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Background: The results obtained from previous trials regarding the effects of vitamin D supplementation on muscle strength and mobility in postmenopausal women have been inconsistent. This systematic review and meta‐analysis of randomised controlled trials (RCTs) aimed to investigate the effect of vitamin D supplementation on muscle strength and mobility in postmenopausal women. Methods: A comprehensive search on EMBASE, PubMed, MEDLINE and SCOPUS was performed to identify relevant articles published up to 28 March 2019. RCTs published in English measuring the effect of all forms and doses of vitamin D supplementation with or without calcium on muscle strength and mobility outcomes in postmenopausal women were included. Results: In total, 29 eligible studies were included in the systematic review. The pooled findings using a random effects model showed that vitamin D supplementation insignificantly increased hand grip strength (HGS) as the measurement of muscle strength (MD = 0.656; 95% confidence interval = −0.037 to 1.350, P = 0.06). However, it did not affect timed‐up‐and‐go (TUG) as the measurement of mobility (MD = 0.118; 95% confidence interval = −0.655 to 0.892, P = 0.76). The subgroup analyses showed that vitamin D supplementation improved HGS with respect to dosages >1000 IU day−1 (P = 0.016), a treatment duration of 3 months (P ˂ 0.001) and subjects with baseline vitamin D <30 ng mL−1 (P = 0.033). Conclusions: The present review demonstrates that vitamin D supplementation resulted in small but nonsignificant improvements in muscle strength compared to control in postmenopausal women. No significant effect was observed in mobility after vitamin D administration. [ABSTRACT FROM AUTHOR]

The present study aimed to determine the effect of whole meat GSM powder on gut microbiota abundance, body composition and iron status markers in healthy overweight or obese postmenopausal women. This was a 3-months trial involving forty-nine healthy postmenopausal women with body mass index (BMI) between 25 and 35 kg/m 2 who were randomly assigned to receive 3 g/d of either GSM powder ( n 25) or placebo ( n 24). The gut microbe abundance, serum iron status markers and body composition were measured at the baseline and the end of the study. The between-group comparison at the baseline showed a lower abundance of Bacteroides and Clostridium XIVa in the GSM group compared with the placebo ( P = 0⋅04). At the baseline, the body fat (BF)% and gynoid fat% were higher in the GSM group compared with the placebo ( P < 0⋅05). No significant changes were found in any of the outcome measures, except for ferritin levels that showed a significant reduction over time (time effect P = 0⋅01). Some trend was observed in bacteria including Bacteroides and Bifidobacterium which tended to increase in the GSM group while their abundance decreased or remained at their baseline level in the control group. Supplementation with GSM powder did not result in any significant changes in gut microbe abundance, body composition and iron markers compared with placebo. However, some commensal bacteria such as Bacteroides and Bifidobacteria tended to increase following supplementation with GSM powder. Overall, these findings can expand the knowledge surrounding the effects of whole GSM powder on these outcome measures in healthy postmenopausal women., (© The Author(s) 2023.)

Highly flexible, deformable, and ultralightweight structures are required for advanced sensing applications, such as wearable electronics and soft robotics. This study demonstrates the three-dimensional (3D) printing of highly flexible, ultralightweight, and conductive polymer nanocomposites (CPNCs) with dual-scale porosity and piezoresistive sensing functions. Macroscale pores are established by designing structural printing patterns with adjustable infill densities, while the microscale pores are developed by phase separation of the deposited polymer ink solution. A conductive polydimethylsiloxane solution is prepared by mixing polymer/carbon nanotubes with non-solvent and solvent phases. Silica nanoparticles are utilized to modify the rheological properties of the ink, making direct ink writing (DIW) feasible. 3D geometries with various structural infill densities and polymer concentrations are deposited using DIW. The solvent is evaporated during a stepping heat treatment, leading to non-solvent droplet nucleation and growth. The microscale cellular network is developed by removing the droplets and curing the polymer. Up to 83% tunable porosity is achieved by independently controlling the macro- and microscale porosity. The effect of macroscale/microscale porosity and printing nozzle sizes on the mechanical and piezoresistive behavior of the CPNC structures is explored. The electrical and mechanical tests demonstrate a durable, extremely deformable, and sensitive piezoresistive response without sacrificing mechanical performance. The flexibility and sensitivity of the CPNC structure are enhanced up to 900 and 67% with the development of dual-scale porosity. The application of the developed porous CPNCs as piezoresistive sensors for detecting human motion is also evaluated.

Objective: To investigate the effect of whole greenshell mussel (GSM) powder on biomarkers of cartilage metabolism, inflammatory cytokines, and joint symptoms in postmenopausal women with overweight/obesity and joint discomfort., Design: Fifty-five postmenopausal women with overweight/obesity were randomly assigned to receive 3 g/day whole GSM powder or placebo for 12 weeks. Cartilage turnover biomarkers urinary C-telopeptide of type II collagen (CTX-II) and serum cartilage oligomeric matrix protein (COMP) were measured at baseline, week 6 and 12. Plasma cytokines were measured at baseline and week 12. Joint pain and knee-related problems were assessed at baseline and week 12 using a 100 mm Visual Analogue Scale (VAS) and the Knee injury and Osteoarthritis Outcome Score (KOOS) questionnaire, respectively., Results: Forty-nine participants completed the study (GSM n = 25, placebo n = 24). After 12 weeks, urinary CTX-II showed no significant change over time or between the groups (interaction effect P = 0.1). However, in women with symptomatic knees, a significant difference was noted between the group (treatment effect P = 0.04), as it was lower in the GSM group compared to placebo group at week 6 ( P = 0.04) and week 12 ( P = 0.03). Serum COMP and plasma cytokines were not affected. GSM supplementation showed greater reduction in the VAS pain score than placebo (-13.2 ± 20.3 vs. -2.9 ± 15.9; P = 0.04). No significant change in KOOS domains between the two groups was observed., Conclusion: Oral supplementation of whole GSM powder at 3 g/day may slow down the degradation of type II collagen in postmenopausal women with symptomatic knees. GSM treatment conferred clinical benefit on overall joint pain. No significant effect was noted for inflammatory cytokines, suggesting that GSM may act within the joint microenvironment rather than at the systemic level., Clinical Trial Registration: [www.australianclinicaltrials.gov.au/clinical-trialregistries], identifier [ACTRN12620000413921p]., Competing Interests: Author HT was employed by New Zealand fisheries that produces and sells GSM (Sanford Ltd.). The remaining 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 © 2022 Abshirini, Coad, Wolber, von Hurst, Miller, Tian and Kruger.)

