Search

Background: Considering the increasing prevalence of obesity/overweight, its treatment or prevention with new interventions can greatly help health and reduce its adverse effects in people. One of these new interventions is investigating the effect of Survodutide as a dual agonist of glucagon and GLP-1 receptors, which seems to be able to influence weight loss processes in different ways. In this study, we investigated the effect of injectable Survodutide on weight loss., Methods: In order to identify all randomized controlled trials that investigated the effects of Survodutide on factores related to obesity, a systematic search was conducted in the original databases using predefined keywords until August 2024. The pooled weighted mean difference and 95% confidence intervals were computed using the random-effects model., Results: The Findings from 18 treatment arms with 1029 participants indicated significant reductions in weight (WMD: -8.33 kg; 95% CI: -10.80, -5.86; I 2  = 99.6%), body mass index (BMI) (WMD:-4.03 kg/m 2 ; 95% CI: -4.86, -3.20; I2 = 72.7%), and waist circumferences (WC) (WMD: -6.33 cm; 95% CI: -8.85 to -3.81; I 2  = 99.5%) following the Survodutide injection compared to the control group. Subgroup analysis reveals that longer interventions (more than 16 weeks) and higher doses (more than 2 mg/week) of Survodutide are associated with more significant reductions in weight and WC. These results were also observed in the meta-regression analysis., Conclusions: The results of this meta-analysis show that Survodutide is effective in reducing weight, BMI and waist circumference, especially with longer interventions and higher doses., (© 2024. The Author(s).)

Background: Although some evidence shows the beneficial effects of meal replacements (MRs) on dyslipidaemias, it is not completely clear. Therefore, we investigate the possible effects of total and partial MRs on lipid profiles., Methods: For this systematic review and meta-analysis, we searched MEDLINE, Web of Science, SCOPUS, and Embase. We included randomized controlled trials (RCTs) that evaluated the effect of MRs on lipid profiles. A random-effects meta-analysis model was used to combine studies and calculate weighted mean difference and 95% confidence intervals (95% CI). Subgroup analysis was realized using intervention type, duration and average participant age., Results: Fifty-one studies were included. The pooled findings showed that total and partial MRs significantly reduced triglycerides (TG) (WMD: -12.20mg/dl, 95% CI -17.46 to -6.93) and increased high-density lipoprotein (HDL) (WMD: 1.06mg/dl, 95% CI 0.35 to 1.77) compared to controls. However, total cholesterol (TC) (WMD: -1.40mg/dl, 95% CI: -3.90 to 1.10) and low-density lipoprotein (LDL) (WMD: -0.85mg/dl, 95% CI: -3.05 to 1.35) were not significant. In addition, the subgroup analysis shows a greater effect on TG reduction and HDL increase in the type of intervention with total MRs compared to partial MRs and during the intervention >24 weeks compared to ≤24 weeks., Conclusions: MRs lead to significant improvements in TG and HDL levels. These results may help strengthen programs for dyslipidaemias prevention/management., Competing Interests: Conflict of interest No financial or non-financial benefits have been received or will be received from any party related directly or indirectly to the subject of this article., (Copyright © 2024. Published by Elsevier Inc.)

