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ABSTRACT The purpose of this study is the characterization of the synoptic circulation patterns leading to extremely warm periods ( EWPs) over the Kurdistan province of Iran. Daily maximum temperature data from 27 meteorological stations were used for the period 1962-2012. Data were interpolated to a 6 × 6 km grid using the geospatial Kriging method. EWPs were defined as a period of at least 6 consecutive days with maximum temperature above the local daily-based 95th percentile of the 1971-2000 period, with additional criteria for spatial extension. The identified EWPs are distributed through the whole year, with maximum frequencies in winter and summer. Interestingly, the decade 1988-1997 did not record any extreme episode and summer extremes were recorded only before 1983. The associated synoptic patterns were classified into four clusters by applying the Ward's hierarchical clustering method to sea level pressure and Z500 data. Four clusters are identified: two represent warm periods in winter, one those occurring spring, especially in March, and another one mainly reflecting summer heat waves. In general, it is found that EWPs are associated with statistically significant anomalies in regional circulation. A deep trough of geopotential height in 500 hPa over North Africa and a ridge directly over the study area were the more important causes for the occurrence of EWPs. Other synoptic configurations that favour extreme periods in winter and summer include, respectively, the northward expansion of the Sudan low pressure with an associated southerly wind advection and the persistence of anticyclonic circulation at all tropospheric levels enhancing subsidence and adiabatic heating. The spring pattern is the most frequent one (nearly 48% of all cases) and reflects a southeastward extension of the subpolar low pressure that leads to the displacement of the Siberian high to south and southwestern Asia and the accompanied northward expansion of the Sudan low. [ABSTRACT FROM AUTHOR]

An abstract of the study "Recognition of Cold Waves and Spatiotemporal Analysis in the Iran" by M. Darand is presented.

The article examines the impact of extensive and persistent frosts in Iran. It outlines the two groups classification of frosts including radiative frosts, and advective frosts. It notes that frosts occurs when the minimum temperature is below 0° centigrade degree. It mentions several related factors of frosts including atmospheric circulation, radiative balance, and soil humidity.

The quantification of the relationship between daily mortality and air temperature, as a fundamental policy is essential to enhance the accuracy of the warning system of decrease and increase of temperature. The objective of this study was to investigate the relationship between temperature and death rate in Tehran during the period (2002-2005) by combining statistical and geographic information system methods. The Results of this study indicate that there is a strong and meaningful correlation between air temperature and death rate especially between monthly averages ones. The highest rate of mortality has occurred in the cold months of the year (December, January and February). and as the temperature decrease, the death rate increase. The increase in death rate caused by cardiovascular, respiratory and stroke diseases in the cold months of the year, bears proof to this matter. Among 22 zones of Tehran, zones 9, 6 and 12 have got the highest number of death occurrence. The correlation between daily death rate and daily temperature averages was V-shaped. Results of this study confirm some previous findings such as those in Moscow, United States, Hong Kong, Madrid, Athens and Shanghai. Temperature minimum mortality for Tehran was calculated as 28.5°C. The obtained results also indicate that the higher was the temperature difference from the Temperature minimum mortality, the more the death rate increased. Finally, the optimum policies for the mitigation of mortality in Tehran are presented. [ABSTRACT FROM AUTHOR]

Background: The fast spread of the coronavirus disease 2019 (COVID-19) epidemic and its high mortality were quickly considered by the health community. Dietary patterns play an important role in strengthening or weakening the immune system and thus incidence of diseases., Aim: The present study can provide a comprehensive picture of the association between adherence to unhealthy plant-based diet (uPDI) and COVID-19 incidence., Methods: This study was undertaken on 8157 adults' participants of the Yazd Health Study (YaHS) and Taghzieh Mardom-e-Yazd (TAMIZ) study aged 20 to 70 years. Data on dietary intakes were obtained using a validated food frequency questionnaire (FFQ). Multivariable logistic regression analysis was used to assess the association between uPDI and COVID-19., Results: We found a significant association between uPDI and the risk of COVID-19 (OR: 1.36; 95% CI: 1.05-1.75) in the crude model. After adjusting potential confounders, a significant increasing trend in the odds of COVID-19 across increasing quintiles of uPDI (OR: 1.58;95% CI: 1.05-2.37; P-value: 0.027) was observed. Stratified analysis based on sex indicated that uPDI significantly increased the risk of COVID-19 only in males (OR: 1.73;95% CI: 1.12-2.67; P-value: 0.012) and had no effect on females., Conclusions: Participants in the highest quintiles of the uPDI had 58% higher odds of COVID-19 compared to subjects in the lowest quintile of uPDI. Although our study has promising results, stronger clinical studies are needed., (© 2024. The Author(s).)

Background: Although adherence to a healthy dietary pattern is one of the primary recommendations for the prevention of polycystic ovary syndrome (PCOS), there is still no conclusive evidence of which specific dietary pattern is best. The Lifelines diet score (LLDS) is a new, evidence-based scoring system to determine diet quality, and its association with PCOS has not been investigated. The present study aimed to assess the association between LLDS and PCOS in Iranian women., Materials and Methods: This frequency-matched case-control study was carried out on 108 women with PCOS and 108 women without PCOS as a control group in Yazd, Iran. Healthy controls were matched to PCOS women based on age and BMI. The validated 178-item food frequency questionnaire was used to assess the usual dietary intake. Logistic regression was used to estimate the association between LLDS and PCOS., Results: The findings of the present study showed women in the highest tertile of LLDS compared with the participants in the lowest tertile had 90% lower odds of PCOS (Odds Ratio (OR): 0.10; 95% Confidence Interval (CI): 0.04 to 0.21, p for trend: <0.001). This association remained significant after adjustment for energy intake, marital status, pregnancy history, WC, chronic disease history, physical activity, and BMI (Odds Ratio (OR): 0.11; 95% (CI):0.05 to 0.27, p for trend: <0.001)., Conclusion: Although the present study found a significant protective association between adherence to LLDS and PCOS, more mechanism-based studies are needed to confirm these findings in the future., (© 2024. The Author(s).)

