan, Iran. Dietary intake was obtained through a validated 168-item semi-quantitative food frequency questionnaire (FFQ). Peripheral blood was obtained after an overnight fast of at least 12 h from each participant. MetS was identified based on the Joint Interim Statement (JIS). AIP was calculated as a logarithmically transformed ratio of triglyceride (TG)/high-density lipoprotein cholesterol (HDL-c), and serum levels of adropin were measured by an ELISA kit., Results: A total of 28.7% of subjects had MetS. No significant association was found between the overall plant-based diet index (PDI) and the healthful plant-based diet index (hPDI) with MetS. However, a non-linear association was observed between hPDI and MetS. Subjects in the third quartile of the unhealthful plant-based diet index (uPDI) had higher odds of MetS compared to the first quartile (OR: 2.39; 95% CI: 1.01, 5.66). The highest quartile of PDI (OR: 0.46; 95% CI: 0.21, 0.97) and the third quartile of hPDI (OR: 0.40; 95% CI: 0.18, 0.89) were associated with decreased odds of having high-risk AIP compared to the first quartile, after adjusting for potential confounders. No linear association was found between quartiles of plant-based diet indices and serum levels of adropin., Conclusion: Plant-based diet index (PDI) and hPDI were not associated with the prevalence of MetS in adults, while moderate adherence to uPDI increased the prevalence of MetS. In addition, high adherence to PDI and moderate adherence to hPDI were associated with decreased odds of high-risk AIP. No significant association was found between plant-based diet indices and serum adropin levels. To confirm these findings, further studies with prospective designs are warranted., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The reviewer SN declared a shared affiliation with the author KL to the handling editor at the time of review., (Copyright © 2023 Shahdadian, Saneei, Lotfi, Feizi, Askari and Safavi.)

The main aim of the current study was to summarize the findings of available clinical studies to assess nano-curcumin's influence on COVID patients. A comprehensive online search was performed in Scopus, PubMed, ISI Web of Science, and Google Scholar until March 2022 to identify trials that investigated the effects of nano-curcumin in patients with COVID-19. Eight studies comprising 569 patients were included in this review. Compared with placebo, nano-curcumin had no significant effect on C-reactive protein (CRP) and high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6). However, gene expression of IL-6 and gene expression as well as secretion of interleukin-1 beta (IL-1β) significantly decreased following nano-curcumin intervention. Nano-curcumin had beneficial effects on fever, cough, chills, myalgia, and olfactory and taste disturbances. The duration of hospitalization and mortality rate were significantly lower in the nano-curcumin group compared with the control group. Lymphocyte count was significantly increased after curcumin supplementation. Nano-curcumin also had favorable effects on O 2 saturation, sputum, chest pain, wheeze, and dyspnea in patients with COVID-19. No major adverse effects were reported in response to nano-curcumin supplementation. In summary, the results of this systematic review of clinical trials suggested that nano-curcumin supplementation has beneficial effects on inflammation, respiratory function, disease manifestations, and complications in patients with COVID-19 viral infection., (© 2023 John Wiley & Sons Ltd.)

Metabolic syndrome (MeS) is a common multifaceted disorder. Plants contain antioxidant bioactive compounds, which are beneficial to improve the health condition of patients with MeS. Propolis is a hive natural product that is composed of various constituent. We aimed to assess the effects of Iranian propolis as a natural and safe agent on indicators of MeS, quality of life and mood status in individuals with MeS. In total, 66 interested eligible patients recruited to the present study. Participants were randomly assigned to consume a tablet at dose of 250 mg of propolis extract, twice daily for 12 weeks or placebo. Propolis supplementation could lead to a significant reduction in waist circumference (WC), increase in physical functioning, general health and the overall score of SF-36 compared with placebo group (P-value < 0.05). However, no significant differences were observed regarding other anthropometric indices and biochemical parameters between two groups (P-value > 0.05). The current study indicated that propolis can be effective in decreasing WC and improving physical health and quality of life, while had no significant effects on other components of MeS among subjects with this syndrome. Clinical trials registration Iran Registry of Clinical Trials.ir IRCT20121216011763N49, registration date 23/12/2020., (© 2023. The Author(s).)

Background: Angiotensin II receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors (ACEinhs) may deteriorate or improve the clinical manifestations in severe acute respiratory syndrome coronavirus 2 infection. A comparative, cross-sectional study was conducted to evaluate the association of ARBs/ACEinhs and hydroxy-3-methyl-glutaryl-CoA reductase inhibitors (HMGRis) with clinical outcomes in coronavirus disease 2019 (COVID-19)., Materials and Methods: From April 4 to June 2, 2020, 659 patients were categorized according to whether they were taking ARB, ACEinh, or HMGRi drugs or none of them. Demographic variables, clinical and laboratory tests, chest computed tomography findings, and intensive care unit-related data were analyzed and compared between the groups., Results: The ARB, ACEinh, and HMGRi groups significantly had lower heart rate ( P < 0.05). Furthermore, a lower percent of O 2 saturation (89.34 ± 7.17% vs. 84.25 ± 7.00%; P = 0.04) was observed in the ACEis group than non-ACEinhs. Mortality rate and the number of intubated patients were lower in patients taking ARBs, ACEinhs, and HMGRis, although these differences failed to reach statistical significance., Conclusion: Our findings present clinical data on the association between ARBs, ACEinhs, and HMGRis and outcomes in hospitalized, hypertensive COVID-19 patients, implying that ARBs/ACEinhs are not associated with the severity or mortality of COVID-19 in such patients., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Journal of Research in Medical Sciences.)

Background: Observational studies have reported that dietary renal acid load has an important role in insulin resistance and metabolic factors. The aim of the present study was to assess the effect of a low renal acid load diet (LRALD) on blood pressure, lipid profile, and blood glucose indices in patients with type 2 diabetes., Methods: In this parallel randomized clinical trial, 80 patients with type 2 diabetes were randomly assigned to the LRALD (n = 40) or control (n = 40) groups, for 12 weeks. Both groups received a balanced diet and a list of nutritional recommendations based on healthy eating behaviors. In the LRALD group, food items with low renal acid load were prescribed. Primary outcomes including: fasting blood glucose (FBG), hemoglobin A1c (HbA1c), fasting serum insulin, quantitative insulin sensitivity check index (QUICKI), homeostatic model assessment for insulin resistance (HOMA) and secondary outcomes including: weight, systolic blood pressure (SBP), diastolic blood pressure (DBP), triglyceride (TG), total cholesterol (TC), low-density lipoprotein (LDL), and high-density lipoprotein (HDL). were measured at baseline and end of the study. The present trial was registered at IRCT.ir (IRCT20130903014551N5)., Results: Seventy subjects completed the study (n = 35 in control group and n = 36 in LRALD). Weight (P < 0.001), body mass index (P < 0.001), FBG (P < 0.001), HbA1c (P < 0.001), SBP (P = 0.004), and TG (P = 0.049) were reduced and HDL (P = 0.002) was increased in both groups, compared with baseline. After adjusting for baseline values, DBP (P = 0.047) was reduced in the LRALD group compared with control group. Results had no changes after using intention to treat analysis., Conclusion: A LRALD may decrease DBP in type 2 diabetic patients. However, it elicited no significant effect on lipid profile compared with a healthy diet., Trial Registration: This randomized clinical trial was registered at IRCT.ir (IRCT20130903014551N5)., (© 2023. The Author(s).)

Objective: Curcumin is a safe phytochemical with antioxidant, anti-inflammatory, antidiabetic, and lipid-lowering effects. This study aims to investigate the efficacy of curcumin-piperine in non-proliferative diabetic retinopathy., Materials and Methods: In this double-blind randomized trial, 60 diabetic retinopathy patients after meeting the inclusion criteria will be randomly assigned to two groups of curcumin-piperine supplementation (1000 mg per day for 12 weeks) or receiving placebo. The density of small blood vessels in the retina by optical coherence tomography angiography (OCTA), fasting blood glucose, triglyceride, renal indices (blood urea nitrogen and creatinine), high-sensitivity C-reactive protein, total antioxidant capacity, total oxidant status, body mass index, waist circumference, and weight will be measured., Conclusion: If the beneficial effects of curcumin on diabetic retinopathy are observed, this safe, this natural and inexpensive herbal supplement can be considered a therapeutic solution in these patients., Competing Interests: Muhammed Majeed is the founder of Sami-Sabinsa group of companies. The other authors have nothing to disclose.

