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Aimed to evaluate the effects of biliopancreatic limb (BPL) length on weight loss, postoperative complications, and remission of comorbidities in OAGB.. An extensive search was conducted in PubMed, Scopus, EMBASE, and Google Scholar databases to find related OAGB articles. Both BPL length 200 cm (by - 17.79, 95% CI - 19.23, - 16.34) and BPL length ≥ 200 cm (by - 14.93, 95% CI - 15.66, - 14.20) significantly decreased BMI. Regarding the effect of BPL length on comorbidities and postoperative complications, it was shown that BPL length 200 cm is safer and more effective. Therefore, standardization of BPL length 200 cm is suggested. Bypassing ≥ 200 cm of the small bowel does not ameliorate weight loss or resolve comorbidities significantly, and it is related to more frequent postoperative complications and nutritional deficiencies. Registration number in PROSPERO: PROSPERO 2021 CRD42021225499.

Purpose This study aims to identify the effect of strawberry supplementation on some metabolic, inflammatory and oxidative parameters in adults with cardiovascular (CV) risk factors. Design/methodology/approach A systematic literature search was performed up to November 2020 using PubMed, Embase, Cochrane, Web of Sciences and Scopus databases. The pooled mean difference (MD) with 95% confidence interval (CI) was used to analyze the data by random-effects model. I2 statistics and Cochrane risk of bias tool were used for investigating heterogeneity and quality of included studies, respectively. Findings In total, 13 randomized controlled trials with 488 participants were included. Strawberry supplementation significantly reduced diastolic blood pressure (MD = −2.1, 95% CI [−3.7, −0.42], P = 0.01), low-density lipoprotein cholesterol (−0.16, −0.30, −0.02, P = 0.03), high-sensitivity C-reactive protein (CRP) (−0.76, −1.4, −0.05, P < 0.001) and CRP (−0.31, −0.43, −0.18, P = 0.04). Leptin levels were raised in control group compared with participants who had received strawberry (0.65, 0.09 and 1.2, P = 0.02). The results of subgroup analysis based on the follow-up duration and supplementation dose showed that consumption of strawberry for more than eight weeks and 50 g day−1 can significantly decrease some other CV risk factors compared to control group. Further, both higher follow-up duration and supplementation dose were more effective in increasing leptin levels of control group compared to intervention group. Originality/value The use of some useful plant foods such as strawberries by the pharmaceutical industry and the community health sector can greatly help improve people’s CV and metabolic health.

The objective is to evaluate the effects of vitamin D3 (VD3) on sperm parameters and seminal and serum oxidative stress (OS) biomarkers in asthenozoospermia infertile men. This randomized, triple-masking, placebo-controlled clinical trial conducted on 86 asthenozoospermia infertile men with serum 25 hydroxy vitamin D3 (25-OH-D3)

Introduction: Type 2 diabetes (T2DM) has become a growing concern in recent years due to its great risks for public health. Nowadays dietary pattern has drawn considerable attention regarding the relationship between diet and diseases. In the present study we aimed at identifying major dietary patterns and their relationship to prediabetes. Methods: In this case control study 5377 individuals (1335 people with prediabetes and 4042 controls) were recruited from Hoveizeh cohort study part of the Persian cohort study. A semi quantitative food frequency questionnaire was used to collect participants’ dietary intake, and major dietary patterns were identified by factor analysis. Adherence to the patterns was divided in to quartiles and the relationship between dietary patterns and prediabetes was then assessed using logistic regression analysis. The correlation between patterns and components of lipid profile was also assessed by logistic regression. Results: four major patterns were identified: 1) fruits and vegetables 2) traditional 3) Sweets and snacks 4) prudent. None of which was associated with prediabetes after adjusting for confounding factors. But fruits and vegetables pattern was associated with low HDL.c (fourth VS first quartile OR: 1.539, 95%CI: 1.094–2.164). Also prudent pattern was negatively associated with high LDL.c (fourth VS. first quartile OR: 0.769, 95%CI: 0.622–0.952) Conclusion: although No significant association was found between identified dietary patterns and the risk of prediabetes, an association was found between fruits and vegetables pattern and low HDL.c in people with prediabetes due to high consumption of refined grains. There was also a negative association between prudent pattern and high LDL.c because of high amounts of olive oil and vegetable oil and low intake of hydrogenated oil and animal fat.

Introduction: Obesity is a multifactorial metabolic disorder, the development and progression of which can be caused by genetic, physiological, metabolic, socioeconomic and lifestyle factors (especially physical activity and diet). Therefore, considering the high prevalence of obesity and its complications, and taking into account that dietary patterns are different in different populations and geographical locations, the present study aims to identify and investigate the relationship between dietary patterns and Obesity diseases was conducted in the adult population of Hovizeh city. Method: 5821 participants (2076 obese group and 3745 not obese group) from Hoveizeh cohort study for this case control study were chosen. Data related to dietary, demographic, anthropometric and physical activity information were previously obtained through a questionnaire. dietary patterns were identified using factor analysis. Then, logistic regression method was used to determine the relationship between major food patterns and obesity. results: In this study, four major food patterns were identified, including 1) vegetable and high-protein food pattern, 2) traditional, 3) sweets and snacks, and 4) good oils. Following these patterns had no significant relationship with obesity and anthropometric indicators Conclusion: There was no association between identified dietary patterns and obesity.