Few studies have investigated the association between herbal medicine consumption and coronary artery disease severity. This cross-sectional study aimed to investigate the association between the frequency of medicinal herbs consumption and coronary artery stenosis (CAS), lipid profile, fasting blood sugar (FBS), and blood pressure level in participants undergoing coronary angiography. This study was conducted on 662 participants aged 35-75 years. Serum cardiometabolic markers were measured using standard kits. The extent and severity of CAS were evaluated using the Gensini score (GS) and syntax score (SS). Higher consumption of Thymus vulgaris and Sumac was associated with decreased odds of artery-clogging according to the GS. A higher intake of Thymus vulgaris and Mentha was associated with lower levels of serum cholesterol and triglyceride. Monthly intake of Thymus vulgaris, and weekly/daily intake of Mentha, Nigella Sativa, and Cuminum Cyminum were associated with lower low-density lipoprotein. Weekly/daily intake of Turmeric and Thymus vulgaris were associated with lower high-density lipoprotein levels and monthly intake of Mentha was related to lower serum FBS levels. Higher consumption of Mentha, Mentha pulegium L, Lavandula angustifolia, and Nigella Sativa was associated with lower levels of systolic blood pressure. According to the results of the present study, herbs consumption might be related to a reduction in CAS risk factors., (© 2024 John Wiley & Sons Ltd.)

Scope: The present study aims to assess the interaction of dietary patterns (DPs) and paraoxonase1 (PON1) rs662 polymorphism on coronary artery disease (CAD) severity and its risk factors., Methods and Results: This cross-sectional study is conducted on 425 patients undergoing angiography. The PON1 genotypes are detected by the polymerase chain reaction-restriction fragment length polymorphism (RFLP-PCR) technique. DPs are extracted by exploratory factor analysis. Two dietary patterns Western (WDP) and Traditional (TDP) are extracted. A gene-diet interaction concerning a high Gensini score is observed. Accordingly, high adherence to the WDP increases the odds of a high Gensini score in R allele carriers compared to QQ genotype carriers by 2.48 times (odds ratio [OR]: 2.48, 95% confidence interval [CI] 0.98-6.26, p = 0.05). Also, the risk of high systolic blood pressure (SBP) is higher in R allele carriers with high adherence to the WDP compared to QQ genotype carriers (OR: 3.49, 95% CI 1.38-8.82, p < 0.001. No significant interaction is observed between TDP and PON1 rs662 on any cardiometabolic risk factors (p-value > 0.05). The results remain significant after adjusting for confounders., Conclusion: The present study's findings indicate the existence of an interaction between the PON1 rs662 polymorphism and the WDP on the risk of stenosis severity and high SBP., (© 2024 Wiley‐VCH GmbH.)

Background: Polycystic ovary syndrome (PCOS) is the most prevalent cause of ovulatory infertility and endocrine abnormalities in reproductive-age women. Although the MIND diet has been introduced to improve brain function, evidence shows that the MIND diet is rich in beneficial food groups that can have a preventive effect on other metabolic disorders. The present study was conducted to investigate the association between adherence to the MIND diet and PCOS., Methods: This age and BMI frequency-matched case-control study was conducted on 216 women between January 2018 and March 2019 in Yazd, Iran. PCOS was diagnosed based on Rotterdam criteria. Participants were selected by convenience sampling method. The validated 178-item food frequency questionnaire was used to assess the usual dietary intake. Logistic regression was used to estimate the association between the MIND diet and PCOS., Results: The findings of the present study showed a significant inverse association between adherence to the MIND diet and PCOS in the crude model (OR for T3 vs. T1: 0.12 (95% CI: 0.05-0.25), P-value < 0.001) and multivariable-adjusted model including energy intake, age, BMI, waist circumference, marital status, pregnancy history, drug use history, education and physical activity (OR for T3 vs. T1 = 0.08 (95% CI: 0.03-0.19), P-value < 0.001). Adherence to the MIND diet had a protective effect of 92%., Conclusion: Although the results of the present study showed that higher adherence to the MIND diet is associated with a lower risk of PCOS, more studies are needed to confirm these findings in the future., (© 2024. The Author(s).)

Background: Although several studies have attempted to identify coronary artery disease (CAD) risk factors, few have explored the association between lifestyle-related factors and the severity of coronary artery stenosis. The present study was designed to assess the association between a combination of lifestyle, dietary, cardiometabolic, psychological, and mental factors, and CAD severity in adults undergoing angiography., Methods: This cross-sectional study aimed to recruit a total of 700 patients (aged 35 to 75 years) who met the inclusion criteria and were referred for angiography between July 2020 and November 2021 to Afshar Hospital, a central heart disease hospital in Yazd city, Iran. To assess the presence and intensity of CAD, we used the Gensini and SYNTAX scores. Biochemical factors were measured using standard kits from serum samples, and extra serum and whole blood samples were retained for further analyses. Data on general information, dietary food and supplement intake, eating habits, medicinal herbs consumption, psychological and mental state, sleep quality, and other variables were gathered by trained interviewers using specific questionnaires., Results: In total, 720 participants (444 males and 276 females) aged 56.57±9.78 years were included in the current study. Moderate to severe coronary artery stenosis was prevalent in 47.0% and 17.9% of participants based on Gensini and SYNTAX scores, respectively., Conclusion: The results of this study will enhance our understanding of the association between different risk factors and the severity of coronary artery stenosis., Competing Interests: The authors declare that they have no personal or financial conflicts of interest. The corresponding author asserts that he has full access to the data generated from this project.

Background: Previous studies examined the effects of obesity on sperm parameters and reported inconsistent results. Thus, the present study aimed to evaluate the association between obesity and the quality of sperm parameters in infertile men., Material and Methods: The present cross-sectional study evaluated 218 infertile men aged 20-50. To this end, the 168-item food frequency questionnaire (FFQ) was utilized to evaluate dietary intake. The anthropometric and biochemical variables were examined using standard methods. Further, the association between obesity and the quality of sperm parameters was evaluated using the controlled linear regression for potential confounders., Results: The normal sperm morphology had a significant inverse association with BMI [adjusted β - 0.074, CI (- 0.141 to - 0.008), P = 0.029] and WC [adjusted β - 0.026, CI (- 0.051 to - 0.001), P = 0.038]. Additionally, visceral fat had a marginal inverse association with normal sperm morphology [adjusted β - 0.065, CI (- 0.138 to 0.008), P = 0.079] and non-progressive sperm motility [adjusted β - 0.241, CI (- 0.495 to 0.014), P = 0.063]., Conclusion: Even though the present results indicated that obesity, abdominal obesity, and visceral fat had inverse associations with normal sperm morphology, more mechanism-based studies should be conducted to confirm these findings., (© 2023. BioMed Central Ltd., part of Springer Nature.)