This study aimed to examine the changes in lipid and metabolite profiles of ovariectomized (OVX) rats with diet-induced metabolic syndrome-associated osteoarthritis (MetOA) after supplementation with greenshell mussel (GSM) using an untargeted liquid chromatography-mass spectrometry (LC-MS) metabolomics approach. Ninety-six rats were fed with one of four diets: control, control supplemented with GSM + GSM, high fat/high sugar (HFHS), or high fat/high sugar enriched with GSM (HFHS + GSM). After 8 weeks on experimental diets, half of the rats in each group underwent OVX and the other half were sham operated. After being fed for an additional 28 weeks, blood samples were collected for the metabolomics analysis. Lipid and polar metabolites were extracted from plasma and analysed by LC-MS. We identified 29 lipid species from four lipid subclasses (phosphatidylcholine, lysophosphatidylcholine, diacylglycerol, and triacylglycerol) and a set of eight metabolites involved in amino acid metabolism (serine, threonine, lysine, valine, histidine, pipecolic acid, 3-methylcytidine, and cholic acid) as potential biomarkers for the effect of HFHS diet and GSM supplementation. GSM incorporation more specifically in the control diet generated significant alterations in the levels of several lipids and metabolites. Further studies are required to validate these findings that identify potential biomarkers to follow OA progression and to monitor the impact of GSM supplementation.

Background: The link between diet quality, food insecurity (FI), and metabolic syndrome (MetS) remains unclear in obese adults. The aim of this study was to examine the association of diet quality and FI with MetS in obese Iranian adults., Methods: This cross-sectional study was conducted on 300 obese adults. Dietary intake was assessed using a validated 168-item food frequency questionnaire. Diet quality and FI were measured using the Diet Quality Index-International (DQI-I) and an adapted USDA2000 household food security status questionnaire, respectively. MetS was defined according to the International Diabetes Federation diagnostic criteria. Association was determined using logistic regression analysis adjusting for potential confounders., Results: MetS subjects had lower DQI-I score than subjects without MetS (67.5 ± 8.7 vs 71.5 ± 7.4, P = 0.05). The prevalence of food insecurity was 48.6% (95% confidence interval (CI): 41.2, 56.1) in MetS subjects and 39.4% (95% CI: 29.4, 49.9) in subjects without MetS. After adjustment, participants in the fourth quartile of DQI-I score had 70% lower odds of MetS (Adjusted odds ratio [AOR], 0.3; 95% CI: 0.1-0.7), 70% lower odds of hypertriglyceridemia (AOR, 0.3; 95% CI: 0.2-0.7) and 60% lower risk of reduced high-density lipoprotein [HDL] (AOR, 0.4; 95% CI: 0.2-0.9) compared with the first quartile. Obese food insecure adults had 60% higher odds of high blood pressure (AOR, 1.6; 95% CI: 1.0-2.6) and 70% higher odds of hypertriglyceridemia (AOR, 1.7; 95% CI: 1.0-2.8) compared with food-secure obese adults. There was no statistically significant interaction observed between DQI-I and food insecurity on MetS., Conclusions: Lower DQI-I score and food insecurity were associated with an increased risk of MetS and some features such as hypertriglyceridemia, reduced HDL, and high blood pressure in obese Iranian adults., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 International Journal of Preventive Medicine.)

Background: Diets with high glycemic index (GI) or high glycemic load (GL) have been linked to important risk factors associated with the development of metabolic syndrome (MetS), such as dyslipidemia, higher blood glucose, and insulin concentrations. However, the role of GI and GL in relation to Mets is still understudied and controversial. This review, therefore, assessed whether high GI or GL contribute to development of Mets., Methods: A systematic search of four bibliographic databases was conducted (MEDLINE/PubMed, EMBASE, Web of Sciences, and Scopus) from inception to January 2020 for observational studies assessing GI/GL in relation to MetS. Risk estimates were pooled using random-effect models for the highest versus lowest intake categories, and assessed for heterogeneity using subgroup analysis. The dose-response nature of the relationship was also investigated. Sensitivity analysis and Egger test were used to check the robustness of findings and the possibility of publication bias, respectively., Results: Data from 12 publications (one cohort study and eleven cross-sectional studies) with a total sample size of 36,295 subjects are included. The pooled effect sizes from the nine studies indicated high versus low dietary GI was associated with increased risk of MetS (OR = 1.05, 95% CI: 1.01 to 1.09) (I 2  = 58.1, P = .004). This finding was supported by all subgroup analyses except where studies used 24-h recalls for dietary assessment. Additionally, a linear dose-response investigation revealed that each 5-point increment in GI was associated with 2% increase in the risk of MetS (OR = 1.02, 95% CI: 1.01 to 1.02); non-linear pattern was insignificant, however (p-nonlinearity = 0.63). Moreover, pooled effect sizes from ten studies suggested that no association was found between the GL and MetS with results remaining consistent in all subgroup analyses., Conclusion: A diet with lower GI may protect against MetS. Nutrition policy and clinical practices should encourage a diet with low GI. Future studies should include both GI and GL and different criteria of MetS to provide a better comparison., (© 2021 John Wiley & Sons Ltd.)