Background: Recently, several have evaluated the association between the components of the dietary inflammatory index (DII) score with the risk and severity of Coronavirus Disease 2019 (COVID-19). For the first time, we examined the association between DII ® with risk of coronavirus infection and symptom severity through a case-control study in Iran., Methods: The present case-control study was conducted on COVID-19 cases (n = 100) and healthy control (n = 100) volunteer, aged from 18 to 65 years. Dietary intake, DII, body mass index, COVID-19 infection, and the severity of its symptoms were assessed for each participant. A multivariable logistic regression analysis test was used to estimate the odds ratio and 95% confidence interval., Results: Our results demonstrated that COVID-19-infected patients were significantly older and had longer history of diabetes as compared to the healthy control group ( P <.05). Furthermore, the participants with COVID-19 had a significantly greater intake of total fat ( P =0.259), saturated fat ( P =0.005), and dietary fiber ( P = .004). In contrast, individuals in the healthy control group had a higher intake of carbohydrate ( P = .005), sodium ( P <.001), and iron ( P <.001). However, there was no significant difference in DII score between COVID-19 and healthy controls ( P =.259). In addition, we did not detect any specific association between DII score and risk of COVID-19 infection (odds ratio = 1.08, 95% confidence interval: 0.92 to 1.27; P =.294) and the severity of its symptoms ( P >.05)., Conclusions: There appears to be no specific association between DII score and risk of COVID-19 infection and the severity of its symptoms. More prospective cohort studies are necessary to confirm the veracity of our results., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 International Journal of Preventive Medicine.)

Introduction: Considering the emergence of the concept of personalized nutrition in recent years and its importance in the treatment of diseases, the purpose of this study was to investigate the interaction of paraoxonase (PON)1 rs662 polymorphism and vitamin C/E intake on coronary artery disease (CAD) severity and lipid profile in patients undergoing diagnostic angiography., Methods: This cross-sectional study was carried out on 428 patients undergoing angiography. The PON-1 genotypes were detected by the polymerase chain reaction-restriction fragment length polymorphism technique. Dietary intake was obtained using a valid questionnaire., Results: After adjustment for potential confounders, R allele carriers (RR + RQ) have lower HDL-C levels than non-carriers (QQ) ( P ≤ 0.05). On the other hand, higher consumption of vitamin C was associated with a reduced risk of high total cholesterol (OR: 0.42, 95% CI 0.23-0.75, P = 0.003) and low-density lipoprotein cholesterol (OR: 0.49, 95% CI 0.25-0.96, P = 0.038) and an increased risk of low high-density lipoprotein cholesterol (OR: 1.88, 95% CI 1.03-3.42, P = 0.037). Furthermore, a significant interaction was observed between vitamin C intake and genotypes of rs66 polymorphism on LDL-C ( P = 0.050). In detail, the R-allele carriers with lower vitamin C intake had higher LDL-C levels than QQ genotype carriers. No significant interaction was found between vitamin E intake and rs662 polymorphism genotypes on the Gensini and SYNTAX scores and lipid profile ( P > 0.05)., Conclusion: The novel finding of the present study was the existence of a significant interaction between rs662 polymorphism and vitamin C intake on LDL-C. More specifically, R allele carriers with lower vitamin C intake were susceptible to higher LDL-C., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Darand, Salehi-Abargouei, Vahidi Mehrjardi, Feizi, Seyedhossaini and Askari.)

Background: Protein gels are used for different purposes, such as providing good texture, serving as fat replacers, and enhancing the nutritional and functional characteristics of foods. They can also deliver controlled release agents for sensitive drugs. The objective of this study was to investigate the impact of κ-carrageenan (kcr) concentration (0, 1.5, 3, and 4.5 mg g -1 ) on the morphological and physicochemical properties and release behavior of glucono-δ-lactone (GDL)-induced pinto bean protein aggregate (PBA) gels., Results: When κ-carrageenan concentration increased from 0 to 1.5 and 3 mg.g -1 , the firmness of the samples increased significantly, by 2.04 and 3.7 fold, respectively (P < 0.05). A compact and homogenous network with considerable strength and maximum water-holding capacity (97.52 ± 1.17%) was obtained with the addition of 3 mg g -1 κ-carrageenan to the gel system. Further increasing the κ-carrageenan concentration to 4.5 mg g -1 produced a coarse gel structure with higher storage modulus (G'), firmness (6.30-fold), thermal stability, and entrapment efficiency (85.6%). Depending on the κ-carrageenan concentration, various microstructures from protein continuous phase to κ-carrageenan continuous phase were observed. The release test indicated that 70.25% of the loaded curcumin was released in the simulated gastrointestinal tract for pure PBA gels. In contrast, for binary gels containing 4.5 mg g -1 κ-carrageenan, curcumin was protected in the upper gastrointestinal tract, and 64.45% of loaded curcumin was delivered to the colon., Conclusion: Our study showed that κ-carrageenan/PBA gels had high entrapment efficiency and could protect curcumin in the upper gastrointestinal tract. The hydrogels are therefore very valuable for colon-targeting delivery purposes. © 2022 Society of Chemical Industry., (© 2022 Society of Chemical Industry.)

This study examines the effect of the chemical modification of alginate (ALG) by octenyl succinic anhydride (OSA) on the physical, mechanical, and barrier properties of the alginate-zein blend film. To reach this goal, the effect of the degree of substitution (DS) of the modified-ALG (OS-ALG) was assessed on the physical, mechanical, and barrier properties of the fabricated composite films. As confirmed by FTIR and XRD, the hydrophobic nature of OS-ALG facilitated the miscibility of OS-ALG-zein than ALG-zein. Moreover, scanning electron microscope (SEM) images confirmed the FTIR and XRD results. Furthermore, the substitution of ALG with OS-ALG in the blend films can significantly improve the water resistance and mechanical strength of the samples. The OSA-modification of ALG increased the water contact angle while decreasing the solubility, moisture content, extensibility, and water vapor permeability. Finally, the OS-ALG (DS = 0.034) and zein would be considered as a new source for the fabrication of biodegradable composite films with excellent structural and barrier properties., Competing Interests: Declaration of competing interest On behalf of all the authors I confirm that:, (Copyright © 2022 Elsevier B.V. All rights reserved.)

Background: As a modifiable risk factor, nutrition plays a pivotal role in the prevention or delay of oral squamous cell carcinoma (OSCC). This study was aimed to investigate and compare the dominant dietary patterns in the patients with and without OSCC., Materials and Methods: This case-control study evaluated the usual dietary intake of 80 cases and 120 controls during 2019-2020 using the 117-item Food Frequency Questionnaire, with confirmed validity and reliability. Factor analysis was used to detect the dominant dietary patterns. Data analysis was done by SPSS (version 21) using the Chi-square test, ANOVA, logistic regression analysis, and independent t -test ( P < 0.05)., Results: Three dietary patterns were identified, including the western dietary pattern, health dietary pattern, and traditional dietary pattern. The odds ratio (OR) = 1.181 and confidence interval (CI) = 0.671 and 2.082 were found for the western dietary pattern, OR = 1.087 and CI = 0.617 and 1.914 were detected for the healthy dietary pattern, and OR = 0.846 and CI = 0.480 and 1.491 were reported for the traditional dietary pattern. No significant difference was found between the study groups in the dietary pattern and the risk of disease. This relationship remained insignificant after adjustment for the energy intake and confounding factors., Conclusion: There was no significant relationship between adherence to healthy, traditional, and western dietary patterns and OSCC. Consumption of vegetables and nuts had a protective role against the disease, but risky behaviors such as smoking and alcohol use were directly associated with the incidence of the disease., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Advanced Biomedical Research.)

Introduction: The present study aimed to investigate the association of the paraoxonase 1 (PON1) Q192R polymorphism with coronary artery disease (CAD) and cardiometabolic risk factors in Iranian patients suspected of CAD., Methods: This cross-sectional study was conducted on 428 patients undergoing angiography. The data related to demographic information and physical activity were collected by valid and reliable questionnaires. The PON-1 genotypes were detected by the polymerase chain reaction-restriction fragment length polymorphism (RFLP-PCR) technique. The Gensini and SYNTAX score, anthropometric measurements, and biochemical and clinical parameters were measured by standard protocols., Results and Discussion: Findings indicated that the odds of obesity was significantly higher in people with the RR genotype compared to the QQ genotype carriers (OR: 2.95 CI: 1.25-6.93, P = 0.014) and also odds of low high-density lipoprotein cholesterol (HDL-C) was marginally higher (OR: 2.31 CI: 0.97-5.49, P = 0.056). There was no significant association between other CAD risk factors with PON1 Q192R polymorphism ( P > 0.05). Further analysis showed a significant interaction between sex and 192QR ( P = 0.019) and 192 RR ( P = 0.007) genotypes on body mass index (BMI). More specifically, the risk of obesity in men carrying the RR genotype was 3.38 times (OR: 3.38 CI: 1.08-10.58, P = 0.036). Also, a significant joint effect of the RR genotype and sex on HDL-C was seen ( P = 0.003). The stratification based on sex showed that the risk of low HDL-C is significantly higher in women carrying the RR genotype (OR: 6.18 CI: 1.21-31.46, P = 0.028). A marginal sex-genotype interaction was also found in the risk of elevated alanine aminotransferase (ALT) ( P = 0.057). In summary, the findings showed that the risk of obesity and low HDL-C was higher in people carrying the RR genotype. On the other hand, a Q192R polymorphism-sex interaction was observed on the risk of obesity, elevated ALT, and low HDL-C., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Darand, Salehi-Abargouei, Vahidi Mehrjardi, Feizi, Seyedhossaini and Askari.)