Background It is suggested that vitamin D may have a beneficial role in male reproduction. The male reproductive system is a target tissue for vitamin D. This study will aim to evaluate the effects of vitamin D supplementation on sperm parameters, seminal and serum levels of oxidative stress and serum endocrine factors in asthenospermia infertile men. Methods/design This randomized, triple-blind, placebo-controlled clinical trial will be conducted on 86 infertile men with idiopathic asthenozoospermia (the mobility of sperm Main outcomes measure (s) Demographic data, dietary intake, physical activity, sun exposure, anthropometric indices, serum and seminal levels of MDA (Malondialdehyde), 8-hydroxy-2- Dioxy Guanosine (8-OHDG), Total Antioxidant Capacity (TAC) and calcium, sperm DNA fragmentation index (DFI), serum 25-OHD, luteinizing hormone (LH), follicle-stimulating hormone (FSH), total testosterone (T), estradiol (E2), sex hormone-binding globulin (SHBG), free androgen index (FAI = T/SHBG. 100), T/LH and T/E2 ratios, prolactin (PRO), parathyroid hormone (PTH), osteocalcin (OCN), phosphorus and sperm parameters. Discussion The deficiency of vitamin D as an antioxidant is common all over the world. Numerous observational studies have shown a positive association between vitamin D levels and semen quality. However, few clinical studies have been conducted in this area. So considering with the high prevalence of this antioxidant deficiency specifically in infertile men, it seems that the supplementation of vitamin D in infertile men with insufficient levels or deficiency may improve the status of oxidative stress and thereby may affect sperm parameters and endocrine factors involved in male fertility. Trial registration Iran Clinical Trials Registry, ID: IRCT20151128025274N4, registered on 28 March 2018.

Purpose The purpose of this paper with meta-analysis is to clarify the effects of cranberry consumption on features of the metabolic syndrome of interest of all relevant randomized controlled trials (RCTs). Design/methodology/approach A systematic literature search was conducted on ISI web of science, PubMed, Embase, the Cochrane library and Google Scholar databases, to include trials published up to March 2019. Weighted mean differences (WMD) were calculated from a random or fixed-effects models. Between‐study heterogeneity was assessed by Cochrane’s test and I2 index. Findings Ten RCTs were included in this review which involving a total of 371 subjects. Our meta-analysis showed that cranberry consumption had beneficial effects on waist circumference (WMD −0.49, 95% CI −0.96 to −0.036; p = 0.034). No significant effect of cranberry consumption on fasting blood glucose, high-density lipoprotein cholesterol, triglycerides and blood pressure was found in this meta-analysis. Originality/value To the best of the authors’ knowledge, this is the first systematic review with meta-analysis of RCTs that investigate the effect of cranberry consumption on features of the metabolic syndrome.

There is no previous study that investigated the association between Dietary Diversity Score (DSS) and odds of nonalcoholic fatty liver disease (NAFLD). The present study aimed to examine the association between DDS and its components and NAFLD among Iranian adults.In the case-control study, we enrolled 121 newly diagnosed cases of NAFLD and 122 with age, BMI and sex-matched controls. All NAFLD patients were diagnosed through ultrasonography methods by gastroenterologists. Anthropometric parameters of participants including weight, height, hip circumference and waist circumference were measured. A validated 147-item semi-quantitative food frequency questionnaire was applied to assess the usual dietary intakes of participants. Binary logistic regression was conducted to estimate the risk of NAFLD in relation to DDS and its components, including refined grains, vegetables, fruits, dairy and meats.The mean age of study participants was 42.7 years of them 53.1% were male. Higher adherence to DDS [odds ratio (OR) = 0.48; 95% confidence interval (CI), 0.25-0.95] and vegetable group (OR = 0.34; 95% CI, 0.16-0.71) were remarkably associated with lower risk of NAFLD, after adjusting for several confounders including age, BMI, physical activity, energy intake, job, education, and antihypertensive drugs usage. Contrastingly, greater adherence to the refined grain (OR = 3.36; 95% CI, 1.44-7.87) and meat group (OR = 3.27; 95% CI, 1.25-6.90) was significantly associated with increased risk of NAFLD.High DDS is inversely correlated with the risk of NAFLD. Hence, increasing the diversity score of diet by emphasizing the higher diversity scores for vegetables and less for meat and refined grains may be profitable for the management of NAFLD.

Different types of glycosides extract of fenugreek have shown androgenic and anabolic effect in male. The aim of the study was to evaluate the effect of fenugreek extract on total testosterone levels in male. Medline via PubMed, Scopus databases, Cochrane Library, Web of Science, and Google Scholar were searched up to November 2018 for randomized clinical trials comparing intake of fenugreek extract with control group. Data on change in serum total testosterone were pooled using random-effects models. A total of four trials were included. Fenugreek extract has a significant effect on total serum testosterone. Results from clinical trials suggest that fenugreek extract supplement has an effect on serum total testosterone levels in male.

Summary Background & aims Several randomized clinical trials (RCTs) have investigated the effect of l -carnitine supplementation on lipid profile and glycaemic control in adults with cardiovascular risk factors; however, the results were conflicting. Therefore, a meta-analysis was performed to assess the effect of l -carnitine on lipid profile and glycaemic control in adults with cardiovascular risk factors. Methods We searched PubMed, Scopus, Cochrane Databases, Google Scholar, ProQuest, Web of Science and Embase for randomized, placebo-controlled human trials that investigated the effect of l -carnitine supplementation on lipid profile and glycaemic control up to April 2017. From the eligible trials, 24 articles were selected for the meta-analysis. The meta-analysis was performed in a random-effects model. Heterogeneity was determined by I2 statistics and Cochrane Q test. Results The result showed significant effect of l -carnitine on TC (WMD: −13.73 [95% CI: −22.28, −5.17] mg/dL; P 0.001), Lp(a) (WMD = − 7.13 [95% CI: −9.82,− 4.43]mg/dL; P l -carnitine was detected in TG, Apo A-I and Apo B 100 on pooled effect size. Additionally, sensitivity analysis showed l -carnitine supplementation could improve glycaemic control, particularly along with hypocaloric diet. Conclusion This meta-analysis showed that l -carnitine supplementation could improve lipid profile levels, particularly in doses more than 1500 mg/day. More RCTs with large sample sizes, focusing on gut microbiome profiles and dietary patterns are needed to better understand the effect of l -carnitine on patients with cardiovascular risk factors.