Objective: The aim of this study was to determine the relationship between carbohydrate quality intake and menopausal symptoms., Study Design: This is a cross-sectional study of 393 postmenopausal women attending municipality health houses and health centers in the south of Tehran, Iran, from September 2016 to January 2017., Main Outcome Measures: The dietary intake and menopausal symptoms of the participants were assessed with a validated food frequency questionnaire and a menopause rating scale (MRS) carbohydrate quality index (CQI) was calculated using three indices: dietary fiber, glycemic index, and the ratio of solid carbohydrates to total carbohydrates. Linear and logistic regressions were used to assess the relationship between CQI and menopausal symptoms., Results: After adjustment for age, education, time passed since menopause, body mass index, physical activity and energy intake, an inverse association was found between CQI and total MRS score (TMRSS) (β -0.61; p <0.001), somatic score (SS) (β -0.27; p <0.001) and psychological score (PS) (β -0.37; p <0.001) in multivariable linear regression. In addition, logistic regression analysis revealed that compared with the lowest quartile of CQI, participants in the highest quartile of CQI had a lower TMRSS (odds ratio (OR) 0.36, 95% confidence interval (CI) 0.19-0.68). Moreover, CQI was inversely related to SS (OR 0.34; 95% CI 0.17-0.68) and PS (OR 0.32; 95% CI 0.16-0.61). However, there was no significant association between CQI and urogenital score (US)., Conclusions: Higher-quality carbohydrate intake was found to be associated with lower somatic and psychological symptoms of menopause. These findings suggest that CQI may be an important basis for developing an effective dietary modification for reducing menopausal symptoms., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Objectives: Intervention studies using New Zealand green-lipped or greenshell™ mussel (GSM) (Perna canaliculus) extract in osteoarthritis (OA) patients have shown effective pain relief. This systematic review summarises the efficacy of GSM extracts in the treatment of OA., Methods: A literature search of the three databases EMBASE, MEDLINE, and Scopus was performed to identify relevant articles published up to March 2020. Inclusion criteria were clinical trials published in English measuring the effect of supplementation of whole or a lipid extract from GSM on pain and mobility outcomes in OA patients., Results: A total of nine clinical trials were included in systematic review, from which five studies were considered appropriate for inclusion in a forest plot. Pooled results showed that GSM extracts (lipid extract or whole powder) provide moderate and clinically significant treatment effects on a visual analogue scale (VAS) pain score (effect size: - 0.46; 95% CI - 0.82 to - 0.10; p = 0.01). The whole GSM extract improved gastrointestinal symptoms in OA patients taking anti-inflammatory medications. The GSM extract was considered to be generally well tolerated in most of the studies., Conclusion: The overall analysis showed that GSM provided moderate and clinically meaningful treatment effects on OA pain. However, the current evidence is limited by the number and quality of studies, and further larger and high-quality studies are needed to confirm the effectiveness and to identify the optimal GSM format. Nevertheless, it is worth considering using GSM extracts especially for patients seeking alternative pain relief treatments with fewer side effects compared to conventional treatment., (© 2021. The Author(s).)

Background: New Zealand Greenshell™ mussels (GSM; Perna canaliculus) have recently been shown to decrease cartilage degradation in a rat model of induced metabolic osteoarthritis (MetOA). However, this effect has not been investigated in human subjects. This study aims to determine the effect of GSM powder on biomarkers of cartilage metabolism, bone resorption, and inflammation in New Zealand healthy overweight/obese postmenopausal women who are at early stage or at high risk of OA., Method: Fifty overweight or obese (BMI 25-35 kg/m 2 ) postmenopausal women (aged 55-75 years) will be recruited by advertisement. Participants will be randomized based on a double-blind randomization schedule and stratified randomization based on BMI and age distribution. The participant will be assigned with a 1:1 allocation ratio to receive 3 g/d whole meat GSM powder or placebo (sunflower seed protein) for 12 weeks. Data on socio-demographics, physical activity, and dietary intake will be collected for each subject. Cartilage turnover biomarkers [(C-telopeptide of type II collagen (CTX-II), C-propeptide of type II procollagen (CPII), Cartilage oligomeric matrix protein (COMP)], and bone resorption marker (CTX-I) will be measured in blood and urine samples. Inflammatory status (hs-CRP and cytokine panel) will be assessed and iron status will be measured. Body composition including fat mass (FM), lean mass (LM), and fat percentage will be measured using dual-energy X-ray absorptiometry (DXA). Joint pain and knee function will be assessed using a 100-mm visual analog scale (VAS) and the Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire, respectively., Discussion: This trial will be the first to explore the effects of whole meat GSM powder on cartilage turnover, bone resorption, and inflammation biomarkers in overweight/obese postmenopausal women. The results from this trial will provide evidence on the efficacy of GSM in the prevention of OA., Trial Registration: Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12620000413921p . Registration on 27 March 2020., (© 2021. The Author(s).)