The global prevalence of obesity and overweight is a significant concern in the field of public health. Numerous interventional studies have been conducted to assess the possible meal replacements (MRs) effect on anthropometric indicators and indices and laboratory test that reflect obesity. However, there are no comprehensive results in this field. The study aim was to understand the possible effects of MRs on body weight, body mass index (BMI), fat mass, waist circumferences (WC), and leptin levels. A systematic search was conducted in five electronic databases in order to find randomized clinical trials (RCTs) that examined the possible MRs effect on obesity. Analyses were performed in R software, version 4.2.1. The random-effects model analysis was used to provide pooled mean difference and 95% confidence intervals (95% CI). Seventy studies were included. Body weight (WMD: -3.35 kg, 95% CI: -4.28 to -2.42), BMI (WMD: -1.12 kg/m2, 95% CI: -1.51 to -0.72), fat mass (WMD: -2.77 kg, 95% CI: -3.59 to -1.6), WC (WMD: -2.82 cm, 95% CI: -3.51 to -2.12) were significantly reduced after MRs compared to control. No significant effect was observed on leptin (WMD: -3.37 ng/ml, 95% CI: -8.23 to 1.49). Subgroup analyses indicated that impact of total MRs on anthropometric factors was greater in comparison to partial MRs. Considering other lifestyle factors, MRs can lead to anthropometric indicators and indices reduction., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Considering the impact of adipokines on metabolic syndrome-related disorders and even chronic illnesses, it would appear vital to look for efficient treatments for these variables. The goal of this study was to thoroughly examine how the ketogenic diet (KD) affects adipokines., Methods: Using standard keywords, the databases Scopus, PubMed/Medline, Web of Science, Cochrane, and Embase were searched to find all controlled trials looking into how KD affected adipokines (leptin, adiponectin, and ghrelin). By using a random-effects model analysis, pooled weighted mean difference and 95% confidence intervals were obtained., Results: This article featured twenty-two studies. The combined results demonstrated that, as compared to the control group, leptin levels in all populations are significantly lower when KD is adhered to (WMD: - 0.14 ng/ml, 95% CI: - 8.66, - 3.61, P < 0.001). On the other hand, no discernible impact of this diet on ghrelin and adiponectin concentrations was noted. The subgroup analysis results demonstrated that the drop in leptin levels was considerably higher in persons with BMI > 30 kg/m 2 and in trials that followed the KD for ≤ 8 weeks than in the other groups., Conclusions: Generally speaking, this diet can be utilized as a potentially helpful supplementary therapy to improve this adipokine, given the significance that leptin plays on numerous metabolic illnesses., (© 2024. Springer-Verlag Italia S.r.l., part of Springer Nature.)

A gluten-free diet (GFD) may have a stronger potential impact on reducing cardiovascular (CV) risk factors, according to research evidence. We investigated the impact of GFD on CV risk variables by doing a systematic review and meta-analysis for this reason. We conducted a thorough database search starting on January 1, 2000, and ending on July 12, 2022. We used random-effects models to pool the data. Totally 19 articles met the eligible criteria and were included. Pooled findings indicated that intervention with GFD has a significantly beneficial effect on high-density lipoprotein (HDL) (WMD: 4.80 mg/dl, 95% CI: 2.09, 7.51, P = 0.001), systolic blood pressure (SBP) (WMD: -2.96 mmHg; 95% CI: -4.11, -1.81, P < 0.001), and C-reactive protein (CRP) (WMD: -0.40, mg/l, 95% CI: -0.67, -0.14, P = 0.002) levels. In celiac patients as well as with an intervention duration of more than 48 weeks, GFD increased TC and HDL compared to non-celiac patients and with an intervention duration lower than 48 weeks, respectively. The results of the present study showed that GFD can have a significant and beneficial effect on HDL, SBP, and CRP., Competing Interests: No financial or non-financial benefits have been received or will be received from any party related directly or indirectly to the subject of this article., (© The Author(s) 2024.)

Introduction: Recent advances in generative Artificial Intelligence (AI) and Natural Language Processing (NLP) have led to the development of Large Language Models (LLMs) and AI-powered chatbots like ChatGPT, which have numerous practical applications. Notably, these models assist programmers with coding queries, debugging, solution suggestions, and providing guidance on software development tasks. Despite known issues with the accuracy of ChatGPT's responses, its comprehensive and articulate language continues to attract frequent use. This indicates potential for ChatGPT to support educators and serve as a virtual tutor for students., Methods: To explore this potential, we conducted a comprehensive analysis comparing the emotional content in responses from ChatGPT and human answers to 2000 questions sourced from Stack Overflow (SO). The emotional aspects of the answers were examined to understand how the emotional tone of AI responses compares to that of human responses., Results: Our analysis revealed that ChatGPT's answers are generally more positive compared to human responses. In contrast, human answers often exhibit emotions such as anger and disgust. Significant differences were observed in emotional expressions between ChatGPT and human responses, particularly in the emotions of anger, disgust, and joy. Human responses displayed a broader emotional spectrum compared to ChatGPT, suggesting greater emotional variability among humans., Discussion: The findings highlight a distinct emotional divergence between ChatGPT and human responses, with ChatGPT exhibiting a more uniformly positive tone and humans displaying a wider range of emotions. This variance underscores the need for further research into the role of emotional content in AI and human interactions, particularly in educational contexts where emotional nuances can impact learning and communication., 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 © 2024 Fatahi, Vassileva and Roy.)