Introduction Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders among women of reproductive age. Chemerin, a novel adipokine, is involved in inflammation, energy metabolism, adipogenesis, angiogenesis and insulin secretion in the adipose cells and ovary. This systematic review with meta‐analysis aimed to compare serum and follicular fluid (FF) chemerin and ovarian chemerin mRNA expression among women with PCOS and non‐PCOS. Methods Electronic databases including Web of Science, PubMed, Google Scholar, Scopus, Cochrane and CINAHL were used for a comprehensive search through April 2021. Of the 174 articles initially identified, 22 studies met the eligibility criteria. A random‐effects model with a weighted mean difference (WMD) and 95% confidence interval (CI) was performed to compare the outcomes between groups. Subgroup and sensitivity analyses were performed to detect the sources of heterogeneity. Results Women with PCOS compared to without PCOS showed significantly higher serum chemerin [WMD: 12.02 pg/ml (95% CI: [10.92, 13.13]), p, This systematic review with meta‐analysis was shown serum, and follicular fluid chemerin levels and chemerin mRNA expression were higher in the PCOS group compared to the controls. Further, serum chemerin was higher in women with PCOS and a more BMI. The present findings illustrated that chemerin may be associated with both PCOS status and BMI, independently.

Curcumin is the principal polylphenol of turmeric that has been used to treat various disorders. However, its anti-obesity effects in patients with non-alcoholic fatty liver disease (NAFLD) remain controversial. Therefore, we aimed to perform a meta-analysis on the effects of supplementation with turmeric/curcumin on body weight, body mass index (BMI) and waist circumference (WC) in these patients. PubMed, Scopus, Cochrane Library, and ISI Web of Science were searched until January 2019, without any restrictions. Clinical trials that reported body weight, BMI and WC in patients with NAFLD were included. Weighted mean differences (WMDs) were pooled using a random-effects model. Eight studies (449 participants) fulfilled the eligibility criteria of the present meta-analysis. Overall, meta-analysis could not show any beneficial effect of turmeric/curcumin supplementation on body weight (WMD, -0.54 kg; 95% confidence interval [CI], -2.40, 1.31; p = 0.56; I2 = 0.0%), BMI (WMD, -0.21 kg/m2; 95% CI, -0.71, 0.28; p = 0.39; I2 = 0.0%) and WC (WMD, -0.88 cm; 95% CI, -3.76, 2.00; p = 0.54; I2 = 0.0%). Subgroup analysis based on participants' baseline BMI, type of intervention, and study duration did not show any significant association in all subgroups. The results showed that turmeric/curcumin supplementation had no significant effect on body weight, BMI and WC in patients with NAFLD. Further studies with large-scale are needed to find out possible anti-obesity effects of turmeric/curcumin.

The finding of studies on the effect of curcumin extract on metabolic factor in patients with metabolic syndrome has had arguable results. This systematic review with meta-analysis of randomized controlled trials (RCT) aimed to analyze the effect of curcumin/turmeric on metabolic factors in patients with metabolic syndrome. The PICO strategy was used to establish the guiding question of this review. Several databases for RCT were searched until September 2018. Of the 144 articles initially identified, seven trials met the eligibility criteria. A random-effects model with a mean weight difference (WMD) and a 95% confidence interval was performed for quantitative data synthesis. Pooled estimates of WMD were calculated between intervention and control groups using random-effects model in the presence of high level of heterogeneity between the studies. The results showed significant improvement of fasting blood glucose (p = 0.01), triglycerides (p < 0.001), high-density lipoprotein cholesterol (p = 0.003), and diastolic blood pressure (p = 0.007) levels. Curcumin was not associated with a significant change in waist circumference measurement (p = 0.6) and systolic blood pressure level (p = 0.269). Curcumin supplementation improves some components of metabolic syndrome.

Background and aims: Current state of evidence recommends beneficial effects of branched chain amino acids (BCAAs) on exercise performance; however, randomized controlled trials (RCTs) of BCAA supplementation yield discordant results. The objective of this study was to clarify the effects of BCAA supplementation in exercise through meta-analysis of all relevant RCTs. Methods: A comprehensive search of PubMed, Embase, ISI web of science, and the Cochrane library has been conducted from inception to September 2016. This meta-analysis includes 31 primary trials of the effect of BCAA supplementation on central fatigue, fatigue substances (lactate and ammonia), energy metabolites (glucose and free fatty acids) and, muscle damage substances (LDH and CK). The estimates were either obtained from a fixed-effects model or a random-effects model. The studies’ heterogeneity was calculated by Cochrane’s test and I2 index. Results: BCAA had no effect on central fatigue (SMD − 0.31, 95% CI − 0.72 to 0.09; p = 0.1; heterogeneity I2 = 0%, p = 0.9). However, a significant reduction was detected in the lactate levels (WMD − 0.16, 95% CI − 0.26 to − 0.53; p = 0.003; heterogeneity I2 = 47.9%, p = 0.023). Moreover, BCAA supplementation had beneficial effects on ammonia, glucose, FFA, and CK, but had no effects on LDH. Conclusion: BCAA supplementation did not have any effect on the feeling of fatigue; however, it led to a favorable effect on fatigue substances, energy metabolites and muscle soreness substances. Therefore, it can be concluded that the ingestion of the BCAA can play a helpful role in the enhancement of the exercise performance.