Long-chain polyunsaturated fatty acids (LCPUFAs) and their metabolites are considered essential factors to support bone and joint health. The n-6 PUFAs suppress the osteoblasts differentiation via increasing peroxisome proliferator-activated receptor gamma (PPARγ) expression and promoting adipogenesis while n-3 PUFAs promote osteoblastogenesis by down-regulating PPARγ and enhancing osteoblastic activity. Arachidonic acid (AA) and its metabolite prostaglandin E2 (PGE2) are key regulators of osteoclast differentiation via induction of the receptor activator of nuclear factor kappa-Β ligand (RANKL) pathway. Marine-derived n-3 LCPUFAs have been shown to inhibit osteoclastogenesis by decreasing the osteoprotegerin (OPG)/RANKL signalling pathway mediated by a reduction of pro-inflammatory PGE2 derived from AA. Omega-3 PUFAs reduce the expression of cartilage degrading enzyme matrix metalloproteinase-13 (MMP-13) and a disintegrin and metalloprotease with thrombospondin motifs-5 (ADAMTS-5) protein, oxidative stress and thereby apoptosis via nuclear factor kappa-betta (NF-kβ) and inducible nitric oxide synthase (iNOS) pathways. In this review, a diverse range of important effects of LCPUFAs on bone cells and chondrocyte was highlighted through different mechanisms of action established by cell cultures and animal studies. This review allows a better understanding of the possible role of LCPUFAs in bone and chondrocyte metabolism as potential therapeutics in combating the pathological complications such as osteoporosis and osteoarthritis., (Copyright © 2021. Published by Elsevier Ltd.)

The interfacial properties of ZnO nanowire (NW)/carbon fiber-reinforced epoxy composites are investigated using molecular dynamics (MD) simulations. An atomistic representative volume element (RVE) is developed in which a single ZnO NW is aligned on carbon fiber and embedded in the cross-linked epoxy. Effects of ZnO NWs on the fiber-matrix adhesion are studied by evaluating the fiber and the enhanced matrix interaction. The traction-separation behavior in both sliding mode (shear separation) and opening mode (normal separation) is evaluated. The cohesive parameters, including the peak traction and adhesion energy, are calculated in each mode. Different numbers of cross-linked epoxy units in the system are studied and validated. The interfacial properties of the hybrid system are compared with the simulated bare RVE containing fiber and epoxy. MD results showed that the interfacial strength is increased from 485 MPa to 1066 MPa with the ZnO NWs. The adhesion energy in both opening and sliding modes is significantly improved by growing ZnO NWs on the carbon fibers. In addition, the hybrid system shows more rate-independent behavior compared with the bare system in the opening mode.

Importance: The beneficial role of soy protein in cardiovascular health has been well documented in observational studies. However, evidence from clinical trials on effects of soy protein on endothelial function in postmenopausal women has been conflicting., Objective: We aimed to systematically review and conduct a meta-analysis of randomized controlled trials (RCTs) investigating the impact of soy protein supplement containing isoflavones on endothelial function in postmenopausal women., Evidence Review: We searched PubMed-Medline, SCOPUS, Embase, and Google Scholar until March 2020 to find RCTs evaluating the impact of soy protein supplementation on endothelial function parameters. Random effects model (using DerSimonian-Laird method) was applied to synthesize quantitative data. We performed the leave-one-out method for sensitivity analysis. To quantitatively assess heterogeneity, the I index was applied., Findings: From a total of 267 studies identified from the initial search 15 and 5 studies were considered appropriate for inclusion into the systematic review and meta-analysis, respectively. In the meta-analysis, an insignificant enhancement in flow-mediated dilation (FMD) after soy protein supplementation (0.882%; 95% CI: -1.059 to 2.822; P = 0.373) was found. However, subgroup analysis showed that supplementation of isolated soy protein had significant effect on FMD (3.39%; 95% CI: 0.733-6.01; P = 0.01)., Conclusions and Relevance: Our findings suggest that soy protein supplementation does not lead to meaningful improvement in FMD in postmenopausal women. However, this finding is based on a limited number of studies. Additional high-quality large-scale RCTs are warranted.

Intermittent fasting (IF) and energy-restricted diets (ERDs) have emerged as dietary approaches to decrease inflammatory status; however, there are no consistent results regarding humans. To achieve a comprehensive conclusion, we aimed to conduct a meta-analysis of randomized control trials (RCTs) to evaluate the effects of IF or ERDs on plasma concentrations of inflammatory biomarkers. We systematically searched online medical databases including Web of Sciences, PubMed, SCOPUS, and Google Scholar up to June 2019. Evaluations of effect sizes were described employing in weighted mean difference and 95% confidence intervals from the random-effects model. Eighteen eligible RCTs were included in this meta-analysis. The pooled estimation from the random-effect model showed that IF regimens and ERDs significantly reduced C-reactive protein (CRP) concentrations (WMD: -0.024 mg/dL; 95% CI: -0.044 to -0.005, I 2  = 7.0%). Additionally, IF regimens (WMD: -0.029; 95% CI: -0.058 to -0.000, I 2  = 17.9%) were more effective in reducing CRP levels than ERDs (WMD: -0.001 mg/dL; 95% CI: -0.037 to 0.034, I 2  = 0.0%). Moreover, based on the treatment duration and types of the studies' population, a greater reduction was observed in overweight and obese individuals (WMD: -0.03 mg/dL; 95% CI: -0.05 to 0.01, I 2  = 42.1%), and in treatment duration ≥8 wk (WMD: -0.03 mg/dL; 95% CI: -0.05 to 0.01, I 2  = 0.0%) as well. However, IF and ERDs did not significantly reduced tumor necrosis factor-α (WMD: -0.158 pg/mL; P = 0.549, I 2  = 98.3) and interleukin-6 (IL-6) concentrations (WMD: -0.541 pg/mL; P = 0.080, I 2  = 94.7%). This meta-analysis demonstrated that IF regimens and ERDs may reduce CRP concentrations, particularly in overweight and obese individuals and through a considerable length of intervention (≥2 mo). However, neither dietary model affected the concentrations of tumor necrosis factor-α or interleukin-6., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Background: The relationship between dietary fat quality (DFQ) indices and pre-diabetes has not been well studied. This study aimed to determine the association of DFQ indices and fatty acid intake with pre-diabetes., Methods: This case-control study included 150 subjects with normal fasting blood glucose (FBG) and 147 pre-diabetic subjects. Dietary intake was assessed by a validated food-frequency questionnaire. DFQ indices including atherogenicity (AI) and thrombogenicity (TI), the ratios of hypo- and hypercholesterolemic (h:H), polyunsaturated:saturated (P:S) and n-3:n-6 polyunsaturated fatty acids were calculated. FBG test and 2-hour oral glucose tolerance test (OGTT) were measured., Results: After adjustment for some confounding variables, a positive association was found between intake of total saturated fatty acids (SFA), myristic acid, palmitic acid, and pre-diabetes, and a negative association was observed among n -3 polyunsaturated fatty acids, eicosapentaenoic, docosahexaenoic and arachidonic acids intake and pre-diabetes. AI was found to be positively associated with pre-diabetes (OR 6.68, 95% CI 2.57-17.34). An inverse relationship was observed between n -3: n -6 (OR 0.37, 95% CI 0.14-0.93) and h:H (OR 0.20, 95% CI 0.07-0.52) ratios with pre-diabetes., Conclusions: Higher intake of dietary n -3 fatty acids was adversely, whereas SFA intake was positively related to pre-diabetes morbidity. DFQ indices may be a useful measure to investigate fat intakes and blood glucose disturbances., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 International Journal of Preventive Medicine.)