In the face of the COVID-19 pandemic, many people around the world have increased their healthy behaviors to prevent transmission of the virus and potentially improve their immune systems. Therefore, the role of diet and food compounds such as spices with bioactive and antiviral properties may be important in these efforts. In this chapter, we review the efficacy of spices such as turmeric (curcumin), cinnamon, ginger, black pepper, saffron, capsaicin, and cumin by investigating the effects of these compounds of COVID-19 disease severity biomarkers., (© 2023. The Author(s), under exclusive license to Springer Nature Switzerland AG.)

Objective: Migraine is one of the most common diseases. Curcumin with anti-oxidative and anti-neuroinflammatory properties might have beneficial effects in migraine patients. This study will be conducted to evaluate the effects of a phytosomal preparation of curcumin on clinical signs, oxidative stress, and inflammatory parameters in patients with migraine., Materials and Methods: This is a randomized, double-blind, placebo-controlled, clinical trial in which, 60 patients with migraine will be assigned to receive a daily dose of 250 mg of phytosomal curcumin for 8 weeks (intervention group) or 250 mg maltodextrin as a placebo for the same duration (control group). Before and after the study, frequency, duration, and severity of the attacks, quality of life and sleep, mood status, high-sensitivity C-reactive protein (hs-CRP), Nitric Oxide (NO), and oxidative stress factors will be measured., Conclusion: It seems that phytosomal formulation of curcumin (a solid dispersion preparation of curcumin with phosphatidylserine) with high bioavailability, can cross the blood-brain barrier (BBB) and result in decreased neuroinflammation, oxidative stress, and neurotoxicity. This way, phytosomal curcumin might lead to reduction of headaches and other complications of migraine and increase the quality of life of patients with migraine., Competing Interests: The authors have declared that there is no conflict of interest.

Competing Interests: Declaration of Competing Interest None of the authors had any personal or financial conflicts of interest.

Background: Curcumin is a traditional remedy for diseases associated with hyper-inflammatory responses and immune system impairment. Piperine, a bioactive compound in black pepper, has the potential to enhance curcumin bioavailability. 0This study aims to examine the effect of the curcumin-piperine co-supplementation in patients infected with SARS-CoV-2 and admitted to the intensive care unit (ICU)., Material and Methods: In this parallel randomized, double-blind, placebo-controlled trial, 40 patients with COVID-19 admitted to ICU were randomized to receive three capsules of curcumin (500 mg)-piperine (5 mg) or placebo for 7 days., Results: After 1 week of the intervention, serum aspartate aminotransferase (AST) (p = 0.02) and C-reactive protein (CRP) (p = 0.03) were significantly decreased, and hemoglobin was increased (p = 0.03) in the curcumin-piperine compared to the placebo group. However, compared with the placebo, curcumin-piperine had no significant effects on the other biochemical, hematological, and arterial blood gas and 28-day mortality rate was three patients in each group (p = 0.99)., Conclusion: The study results showed that short-term curcumin-piperine supplementation significantly decreased CRP, AST, and increased hemoglobin in COVID-19 patients admitted to the ICU. Based on these promising findings, curcumin appears to be a complementary treatment option for COVID-19 patients, although some parameters were not affected by the intervention., (© 2023. The Author(s), under exclusive license to Springer Nature Switzerland AG.)

The COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has now plagued the world for almost 3 years. Although vaccines are now available, the severity of the pandemic and the current dearth of approved effective medications have prompted the need for novel treatment approaches. Curcumin, as a food nutraceutical with anti-inflammatory and antioxidant effects, is now under consideration for the prevention and treatment of COVID-19. Curcumin has been demonstrated to retard the entrance of SARS-CoV-2 into cells, interfere with its proliferation inside cells, and curb the hyperinflammatory state caused by the virus by modulating immune system regulators, minimizing the cytokine storm effect, and modulating the renin-angiotensin system. This chapter discusses the role of curcumin and its derivatives in the prevention and treatment of COVID-19 infection, considering the molecular mechanisms involved. It will also focus on the molecular and cellular profiling techniques as essential tools in this research, as these can be used in the identification and development of new biomarkers, drug targets, and therapeutic approaches for improved patient care., (© 2023. The Author(s), under exclusive license to Springer Nature Switzerland AG.)

Background: The present study was conducted to explore the association between adherence to Mediterranean dietary pattern and migraine headache features including frequency, duration, and severity, as well as patients' migraine-related disabilities among the Iranian population diagnosed with migraine., Methods:  In the present cross-sectional study on 262 migraine patients aged 20-50 years old, a validated 168-item, food frequency questionnaire was used to assess the dietary intakes of participants. The Mediterranean diet score was calculated for each subject using nine pre-defined dietary components and ranged from 0-9. The headache severity, duration, frequency, migraine headache index score (MHIS), and headache impact test-6 (HIT-6) were measured using related questionnaires., Results:  After controlling for potential confounders, Mediterranean diet tended to be associated with lower headache frequency (β = -1.74, 95% CI: -3.53,0.03) and duration (β = -0.28, 95% CI: -0.59, -0.02) and was significantly associated with lower MHIS (β = -29.32, 95% CI: -51.22, -7.42), and HIT-6 score (β = -2.86, 95% CI: -5.40, -0.32) for those in the highest category of Mediterranean diet scores compared to the lowest category. A subgroup analysis of women also revealed a negative association between Mediterranean diet and headaches frequency (β = -2.30, 95% CI: -4.27, -0.32), duration (β = -0.42, 95% CI: -0.78, -0.07), scores of MHIS (β = -47.44, 95% CI: -71.90, -22.99), and HIT-6 (β = -3.45, 95% CI: -6.29, -0.61), after controlling for potential confounders., Conclusions: The present study suggests that adherence to the Mediterranean dietary pattern is associated with lower headache frequency, duration, MHIS, and HIT-6 score.

Background and Aims: Polycystic ovary syndrome (PCOS) is one of the common endocrine disorders in women, which causes numerous symptoms in women. The relationship of many micronutrients with this syndrome has been investigated. This study was conducted to examine the effects of magnesium supplementation on hyperandrogenism, hirsutism, and sleep quality in women with PCOS., Methods: In this parallel randomized clinical trial, 64 women with PCOS were randomly assigned to the magnesium group ( n  = 32) or placebo group ( n  = 32) for 10 weeks. Patients in the magnesium group received one 250 mg magnesium oxide tablet, per day. Hyperandrogenism, hirsutism, and sleep quality were measured at the beginning and end of the study. This randomized clinical trial was registered at https://www.IRCT.ir (IRCT20130903014551N8)., Results: Magnesium supplementation had no significant effect on hyperandrogenism ( p  = 0.51 for dehydroepiandrosterone sulfates, p  = 0.27 for testosterone), hirsutism ( p  = 0.23), and sleep quality ( p  = 0.85) compared with placebo., Conclusions: The present study showed that a single dose of magnesium supplementation elicited no beneficial effects on the mentioned symptoms in polycystic women. It is possible that the positive effects of magnesium observed in the former studies were due to the synergistic effects of other vitamins or minerals. More studies are needed in this area., Competing Interests: The authors declare no conflict of interest., (© 2022 The Authors. Health Science Reports published by Wiley Periodicals LLC.)