Aim The present study aimed to investigate major dietary patterns and their association with risk of gestational diabetes mellitus (GDM) in Yazd city located in Iran. Methods This case-control designed study was conducted at six healthcare centres. Two hundred and seventy-eight pregnant women who referred for GDM screening participated. Dietary assessment was carried out by using a 67-item validated food frequency questionnaire to evaluate dietary history of participants during the last year. Principal component analysis was used to identify major food patterns. Multivariable logistic regression model was employed to identify the association between dietary patterns and risk of GDM. Results Two major dietary patterns were detected. The Western dietary pattern was associated with higher intakes of sugar-sweetened beverages, refined grain products, fast foods, salty snacks, sweets and biscuit, mayonnaise and saturated oils, while the prudent dietary pattern was associated with higher intakes of fruits, low-fat dairy, potato, egg, fish, poultry, nuts, organs meat and red meat. Furthermore, prudent dietary pattern was negatively associated with GDM risk (OR = 0.88, 95% CI: 0.44-0.99). However, there was no significant association between adherence of the Western dietary pattern and risk of GDM. Conclusions Pre-pregnancy adherence of the prudent dietary pattern was significantly associated with reduced risk of GDM.

We performed a meta-analysis to evaluate the efficacy of turmeric/curcumin supplementation on serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in patients with nonalcoholic fatty liver disease (NAFLD). We searched PubMed, Scopus, Cochrane Library, ISI Web of Science, and Google Scholar up to November 20, 2018. Studies that examined the effect of turmeric/curcumin on serum concentrations of ALT and AST among patients with NAFLD were included. The mean difference and standard deviation (SD) of changes in ALT and AST between intervention and control groups were used as effect size for the meta-analysis. A total of six randomized controlled trials (RCTs) were eligible for meta-analysis. Results from pooled analysis revealed that turmeric/curcumin supplementation reduced ALT (MD: -7.31 UL/L, 95% CI [-13.16, -1.47], p = 0.014) and AST (MD: -4.68 UL/L, 95% CI [-8.75 -0.60], p = 0.026). When RCTs stratified on the basis of their treatment duration, the significant reduction in serum concentrations of ALT and AST was observed only in studies lasting less than 12 weeks. This review suggests that turmeric/curcumin might have a favorable effect on serum concentrations of ALT and AST in patients with NAFLD. However, further clinical trials are needed to confirm these findings.

Objective Evaluate the effects of vitamin D3 (VD3) on sperm parameters and endocrine markers in infertile men with asthenozoospermia. Materials and methods This randomized, triple-masking, placebo-controlled clinical trial conducted on 86 asthenozoospermia infertile men with serum 25 hydroxy vitamin D3 (25(OH)VD3) < 30 ng/ml in the infertility clinic of Ahvaz Jahad daneshgahi, Iran. Patients were randomly allocated to groups A and B, who received daily 4000 IU VD3 and matching placebo respectively for 3 months. Demographic data, dietary intake, physical activity, sun exposure, anthropometric indices, serum 25(OH)VD3, luteinizing hormone (LH), follicle-stimulating hormone (FSH), total testosterone (T), estradiol (E2),, sex hormone-binding globulin (SHBG), free androgen index (FAI = T/SHBG. 100), T/LH and T/E2 ratios, prolactin (PRO), parathyroid hormone (PTH), osteocalcin (OCN), phosphorus and sperm parameters were assessed. Results Three months VD3 supplementation with 4000 IU/day had no significant effects body weight, body mass index (BMI), waist circumference (WC), body fat (BF), serum, OCN, LH, FSH, T, E2, SHBG, PRO, T/E2 ratio, FAI, semen volume, sperm count and normal sperm morphology. It increases serum 25(OH)VD3, PTH and phosphorus and seminal and serum calcium, T/LH ratio and total and progressive sperm motility and decreased significantly compared to the baseline and placebo group. Conclusion VD3 supplementation may affect sperm motility in men with asthenozoospermia and serum 25(OH)VD3 Trial registration Iran Clinical Trials Registry, ID: IRCT20151128025274N4, registered on 28 March 2018, URL of trial registry record: https://www.irct.ir/trial/29983

Summary Background & aims Although several clinical trials have assessed the effect of Resistant Starch (RS) supplementation on appetite, the results have been inconsistent. Therefore, this study aimed to assess the effect of RS on the healthy adults' rating of appetite. Materials and methods To this end, Pubmed, CENTRAL, Web of science, Scopus, Medline, and Proquest were systematically searched to find the relevant randomized, and placebo-controlled human trials up to June 2019. As a result, the area under curve (AUC) and standard deviations of the participants' rating appetite were extracted from four eligible studies. Results Meta-analysis showed a lower appetite in RS group compared to the controls (weighted mean difference [WMD] = −1.375 mm min, 95% confidence interval [95%CI]: −1.673, −1.076). Since high heterogeneity was observed among the included studies (I2 = 94.5%, P Conclusions To decrease the rate of appetite more effectively, we suggest other researchers to identify RS dose and type.