Background: There are conflicting findings regarding the effect of low-carbohydrate diets on obesity-related factors. This study aimed to investigate the effect of a carbohydrate-restricted (CR) diet on changes in anthropometric indicators of adiposity and fat distribution in pediatrics populations., Methods: A systematic search was conducted in PubMed/MEDLINE, Web of Science, Scopus, and Embase electronic databases using predefined keywords to identify all randomized controlled trials examining the effects of CR on obesity-related factors. The pooled weighted mean difference (WMD) and 95% confidence intervals (CI) were calculated using a random-effects model., Results: Findings from 11 studies demonstrated significant reductions in weight (WMD: -2.31 kg; 95% CI: -4.44, -0.18), BMI (WMD:-1.08 kg/m 2 ; 95% CI: -1.91, -0.26), and fat mass (WMD: -1.43%; 95% CI: -2.43 to -0.43) as well as a significant increase in adiponectin levels (WMD: 0.74 ng/ml; 95% CI: 0.02, 1.47) in the CR diet group compared to the control group. However, no significant effect was observed on BMI z-score (WMD:-0.10; 95% CI: -0.21, 0.01), waist circumference (WMD:-3.03 cm; 95% CI: -6.57, 0.51) or leptin levels (WMD: -0.82 ng/ml; 95% CI: -2.26, 0.61). Stratified analysis rrevealed a greater effect of CR on weight and BMI reduction in interventions ≤ 12 weeks and in very low-carbohydrate diets., Conclusions: In conclusion, it appears that CR diet, along with other lifestyle factors, can lead to significant improvements in weight loss on pediatrics with obesity/overweight., (© 2024. The Author(s).)

Generative AI models, such as ChatGPT, have significantly impacted healthcare through the strategic use of prompts to enhance precision, relevance, and ethical standards. This perspective explores the application of prompt engineering to tailor outputs specifically for healthcare stakeholders: patients, providers, policymakers, and researchers. A nine-stage process for prompt engineering in healthcare is proposed, encompassing identifying applications, understanding stakeholder needs, designing tailored prompts, iterative testing and refinement, ethical considerations, collaborative feedback, documentation, training, and continuous updates. A literature review focused on "Generative AI" or "ChatGPT," prompts, and healthcare informed this study, identifying key prompts through qualitative analysis and expert input. This systematic approach ensures that AI-generated prompts align with stakeholder requirements, offering valuable insights into symptoms, treatments, and prevention, thereby supporting informed decision-making among patients.

Introduction and Importance: Diabetic foot ulcers are a prevalent and challenging issue among diabetes patients, frequently leading to notable health concerns and reduced quality of life. Effectively addressing diabetic foot ulcers necessitates a comprehensive treatment strategy., Case Presentation: The 69-year-old patient with Type 2 diabetes, complicated by illiteracy and poor glycemic control, developed a foot wound that escalated to cellulitis and abscess due to diabetes and peripheral vascular disease. After angioplasty and midfoot amputation, treatment focused on wound healing with antibiotics, local anesthesia, larval therapy, vacuum-assisted closure (VAC), platelet-rich plasma (PRP) injections, and specialized dressings. A multidisciplinary team approach facilitated successful wound healing and functional improvement, highlighting the importance of comprehensive care and innovative treatments in complex diabetic foot ulcers., Discussion: Diabetic foot ulcers, a frequent complication of diabetes, present notable hurdles in treatment and care. Comprehensive strategies are typically essential for managing these ulcers efficiently and averting additional issues. Recently, there has been increasing attention towards employing various dressing techniques, maggot therapy, and vacuum therapy as integral components of a holistic diabetic foot ulcer treatment approach., Conclusion: Employing a comprehensive method involving various dressing techniques, maggot therapy, and vacuum therapy for diabetic foot ulcers can significantly boost wound healing, curb infections, and lower the chances of additional complications., Competing Interests: Conflict of interest statement None., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Overall, there is conflicting evidence regarding the beneficial effects of optimal lifestyle modification, particularly weight loss interventions, with nonalcoholic fatty liver disease (non-alcoholic fatty liver disease (NAFLD)). Therefore, this study investigated the effects of weight loss interventions on laboratory and clinical parameters in children and adolescents with NAFLD., Methods: Original databases (PubMed/MEDLINE, Web of Science, SCOPUS, and Embase) were searched using standard keywords to identify all controlled trials investigating the effects of weight loss interventions among NAFLD children and adolescents. Pooled weighted mean difference and 95% confidence intervals were achieved by random-effects model analysis., Results: Eighteen eligible clinical trials were included in this systematic review and meta-analysis. The pooled findings showed that especially more intense weight loss interventions significantly reduced the glucose ( p  = 0.007), insulin ( p  = 0.002), homeostatic model assessment-insulin resistance (HOMA-IR) ( p  = 0.003), weight ( p  = 0.025), body mass index (BMI) ( p  = 0.003), BMI z -score ( p  < 0.001), waist circumference (WC) ( p  = 0.013), triglyceride (TG) ( p  = 0.001), and aspartate transaminase (AST) ( p  = 0.027). However, no significant changes were found in total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), alanine transaminase (ALT), and hepatic steatosis grades (all p  > 0.05) following weight loss interventions., Conclusions: Weight loss interventions had significant effects on NAFLD-related parameters including glucose, insulin, HOMA-IR, weight, BMI, BMI z-score, WC, TG, and AST., Competing Interests: The authors declare that they have no competing interests., (© 2024 The Authors. Obesity Science & Practice published by World Obesity and The Obesity Society and John Wiley & Sons Ltd.)