Controlled oral delivery of bioactive molecules remains a promising platform for the food and biomedical realm. Nonetheless, there are many bottlenecks to the efficient oral bioactive delivery that necessitates the development of advanced approaches. In recent years, prebiotic carbohydrates have drawn surging interest for targeted bioactive delivery due to their potential of multi-stimuli release mechanisms. Harnessing prebiotic-based vehicles confers novel possibilities for intact oral bioactive delivery, improving their bioavailability and efficacy. This critical review updates state of the art on progresses in oral delivery of natural active agents via prebiotic carbohydrates. We offer the latest advances concerning prebiotic-based vehicles (i.e., pH/time-dependent systems, enzyme-sensitive polymers, and colonic microbiota-dependent vehicles), emphasizing their key attributes to attaining controlled/targeted bioactive delivery to the intended locus. Finally, we discuss safety considerations, challenges, and future perspectives toward advances in the field., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Objectives: The association between major dietary patterns and metabolic health status in adolescents has been understudied, especially in Middle Eastern populations. The aim of this study was to evaluate this association in overweight/obese adolescents., Methods: In this cross-sectional study, the usual of 203 overweight/obese adolescents selected by a multistage, cluster random-sampling method was evaluated through a validated food frequency questionnaire. Anthropometric indices and blood pressure values were measured. Fasting blood samples were obtained to determine insulin, glucose, and lipid profile concentrations. Two methods (modified International Diabetes Federation [IDF] criteria and IDF criteria along with insulin resistance or homeostasis model assessment insulin resistance [HOMA-IR] &gt;3.16) were applied to classify participants into metabolically healthy obese (MHO) or unhealthy obese (MUO)., Results: Two major dietary patterns, Mediterranean-like and Western, were identified. After adjustments for potential confounders, high adherence to Mediterranean-like dietary pattern was related to 72% (odds ratio [OR], 0.28; 95% confidence interval [CI], 0.10-0.76) and 67% (OR, 0.33; 95% CI, 0.11-0.98) lower odds for being MUO based on IDF and HOMA-IR definitions, respectively. Higher adherence to the Western dietary pattern was related to higher odds of being MUO, either in the crude or adjusted models in both metabolic status definitions (for IDF definition: OR, 9.85; 95% CI, 2.75-35.19; for HOMA-IR definition: OR, 9.15; 95% CI, 2.02-41.52, in fully adjusted model)., Conclusions: We found an inverse association between the Mediterranean-like dietary pattern and odds of MUO in Iranian overweight/obese adolescents, whereas the Western dietary pattern was associated with an increased likelihood of being MUO. Further studies, with a prospective nature, are required to confirm these findings., Competing Interests: Conflict of interest None, (Copyright © 2022. Published by Elsevier Inc.)

Aims: The relationship between the Dietary Approaches to Stop Hypertension (DASH) diet and oxidative stress (OS) in patients diagnosed with migraine is unknown and remains to be examined. Hence, we conducted a parallel-group, randomized controlled trial to investigate this issue., Methods: Of the 102 women who met all the inclusion criteria, 51 individuals were randomized to the DASH diet group and 51 to the usual dietary advice group to receive allocated intervention for three months. In order to assess the compliance of participants to the DASH diet, dietary records, and serum vitamin C levels were examined. Parameters of OS status (e.g. nitric oxide (NO), total antioxidant capacity (TAC), total oxidative status (TOS), malondialdehyde (MDA), and oxidative stress index (OSI)) and clinical indices of migraine (e.g. migraine index (MI), headache dairy result (HDR), and migraine headache index score (MHIS)) were assessed at the beginning and the end of the study., Results: There was a significant reduction in NO (-5.75 vs. + 4.18, P = 0.025) and TOS (-1.55 vs. + 0.71, P = 0.034), and a marginally significant reduction in OSI (-0.10 vs. + 0.14, P = 0.060) in the DASH group compared with the control. Compliance with the DASH diet resulted in a significant decrease in the score of MI (-31.33 vs. - 15.09), HDR (-5.04 vs. -2.51), and MHIS (-44.21 vs. -26.74). Moreover, no significant change was observed in TAC, MDA, and total thiol content., Conclusion: This type of dietary approach can be considered as a complementary treatment for migraine patients, also further investigations are needed to replicate our findings. Trial registration: Iranian Registry of Clinical Trials identifier: IRCT20121216011763N38.

The relationship between the Dietary Approaches to Stop Hypertension (DASH) diet and clinical, quality of life and mental health outcomes in migraine is unknown. To address this knowledge gap, we conducted a parallel-group, randomised controlled trial to evaluate the effect of the DASH diet on these health outcomes in women with migraine. Of 102 eligible women (20-50 years), fifty one randomised to the DASH and fifty one to the usual dietary advice (control) groups completed a 12-week intervention. The DASH diet was designed using a 7-d menu cycle to provide 15-20 % of total daily energy requirements from proteins, 25-30 % from fats and 55-60 % from carbohydrates. Dietary records and serum vitamin C levels were used to assess women's compliance with the DASH diet. The clinical symptoms of migraine (i.e., frequency, duration and severity) and quality of life and mental health (i.e., depression, anxiety and stress) outcomes were assessed in groups pre-and post-intervention. We observed greater decreases in the frequency (-3·00 v . -1·40, P = 0·025) and severity (-1·76 v . -0·59, P < 0·001) of migraine in the DASH v . control group post-intervention. Similarly, the DASH group exhibited a tendency towards greater decreases in migraine duration (-0·58 v . -0·33 d, P = 0·053) and had lower scores of depression (-4·50 v . -2·73, P = 0·019) and stress (-5·84 v . -2·98, P = 0·011) v . controls. However, the quality of life and anxiety outcomes remained comparable in groups post-intervention. Together, evidence supports the benefits of the DASH diet on improving migraine health outcomes in reproductive-aged women. Further research is needed to confirm our findings.

There is a lack of evidence and consensus in terms of the association between dietary intake of sodium (Na) and potassium (K) with mental health. By using 24-hours urinary samples as the gold standard method, we conducted a study to explore the association between dietary intake of Na and K with parameters of mental health including depression, anxiety, and stress among an Iranian population diagnosed with migraine. In the present study, 262 subjects (20-50 years old), with a confirmed diagnosis of migraine were enrolled. Mental health was investigated by the Depression, Anxiety, and Stress Scales (DASS-21) questionnaire. Dietary intake of Na and K was estimated by means of a 24-hour urine sample. Multinomial logistic regression analysis was implemented and odds ratio (OR) with 95% confidence interval (CI) was stated. After controlling for potential confounders, the 24-hour urinary Na was associated significantly with the risk of depression (OR = 0.55, 95% CI: 0.30, 1.00; P = .053). After adjustment for confounders, those in the highest tertile of the 24-hour urinary Na/K ratio had lower odds for having depression (OR = 0.54, 95% CI: 0.31, 0.93; P = .027), and marginally significantly lower risk of anxiety (OR = 0.58, 95% CI: 0.31, 1.06; P = .079) and stress (OR = 0.56, 95% CI: 0.31, 1.02; P = .061). In conclusion, higher 24-hour urine Na was associated with a significantly lower risk of depression. Moreover, the 24-hour Na/K ratio was significantly associated with lower risk of depression, anxiety, and stress., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.)

Dietary factors may play a role in the etiology of endometriosis and dietary intake of some food groups and nutrients could be associated with endometriosis risk. This systematic review and meta-analysis of observational studies was conducted to summarize the findings on the association between dietary intakes of selected food groups and nutrients (dairy, fats, fruits, vegetables, legumes, and animal-derived protein sources), and the risk of endometriosis among adult women. PubMed, Scopus, and ISI Web of Science were systematically searched up to September 2022. The inverse variance-weighted fixed-effect method was used to estimate the effect size and corresponding 95% CI. A total of 8 publications (4 studies) including 5 cohorts and 3 case-control with a sample size ranging from 156 to 116,607 were included in this study. A higher intake of total dairy [all low-fat and high-fat dairy foods] was associated with decreased risk of endometriosis (RR 0.90; 95% CI, 0.85 to 0.95; P < 0.001; I 2  = 37.0%), but these associations were not observed with intakes of low or high-fat dairy, cheese or milk. Increased risk of endometriosis was associated with higher consumption of red meat (RR 1.17; 95% CI, 1.08 to 1.26; P < 0.001; I 2  = 82.4%), trans fatty acids (TFA) (RR 1.12; 95% CI, 1.02 to 1.23; P = 0.019; I 2  = 73.0%), and saturated fatty acids (SFA) (RR 1.06; 95% CI, 1.04 to 1.09; P < 0.001; I 2  = 57.3%). The results of this meta-analysis suggest that there may be differing associations between dietary intake of dairy foods, red meat, SFAs, and TFAs and the risk of endometriosis. It may be useful to extend the analysis to other types of food groups and dietary patterns to obtain a complete picture. Additionally, further investigations are needed to clarify the role of diet in the incidence and progression of endometriosis.Trial registration: PROSPERO, CRD42020203939., (© 2022. The Author(s).)