The fast spread of the coronavirus disease 2019 (COVID-19) epidemic and its high mortality were quickly noticed by the health community. B vitamins are essential micronutrients for the body with antioxidant, anti-inflammatory and immune-regulating properties. The present study can provide a comprehensive picture of the associations between B vitamins and COVID-19 incidence. This study was undertaken on 9189 adult participants of the Yazd Health Study (YaHS) and Taghzieh Mardom-e-Yazd (TAMIZ) study aged 20 to 69 years. Data on dietary intakes were obtained using a validated FFQ. Multivariable logistic regression analysis was used to evaluate the association between B vitamins and COVID-19. Our findings indicated that participants in the fourth quartile of vitamin B 5 intake compared with the first quartile had a protective effect against COVID-19 (OR: 0·53, 95 % CI 0·28, 0·99, P -trend = 0·02) after adjustment for all possible confounds in model 3. In addition, participants in the third quartile of vitamin B 12 intake compared with the first quartile (OR: 0·63, 95 % CI 0·40, 0·98, P -trend = 0·11) had fewer odds of COVID-19 after full adjustments for confounders. Our findings indicated no significant relationship between dietary intake of vitamin B 1 , B 2 , B 3 , B 9 and B-complex and COVID-19. A higher intake of vitamin B 5 could reduce the odds of COVID-19 by 47 %, and a moderate intake of vitamin B 12 had a protective effect on COVID-19. Although our study has promising results, stronger clinical studies are needed.

The present meta-analysis aimed to determine the effectiveness of L-arginine supplementation in improving biomarkers of glycemic control in adults. Electronic databases including PubMed, ISI Web of Science, Scopus, and the Cochrane Collaboration Library were searched up to January 2020. The meta-analysis of twelve randomised clinical trials indicated that L-arginine had no significant effect on serum fasting blood sugar (FBS) (weighted mean difference [WMD]: -3.38 mg/dl, 95% CI: -6.79 to 0.04, p  = .53), serum insulin (WMD: -0.12 Hedges' g 95% CI: -0.33 to 0.09, p  = .27), glycated haemoglobin A1c (HbA1c; WMD: -0.04%, 95% CI: -0.25 to 0.17, p  = .71), and homeostasis model assessment for insulin resistance (WMD: -0.48, 95% CI: -1.15 to 0.19, p  = .15). Although several animal studies have proposed that L-arginine supplementation might improve blood glucose control, the present study could not confirm this benefit in humans.

Background: Despite considerable advances in pharmacological and non-pharmacological treatments, mental health illnesses carry many economic and social burdens. Depression and anxiety are known as mental disorders which are highly prevalent worldwide. Previous studies have shown different results. This diet has attracted enormous interest., Objective: This is the first meta-analysis conducted to review systematically all trials to evaluating the effect of a low carbohydrate diet (LCD) on depression, and anxiety., Methods: PubMed, Web of Science, and Scopus have been searched until 9 September 2021. In total, 8 RCTs (n = 590) were carried out for evaluation the effects of LCDs on depression and anxiety were included. All the trials included in the analyses evaluated patients without a mood disorder. Random model effects meta-analysis was conducted. To evaluate the heterogeneity among the included studies. The egger test was used. Subgroup analyses performed based on regions, assessment methods, carbohydrate intake and duration of studies., Results: This study did not show any significant association between a low carbohydrate diet and the of anxiety (SMD = 0.19, 95 % CI -0.10, 0.47; P = 0.20) and also depression (SMD = 0.06, 95 % CI -0.11, 0.24; P = 0.49). If one of the studies is excluded, this diet significantly increases anxiety (SMD = 0.33, 95 % CI 0.12, 0.54; P ≤ 0.001). This study showed that this diet increases anxiety in studies with <26 % carbohydrate intake (SMD = 0.31; 95%CI 0.10, 0.52; P ≤ 0.001; I 2  = 0.00, P = 0.52), in the Australia (SMD = 0.29; 95%CI 0.08, 0.49; P = 0.01; I 2  = 0.00, P = 0.42), and in studies that used the Spielberger State Anxiety Inventory (SAI) to assess anxiety (SMD = 0.33; 95%CI 0.11, 0.54; P ≤ 0.001; I 2  = 0.00, P = 0.54)., Limitations: One of the limitations of intervention studies examining the effect of diet is that it is difficult to blind people under intervention., Conclusion: The present study did not demonstrate significant association between a low carbohydrate diet and improvement of depression and anxiety. More accurate studies are needed to reach definitive conclusions., Competing Interests: Conflict of interest The authors declare no conflicts of interest., (Copyright © 2023 Elsevier B.V. All rights reserved.)

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

Background and Aims: Anthocyanins (ACNs) are water-soluble plant pigments belong to flavonoids with beneficial effects on health and disease prevention. Some studies have examined the effect of ACNs on anthropometric and body composition indices, but the findings were inconsistent. This systematic review and meta-analysis aimed to investigate the effect of ACNs and sources rich in anthocyanins on body mass index (BMI), body weight (BW), waist circumference (WC), hip circumference (HC), waist-hip ratio (WHR), percentage of fat mass (PFM) and fat free mass (FFM)., Methods: PubMed, Web of Science, Scopus, and Google Scholar were searched with no limitation until May 2021 to find relevant randomized controlled clinical trials (RCT). The risk of bias was assessed utilizing Cochrane collaboration's tool. Weighted mean differences (WMD) and 95% confidence intervals (CIs) were obtained using a random effects model., Results: A total of 31 RCTs (with 0.77-640 mg/day of ACNs supplementation for 28-90 days) with 1438 participants were included. No significant effect was found in BMI, WC, HC, WHR, PFM and FFM after ACNs consumption., Conclusions: The results showed that ACNs did not significantly affect anthropometric and body composition parameters. Further high-quality RCTs are required to validate these findings., Competing Interests: The authors declare no conflict of interest to report regarding this study., (© 2022 The Authors. Obesity Science & Practice published by World Obesity and The Obesity Society and John Wiley & Sons Ltd.)