The aims of this systematic review and meta-analysis were to evaluate the effectiveness of soy isoflavones on serum levels of total testosterone (TT) and follicle-stimulating hormone (FSH) in women with polycystic ovary syndrome (PCOS).A meta-analysis was performed by searching for relevant randomised controlled trials (RCTs) in several databases. Of the four trials found, the eligibility criteria to evaluate the efficacy of soy isoflavones on serum levels of FSH were met by three trials and of TT by four trials. The Cochrane scale was used to evaluate the risk of bias. Fixed-effects and random-effects models were used to evaluate overall effect. TheOur results showed that soy isoflavones significantly decreased TT (weighted mean difference [WMD] - 0.14; 95% confidence interval [CI] - 0.2, -0.02;Although the results of this meta-analysis showed that soy isoflavones in women with PCOS decreased TT and had no significant effect on FSH, better and more valid studies are needed to confirm these results.

Background Investigating effects of whole diets on non-alcoholic fatty liver disease can contribute to development of diet-based recommendations for prevention and treatment of this disease. the aim of the present study is the identification of major dietary patterns and their association with the risk of non-alcoholic fatty liver disease (NAFLD). Methods A total of 244 individuals (122 NAFLD patients and 122 controls) participated in this case-control study. NAFLD patients were diagnosed by a gastroenterologist. Dietary intake data of participants were collected using a 147 item semi-quantitive food frequency questionnaire and major dietary patterns were identified by principal component analysis. The consumption of dietary patterns was divided into tertiles. The association of dietary patterns with the odds of NAFLD was investigated by multivariate logistic regression. Results four major dietary patterns were recognized. The "ordinary pattern" adherence was positively associated with NAFLD risk. Although, results were statistically significant only for the third tertile versus the first tertile after adjusting for confounding factors (OR: 3.74, P-trend

Aim Chronic venous insufficiency (CVI) is common in adults. Some complications include skin changes, edema, heavy legs, muscle cramps, pain, and varicose veins. In traditional medicine, red vine leaf extract (AS 195) has been used to cure the symptoms of CVI. This systematic review was aimed to assess the effects of AS 195 in patients with CVI. Material and methods A systematic literature search was performed to identify trials that reported the impact of red vine leaf extract on CVI. The primary outcomes investigated were Leg (limb) volume, calf circumference, ankle circumference, tired and heavy legs, a sensation of tension, tingling sensation, and pain. Results From the 56 studies, 5 trials were selected according to our inclusion criteria. Red vine leaf extract significantly improved numbers of outcomes (lower leg volume, calf and ankle circumference, tired, heavy legs, tingling sensation, pain, the sensation of tension in the legs, cutaneous microcirculation, and transcutaneous oxygen pressure) in only some trials. The tolerability for red vine leaf extract was reported good or satisfactory. Conclusions Red vine leaf extract had a beneficial therapeutic role in patients with CVI. Further high-quality trials are required to be carried out to provide strong evidence.

Whether consumption of omega-3 affects circulating adiponectin has not been established. The objective of this study was to evaluate the effect of omega-3 (food or supplement) on circulating adiponectin in patients with type 2 diabetes through a systematic review of meta-analyses of randomized controlled trials. PubMed, Scopus and Web of Science were searched for relevant studies through May 2016. Two researchers screened and abstracted the literature independently. Pooled estimates were obtained using the random-effects models. Overall, omega-3 increased adiponectin by 0.57 µg/mL (95% confidence interval [CI] 0.15 to 1.31; p=0.01, I-square=74.2% p for heterogeneity

Introduction Major depressive disorder is among main worldwide causes of disability. The low medication compliance rates in depressed patients as well as the high recurrence rate of the disease can bring up the nutrition-related factors as a potential preventive or treatment agent for depression. The aim of this study was to investigate the association between dietary patterns and depression via the intermediary role of the serum folate and vitamin B12, total homocysteine, tryptophan, and tryptophan/competing amino acids ratio. Methods This was an individually matched case-control study in which 110 patients with depression and 220 healthy individuals, who completed a semi-quantitative food frequency questionnaire were recruited. In addition, to measure the serum biomarkers 43 patients with depression and 43 healthy people were randomly selected from the study population. To diagnose depression the criteria of Diagnostic and Statistical Manual of Mental Disorders, fourth edition, were utilized. Results The findings suggest that the healthy dietary pattern was significantly associated with a reduced odds of depression (OR: 0.75; 95% CI: 0.61-0.93) whereas the unhealthy dietary pattern increased it (OR: 1.382, CI: 1.116–1.71). The mediation analysis showed that the healthy dietary pattern was associated with a reduced risk of depression via increased serum levels of the folate and vitamin B12; however, the unhealthy dietary pattern was associated with increased risk of depression via decreased serum levels of folate and vitamin B12, based on tree adjusted logistic regression models. Conclusion Dietary patterns may be associated with depression by changing the serum levels of folate and vitamin B12. Further studies are required to confirm the mechanism.

Summary Objective The present study investigated the effects of docosahexaenoic acid (DHA)-enriched fish oil supplement on telomerase activity, mRNA expression of P16 INK , IL-6, and TNF-α considering Pro12Ala polymorphism in the PPARγ gene. Methods/Design In this double-blind randomized controlled trial, 72 PPARγ Pro12Ala polymorphism genotyped type 2 diabetic patients aged 30–70 years were randomly assigned to receive 2.4 gr of DHA-enriched fish oil or a placebo for 8 weeks. Genotyping of the Pro12Ala polymorphism in the PPARγ gene was assessed using polymerase chain reaction-restriction length polymorphism (PCR-RFLP), telomerase activity in the peripheral blood mononuclear cell (PBMC) was measured using PCR-ELISA based on the telomeric repeat amplification protocol (TRAP), and changes in the mRNA expression of P16, IL-6, and TNF-α were measured using real-time quantitative reverse transcription–polymerase chain reaction (RT-PCR). Results In the DHA group, telomerase activity was decreased (p = 0.001) during the intervention. In addition, between-group comparisons showed significant differences in the changes in telomerase activity (p = 0.003) and P16 mRNA expression (p = 0.028) and non-significant differences in TNF-α and IL-6 mRNA expression. The gene*DHA interaction could not affect changes in P16, IL-6, or TNF-α mRNA expression or in telomerase activity in PBMC. Discussion Short-time DHA-enriched fish oil supplementation caused increased levels of P16 expression and a decline in telomerase activity compared with the control group without modulating the effects of Pro12Ala polymorphism on the PPARγ gene. Because of the positive correlation between P16 activity and cellular senescence, the possibility of senescence stimulation by DHA is proposed.