Introduction: The mortality of patients on chronic haemodialysis is 10-30 times greater than that of the general population and over 60% of these individuals die within the first 5 years of beginning haemodialysis. Although causes for excessive mortality in haemodialysis patients are not clearly defined, it seems that nutrition, inflammation and oxidative stress play key roles in this regard. Until now, no cohort study has focused on the association between nutritional, inflammatory or oxidative status and risk of complications and adverse outcomes in Iranian haemodialysis patients. Therefore, we sought to fill this gap and designed the Nutritional, Inflammatory, and Oxidative Status in Hemodialysis (NIOS-HD) prospective cohort study to determine the association of dietary factors, malnutrition, anthropometric indices, body composition, inflammation and oxidative stress with quality of life, dialysis access infections, hospitalisation, potential years of life lost and mortality in adults on maintenance haemodialysis in Isfahan, Iran., Methods and Analysis: The sample size of this cohort was estimated to be 300 participants. At baseline, demographic, medical and dialysis-related data of eligible patients will be recorded. In addition, participants will undergo anthropometric measurements, malnutrition assessment and body composition analysis. Also, their dietary intake and quality of life will be evaluated through interviewer-administered questionnaires. Moreover, their fasting blood samples will be collected and stored for biochemical assays including transthyretin, albumin, serum amyloid A, pentraxin-3, trimethylamine N-oxide, myeloperoxidase, paraoxonase-1 and superoxide dismutase. After baseline evaluation, patients will be followed up to 3 years to update exposure information (except biochemical assays) and measure adverse outcomes. Finally, collected data will be analysed using descriptive and inferential statistics., Ethics and Dissemination: The NIOS-HD is in agreement with the Declaration of Helsinki and has been approved by the Ethics Committee of Isfahan University of Medical Sciences (reference number: IR.MUI., Research: REC.1399.605). Findings of this study will be published in academic journals., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

The aim of this paper is to predict the patient hospitalization time with coronavirus disease 2019 (COVID-19). It uses various data mining techniques, such as random forest. Many rules were derived by applying these techniques to the dataset. The extracted rules mainly were related to people over 55 years old. The rule with the most support states that if the person is between 70 and 80 years old, has cardiovascular disease, and the gender is female; then, the person will be hospitalized for at least five days. The gradient boosting random forest technique has performed better than other techniques. As a limitation of the study, it can be pointed out that a few features were unavailable and had not been recorded. Patients with diabetes, chronic respiratory problems, and cardiovascular diseases have a relatively long hospitalization. So, the hospital manager should consider a suitable priority for these patients. Older people were also more likely to take part in the selection rules., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2022 GholamReza Askari et al.)

Currently, there is no consensus on the optimal vitamin D administration in bariatric patients. The present systematic review and meta-analysis were conducted to examine the effect of vitamin D supplements on serum level of 25(OH) vitamin D in the patients undergoing bariatric surgery (BS).Random model effects were used to estimate standardized mean difference (SMD) with a 95% confidence interval (CI). Nine clinical trials were included in the meta-analysis. Vitamin D supplementation in patients undergoing BS modestly improves vitamin D status (SMD, 0.53; 95% CI, 0.28, 0.77) particularly, in the dosages above 2850 IU/day and in the patients with BMI greater than 50 kg/m 2 . Vitamin D supplementation was associated with prevention of raising of the PTH serum concentration and without impact on serum calcium levels., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: This study aimed to evaluate the effects of compact food bar (CFB) designed on cardiopulmonary function in men athletes who serve in military service., Materials and Methods: In this randomized, single-blind, controlled clinical trial, 46 men of military staff were arranged into 2 groups and studied for 28 days; one branch used 3 packs daily, 700 kcal each, of CFB with Functional compounds (Caffeine and L-arginine) and the other group used regular food during training course. Maximal oxygen uptake (VO 2 Max) in vitro with cardiopulmonary exercise test, body composition, and physical activity were assessed and recorded at baseline and end of the study period., Results: VO 2 Max ( P = 0.05) significantly increased in CFB group compared with baseline. Moreover, VO 2 Max ( P = 0.01), VO 2 /HR ( P = 0.04), oxygen uptake/heart rate (VO 2 /HR) ( P = 0.03), and ventilation per minute/oxygen uptake (VE/VO 2 ) ( P = 0.03) significantly increased in CFB group compared with control group. In comparison, there was no significant difference in mean ventilation per minute/carbon dioxide production (VE/VCO 2 ) ( P = 0.41), ventilation per minute (VE) ( P = 0.69), and breathing frequency ( P = 0.056). No significant effect of CFB was found on weight, body mass index ( P = 0.23), lean body mass ( P = 0.91), and body fat mass ( P = 0.91)., Conclusion: Our results show that intervention with CFB is more effective than regular diet in improving cardiopulmonary function in men athletes who serve in military service., Competing Interests: There are no conflicts of interest, (Copyright: © 2022 Journal of Research in Medical Sciences.)

In this study, a novel approach was investigated to improve the stability of anthocyanin compounds (AC) by encapsulating them in nanoliposomes resulting from rapeseed lecithin alongside chitosan coating. The results indicate that the particle size, electrophoretic mobility, encapsulation efficiency, and membrane fluidity of nanoliposomes containing anthocyanin compounds were 132.41 nm, -3.26 µm·cm/V·S, 42.57%, and 3.41, respectively, which changed into 188.95 nm, +4.80 µm·cm/V·S, 61.15%, and 2.39 after coating with chitosan, respectively. The results also suggest improved physical and chemical stability of nanoliposomes after coating with chitosan. TEM images demonstrate the produced particles were spherical and had a nanoscale, where the existence of a chitosan layer around the nanoparticles was visible. Shear rheological tests illustrate that the flow behavior of nanoliposomes was altered from Newtonian to shear thinning following chitosan incorporation. Further, chitosan diminished the surface area of the hysteresis loop (thixotropic behavior). The oscillatory rheological tests also show the presence of chitosan led to the improved mechanical stability of nanoliposomes. The results of the present study demonstrate that chitosan coating remarkably improved encapsulation efficiency, as well as the physical and mechanical stability of nanoliposomes. Thus, coating AC-nanoliposomes with chitosan is a promising approach for effective loading of AC and enhancing their stability to apply in the pharmaceutic and food industries.

Background: Abnormal uterine bleeding (AUB), alopecia, low quality of life, and acne are considered as complications of polycystic ovary syndrome (PCOS). We hypothesized that magnesium supplementation would yield beneficial effects on PCOS related complications., Objective: To examine the effects of magnesium supplementation on AUB, alopecia, quality of life, and acne., Methods: In this parallel randomized clinical trial, we randomly assigned 64 women with PCOS to the magnesium group (n = 32) or placebo group (n = 32) for 10 weeks. AUB, alopecia, quality of life, and acne were assessed by the International Federation of Gynecology and Obstetrics criterion, the Sinclair Scale, the Health Survey Quality of Life Questionnaire, and the Global Acne Grading System, respectively. This randomized clinical trial was registered at IRCT.ir (IRCT20130903014551N9)., Results: Magnesium supplementation significantly improved the components of quality of life including physical functioning (p = 0.011), role limitations due to physical health (p = 0.012), role limitations due to emotional problems (p < 0.001), energy/fatigue (p = 0.005), emotional wellbeing (p < 0.001), social functioning (p = 0.002), general health (p = 0.013), and total quality of life (p < 0.001), compared with placebo. No significant effect was observed on acne, alopecia, and AUB., Conclusion: Magnesium supplementation in women with PCOS had a significant positive effect on improving total quality of life., Trial Registration: This randomized clinical trial was registered at IRCT.ir on 2020-10-18 (Registration Code: IRCT20130903014551N9 )., (© 2022. The Author(s).)

Background: Literature suggests a relationship between estrogen levels and migraine headache pathogenesis. However, the effect of soy isoflavones on migraine characteristic remains unclear. This study aimed to investigate the effect of soy isoflavones on migraine characteristics and calcitonin gene-related peptide (CGRP) levels in women with migraine., Methods: Eighty-three participants completed a randomized double-blind controlled trial, receiving 50 mg per day soy isoflavones or placebo supplementation for 8 weeks. Migraine severity, migraine days per month, frequency and duration of attacks, mental status, quality of life and serum CGRP levels were measured at baseline and the end of the intervention. Bivariate comparison and intention-to-treat (ITT) were used for analysis., Results: Soy isoflavones intake resulted in a significant decrease in mean frequency (-2.36 vs -0.43, P < 0.001), duration (-2.50 vs -0.02, P < 0.001) of migraine attacks and CGRP level (-12.18 ng/l vs -8.62, P = 0.002) in compared to placebo group. Also, a significant improvement was found in quality of life (16.76 vs 2.52, P < 0.001). Although, reduction in the migraine severity and mental status did not reach a statistically significant level (P > 0.05)., Conclusion: soy isoflavones supplementation may be considered as a complementary treatment for women with migraine to improve migraine characteristics and reduce the burden of disease., (© 2022. The Author(s).)