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

Purpose: The aim of this comprehensive systematic review and meta-analysis was to evaluate the beneficial effects of melatonin supplementation on brain-derived neurotrophic factor (BDNF) concentration and clinical depressive disorder., Methods: A comprehensive electronic search was conducted of Medlin, Web of Science, Science Direct, and Google scholar, from database inception to January 20, 2021. Studies were eligible if they: (1) were a clinical trial; (2) enrolled adults; (3) assessed the effect of melatonin supplementation on serum concentration of BDNF or depression score. Overall effects, as weighted mean difference (WMD), were calculated for concentration of BDNF and depression score., Results: Melatonin supplementation yielded no significant effect on BDNF concentration (WMD: -5.61; 95% CI: -14.10, 2.88; I-square: 85.6%), but improved depression by decreasing the score (WMD: -0.76; 95% CI: -1.12, -0.4; I-square: 88.0%). Due to high heterogeneity between studies, subgroup analysis for gender, duration and dose in BDNF studies and duration, age, dose, continent and Questionnaire type in depression studies, was utilised. The subgroup analysis showed that melatonin supplementation had a significant decreasing effect on BDNF levels in doses ≤ 10 mg/day, with more than 4 weeks of duration, and in men., Conclusion: The present study revealed that melatonin supplementation has a decreasing effect on depression in all duration of studies and doses subgroup and in age more than 65 years in depression studies but heterogenicity of the included studies, did not allow a definitive conclusion. There is limited evidence for effects of melatonin on serum BDNF., Implications for Practice: Melatonin is a safe and effective supplement for depressive patients., Competing Interests: Conflicts of interest None., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Background: Non-alcoholic fatty liver disease (NAFLD) is defined as the excessive accumulation of fat in the liver cells of people who do not drink alcohol. The aim of study is investigated the association between low carbohydrate diets (LCDs) and NAFLD., Methods: This age and gender-matched case-control study was conducted on 120 patients newly diagnosed with NAFLD and 120 adults without NAFLD. Diagnosis of NAFLD based on laboratory tests and abdominal ultrasound. Low carbohydrate diets score calculated on the percentage of energy as carbohydrate, fat, and protein. Participants in the highest rank intake of fat and protein and lowest intake of carbohydrate received 10 points. Multivariable logistic odds ratio was used for examine the relation between LCDs and NAFLD., Results: This study showed subjects in the highest tertile of LCD has more intake of zinc and vitamin B12 compare to lowest. Also, intake of protein (p = 0.02) carbohydrate (p < 0.02) and cholesterol (p = 0.02) were significantly higher in patient with NAFLD compare to control subjects. There was no significant association between LCD and risk of NAFLD (OR: 1.36; 95% CI: 0.97-1.92; P-trend = 0.13) in crude and adjusted (OR: 1.31; 95% CI: 0.84-2.04; P-trend = 0.23) model., Conclusion: However, we showed that intake of protein, carbohydrate and cholesterol are higher in NAFLD, but our results of study showed that LCDs with higher proportion intakes of protein and fat was not associated with NAFLD. Further prospective studies are required for confirm these associations., (© 2022. The Author(s).)

Background: The fast spread of the coronavirus disease 2019 (COVID-19) epidemic and its high mortality were quickly noticed by the health community. Dairy products have been recognized as part of a healthy diet that helps strengthen body immunity and prevent infections. The present study can provide a comprehensive picture of the associations between dairy products consumption and COVID-19 incidence., Methods: This study was undertaken on 8801 adults participants of Yazd Health Study (YaHS) and Taghzieh Mardom-e-Yazd (TAMIZ) study aged 20 to 70 years. Data on dietary intakes were obtained using a validated food frequency questionnaire (FFQ). Multivariable logistic regression analysis was used to assess the association between dairy consumption and COVID-19., Result: Our finding indicated that moderate intake of total dairy (OR: 0.63, 95% CI 0.46-0.87, P-trend = 0.97) could reduce the odds of COVID-19 and higher intake of low-fat dairy products (OR: 0.51 CI: 0.37-0.69, p-trend &lt; 0.001) and low-fat milk (OR: 0.47 CI: 0.35-0.64, p-trend &lt; 0.001) had a protective effect on COVID-19 after adjusting for confounders. However, higher intake of high-fat-dairy-product (OR: 1.40 CI: 1.09-1.92, p-trend = 0.03), high-fat milk (OR: 1.54 CI: 1.20-1.97, p-trend &lt; 0.001), total yogurt (OR: 1.40 CI: 1.04-1.89, p-trend = 0.01), cheese (OR: 1.80 CI: 1.27-2.56, p-trend = 0.001), and butter (OR: 1.80 CI: 1.04-3.11, p-trend = 0.02) were related to increase the odds of COVID-19., Conclusions: Moderate intake of total dairy could reduce odds of COVID-19 by 37% and, a higher intake of low-fat dairy products had a protective role on COVID-19. Although our study has promising results, stronger clinical studies are needed., (© 2022. The Author(s), under exclusive licence to Springer Nature Limited.)

Objective: Metabolic syndrome (MetS) is a complex disorder with an increasing prevalence globally. Limited data are available about the association between dietary habits and the prevalence of MetS. The present cross-sectional study aimed to investigate the association between dietary habits and MetS in a large population sample from Iranians., Methods: The study was conducted on 9261 adults aged 35-70 years who attended the baseline phase of Shahedieh cohort study, Yazd, Iran. Dietary habits including meal frequency, fried food consumption, adding salt to prepared meal, barbecued food consumption, used oil type and reuse oil number were assessed by a standard questionnaire. MetS was defined using the National Cholesterol Education Program Adult Treatment Panel III criteria. Logistic regression was used in different adjusted models to investigate the relationship between dietary habits and MetS: (Model I: adjusted for age, sex and energy. Model II: Model I + adjusted for wealth score index and physical activity. Model III: Model II + adjusted for cardiovascular diseases and liver diseases)., Results: The subjects who ate barbecued-food more than 3 times/ month had 1.18 times greater odds for MetS than individual who ate this less than once/ month (OR: 1.18, 95% CI: 1.01-1.38). After further adjustment for other confounding variables, the association remained significant. No significant association was found between other dietary habits and odds of MetS., Conclusion: Higher intakes of barbecued-food consumption were related to the prevalence of MetS. Larger longitudinal studies in other population groups are needed to confirm these associations., (© 2022. The Author(s).)