Background and Objective: Few studies have examined the relationship between dietary patterns and antioxidant status. We aimed to explore the association between major dietary patterns and oxidative stress biomarkers including serum protein carbonyl (PC), ceruloplasmin and total antioxidant capacity (TAC)., Method: In this cross-sectional study, we randomly selected 320 female nurses aged 20-45 years. General information of participants was collected by trained interviewers. Their weight and height were measured and dietary intakes were determined by the 147-food-item semiquantitative food frequency questionnaire. Dietary patterns were derived by principal component analysis of yielding 25 food groups. In this study, 90 subjects were randomly selected from all participants with serum levels of PC, ceruloplasmin and TAC measured further. To determine the association between dietary patterns' score and oxidative stress biomarkers, multiple linear regression analysis was conducted., Results: Three dietary patterns were derived: healthy, unhealthy and traditional. After adjusting for several confounding factors, the unhealthy dietary pattern was inversely related to the serum concentration of ceruloplasmin and PC (p<0.05). The relationship between other dietary patterns and antioxidant biomarkers was not significant., Conclusions: According to the results of this study, unhealthy dietary patterns may have an adverse effect on serum ceruloplasmin., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.)

Objectives: The aim of this study was to explore the associations between fruit and vegetable (FV) intake, and its subgroups and menopausal symptoms along with its subtypes in postmenopausal women., Methods: This cross-sectional study included 393 postmenopausal women in municipality health centers in the south of Tehran, Iran. Sociodemographic data, dietary intakes, and anthropometric measures were obtained from individuals. Menopause rating scale (MRS) questionnaire was employed to measure menopausal symptoms. The total MRS score (TMRSS) was the sum of the somatic score (SS), psychological score (PS), and urogenital score (US). Participants were divided into low and high total MRS and its domain scores., Results: After adjustment for confounding variables, an inverse relationship was found between total FV with TMRSS (odds ratio [OR] 0.23, 95% confidence interval [CI] 0.06-0.81) and SS (OR 0.30, 95% CI 0.11-0.82). In addition, the consumption of total fruits was significantly related to lower SS (OR 0.27, 95% CI 0.10-0.71). Only intake of citrus fruits was inversely associated with TMRSS (OR 0.23, 95% CI 0.07-0.71) and SS (OR 0.28, 95% CI 0.11-0.70). Likewise, intakes of total FV (OR 2.46, 95% CI 1.37-4.41), total vegetables (OR 2.54, 95% CI 1.10-5.88), green leafy vegetables (OR 3.59, 95% CI 1.47-8.75), dark yellow vegetables (OR 2.28, 95% CI 1.00-5.18), other vegetables (OR 5.23, 95% CI 1.17-15.39), and citrus fruits were linked to higher US (OR 4.35, 95% CI 1.77-10.71)., Conclusion: The results of the present study showed that some FV subgroups had inverse associations with climacteric symptoms, whereas higher intake of some subgroups of FV appeared to be associated with more urogenital symptoms in postmenopausal women.

Objectives: No previous study has evaluated the association of the dietary inflammatory index (DII) and dietary energy density (DED) with menopausal symptoms and its subclasses in postmenopausal women. The aim of this study was to evaluate the association of DII score and DED with menopausal symptoms and its subtypes in Iranian postmenopausal women., Methods: This cross-sectional study was conducted on 393 postmenopausal women who attended health centers in the south of Tehran, Iran. The DII score was calculated using dietary factors obtained by a validated food frequency questionnaire. DED was defined as average daily energy intake (kcal) per gram of food. The Menopause Rating Scale questionnaire was used to evaluate the menopausal symptoms. The total Menopause Rating Scale score (TMRSS) was the sum of the somatic score (SS), psychological score (PS), and urogenital score. Linear regression analysis was used to assess the association of the DII score and DED with menopausal symptoms., Results: After adjusting for covariates, participants in the highest tertile of DII score had greater SS compared to those in the lowest tertile (βDIIt3vs1= 0.032, 95% confidence interval (CI): 0.004-0.068, P = 0.04). No significant relationship was found between DII score and PS, urogenital score or TMRSS. Furthermore, higher DED was associated with greater SS (βDIIt3vs1 = 0.071, 95% CI: 0.028-0.115, P = 0.001), PS (βDIIt3vs1 = 0.065, 95% CI: 0.012-0.121, P = 0.01) and TMRSS (βDIIt3vs1 = 0.053, 95% CI: 0.017-0.088, P = 0.004)., Conclusion: A proinflammatory diet was associated with higher menopause-specific somatic symptoms and higher DED was positively associated with menopausal symptoms.