Background: This study aimed to investigate the comparison of G1359A variant of cannabinoid receptor gene (rs1049353) with obesity-related traits including body mass index (BMI), fat mass (FM), fat-free mass (FFM), food-related traits, and leptin among healthy and non-healthy adults. Methods: We searched PubMed, Cochrane, Scopus, Web of Science, and EMBASE until December 2016 for observational studies assessing each of the anthropometric measurements, food-related traits, and leptin of 1359 G/A polymorphism of CNR1 gene. A total of 22 studies were included in the meta-analysis comparing mean and SD differences of the anthropometric measurements, leptin, and dietary intake between GA/AA and GG genotypes. Results: The results showed that subjects with GA/AA genotype had significantly lower BMI (weighted mean difference = –0.59 kg/m2, p < 0.001) compared to those with the GG genotype. Dietary intake of fat, carbohydrate, and protein as well as serum levels of leptin was not significantly different between GA/AA and GG genotypes. Conclusion: It was revealed that subjects with mutant polymorphism (GA/AA) of CNR1, compared to the wild-type group (GG), had lower BMI (although there was unexplained heterogeneity).

Background and Objective:Recent studies have shown a relationship between energy regulation and the circadian rhythm at behavioral, molecular, and physiological levels. The present study investigated the effect of chronotype on meal timing and obesity in Iranian housewives. Materials and Methods:This cross-sectional study was carried out using a convenience-sampling method through the participation of housewives living in Ahvaz in 2018. Anthropometric information was collected. To assess food intake timing, energy intake and sleep patterns during seven days of normal living were recorded by the researchers. Dietary information was obtained by using a 24-hour recall questionnaire and analyzed by NUT IV software. The morningness-eveningness questionnaire (MEQ) was used to determine chronotypes. Results:There was a significant difference between the morning and evening groups in terms of the timing of lunch (P=0.004) and mid-afternoon snacks (P=0.04). There was no significant difference between mean energy intake in the morning and evening chronotypes in women who were overweight or obese (P=0.31). There was also no significant difference between morning and evening chronotypes in terms of the percentage of energy intake of meals and snacks (P>0.05). The only significant difference, detected between morning and evening chronotypes in normal-weight women, was for the percentage of energy intake after 3:00 PM. (P=0.008). Conclusion:The present study showed no effect of chronotype on obesity. However, energy intake calculations were based on self-reports, which could lead to information bias. Therefore, in future studies, researchers should carry out clinical trials while controlling food intake and considering meal timing. Keywords:Chronotype,Energy regulation,Obesity,Meal timing,Sleep patterns

Background Major depressive disorder is among main worldwide causes of disability. The low medication compliance rates in depressed patients as well as the high recurrence rate of the disease can bring up the nutrition-related factors as a potential preventive or treatment agent for depression. The aim of this study was to investigate the association between dietary patterns and depression via the intermediary role of the serum folate and vitamin B12, total homocysteine, tryptophan, and tryptophan/competing amino acids ratio. Methods This was an individually matched case-control study in which 110 patients with depression and 220 healthy individuals, who completed a semi-quantitative food frequency questionnaire were recruited. We selected the depressed patients from three districts in Tehran through non-probable convenience sampling from which healthy individuals were selected, as well. The samples selection and data collection were performed during October 2012 to June 2013. In addition, to measure the serum biomarkers 43 patients with depression and 43 healthy people were randomly selected from the study population. To diagnose depression the criteria of Diagnostic and Statistical Manual of Mental Disorders, fourth edition, were utilized. Results The findings suggest that the healthy dietary pattern was significantly associated with a reduced odds of depression (OR: 0.75; 95% CI: 0.61–0.93) whereas the unhealthy dietary pattern increased it (OR: 1.382, CI: 1.116–1.71). The mediation analysis showed that the healthy dietary pattern was associated with a reduced risk of depression via increased serum levels of the folate and vitamin B12; however, the unhealthy dietary pattern was associated with increased risk of depression via decreased serum levels of folate and vitamin B12, based on tree adjusted logistic regression models. Conclusion Dietary patterns may be associated with depression by changing the serum levels of folate and vitamin B12. Further studies are required to confirm the mechanism.