Background: Depression, anxiety, and stress are common mental problems. The aim of this cross-sectional study was to investigate the association between two indexes that measure postprandial insulin response to different food, dietary insulin index (DII) and insulin load (DIL), with psychological disorders., Method: Participants (n = 10,000) aged 20-69 were randomly selected from 200 clusters in Yazd from the recruitment phase of the Yazd Health Study. The dietary intake of participants was collected by a reliable and validated food frequency questionnaire (FFQ) consisting of 178 food items. DII and DIL were calculated from the FFQ data using previously published reference values. To assess psychological disorders an Iranian validated short version of a self-reported questionnaire (Depression Anxiety Stress Scales 21 [DASS21]) was used., Results: No significant association was observed between DIL and DII with odds of depression or anxiety using crude or adjusted models. However, individuals in the highest quartiles of DIL had the lowest odds of stress (OR: 0.69; 95% CI 0.48-1.01, P-trend = 0.047). This association remained significant after adjustment for potential confounders in model II including marital status, smoking, education, job status, salt intake, and multi-vitamin supplement use (OR: 0.38; 95% CI 0.16-0.91, P-trend = 0.039) and the third and final model which is further adjusted for BMI (OR: 0.39; 95% CI 0.16-0.91, P-trend = 0.041)., Conclusion: Overall, consumption of foods with higher DII as well as DIL were associated with lower stress scores; however, no significant relationship was observed between DII or DIL with respective depression or anxiety scores., (© 2022. The Author(s).)

Objective: Attention-deficit hyperactivity disorder (ADHD) is the most prevalent neurodevelopmental disorder with a prevalence of 5 % among children and adolescents worldwide. Plant foods have a protective effect against inflammation and oxidative stress which both are involved in psychiatric disorders pathophysiology including ADHD. Accordingly, we investigated the association between plant-based diet (PDI) and ADHD., Methods: This case-control study was conducted on 345children and adolescents 7-13 years old in Yazd, Iran. Subjects were categorized into the case (n = 113) and control groups (n = 232) based on matching age and sex. To diagnose ADHD, the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSMIV-TR) was used. Food frequency questionnaire was used to measure food intake. The association of PDI with ADHD was examined by logistic regression., Results: Children in the highest quartile of PDI compared to the lowest quartile had a higher energy and macronutrient intake, calcium, zinc, iron, vitamin B12, B6, and folic acid. After adjusting for potential confounders, a significant decreasing trend in the odds of ADHD across increasing quartiles of the PDI (P-trend = 0.001) was observed. In addition, children in the fourth quartile of PDI had 68 % lower odds of ADHD than the first quartile. This association remained significant after further adjustment for BMI (OR: 0.32;95 % CI: 0.13-0.79; P for trend: 0.001)., Conclusion: We found that PDI is associated with lower risk of ADHD in children. Cohort and clinical studies are necessary to approve our results., (Copyright © 2022. Published by Elsevier B.V.)

Introduction: Nutritional problems in children cause major morbidity and mortality in the world. This study aimed to assess the nutritional status of under six years old children in Kalar city, Kurdistan Region, Iraq., Methods: In this longitudinal study, data from 403 Iraqi Kurdish children aged 0-72 months and their mothers were extracted from Health Centre in Kalar city undertaken between 2013 and 2019. The children`s growth data were obtained at birth time, 6, 12, 24, and 72 months. Epi Info was used to classify the children of nutritional status by converting the anthropometric measurements into Z-scores. Data were analyzed using SPSS 25 software., Results: The prevalence of overweight and obesity rose from birth to age 6 years old, from 19.6% and 7.4% to 52.2% and 30.5%, respectively. At 24 month, children had the highest rates of being overweight (56.1%) and obesity (34%). At 6 month, the highest prevalence of wasting exists (9.5%). At 6 month boys and girls had the highest frequency of stunting, 17.2% and 7.2% respectively. Considering the association of all characteristic variables and growth data at birth time, only mothers with academic education had children with significantly higher BMI for age compared to illiterate mothers after adjusting for all potential confounders (β: 0.573, 95% CI: 0.105, 1.04, P: 0.017)., Conclusion: The study suggests that some analysed factors that accounted for malnutrition in Kalar city's children are preventable. Therefore, to reduce the burden of malnutrition, community-based education and targeted nutritional interventions are required., (© 2022. The Author(s).)

Background: Psychological disorders including depression, anxiety, and stress comprise a huge public health problem. The aim of this cross-sectional study is to assess the relationship between dietary glycemic index (DGI) and glycemic load (DGL) and mental disorders., Method: Participants (n = 10,000) aged 20-69 were randomly selected from 200 clusters in Yazd from the recruitment phase of Yazd Health Study. The dietary intake of study participants was collected by a reliable and validated food frequency questionnaire consisting of 178 food items. DGI and DGL were calculated from the FFQ data using previously published reference values. To assess psychological disorders an Iranian validated short version of a self-reported questionnaire Depression Anxiety Stress Scales 21 was used., Results: There were no significant associations between DGI and DGL with odds of depression or anxiety in crude and adjusted models. However, individuals in the highest quartiles of DGL had the lowest odds of stress (OR: 0.69; 95% CI 0.47-1, P-trend = 0.023). This association remained significant after adjustment for potential confounding variables in model I (OR: 0.45; 95% CI 0.22-0.9, P-trend = 0.023), model II (OR: 0.46; 95% CI 0.22-0.96, P-trend = 0.039) and model III (OR: 0.46; 95% CI 0.22-0.96, P-trend = 0.042)., Conclusion: In conclusion, consumption of foods with higher GL was associated with lower odds of stress; however, no significant association was found between DGI or DGL and risk of depression and anxiety. Performing further studies with longitudinal design is suggested to confirm these results., (© 2022. The Author(s).)