Few studies have assessed the association between sodium (Na) and potassium (K) and migraine headaches. In this study, we aimed to examine the relationship between 24-hour urine Na and K intakes and clinical findings of migraine in an Iranian sample. In this cross-sectional study, 262 participants, aged 20-50 years, were included with a body mass index (BMI) of 18·5-30 kg/m 2  and a diagnosis of migraine. One 24-hour urine sample was collected from each subject to estimate the Na and K intakes. The clinical features of migraine, including frequency, duration, severity, Migraine Headache Index Score (MHIS), and Headache Impact Test (HIT) score, were assessed. Besides, a multiple linear regression analysis was performed, and beta estimates and the corresponding 95% confidence intervals (CIs) were reported. Overall, 224 women and 38 men, with a mean age of 36·10 years and BMI of 25·55 kg/m 2 comprised our study population. After controlling for potential confounders, the 24-hour urine Na was positively associated with a longer headache duration ( β = 0·29; 95% CI: 0·06, 0·53) in the group with the highest urine Na levels as compared to the group with the lowest levels. After adjustments for potential confounders, an increase of 13·05 in the MHIS was observed when the 24-hour urine Na level increased from the first to the third tertile ( β = 13·05; 95% CI: 1·70, 24·41). Our findings suggested that a higher 24-hour urine Na level was positively associated with a longer duration of migraine headaches and a higher MHIS.

Background: COVID-19 pandemic has made the disease a major global problem by creating a significant burden on health, economic, and social status. To date, there are no effective and approved medications for this disease. Curcumin as an anti-inflammatory agent can have a positive effect on the control of COVID-19 complications. This study aimed to assess the efficacy of curcumin-piperine supplementation on clinical symptoms, duration, severity, and inflammatory factors in patients with COVID-19., Methods: Forty-six outpatients with COVID-19 disease were randomly allocated to receive two capsules of curcumin-piperine; each capsule contained 500 mg curcumin plus 5 mg piperine or placebo for 14 days., Results: Mean changes in complete blood count, liver enzymes, blood glucose levels, lipid parameters, kidney function, and c-reactive protein (CRP) were not significantly different between the two groups. There was a significant improvement in health status, including dry cough, sputum cough, ague, sore throat, weakness, muscular pain, headache, and dyspnea at week 2 in both curcumin-piperine and placebo groups (P value < 0.05); however, the improvement in weakness was more in the curcumin-piperine group than with placebo group (P value 025)., Conclusion: The present study results showed that curcumin-piperine co-supplementation in outpatients with COVID-19 could significantly reduce weakness. However, in this study, curcumin-piperine co-supplementation could not significantly affect the other indices, including biochemical and clinical indices., Trial Registration: Iranian Registry of Clinical Trials IRCT20121216011763N46 . 2020-10-31., (© 2022. The Author(s).)

Objectives: Based on a comprehensive search, we realized that there is no previous study conducted among migraine patients to assess the association between major dietary patterns and mental health. Therefore, the present study aims to explore the relationship between empirically-derived dietary patterns and depression, anxiety, and stress in a sample of Iranian migraine patients., Methods: A total of 262 migraine patients (20-50 years) were selected through simple random sampling method for this study. Dietary intake during the previous year was determined using a validated 168-item, semi-quantitative food frequency questionnaire (FFQ), and major dietary patterns were derived using principal component analysis (PCA). For mental health evaluation, authors used the Depression, Anxiety, and Stress Scales (DASS- 21) questionnaire. Statistical analysis included multinomial logistic regression analysis and results were expressed as odds ratio (OR) with a 95% confidence interval (CI)., Results: We identified three major dietary patterns including "traditional", "western", and "healthy". After controlling for potential confounders, those in the highest tertile of the healthy dietary pattern had lower odds of depression (OR = 0.44, 95% CI: 0.22, 0.88; P for trend: 0.030) and stress (OR = 0.50, 95% CI: 0.25, 0.99; P for trend: 0.049). However, no significant association was observed between western and traditional dietary patterns and mental disorders., Conclusions: In summary, significant associations were documented between healthy dietary patterns and risk of depression and stress. Current findings urge migraine patients to increase their intakes of fruits, vegetables, eggs, whole grains, nuts and seeds, meat, and poultry and reduce the intake of fast foods and snacks, processed meat, fish, cola drink, condiments, dairy, and vegetable pickles to diminish the chance of depression and stress., (© 2022. The Author(s).)

Background: Sepsis is a common cause for admission to the intensive care unit (ICU), and its incidence has been increasing. It is associated with a significant increase in serum inflammatory biomarkers such as C-reactive protein (CRP) and cytokines such as interleukin 1 (IL-1), IL-6, and tumor necrosis factor (TNF). Sepsis is also associated with pathophysiological changes that include fluid accumulation in the lungs, eventually leading to acute respiratory distress syndrome (ARDS), tissue edema, hypotension, and acute kidney injury (AKI). Conventional therapies include antibiotics, but these may have important adverse effects, so novel therapeutic approaches are required. In animal studies, L-carnitine improves antioxidant status, and in some clinical trials, it has been shown to reduce inflammation. It has also been shown to improve respiratory distress and help maintain coenzyme A homeostasis, metabolic flexibility, promoting the normal function of the tricarboxylic acid (TCA) cycle, and oxidation of fatty acids by peroxisomes. We aim to determine the effects of very high doses of L-carnitine on inflammatory factors, oxidative stress, and clinical outcomes of patients with sepsis in ICU., Method and Design: In this double-blind, randomized controlled clinical trial, we will use block randomization of 60 patients with sepsis, aged between 20 and 65 years from Al-Zahra Hospital, Isfahan, Iran. The intervention group (n = 30) will receive three capsules of L-carnitine (each capsule contains 1000 mg L-carnitine; totally 3000 mg/day) for 7 days, and a control group (n = 30) will receive a placebo with the same dose and for the same duration in addition to usual care. At baseline, scores for clinical and nutritional status (Acute Physiology and Chronic Health Evaluation II (APACHE II), Sequential Organ Failure Assessment (SOFA), Quick SOFA (qSOFA), and NUTRIC Score) will be assessed. At beginning and end point of the study, inflammatory markers (CRP, erythrocyte sedimentation rate (ESR)), oxidative stress status (total oxidative stress (TOS), total antioxidant capacity (TAC)), and clinical variables will be evaluated also. The mortality rate will be assessed within 28 days of the beginning of the intervention., Discussion: Because of the anti-inflammatory and antioxidant properties of L-carnitine, it is possible that using a high dose of 3000 mg daily of this nutritional supplement may reduce inflammation and oxidative stress and improve subsequent mortality of critically ill patients with sepsis., Trial Registration: Iranian Registry of Clinical Trials IRCT20201129049534N1 . Registered on 2 May 2021., (© 2022. The Author(s).)

Despite a large body of literature on the association between the dietary inflammatory index (DII) and various chronic diseases, limited knowledge is available regarding the association between DII and migraine. Therefore, we assessed the relationship between the DII and migraine characteristics, including duration, frequency, and severity of migraine headaches, Headache Impact Test-6 (HIT-6), and serum levels of nitric oxide (NO). This population-based cross-sectional study was conducted from August 2019 to June 2020 among 262 patients (38 men and 224 women; 20-50 years). A 168-item semiquantitative food frequency questionnaire (FFQ) was gathered to evaluate dietary intake, and subsequently, an energy-adjusted DII score was calculated. After controlling for potential confounders, an increase of 3.48 in headache frequency was observed when the DII score increased from - 4.04 to - 1.83 (β = 3.48; 95% CI 1.43, 5.54). In the crude model, headache duration tended to be inversely associated with DII in the subjects with the pro-inflammatory diet compared to those with the anti-inflammatory diet (β = - 0.22; 95% CI - 0.46, 0.02). After adjustment for confounders, those with the highest DII values were at a higher risk of severe headaches than those with the lowest values (OR = 2.25; 95% CI 1.17, 4.32). No other significant results were found in terms of the association between DII and HIT-6 or serum NO levels. We found evidence suggesting that higher adherence to a diet with anti-inflammatory properties was significantly and inversely related to headache frequency. Furthermore, our results suggest that the DII score is substantially related to migraine severity., (© 2022. The Author(s).)

There is limited evidence regarding the possible role of dietary acid load (DAL) in the pathophysiology of migraine headaches. Therefore, we sought to examine DAL in relation to the clinical features of migraine including headache frequency, severity and duration, headache impact test-6 (HIT-6), and serum levels of nitric oxide (NO). In the present cross-sectional study, 262 patients (38 men and 224 women aged 20-50 years) were recruited through a simple random sampling method. Dietary intakes were obtained by using a validated 168-item semi-quantitative food frequency questionnaire (FFQ). DAL was then calculated by two different methods; potential renal acid load (PRAL) and net endogenous acid production (NEAP). In total, 262 patients with a mean (SE) age of 36.1 (0.53) and a BMI of 25.55 (0.21) were included in the current study. After controlling for potential confounders, a higher DAL was positively associated with headache frequency in those with the highest DAL score compared to the lowest (PRAL; β = 2.33; 95% CI 0.78, 3.88; NEAP; β = 1.74; 95% CI 0.13, 3.34). Increasing NEAP from 28.96 to 35.89 resulted in a 3.43 and 2.74 increment in HIT-6 scores in the crude (95% CI 1.35, 5.52) and fully-adjusted models (95% CI 0.40, 5.07), respectively. Moreover, a higher dietary PRAL was significantly associated with migraine-related disability, as shown by HIT-6, in subjects of the third tertile compared to those in the first tertile after controlling for confounders (β = 2.42; 95% CI 0.13, 4.70). In conclusion, our study highlighted the importance of the acid-base properties of a diet in the pathophysiology of migraine headaches. However, further well-designed studies are needed to confirm our findings., (© 2022. The Author(s).)