A three-dimensional multiscale modeling framework is developed to analyze the failure procedure of radially aligned zinc oxide (ZnO) enhanced single fiber composites (SFC) under tensile loading to understand the interfacial improvement between the fiber and the matrix. The model introduces four levels in the computational domain. The nanoscale analysis calculates the size-dependent material properties of ZnO nanowires. The interaction between ZnO nanowires and the matrix is simulated using a properly designed representative volume element at the microscale. At the mesoscale, the interface between the carbon fiber and the surrounding area is modeled using the cohesive zone approach. A combination of ABAQUS Finite element software and the failure criteria modeled in UMAT user subroutine is implemented to simulate the single fiber fragmentation test (SFFT) at the macroscale. The numerical results indicate that the interfacial shear strength of SFC can be improved up to 99% after growing ZnO nanowires on the fiber. The effect of ZnO nanowires geometries on the interfacial shear strength of the enhanced SFC is also investigated. Experimental ZnO nanowires enhanced SFFTs are performed on the fabricated samples to validate the results of the developed multiscale model. A good agreement between the numerical and the experimental results was observed.

Background: Several researches have recommended vitamin D possible health benefits on diabetic complications development, but a few number of studies have been accomplished on the molecular and cellular mechanisms. Certain cellular pathways modification and also some transcription factors activation may protect cells from hyperglycemia condition induced damages. This study purpose was to determine the vitamin D supplementation effect on some key factors [advanced glycation end products (AGEs) signaling pathway] that were involved in the diabetic complications occurrence and progression for type-2 diabetes participants., Methodology: 48 type-2 diabetic patients (T2DM) randomly divided into two groups (n = 24 per group), receiving: 100-µg vitamin D or placebo for 3 months. At this study beginning and the end, the receptor expression for advanced glycation end products (RAGE) and glyoxalase I (GLO1) enzyme from peripheral blood mononuclear cells (PBMCs) and AGEs and tumor necrosis factor-α (TNF-α) serum levels were measured by the use of real-time PCR and ELISA methods, respectively., Results: This study results demonstrated that vitamin D supplementation could down-regulate RAGE mRNA [fold change = 0.72 in vitamin D vs. 0.95 in placebo) P = 0.001)]. In addition, no significant changes were observed for GLO1 enzyme expression (P = 0.06). This study results also indicated that vitamin D serum level significantly increased in vitamin D group (P < 0.001). Moreover, AGES and TNF-α serum levels significantly reduced in vitamin D group, but they were remained unchanged in the placebo group., Conclusion: In conclusion, vascular complications are more frequent in diabetic patients, and vitamin D treatment may prevent or delay the complications onset in these patients by AGEs serum level and RAGE gene expression reducing. Trial registration NCT03008057. Registered December 2016., Competing Interests: Competing interestsThe authors declare that they have no competing interests., (© The Author(s) 2019.)

Aim: Diabetic patients predispose to vascular diseases such as nephropathy, and retinopathy. Poor adherence to medical treatment and dietary recommendations in uncontrolled diabetes leads to vascular damages. Vitamin D has been extensively studied and found to be protective against diabetes mellitus. YKL-40 and Monocyte chemoattractant protein-1 (MCP-1) are considered to exert crucial role in diabetes and its complications. Therefore, this study was designed to investigate effects of vitamin D supplementation on serum levels of YKL-40 and MCP-1 involved in the development of diabetic complications., Methods: For 12 weeks, 48 type 2 diabetic patients enrolled in the trial and randomly were divided into two groups (n = 24 per group), receiving one of the following: 100 μg (4000 IU) vitamin D or placebo. Before and after intervention, serumYKL-40, MCP-1, insulin, IL-6, TNF-α, 25- (OH) vitamin D and HbA1c were measured., Results: Our results revealed that serum levels of 25 (OH) vitamin D significantly increased in vitamin D group (p < 0.001). Vitamin D supplementation also significantly reduced serum YKL-40 levels (-22.7 vs. -2.4 ng/ml; (p-value = 0.003)). There was a significant decline in MCP-1 concentration in intervention group at the end of the study (-45.7 vs. -0.9 pg/ml; (p = 0.001)). Furthermore, there was a significant decrease in IL-6, fasting insulin and HOMA-IR in intervention group after 3 months supplementation., Conclusions: Daily vitamin D supplementation effectively reduced circulatory YKL-40 and MCP-1 levels in patients with type-2 diabetes and vitamin D deficiency. Vitamin D might contribute in reducing diabetic complications via modulating YKL-40 and MCP-1 signaling pathways., (Copyright © 2019. Published by Elsevier Ltd.)

Background: We aimed to examine the association of dietary acid load and prediabetes in a case-control study., Methods: This study recruited 297 subjects including 147 prediabetic subjects and 150 controls referred to diabetes screening center in Shahreza, Iran. Participants were frequency-matched by sex and age. Blood pressure, anthropometric measures and blood glucose levels were measured. Dietary intake was assessed using a validated 168-items food frequency questionnaire (FFQ). The dietary acid load scores including the potential renal acid load (PRAL) and net endogenous acid production (NEAP) were calculated based on nutrients intake. NEAP and PRAL scores were categorized by quartiles based on the distribution of controls. Logistic regression models were used to estimate multivariable odds ratio (OR) of prediabetes across the energy-adjusted and sex-specific quartiles of NEAP and PRAL scores., Results: Participants of control group in the higher quartiles of NEAP and PRAL tended to have higher body weight compared to the lower quartiles (P-trend < 0.04). After adjustment for multiple confounding variables, participants in the highest quartiles of NEAP and PRAL had increased OR for prediabetes (OR = 14.48 95% CI 5.64-37.19), and (OR = 25.61 95% CI 9.63-68.08) (P-trend < 0.001), respectively., Conclusion: Our data indicated subjects with prediabetes had diets with more acid-forming potential than control group. Our findings suggest that higher dietary acid load was associated with increased prediabetes morbidity. Interventional studies are warranted to elucidate the role of acidogenic diets in the development of prediabetes., Competing Interests: Competing interestsThe authors declare that they have no competing interests.