Previous studies on the effect of Brassica vegetables on blood glucose and lipid profile have reported inconclusive findings. Due to the high prevalence of glucose and lipid metabolism disorders and their importance as predictors of chronic diseases, the present meta-analysis was performed to clarify the effect of Brassica vegetables on blood glucose and lipid profile. A systematic search of the databases of PubMed, Scopus, and Cochran Library was performed up to October 2020. All randomized controlled trials (RCTs) that examined the effect of Brassica vegetables on blood glucose and lipid profile were included in the study. The search results were limited to English-language publications. Finally, nine RCTs, including 548 participants, were selected for the present study. Pooled analysis indicated a significant reduction in total cholesterol (TC) (SMD = -0.28, 95%CI: 0.48 to 0.08; p = 0.005) following Brassica vegetables consumption. Overall, Brassica vegetables had no significant impact on serum levels of triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, fasting blood sugar, and glycated hemoglobin. Consumption of Brassica vegetables had a statistically significant effect on TC concentration. However, further high-quality studies are needed to firmly establish the clinical efficacy of these plants., (© 2022 John Wiley & Sons Ltd.)

Purpose: The 2019 novel coronavirus (COVID-19) is an emerging pandemic, with a disease course varying from asymptomatic infection to critical disease resulting to death. Recognition of prognostic factors is essential because of its growing prevalence and high clinical costs. This meta-analysis aimed to evaluate the global prevalence of obesity in COVID-19 patients and to investigate whether obesity is a risk factor for the COVID-19, COVID-19 severity, and its poor clinical outcomes including hospitalization, intensive care unit (ICU) admission, need for mechanical ventilation, and mortality., Methods: The study protocol was registered in PROSPERO (CRD42020203386). A systematic search of Scopus, Medline, and Web of Sciences was conducted from 31 December 2019 to 1 June 2020 to find pertinent studies. After selection, 54 studies from 10 different countries were included in the quantitative analyses. Pooled odds ratios (OR) with 95% confidence intervals (CIs) were calculated to assess the associations., Results: The prevalence of obesity was 33% (95% CI 30.0%-35.0%) among patients with COVID-19. Obesity was significantly associated with susceptibility to COVID-19 (OR = 2.42, 95% CI 1.58-3.70; moderate certainty) and COVID-19 severity (OR = 1.62, 95% CI 1.48-1.76; low certainty). Furthermore, obesity was a significant risk factor for hospitalization (OR = 1.75, 95% CI 1.47-2.09; very low certainty), mechanical ventilation (OR = 2.24, 95% CI 1.70-2.94; low certainty), intensive care unit (ICU) admission (OR = 1.75, 95% CI 1.38-2.22; low certainty), and death (OR = 1.23, 95% CI 1.06-1.41; low certainty) in COVID-19 patients. In the subgroup analyses, these associations were supported by the majority of subgroups., Conclusion: Obesity is associated with COVID-19, need for hospitalization, mechanical ventilation, ICU admission, and death due to COVID-19., Level of Evidence: Level I, systematic reviews and meta-analyses., (© 2021. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Objective: Attention Deficit/Hyperactivity Disorder (ADHD) is a common behavioral disorder among children. Based on literature, it has been hypothesized that the higher intake of rich sources of phytochemicals may be inversely related to the risk of ADHD. We investigated the association of dietary phytochemical index (DPI) with odds of ADHD., Methods: This case-control study was conducted on 360 children and adolescents 7-13 years old in Yazd, Iran. Subjects were categorized into the case (n = 120) and control groups (n = 240) based on matching age and sex. To diagnose ADHD, the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSMIV-TR) was used. Food frequency questionnaire was used to measure food intake. DPI was calculated by percent of daily energy intake from phytochemical-rich foods. The association of DPI with the odds ratio of ADHD was examined by logistic regression., Results: Subjects in the highest quartile of DPI have higher intake of macronutrient, eicosatetraenoic acid, docosahexaenoic acid, calcium, zinc, iron, vitamins B12, B6, and folic acid compared to lowest quartile. After adjusting for potential confounders, subjects in the highest quartile of DPI compared with subjects in the lowest quartile showed a lower risk of ADHD (OR: 0.44; 95% CI: 0.18-0.90). There was a significant decreasing trend in the odds of ADHD across increasing quartile of DPI (P for trend: 0.02)., Conclusion: We found that higher DPI score is associated with lower risk of ADHD in children. Cohort and clinical studies are necessary to approve our results., (© 2021. The Author(s), under exclusive licence to Springer Nature Limited.)

Objective: Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders. The Mediterranean diet as a plant-based diet has a beneficial effect on mental health. The present study was designed to investigate the association between adherence to Mediterranean diet and odds of ADHD in Iranian children., Methods: This age and gender matched case-control study was conducted on 360 children 7-13 years old in Yazd, Iran. Children were categorized into new diagnosed case (n = 120) and control groups (n = 240). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSMIV-TR) was used to diagnose ADHD. A validated food frequency questionnaire was used to measure food intake. The association of adherence to the Mediterranean with the odds ratio of ADHD examined by logistic regression., Results: After adjusting for potential confounders including energy intake, parents' educational level, economic status, family history ADHD and physical activity, the children in the highest tertile of adherence to Mediterranean diet had a lower odd of ADHD (odds ratio [OR]: 0.49; 95% Confidence Interval [CI]: 0.27-0.89) compared to the children in the lowest. In addition, an association was observed between increasing trend adherence to Mediterranean diet and decrease odds of ADHD after full adjustments (P for trend <0.001)., Conclusion: We found that higher adherence to Mediterranean diet containing vegetables, legumes, fruits and nuts, grains, and fish could decrease the odds of ADHD in primary school children. Further studies are suggested to approve our vision., Competing Interests: Declaration of competing interest The authors have declared no competing interests., (Copyright © 2021 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.)

Background: Previous studies have proposed that the maternal intake of pre/probiotics may affect the immune composition of breast milk. Nevertheless, the available findings are contradictory. This meta-analysis aimed to examine the impact of maternal supplementation with pre/probiotics on the levels of total immunoglobulin A (IgA), secretory IgA (SIgA), transforming growth factor beta 1 (TGF-β1), and TGF-2 in breast milk. Methods: PubMed and Scopus were systematically searched using a comprehensive search strategy for eligible randomized-controlled trials published up to February 2021. A random-effects model was applied to pool weighted mean difference and 95% confidence interval (CI) as effect size. Cochran's Q statistic and the I2 statistic were used to measure the between-study variance. Egger's regression test was used to assess publication bias. Results: A total of 12 different studies, with a total sample size of 1722 individuals (probiotic group: 858, placebo group: 864), were included in this meta-analysis. In the overall analysis, compared with placebo, maternal supplementation with pre/probiotics had no significant effect on concentrations of total IgA, SIgA, TGF-β1, and TGF-β2 in the breast milk. In the subgroup analysis, pre/probiotics did not affect total IgA, TGF-β1, and TGF-β2 in both colostrum/transitional and mature milk. However, a significant increase in SIgA was found in colostrum/transitional milk following pre/probiotic administration (WMD = 19.33, 95% CI: 0.83-37.83; p  = 0.04), without evidence for remarkable heterogeneity ( I 2  = 0.0, p  = 0.57). Conclusions: Maternal supplementation with pre/probiotics may increase SIgA in colostrum/transitional milk, without any effect on total IgA, TGF-β1, and TGF-β2.