Background: Bronchopulmonary Dysplasia (BPD) has a multifactorial etiology. Vitamin E and vitamin D play an important role in lung development and can potentially be beneficial in the prevention of BPD., Objective: The study aimed to compare the risk of BPD occurrence in preterm neonates supplemented with vitamin D or E versus those who did not get supplementation., Methods: The literature search was conducted for this systematic review by searching the PubMed, Scopus, and Web of Science databases up to December 2022. Randomized controlled trials involved administering vitamin D or E to preterm neonates and examining the occurrence of BPD. We excluded non-English articles, and articles with non-relevant and insufficient data. We used the Critical Appraisal Skills Programme (CASP) checklist to assess the quality of the included studies. We used Egger's test to evaluate the risk of bias among the included studies. Heterogeneity was also assessed through Q-test and I2. We applied the random effect model for analysis. A P-value less than 0.05 was considered as significant. All the statistical analysis in the current study was performed using STATA 14. The Relative Risk (RR) was calculated as the effect size with 95% Confidence Interval (CI)., Results: Three eligible studies seeking the role of vitamin D in the prevention of BPD were analysed. Meta-analysis revealed that receiving vitamin D supplementation can significantly reduce the risk of BPD in preterm infants (RR = 0.357, 95% CI: 0.189-0.675, I2 = 0.0%; p = 0.002). Similarly, for assessing the role of Vitamin E in the prevention of BPD, three eligible studies were analysed. Vitamin E supplementation was not found to play a significant role in the reduction of BPD (RR = 0.659, 95%CI = 0.243-1.786, I2 = 38.7%; p = 0.412)., Conclusion: Vitamin D supplementation could be beneficial in preventing BPD in preterm infants. However, evidence is not enough regarding vitamin E's role in reducing the incidence of BPD in preterm infants., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Background: Considering the conflicting effects of bupropion on parameters related to cardiovascular system including blood pressure and inflammation, in this meta-analysis study, we investigated the effects of this drug alone or in combination with naltrexone on systolic (SBP) and diastolic blood pressure (DBP) and C-reactive protein (CRP)., Methods: Scopus, PubMed/Medline, Web of Science and Embase databases were searched using standard keywords to identify all controlled trials investigating effects of bupropion alone and combined with naltrexone on the BP and CRP. Pooled weighted mean difference and 95% confidence intervals (CIs) were achieved by random-effects model analysis for the best estimation of outcomes., Results: The pooled findings showed that that bupropion alone or in combination with naltrexone would significantly increase SBP (weighted mean difference (WMD): 1.34 mmHg, 95% CI: 0.38-2.29) and DBP (WMD: 0.93 mmHg, 95% CI 0.88-0.99) as well as decrease CRP (WMD: -0.89 mg/L, 95% CI -1.09 to -0.70). The findings of the subgroup also show the greater effect of bupropion on blood pressure (SBP and DBP) increase in a dose greater than 360 mg and a duration of intervention less equal to 26 weeks. In addition, the subgroup analysis showed that changes in SBP after receiving bupropion together with naltrexone were more compared to bupropion alone., Conclusions: The addition of combination therapies such as bupropion and naltrexone can significantly improve CRP levels. However, its effect on blood pressure requires proper management of this drug., (© 2023 Stichting European Society for Clinical Investigation Journal Foundation. Published by John Wiley & Sons Ltd.)