Aim: Diabetes increases the odds of depression and depression is often associated with poor glycemic control and complications of diabetes. Vitamin D is also believed to improve glycemic control and ameliorate depressive symptoms. Therefore, we examined effects of vitamin D monotherapy (without antidepressant drugs) on depressive symptoms in Type 2 diabetic patients with mild to moderate depressive symptoms., Methods: We conducted 12 weeks, placebo-controlled, double-blind, randomized trial on 68 subjects with T2DM and mild to moderate depressive symptoms. Subjects received 100 μg (4000 IU) vitamin D (n = 32) or placebo (n = 34) daily. Beck Depression Inventory-II (BDI-II-PERSIAN) was applied for assessment of the severity of depression. Depression scores and metabolic profiles were measured at the beginning and end of trail., Results: after 3 months of vitamin D supplementation, mean values of 25(OH) D increased from 15.5 ± 8.8 to 32.2 ± 8.9 ng/ml (p-value <0.001) in the vitamin D group. Moreover, BDI-II scores decreased from 15.2 ± 9.6 to 9.8 ± 7.2 (p-value <0.001) in the vitamin D group and 15.5 ± 11.2 to 13.7 ± 11.5 (p-value = 0.03) in placebo group. This decrease in BDI-II scores were significant (27.6% vs 10.8%) compared with placebo (p-value = 0.02). In term of metabolic profiles, mean change in level of Hemoglobin A1c (HbA1c), insulin and triglycerides (TG) were significantly higher in response to the treatment with vitamin D compared to placebo (p-value <0.02)., Conclusions: In conclusion, supplementation of vitamin D in T2DM patients may protect these patients against the onset of major depressive disorder (MDD), with noticeable favorable effects on measures of metabolic profiles., Trial Registration: NCT03008057., (Copyright © 2019 Diabetes India. Published by Elsevier Ltd. All rights reserved.)

Objective: Although menopause is a natural event in a woman's life, some of its symptoms can be severe enough to adversely affect her health. There is some evidence to suggest that diet has an influence on menopausal symptoms, but less attention has been paid to dietary patterns. The purpose of this study is to determine the association of dietary patterns with physical, mental, and genitourinary menopausal symptoms., Methods: A cross-sectional study design was applied using a sample of 400 postmenopausal women who attended health centers in the south of Tehran, Iran. The menopausal symptoms were assessed by a Menopause Rating Scale (MRS) questionnaire; a 147-item, semi-quantitative food-frequency questionnaire was used to collect dietary information, and major dietary patterns were identified by principal component analysis. Linear regression was used to evaluate the relationship between menopausal symptoms and dietary patterns., Results: Three major dietary patterns were identified: vegetables and fruits (VF); mayonnaise, liquid oils, sweets, and desserts (MLSD); and solid fats and snacks (SFS). It has been found that the VF dietary pattern is inversely associated with general (β = -1.37; SE = 1.08; P for trend <0.001), physical (β = -1.54; SE = 1.09; P for trend <0.001), and mental (β = -1.58; SE = 1.11; P for trend <0.001) symptoms. A stronger adherence to the MLSD dietary pattern was directly associated with general (β = 1.15; SE = 1.08; P for trend <0.001) and genitourinary symptoms (β = 1.54; SE = 1.1; P for trend <0.001). Moreover, the SFS dietary pattern was directly related to the general (β = 1.23; SE = 1.09; P for trend = 0.01), physical (β = 1.24; SE = 1.09; P for trend = 0.04), and mental (β = 1.29; SE = 1.12; P for trend < 0.001) symptoms., Conclusion: The present study demonstrated that there is an inverse association between VF dietary pattern and menopausal symptoms. In contrast, the MLSD and SFS dietary patterns were correlated to an increased risk of these symptoms.

Background: Postmenopausal women are at higher risk of mental disorders. Oxidative stress has implication in the development of these disorders. Dietary total antioxidant capacity (DTAC) has been proposed as a tool for assessing dietary antioxidants intake. The relationship between DTAC with depression, anxiety and stress has not been investigated in postmenopausal women. Thus, we aimed to assess the association between DTAC and depression, stress and anxiety as well as oxidative stress biomarkers., Methods: This cross-sectional study was carried out on 175 postmenopausal women. Data on dietary intake and mental health were collected by 147-item semi-quantitative food frequency questionnaires (FFQ) and Depression Anxiety Stress Scales (DASS-42), respectively. Dietary and serum total antioxidant capacity (TAC), malondialdehyde (MDA), oxidized-LDL, and superoxide dismutase (SOD) were measured. ANOVA test was applied to compare the mean of variables across the tertiles of DTAC. The relationship between DTAC and oxidative stress biomarkers was determined through ANCOVA method. Simple and multivariate linear regression tests were performed to measure the relationship between DTAC and mental health., Results: Serum MDA level was significantly lower in the subjects at the highest tertiles of DTAC ( P -value < 0.001). In addition, serum TAC level was significantly higher in subjects at the second tertile of DTAC ( P -value = 0.04). DTAC was inversely and independently related to depression (β = - 0.16, P -value = 0.03) and anxiety scores (β = - 0.21, P -value = 0.007). There was no significant association between DTAC and stress score (β = - 0.10, P -value = 0.1)., Conclusion: An inverse relationship was found between DTAC with depression, anxiety scores and some oxidative stress biomarkers in postmenopausal women. These findings indicate DTAC may be used for developing effective dietary measures for reducing depression and anxiety in these women., Competing Interests: The authors declare that they have no competing interests.