Background: Previous investigations have proposed that the consumption of infant formula supplemented with prebiotics, probiotics and synbiotics (PRO-formula) may have protective impacts on respiratory tract infections (RTIs). Nevertheless, the findings of studies are contradictory. This meta-analysis aimed to explore the influence of PRO-formula on RTIs in infants by pooling randomized controlled trials (RCTs)., Methods: To obtain eligible RCTs, Scopus and PubMed databases were systematically searched from their inception to November 2020. A random-effects model was applied to pool the relative risks (RR) and corresponding 95% confidence intervals (CI) for RTIs following consumption of PRO-formula., Results: A total of 15 RCTs, with a total sample size of 3805 participants (1957 for intervention and 1848 for placebo), were included in the present meta-analysis. In the overall analysis, in comparison to placebo, consumption of PRO-formula had a significant protective impact against RTIs (RR = 0.89, 95%CI: 0.82-0.97) in infants, with a remarkable evidence of heterogeneity across studies (I2 = 61.4%, P < 0.001). In the meta-regression analysis, the effect of PRO-formula on RTIs was not modified by the follow-up duration. No evidence for publication bias was detected., Conclusions: Administration of PRO-formula may be a potential approach for the prevention of respiratory tract infections in infants., (Copyright © 2021. Published by Elsevier Ltd.)

Due to the increasing rate of cardiovascular disease and related risk factors in the worldin recent decades, the present meta-analysis was performed to investigate the effects ofcocoa/chocolate consumption on lipid profile, glycemia, and blood pressure control in diabetic patients. A systematic search of the databases PubMed, Scopus, Web of Science, and Cochran Library was performed up to July 2020. All randomized controlled trials (RCTs) using cocoa/dark chocolate in diabetic patients were included in the study. The search results were limited to English-language publications. Eight RCTs, including 433 participants, were selected for this meta-analysis. Pooled analysis indicated a significant reduction in low-density lipoprotein cholesterol LDL-c levels (WMD: -15.49 mg/dl; 95% CI: -24.56, -6.42, p = .001) and fasting blood sugar (FBS) concentrations (WMD: -6.88 mg/dl; 95% CI: -13.28, -0.48, p = .03) following cocoa/dark chocolate consumption. The analysis of papers included in current study indicates that the consumption of cocoa/dark chocolate reduced the serum fasting blood glucose (FBS) and LDL cholesterol concentrations. However, further high quality trials are essential for confirming the clinical efficacy of cocoa/dark chocolate consumption on complete metabolic profile., (© 2021 John Wiley & Sons Ltd.)

Background: Previous studies have suggested that the consumption of probiotic fermented dairy products (PFDP) may have a protective effect on respiratory tract infections (RTIs). However, the results of studies are inconclusive. We aimed to systematically investigate the effect of PFDP on RTIs by performing a meta-analysis of randomized controlled trials (RCTs)., Methods: PubMed and Scopus databases were systematically searched up to October 2020 to identify eligible RCTs. Meta-analysis outcomes were risk of incidence of upper (URTIs ) and lower (LRTIs ) respiratory tract infections. A random-effects model was used to pool the relative risks (RR) and corresponding 95 % confidence intervals (CI) for outcomes following conception of PFDP., Results: A total of 22 RCTs, with a total sample size of 10,190 participants, were included in this meta-analysis. Compared with placebo, consumption of PFDP had a significant protective effect against RTIs in the overall analysis (RR = 0.81, 95 %CI: 0.74 to 0.89) and in children (RR = 0.82, 95 %CI: 0.73 to 0.93), adults (RR = 0.81, 95 %CI: 0.66 to 1.00), and elderly population (RR = 0.78, 95 %CI: 0.61 to 0.98). The significant decreased risk of RTIs was also observed for URTIs (RR = 0.83, 95 %CI: 0.73 to 0.93), while, this effect was marginal for LRTIs (RR = 0.78, 95 %CI: 0.60 to 1.01, P = 0.06). The disease-specific analysis showed that PFDP have a protective effect on pneumonia (RR = 0.76, 95 %CI: 0.61 to 0.95) and common cold (RR = 0.68, 95 %CI: 0.49 to 0.96)., Conclusions: Consumption of PFDP is a potential dietary approach for the prevention of RTIs.

This meta-analysis was performed to resolve the inconsistencies regarding resistin and follistatin levels in women with polycystic ovary syndrome (PCOS) by pooling the available evidence. A systematic literature search using PubMed and Scopus was carried out through November 2020 to obtain all pertinent studies. Weighted mean differences (WMDs) with corresponding 95% confidence intervals (CIs) were calculated to evaluate the strength of the association between the levels of resistin and follistatin with PCOS in the overall and stratified analysis by obesity status. A total of 47 publications, 38 for resistin (2424 cases; 1906 controls) and 9 studies for follistatin (815 cases; 328 controls), were included in the meta-analysis. Resistin levels were significantly higher in PCOS women compared with non-PCOS controls (WMD = 1.96 ng/ml; 95%CI = 1.25-2.67, P≤0.001) as well as in obese PCOS women vs. obese controls, and in non-obese PCOS women compared with non-obese controls, but not in obese PCOS vs. non-obese PCOS patients,. A significantly increased circulating follistatin was found in PCOS patients compared with the controls (WMD = 0.44 ng/ml; 95%CI = 0.30-0.58, P≤0.001) and in non-obese PCOS women compared with non-obese controls and in obese PCOS women vs. obese controls, but, no significant difference in follistatin level was observed in obese PCOS compared with non-obese PCOS women. Significant heterogeneity and publication bias was evident for some analyses. Circulating levels of resistin and follistatin, independent of obesity status, are higher in women with PCOS compared with controls, showing that these adipokines may contribute to the pathology of PCOS., Competing Interests: The authors have declared that no competing interests exist.