Background: Ready-to-use therapeutic food (RUTF) spread has been highly effective in the treatment of malnutrition in those affected by disasters since it does not require preparation and baking and has a long shelf life and sufficient energy to improve growth and weight loss. Such features may be crucial during crises such as wars and natural disasters. The present study aimed to design a high-energy and nutrient-dense RUTF formulation., Methods: Soybean flour and milk protein concentrate were used as protein sources, corn flour, and sugar were employed as carbohydrate sources, cacao butter substitute was used as the lipid source, and vitamin/mineral, beta-alanine, arginine, Nigella sativa , and sesame seeds were used as a functional food. The study was performed in accordance with the guidelines of the Institute of Medicine (IOM) and criteria for food products., Results: To design the formulation, we used carbohydrates (45% of total energy), protein (13% of total energy), fat (42% of total energy), vitamins, minerals, beta-alanine, and arginine, and 100 grams of the diet was considered to release 525 kilocalories of energy. The experimental results of food safety at the determined intervals (at the beginning and 45 and 90 days after the production) showed acceptable values., Conclusions: Since nutritional requirements are among essential human needs (especially in the management of malnutrition in crisis), it is of utmost importance to prepare RUTF products in order to meet all human nutritional needs by facilitating the easy use of these products, particularly for the prevention of malnutrition and diseases., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 International Journal of Preventive Medicine.)

The current study was performed to evaluate the effects of alpha-lipoic acid (ALA) supplementation on lactate, nitric oxide (NO), vascular cell adhesion molecule-1 (VCAM-1) levels, and clinical symptoms in women with episodic migraines. Considering the inclusion and exclusion criteria, ninety-two women with episodic migraines participated in this randomized, double-blind, placebo-controlled, parallel-design trial. The participants were randomly assigned to receive either 300 mg/day ALA or placebo, twice per day for 12 weeks. The primary outcomes included headache severity, headache frequency per month, and duration of attacks and the secondary outcomes included lactate (a marker of mitochondrial function), NO, and VCAM-1 serum levels were measured at baseline and the end of the intervention. At the end of the study, there was a significant decrease in lactate serum levels (- 6.45 ± 0.82 mg/dl vs - 2.27 ± 1.17 mg/dl; P = 0.039) and VCAM-1 (- 2.02 ± 0.30 ng/ml vs - 1.21 ± 0.36 ng/ml; P = 0.025) in the ALA as compared to the placebo group. In addition, the severity (P < 0.001), frequency (P = 0.001), headache impact test (HIT-6) (P < 0.001), headache dairy results (HDR) (P = 0.003), and migraine headache index score (MHIS) (P < 0.001) had significantly decreased in the intervention as compared to the control group. No significant changes were observed for NO levels and duration of migraine pains. ALA supplementation can be considered a potential adjunct treatment in patients with migraine due to its improving mitochondrial and endothelial functions and clinical symptoms., (© 2022. The Author(s).)

Background & Objective: Current evidence is debatable regarding the feasible effects of zinc supplementation on the inflammation and oxidative stress status of adults. This systematic review and meta-analysis aimed to clarify this inconclusiveness., Materials and Methods: Literature search was conducted via online databases such as PubMed, Scopus, ISI Web of Science, Cochrane Library, and Google Scholar until June 2020. The overall effect was presented as the weighted mean difference (WMD) at 95 % confidence interval (CI) in a random-effects meta-analysis model. Publication bias was also assessed using Egger's and Begg's statistics., Results: In total, 25 clinical trials (n = 1428) were reviewed, which indicated that zinc supplementation significantly affects the concentration of C- reactive protein (WMD: -0.03 mg/l; 95 % CI: -0.06, 0.0; P = 0.029), interlukin-6 (WMD: -3.81 pg/mL; 95 % CI: -6.87, -0.76; P = 0.014), malondialdehyde (WMD: -0.78 μmol/l; 95 % CI: -1.14, -0.42; P < 0.001), and total antioxidant capacity (WMD: 95.96 mmol/l; 95 % CI: 22.47, 169.44; P = 0.010). In addition, a significant between-study heterogeneity and a non-significant increment was reported in nitric oxide (WMD: 1.47 μmol/l; 95 % CI: -2.45, 5.40; P = 0.461) and glutathione (WMD: 34.84 μmol/l; 95 % CI: -5.12, 74.80; P = 0.087)., Conclusion: According to the results, zinc supplementation may have beneficial anti-inflammatory and anti-oxidative effects in adults., (Copyright © 2021. Published by Elsevier GmbH.)

Background: Migraine is a prevalent health condition associated with significant pain and disability. Neurogenic inflammation has a key role in migraine pathophysiology. Curcumin is a well-known herb compound with anti-inflammatory function. This study was aimed to evaluate the effects of curcumin supplementation on clinical features, as well as on serum levels of calcitonine gene-related peptide (CGRP) and interleukin-6 (IL-6)., Methods: This randomized double-blind placebo-controlled clinical trial was carried out on 44 women with migraine, receiving either 500 mg curcumin twice a day or placebo supplements for 8 weeks. Serum CGRP and IL-6 concentration, and clinical symptoms including headache severity, duration and frequency were measured at the baseline and end of study., Results: After 8-week intervention, compared with placebo, curcumin supplementation led to significand reduction in CGRP ( P < 0.001 ), IL-6 ( P = 0.041 ), severity ( P = 0.001 ), and duration of headache ( P = 0.007 ). Headache frequency showed marginal improvement in curcumin group, compared to controls ( P = 0.052 ). Within-analysis indicated significant decrease in CGRP and severity ( P < 0.001 ), frequency ( P = 0.014 ) and duration ( P = 0.003 ) and no significant decrease in IL-6 ( P = 0.454 ), compared to baseline in curcumin group. There were no significant changes in body mass index (BMI), weight, percent body fat (PBF), and percent body muscle (PBM) between the two groups., Conclusions: Curcumin supplementation improved the pro-inflammatory markers and clinical features of migraine headaches and that could be contributed to could be to its anti-inflammatory properties., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 International Journal of Preventive Medicine.)

Neuroprotective effects of curcumin have been shown in previous studies. This updated systematic review of clinical trials aimed to investigate the effect of curcumin on neurological disorders. Databases including PubMed, Scopus, Web of Science, and Google Scholar were systematically searched to identify clinical trials investigating the effects of curcumin/turmeric supplements alone, or in combination with other ingredients, on neurological diseases. Nineteen studies comprising 1,130 patients met the inclusion criteria. Generally, intervention and study outcomes were heterogeneous. In most of the studies, curcumin had a favorable effect on oxidative stress and inflammation. However, with the exception of AD, curcumin supplementation either alone, or in combination with other ingredients, had beneficial effects on clinical outcomes for the other aforementioned neurodegenerative diseases. For example, the frequency, severity, and duration of migraine attacks, scores on the revised ALS functional rating scale, and the occurrence of motor complications in PD were all significantly improved with curcumin supplementation either alone or in combination with other ingredients. However, in three studies, several adverse side effects (mostly gastrointestinal in nature) were reported. Curcumin supplementation may have favorable effects on inflammatory status and clinical outcomes of patients with neurological disease, although the results were not consistent., (© 2021 John Wiley & Sons Ltd.)