The original article [1] contained an error in author Mohammad Taghi Mansouri's name.

Background: Vitamin D plays an important role in etiology of Autism Spectrum Disorders (ASDs). We aimed to evaluate the serum 25 - hydroxyl vitamin D level among children with ASDs in Ahvaz city, Iran., Methods: It was a cross-sectional study which had conducted on 62 subjects in two groups: a case group (n = 31) consisted of ASD children who study in especial schools; and a control group (n = 31) of healthy children who were selected by simple random sampling from regular schools in Ahvaz city, Iran during 2016. Maching between two groups has done regarding Socioeconomic status, type and amount of food intake, place of living and age. The levels of serum 25 - hydroxyl vitamin D were assessed in early morning means fasted state and also measured using ELISA method. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 20. The significant level was considered < 0.05., Results: In ASD children, the average serum 25-hydroxyvitamine D level was 9.03 ± 4.14 ng/mg. In ASD group, 96.8% (30 subjects) had vitamin D deficiency. In healthy children group, average serum 25-hydroxyvitamine D level was 15.25 ± 7.89 ng/mg. Average serum 25-hydroxyvitamine D level in intervention group was significantly lower than the control group (P > 0.001). Although the parents of patients in control group reported longer exposure to sun (27.42 m per day against 33.06 m per day), no significant difference was observed between these groups in terms of exposure to sun (P < 0.05)., Conclusions: A significant difference was observed between serum 25-hydroxyvitamine D levels between the healthy and ASD children. It is recommended to use vitamin D supplement in children with ASDs under medical care.

Objective: The aim of this study was to assess the association between dietary total antioxidant capacity (DTAC) and menopausal symptoms (MS) in postmenopausal middle-aged women., Methods: A cross-sectional study was conducted with 400 postmenopausal women who referred to municipality health houses and health centers in south Tehran, Iran. Sociodemographic data and anthropometric measures such as body weight, height, and waist circumference were determined. Dietary intake was assessed using a 147-item validated food frequency questionnaire. Energy-adjusted DTAC was calculated using the US Department of Agriculture database. Individual MS was measured by the Menopause Rating Scale questionnaire., Results: Multivariable linear regression analyses indicated that DTAC was negatively associated with total Menopause Rating Scale score, somatic and psychological score, which was independent of confounding variables such as age, education, waist circumference, total physical activity, dietary intake of fiber, tea and coffee intake, total energy intake, and dietary supplement use (P < 0.001). Additionally, in logistic regression, a negative association between MS and DTAC was observed, which was independent of confounding variables (P trend  = 0.002). Logistic regression for each symptom indicated that higher DTAC was associated with reduction in hot flashes and sweating, sleep problems, anxiety, exhaustion, and difficulty concentrating. However, a significant positive association was observed between DTAC and sexual problems., Conclusion: DTAC is inversely associated with MS, which could be of particular significance for somatic and psychological symptoms. These findings indicate that DTAC could be an important basis for developing an effective dietary measure for reducing MS., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Background: Dietary phytochemical index (DPI) has introduced as an inexpensive method for quantifying the phytochemicals in foods. For the first time, this study was conducted to investigate the relationship between DPI and the risk of prediabetes., Methods: Three hundred participants were assigned to 150 prediabetics (cases) and 150 healthy (controls) groups. Anthropometric values, fasting blood glucose, and 2-h oral glucose tolerance test (OGTT) were measured. The DPI was calculated based on data collected from 168-item validated food frequency questionnaire., Results: The sex-specific energy-adjusted DPI was inversely related to fasting blood glucose (FBG) and OGTT ( P < 0.001). The odds ratio (OR) of prediabetes was assessed across sex-specific energy-adjusted DPI quartiles. After adjusting for body mass index, physical activity, education, dietary intake of energy, fiber, carbohydrate (% of energy), fat (% of energy), and protein (% of energy), the OR of prediabetes across the sex-specific energy-adjusted DPI quartiles decreased significantly ( P -trend < 0.001)., Conclusions: We found that higher DPI score is related to lower prediabetes OR. This simple method may be used for the improvement of dietary intake to prevent prediabetes., Competing Interests: There are no conflicts of interest.

Objectives: Dietary total antioxidant capacity (DTAC) has been proposed as a tool for assessing the intake of antioxidants. The relationship between DTAC and blood glucose levels has been investigated mostly in healthy people. The aim of this study was to evaluate the association between DTAC and prediabetes morbidity in a case-control study., Methods: We examined 300 individuals with and without prediabetes (n = 150/group) who attended a Diabetes Screening Center in Shahreza, Iran. The anthropometric measures, physical activity, and blood glucose levels of all participants were measured. Food intake over the previous year was determined using a semiquantitative food frequency questionnaire, and sex-specific, energy-adjusted DTAC was calculated using the U.S. Department of Agriculture's database. Logistic reg/ression was used to model the relationship between DTAC and prediabetes morbidity., Results: The mean DTAC was significantly lower in individuals with prediabetes than in the control group (P < 0.001). Across increasing DTAC quartiles, the participants had lower fasting blood glucose and 2-h postchallenge plasma glucose (P trend  < 0.02). After adjustment for body mass index; physical activity; education; dietary intake of fiber, fat, energy, and coffee; participants in the fourth quartile of DTAC were less likely to experience prediabetes compared with those in the first quartile (odds ratio, 0.18; 95% confidence interval, 0.07-0.49)., Conclusion: The DTAC score appears useful when assessing the antioxidant capacity of diet and to better understand the relationship between diet and prediabetes morbidity. Future studies are needed to confirm the findings from the present study in other populations., (Copyright © 2017 Elsevier Inc. All rights reserved.)