Background: The available evidence regarding the possible effects of resveratrol on liver function is inconsistent. Therefore, the present meta-analysis was performed to investigate the overall effects of resveratrol supplementation on liver enzymes in adults., Methods: A systematic and comprehensive search of the online medical databases including PubMed, Scupos, Web of Science and Cochran Library was performed up to February 2020. All RCTs using resveratrol supplements in adults were included in this systematic review and meta-analysis. The overall effect was presented as weighted mean difference (WMD) and 95% confidence interval (CI) in a random-effects meta-analysis model., Results: Finally, 15 randomised trials including 714 participants were selected for the present meta-analysis. Pooled analysis did not show any significant changes in alanine aminotransferase (ALT) (WMD: 0 IU/L, 95% CI: -3.17 to 3.17, P = .99; I 2 = 74.2%), aspartate aminotransferase (AST) (WMD: -2.40 IU/L, 95% CI: -5.45 to 0.65, P = .11; I 2 = 82.9%), gamma-glutamyl transferase (GGT) (WMD: -1.26 IU/L, 95% CI: -4.64 to 2.13, P = .64; I 2 = 23.7%), alkaline phosphatase (ALP) (WMD: 3.80 IU/L, 95% CI: -4.65 to 12.25, P = .37; I 2 = 29.9%) and bilirubin (WMD: 0.13 IU/L, 95% CI: -0.43 to 0.17, P = .39; I 2 = 8.9%) after supplementation with resveratrol., Conclusion: Overall, in our study, resveratrol does not affect liver enzyme levels significantly, but subgroup analysis indicates that these results may be influenced by resveratrol dose, duration of the study and population status, so future high-quality studies are necessary to get definitive results., (© 2020 John Wiley & Sons Ltd.)

Rheumatoid arthritis (RA) is a chronic inflammatory disease of the joints, which is prevalent in about 0.5-1.0% of the world population. Newer therapies for RA have only minimal efficacy in some cases and some adverse effects. Curcumin with anti-antioxidant, anti-inflammatory, and immunomodulatory properties might have beneficial effects on RA. We have carried out a systematic review with the main aim of estimating the effect of curcumin supplementation on RA. A systematic search of the medical databases, PubMed, Scopus, ISI, and Google Scholar was performed up to March 21, 2020 to identify clinical trials assessing the effect of turmeric or curcumin on RA. Six studies, comprising 259 patients with RA of 6-12 weeks duration, were included. Disease activity was assessed using 28 joints (DAS-28), visual analog scale (VAS), and American College of Rheumatology (ACR-20) scores. Treatment with curcumin significantly reduced DAS-28 scores in four out of five studies and VAS scores for pain in all three studies and significantly increased ACR-20 scores in all three studies in which it was measured. Erythrocyte sedimentation rate (ESR) and circulating C-reactive protein (CRP) were assessed in six and five studies, respectively, out of which four studies reported significant reductions in these parameters in response to curcumin treatment. Rheumatoid factor (RF) was significantly reduced after consumption of curcumin in all three relevant studies. None of the studies reported serious adverse effects with curcumin consumption. The present systematic review suggests that curcumin could be used as a safe agent to treat RA. Thus, further validation is justified., (© 2021. The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG.)

Gastrointestinal (GI) diseases are highly prevalent worldwide, with considerable morbidity and mortality. Curcumin has been used for many years as a plant-derived product for the management of various conditions such as abdominal pain and poor digestion. This systematic review was undertaken with the aim of investigating the effect of curcumin or turmeric supplementation on GI diseases. A comprehensive systematic search was conducted in PubMed, Scopus, Web of Science and Google Scholar up to March 2020 to identify clinical trials assessing the effect of curcumin/turmeric alone or in combination with other herbs or nutrients on GI diseases. Twenty-one studies comprising 1478 GI patients were included in the study. Four out of seven studies showed a beneficial effect of curcumin/turmeric supplementation on irritable bowel syndrome (IBS) and six out of seven showed positive effects of these herbs on ulcerative colitis. Two out of four studies highlighted the potential role of curcumin/turmeric in eradication of H. pylori infection. Both studies conducted on peptic ulcer disease and two out of four studies performed on Crohn's disease demonstrated positive effects of curcumin/turmeric supplementation. One study showed curcumin supplementation had no effect on familial adenomatous polyposis. However, in another study, curcumin had favorable effects on proctosigmoiditis. Nine studies reported some minor adverse effects. The results of this systematic review suggest a beneficial effect of curcumin/turmeric supplementation on the management of GI diseases. More randomized clinical controlled trials are needed to confirm these results., (© 2021. The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG.)

Pemphigus vulgaris (PV) is a chronic autoimmune disorder with potentially fatal outcomes. The aim of this study was to investigate the effect of l-carnitine (LC) on secreted frizzled-related protein-5 (SFRP5), omentin, visfatin, and glycemic indices in PV patients under corticosteroid treatment. In this randomized, double-blind, placebo-controlled clinical trial, 52 patients with PV were divided randomly into two groups to receive 2 g of LC or a placebo for 8 weeks. Serum levels of SFRP5, omentin, visfatin, and also glycemic indices were evaluated at the baseline and end of the study. LC supplementation significantly decreased the serum level of visfatin (95% CI [-14.718, -0.877], p = .05) and increased the serum levels of SFRP5 (95%CI [1.637, 11.380], p < .006) and omentin (95% CI [9.014, 65.286], p < .01). However, LC supplementation had no significant effects on the serum levels of glycemic factors such as insulin (95% CI [-1.125, 3.056], p = .426), fasting blood sugar (95% CI [-4.743, 3.642], p = .894), homeostatic model assessment of insulin resistance (95% CI [-0.305, 0.528], p = .729), and quantitative insulin-sensitivity check index (95% CI [-0.016, -0.010], p = .81). LC supplementation decreased visfatin serum level and increased omentin-1 and SFRP5 serum levels in patients with PV. However, it has no significant effect on the serum levels of insulin and glycemic indices., (© 2019 John Wiley & Sons, Ltd.)