Abstract. Background: Peroxisome proliferator-activated receptor γ (PPARγ) Pro12Ala polymorphism (rs1801282) has been associated with metabolic syndrome components in some studies. Moreover, the PPARγ gene may mediate the physiological response to dietary fat intake in a ligand-dependent manner. Methods: Metabolic syndrome components (body mass index, waist circumference, and lipid profile) were determined in 290 type 2 diabetes mellitus patients in a cross-sectional study. DNA genotyping for determining PPARγ Pro12Ala polymorphism was conducted using the polymerase chain reaction-restriction length polymorphism method. A semi-quantitative food frequency questionnaire was used to assess the participants’ dietary intakes in the previous year. Results: There were significant differences between the two genotype groups of PPARγ Pro12Ala polymorphism, Ala carriers (Pro/Ala + Ala/Ala) versus non-Ala carriers (Pro/Pro), in terms of mean body mass index (p = 0.04) and waist circumference (p = 0.02). Below the median percentage of energy from monounsaturated and polyunsaturated fatty acids, Ala carriers had a higher body mass index (p = 0.01) compared to non-Ala carriers. Furthermore, a significant interaction between this single-nucleotide polymorphism and polyunsaturated fatty acids intake on serum triglyceride levels (p = 0.01) was seen, and in higher polyunsaturated fatty acids intake (≥ median) Ala carriers had lower triglyceride levels than non-Ala carriers (p = 0.007). Conclusions: The findings of the current study support a significant association between PPARγ Pro12Ala polymorphism and metabolic syndrome components, and they suggest that this polymorphism can modulate the biological response of dietary fat intake on body mass index and triglyceride levels.

Background and aims Curcumin has anti-inflammatory properties. The aim of this study was to evaluate the effect of curcumin on improvement of the disease activity in ulcerative colitis (UC). Methods In this randomized double-blind clinical trial, 70 patients with mild-to-moderate UC were randomly assigned to curcumin (1,500 mg/day) or placebo intake for 8 weeks. Disease clinical activity, quality of life, serum levels of tumor necrosis factor alpha (TNF-α), high-sensitivity C-reactive protein (hs-CRP), erythrocyte sedimentation rate (ESR) values, and complete blood count were measured. Results Changes in Simple Clinical Colitis Activity Index score were significantly higher in the curcumin than the placebo group (-5.9 ± 2.08 vs. -2.1 ± 2.6; p = .001). The scores of Inflammatory Bowel Disease Questionnaire-9 and quality of life were significantly higher in the intervention group compared to the control group (p = .006). Furthermore, the curcumin supplementation reduced the serum hs-CRP concentration (-6.3 ± 13.6 vs. 3.7 ± 11.6 μg/ml; p = .01) and ESR levels significantly (-1.6 ± 2.7 vs. -0.09 ± 2.4 mm/hr; p = .02) in comparison with the control group. No significant changes were observed in the TNF-α levels of both groups. Conclusions Consumption of the curcumin supplement, along with drug therapy, is associated with significant improvement of the clinical outcomes, quality of life, hs-CRP, and ESR in patients with mild-to-moderate UC.

Several randomized clinical trials (RCTs) evaluated the effect of melatonin supplementation on liver enzymes in patients with non-alcoholic fatty liver disease (NAFLD) and reported conflicting results. To meet these discrepancies, a meta-analysis was conducted to evaluate the eff ;ect of melatonin on liver indices in patients with NAFLD. To collect the required data, a thorough search was conducted through Web of science, Pubmed, Cochrane database, Embase, Google Scholar, ProQuest, and Scopus databases. The aim was to find clinical trials over the effect of melatonin supplementation on liver indices up to 16 May 2019. As a result, five eligible articles were selected and analysed in this meta-analysis using a fixed-effects model. Heterogeneity test was performed by I2 statistics and Cochrane Q test. The results showed that melatonin had a significant effect on aspartate aminoteransferase (AST) (WMD = 2.29, [95 %CI: 1.14, 3.43] IU/L, p =

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

Background The beneficial effects of omega-3 polyunsaturated fatty acids on lipid levels are well documented. However, the related molecular mechanisms are widely unknown. Omega-3 polyunsaturated fatty acids are natural ligand for peroxisome proliferator–activated receptor γ (PPARγ). Objective The aim of this study was to evaluate the effect of docosahexaenoic acid (DHA)-rich fish oil supplementation on modulation of some PPARγ-responsive genes related to lipid metabolism. Methods Patients with type 2 diabetes were randomly assigned to consume either DHA-rich fish oil (containing 2400 mg/d fish oil; DHA: 1450 mg and eicosapentaenoic acid: 400 mg) or placebo for 8 weeks. Lipid profile and glycemic control parameters as well as the gene expression of PPARγ, liver x receptor-a, ATP-binding cassette A1, and CD36 in peripheral blood mononuclear cells were measured at baseline and after 8 weeks. Results DHA-rich fish oil supplementation resulted in decreased triglycerides (TG) level compared with placebo group, independently of the baseline value of TG (all patients ( P = .003), hypertriglyceridemic subjects ( P = .01), and normotriglyceridemic subjects ( P = .02)). Moreover, a higher reduction in TG level was observed in hypertriglyceridemic subjects, comparing to normotriglyceridemic subjects with DHA-rich fish oil supplementation ( P = .01). Other lipid parameters as well as the expression of PPARγ, liver x receptor-a, ATP-binding cassette A1, and CD36 were not affected by DHA-rich fish oil supplementation. Only in hypertriglyceridemic subjects, DHA-rich fish oil supplementation upregulated CD36 expression, compared with the placebo group ( P = .01). Conclusions DHA-rich fish oil supplementation for 8 weeks increased CD36 expression in hypertriglyceridemic subjects, which might result to higher reduction in TG level, comparing with normotriglyceridemic subjects. However, this finding should be investigated in further studies.