Aim: Migraine is a common neurovascular disorder, which is associated with severe to moderate disabling headaches. Oxidative stress and inflammation might play a role in migraine pathogenesis and the mood disorders. Considering the antioxidant and anti-inflammatory properties of alpha-lipoic acid (ALA), this study was designed to investigate its effect on oxidative, inflammatory, and mood conditions in women with episodic migraine., Methods: In total, 92 women with episodic migraine participated in the study. The patients were randomly divided into two groups, receiving a 300-mg capsule of ALA or placebo twice daily for 3 months. To assess the oxidative and inflammatory status, the serum levels of total antioxidant capacity (TAC), total oxidant status (TOS), glutathione (GSH), malondialdehyde (MDA), oxidative stress index (OSI), and C-reactive protein (CRP) were determined at the beginning and at the end of the intervention. A depression, anxiety, stress scale (DASS-21-items) questionnaire was used to evaluate mood status., Results: Finally, 79 patients reached the final analysis stage. At the end of the intervention, a significant decrease in the serum levels of MDA (means difference [MD]: -0.83, 95% confidence intervals (CI): -1.04, -0.62 nmol/mL vs MD: -0.32, CI: -0.48, -0.15 nmol/mL; P < .001) and CRP (MD: -0.78, CI: -1.17, -0.39 mg/L vs MD: -0.63, CI: -1.80, 0.52 mg/L; P < .001) was observed in the ALA as compared with the placebo group, but changes in serum GSH (P = .086), TAC (P = .068), TOS (P = .225), and OSI (P = .404) were not statistically significant. In addition, depression, anxiety, and stress (with P < .001, in all cases) had significantly decreased in the intervention as compared with the control group., Conclusion: The results of this study suggest that ALA supplementation for 3 months has beneficial effects on improving the oxidative, inflammatory, and mood conditions of patients suffering from episodic migraine., (© 2021 John Wiley & Sons Ltd.)

Background: Enteral tube feeding intolerance (ETFI) is one of the most common complications of enteral nutrition (EN), which may lead to increased mortality and length of intensive care unit (ICU) stay. This study aimed to determine the prevalence of ETFI and effects on feeding intolerance on nutrition and clinical outcomes in Iran., Materials and Methods: This cross-sectional study was conducted in 2019 at the three general ICUs of Imam Reza Hospital in Mashhad, Iran, during 7 days on 245 patients. The collected data included demographic characteristics, primary diagnosis, the Acute Physiology and Chronic Health Evaluation II (APACHE ІІ) score, Sequential Organ Failure Assessment (SOFA) score, duration of mechanical ventilation, and length of ICU stay. Feeding intolerance was assessed using daily questionnaires for 7 days. ETFI was determined as the interruption of EN based on gastrointestinal causes, including large gastric residuals, abdominal distension, vomiting, diarrhea, and subjective discomfort., Results: Overall, 245 critically ill patients (122 males and 123 females) were included in this study, with a mean age of 58.43 ± 19.2 years in three general ICUs. The highest prevalence rate of ETFI was 91.8%, which occurred on the 2 nd day although the rate decreased in the following days. The minimum ETFI was observed on the last day (38.8%). Feeding intolerance was associated with the increased APACHE II scores ( P = 0.04), SOFA scores ( P < 0.001), and duration of mechanical ventilation ( P < 0.001) compared with the tolerant patients. The most common causes of ETFI in the patients admitted to the ICU were gastric residual volume (GRV), large GRV, vomiting, and distension., Conclusion: ETFI was prevalent in almost two-third (66%) of the critically ill patients receiving EN based on the GRV. ETFI was associated with deteriorated nutritional status and clinical outcomes., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Journal of Research in Medical Sciences.)

Background: Statins reportedly have anti-inflammatory effects aside from their lipid-lowering impact. We investigated the effects of statin therapy on the level of C-reactive protein (CRP) or highly sensitive CRP (hs-CRP), a liver-derived marker of systemic inflammation, among stroke patients., Methods: An online search was performed in Scopus, PubMed/MEDLINE, ISI Web of Science, and Google Scholar up to November 2020 to recognize clinical trials investigating the effects of statins on the CRP level in stroke patients., Results: Overall, nine studies (11 treatment arms) with 1659 participants met the inclusion criteria. Six out of 9 studies (8 out of 11 arms) were categorized as studies with a high-quality methodological approach using the Cochrane Collaboration's tool. Data from 5 treatment arms indicated a significant decrease in CRP concentration, and in one treatment arm, CRP concentration did not suggest any considerable alteration following statin therapy. Moreover, two treatment arms showed a significant reduction in hs-CRP concentration and three treatment arms revealed no significant alteration in hs-CRP concentration following statin therapy. Generally, results were heterogeneous and independent of the type of statin, statin dose, treatment duration, and changes in plasma low-density lipoprotein cholesterol concentration., Conclusion: The results suggest that statin therapy could reduce and, therefore, could be considered in these patients as potential anti-inflammatory agents., Competing Interests: The authors declare no conflict of interest., (Copyright © 2021 Babak Alikiaii et al.)

Background: The contribution of vitamin D to thyroid disorders has received paramount attention; however, results are mixed. Hence, we designed a systematic review and meta-analysis to obtain a definitive conclusion., Methods: The search included PubMed, ISI Web of Science, Scopus, and Google Scholar databases up to March 2021 to collect available papers reporting the relationship between serum levels of vitamin D and thyroid disorders. The pooled effect was reported as weighted mean difference (WMD) and 95% confidence interval (CI)., Results: Out of 6123 datasets, 42 were eligible to get into this systematic review and meta-analysis. Serum vitamin D was markedly lower in autoimmune thyroid diseases (AITD) (WMD - 3.1 ng/dl; 95% CI, - 5.57 to - 0.66; P = 0.013; I 2  = 99.9%), Hashimoto's thyroiditis (HT) (WMD - 6.05 ng/dl; 95% CI, - 8.35 to - 3.75; P < 0.001; I 2  = 91.0%) and hypothyroidism patients (WMD - 13.43 ng/dl; 95% CI, - 26.04 to - 0.81; P = 0.03; I 2  = 99.5%), but not in subjects with Graves' disease (GD) (WMD - 4.14 ng/dl; 95% CI, - 8.46 to 0.17; P = 0.06; I 2  = 97.5%)., Conclusions: Our findings suggested lower vitamin D levels in patients with hypothyroidism, AITD, and HT compared to healthy subjects. However, the link between serum vitamin D and GD was only significant among subjects ≥40 years old., (© 2021. The Author(s).)

Our aim was to conduct a systematic review and meta-analysis on randomized controlled trials (RCTs) evaluating the effect of garlic on serum adiponectin levels. We searched Scopus, Web of Science, PubMed, and Cochrane Library to databases up to January 2021. RCTs investigating the effects of garlic on serum adiponectin levels in adult participants were included. The change in serum adiponectin levels was estimated using weighted mean differences (WMD) and standard deviations (SD). The random effects model was used to provide a summary of mean estimates and their SDs. Out of 386 records, 6 trials with 8 arms treatment which enrolled 266 subjects were included. Garlic supplementation resulted in a non-significant increase in adiponectin concentrations when compared to placebo, according to the pooled data (WMD, 0.27 Hedges' g; 95% confidence interval [CI], -0.07, 0.62; p = 0.124). Greater effects on adiponectin were observed in trials with supplementation dose less than 1.5 gram per day (WMD, 0.71 Hedges' g; 95% CI, -0.01, 1.43; p = 0.600) and in trials with female subset (WMD, 0.62 Hedges' g; 95% CI, -0.96, 2.21; p = 0.441). Garlic boosts adiponectin levels in general. However, due to different target population, various units for reporting adiponectin level and few eligible studies in final analysis, more research is needed to get a firm conclusion about the influence of garlic on adiponectin levels., Competing Interests: Conflict of Interest: The authors declare that they have no competing interests., (Copyright © 2021. The Korean Society of Clinical Nutrition.)

Background: Exercise-induced oxidative stress, muscle damage, and inflammation represent major contributors to why athletes use ergogenic aids. Turmeric is used as a spice because of its polyphenol ingredient named curcumin. We assessed the effects of curcumin supplementation on inflammatory, oxidative stress markers, muscle damage, and anthropometric indices in women with moderate physical activity., Methods: This double-blind, placebo-controlled clinical trial was conducted on 80 women with moderate physical activity levels (defined as walking or swimming for at least 1 h per day) for 8 weeks. Mean ± SD of age (years) all participants was 21 ± 2. Participants were randomly assigned into two groups: curcumin (500 mg/day) and placebo (500 mg/day cornstarch). Serum C-reactive protein (CRP), total antioxidant capacity (TAC), malondialdehyde (MDA), lactate dehydrogenase (LDH) levels, body composition, and maximum oxygen uptake (VO2 max) were evaluated before and after an intervention., Results: Sixty-five subjects completed the 8-week intervention. Within analysis indicated a significant decrease in CRP, LDH, MDA levels, and a significant increase in VO2 max in the curcumin group after an intervention ( P < 0.05). There were significant decreases in CRP ( P = 0.002), LDH ( P = 0.041), and MDA ( P = 0.005), no significant increase in TAC, and significant increase in VO2 max ( P = 0.0001) levels in the curcumin group compared with placebo group. There were no significant changes in weight, body mass index, body fat, and lean body mass between two groups., Conclusions: Our findings indicated that 8-week curcumin administration could significantly improve CRP, LDH, MDA, and VO2 max. Curcumin supplementation did not elicit significant changes in anthropometric indices in this study., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 International Journal of Preventive Medicine.)