Background: The aims of this research were to investigate (1) the impact of docosahexaenoic acid (DHA)-rich fish oil supplementation on body composition, plasma adiponectin level, and peroxisome proliferator-activated receptor γ (PPARγ) gene expression, and (2) whether the effect of DHA-rich fish oil supplementation on the aforementioned variables is modulated by PPARγ Pro12Ala polymorphism. Methods: We genotyped PPARγ Pro12Ala polymorphism in subjects with type 2 diabetes mellitus (T2DM). Ala carriers and non-Ala carriers were randomly assigned to DHA-rich fish oil or placebo intake for 8 weeks. Results: Glycemic control was not affected by the intervention. The supplementation with DHA-rich fish oil decreased waist circumference (p < 0.001), body fat mass (p = 0.01), body fat percent (p = 0.04), and visceral fat rating (p = 0.02) as well as trunk fat mass (p = 0.04). Weight, body mass index, fat-free mass, adiponectin level, and PPARγ gene expression changes showed no significant difference. No gene-diet interaction was found on body composition, adiponectin level, and PPARγ gene expression. Conclusions: DHA-rich fish oil supplementation favorably modulated body composition in patients with T2DM and could be useful to reduce visceral obesity. However, the PPARγ Pro12Ala polymorphism did not influence the changes in the desired variables.

Summary Background & aim This systematic review and meta-analysis of available evidence was conducted to obtain a conclusive result on the effects of glutamine supplementation on athletes. Methods Systematic review and meta-analysis. Data related to body mass, lean body mass, body fat percentage, Vo2 max, lymphocytes, leukocytes and neutrophil counts were extracted to determine the effects of GLN on performance outcomes. Data Sources The literature search was conducted across the databases Pubmed, Scopus, ISI Web of Science, SID (Scientific Information Database) and Cochrane Central Register of Controlled Trials, covering a period up to January 2017. Eligibility Criteria for Selecting Studies Clinical trials evaluating glutamine supplementation outcomes on athletes aged over 18 were included. Results A total of 47 studies were included in the systematic review, and 25 trials matched the inclusion criteria for the meta-analysis. According to the meta-analysis, glutamine has a significant effect on weight reduction (WMD = −1.36 [95% CI: −2.55 to −0.16], p = 0.02). Moreover, neutrophil numbers were reduced following glutamine intake at doses greater than 200 mg/kg body weight (WMD = −605.77 [95% CI: −1200.0 to 52.1]; P = 0.03). Also, supplementation by glutamine dipeptide resulted in higher blood glucose after exercise (WMD = 0.51 [95% CI: 0.18, 0.83] mmol/l; P = 0.002). There was no association between glutamine ingestion and other outcomes investigated. Conclusion According to this meta-analysis, generally, glutamine supplementation has no effect on athletics immune system, aerobic performance, and body composition. However, the current study showed that glutamine resulted in greater weight reduction. In addition, the present study suggests that the efficacy of glutamine supplementation on neutrophil numbers could be affected by supplement type and dose.

The present systematic review with meta-analysis of randomized controlled trials (RCTs) aimed to analyze the effectiveness of omega-3 fatty acids on the frequency, severity, and duration of migraine. This systematic review was performed by searching several databases for controlled clinical trials. Of the 13 trials, five, two, and three RCTs met the eligibility criteria to evaluate the efficacy of omega-3 on the frequency, duration, and severity of migraine attacks, respectively. The Jadad scale was used to evaluate the risk of bias analysis. Overall estimates of the intervention effect were obtained from random-effect meta-analysis. The studies' heterogeneity was evaluated using the chi-squared test (χ

Background & Aims: Regarding the rapid increase in the number of doctoral students in nursing, evaluation of PhD course to ensure quality of education is necessary. By the assessment of doctoral program from the viewpoint of the students, this study aims to provide a clear picture of the educational quality of this course. Material & Methods: In this descriptive study, 64 doctoral students recruited by census from the nursing and midwifery schools of Tabriz, Shiraz, Mashhad and Tehran University of medical sciences were surveyed. Quality of PhD nursing course was evaluated by international questionnaire of QCSI (quality criteria, standards and indicators ) in three dimensions of educational programs, faculty and resources. Data was analyzed by descriptive statistics using SPSS-PC (v. 13.5). Results: The mean score of doctoral students’ point of view in the three parts of educational programs (48.4±3.17), faculty (31.42±2.03) and resources (18.95±2.76) was moderate. In the dimension of educational programs, components of emphasizing the research ( 49.3 ±0.67) and teachers’ support of students ( 3.32 ± 0.64) were more satisfied by students. The students were dissatisfied with the adequacy of faculty members (1.37 ± 0.77) and relevance of doctoral courses with nursing profession (1.84 ± 0.66). In the faculty dimension, students had been criticized the teachers’ performance for the supervision of dissertations (1.15 ± 0.60), and teachers’ knowledge (1.67 ± 0.87). In the resource dimension, students were dissatisfied of the adequacy of financial resources (1.95 ± 0.75) and necessary infrastructure for research (1.98 ± 0.66). Conclusion: Regarding the intermediate quality of doctoral course of nursing in the dimensions of curriculum , faculty and resources , revising the content of courses , increasing the number of faculty members and improvement of the resources are necessary to improve the quality of the course.

Objective Postprandial hyperglycemia plays a decisive role in the development of chronic metabolic disorders. The effect of vinegar intake with a meal on postprandial glucose has been studied in several trials with conflicting results. Research methods and procedures The purpose of the current study was to systematically review control trials that report on the effect of vinegar intake on postprandial glucose response. Postprandial insulin response was considered as secondary outcome. Results The pooled analysis of studies revealed a significant mean glucose and insulin area under the curve (AUC) reduction in participants who consumed vinegar compared with the control group (standard mean difference=−0.60, 95%CI −1.08 to −0.11, p =0.01 and −1.30, 95%CI −1.98 to −0.62, p Conclusions The findings suggest that vinegar can be effective in reducing postprandial glucose and insulin levels, indicating it could be considered as an adjunctive tool for improving glycemic control.