Aim: Vitamin D is a prominent modulator of immunity and respiratory function. It plays a vital role in respiratory diseases such as cystic fibrosis (CF). S. However, there is a dearth of information on patients with CF. The purpose of the meta-analysis is to highlight the importance of following the existing guidelines regarding maintenance of Vitamin D serum levels in patients with CF., Methods: The systematic search was conducted without utilizing any time or language limitations in original database from the beginning until March 2022. The meta-analysis was performed using a random-effects model. Heterogeneity was determined by I 2 statistics and Cochrane Q test., Results: Pooled analysis using the random-effects model of the 8 case-control studies with 13 effect sizes revealed that the serum 25-OH-vitamin D in participants with cystic fibrosis was significantly lower than controls in pediatrics and adolescences (WMD: - 3.41 ng/ml, 95% CI - 5.02, - 1.80, p =  < 0.001) and adults (WMD: - 2.60 ng/ml, 95% CI - 4.32, - 0.89, p = 0.003). Based on data from 12 studies (21 effect sizes) with a total of 1622 participants, the prevalence of vitamin D levels of 20-30 ng/ml in CF patients was 36% among pediatrics/adolescents and 63% among adults. In addition, 27% of pediatric/adolescent CF patients and 35% of adult CF patients had vitamin D levels of below 20 ng/ml., Conclusions: As a result, according to the existing guidelines, our results proved the need to pay attention to the level of vitamin D in these patients., (© 2024. The Author(s).)

Context: Despite the important role of inflammation-related factors on the occurrence of chronic diseases, there is still conflicting evidence about the effects of the ketogenic diet (KD) on these factors., Objective: In order to obtain a better viewpoint, this study aimed to comprehensively investigate the effects of a KD on inflammation-related markers., Data Sources: To find pertinent randomized controlled trials up to August 2023, databases including PubMed/Medline, Web of Science, Scopus, Cochrane Library, and Embase were searched., Data Extraction: This study included all randomized controlled trials investigating the effects of a KD on C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-α), interleukin (IL)-6, IL-8, and IL-10 levels. Pooled weighted mean difference (WMD) and 95% confidence intervals (CIs) were achieved by random-effects model analysis for the best estimation of outcomes., Data Analysis: Forty-four studies were included in this article. The pooled findings showed that a KD has an effect on lowering TNF-α (WMD: -0.32 pg/mL; 95% CI: -0.55, -0.09; P = 0.007) and IL-6 (WMD: -0.27 pg/mL; 95% CI: -0.52, -0.02; P = 0.036) compared with control groups. However, no significant effect was reported for others inflammation marker-related levels. The results of the subgroup analysis showed that, in trials following the KD for ≤8 weeks and in people aged ≤50 years, the reduction in TNF-α levels was significantly higher than in other groups. In addition, in people with a body mass index greater than 30 kg/m2 compared to a body mass index ≤30 kg/m2, IL-6 levels decreased to a greater extent after receiving the KD., Conclusions: Consequently, adherence to a KD appears to improve some markers associated with inflammation, including TNF-α and IL-6., (© The Author(s) 2024. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Objectives: Functional retentive overflow incontinence (retentive FI) is the most common cause of fecal soiling in children. Based on the clinical experiences, the treatment of retentive FI in patients with comorbid psychiatric disorders was accelerated when Risperidone was used as treatment for their psychiatric comorbidities; therefore, this study was conducted to evaluate the effect of risperidone in the treatment of retentive FI in children and adolescents., Methods: In this double-blind, randomized, placebo-controlled trial, 140 patients aged 4-16 years eligible for the study were randomized into two groups, receiving either 0.25-0.5 mg of Risperidone syrup (n = 70) or maltodextrin syrup (placebo group, n = 70) every 12 h daily for 12 weeks. Sociodemographic data, including age, sex, weight, height, BMI, BMI z-score, and socioeconomic status, was recorded, and the number of nocturnal FI, diurnal FI, and painful defecations was measured., Results: 136 participants (69 on Risperidone and 67 on placebo) were included in the study. Mean age of participants in the intervention and placebo groups were 7.2 ± 2.4 years and 8.0 ± 3.1 years, respectively. The mean number of nocturnal FI (P trend =0.39) and diurnal FI (P trend =0.48) in patients without psychiatric comorbidities, and the number of painful defecations for participants with and without psychiatric comorbidities (P = 0.49, P = 0.47, respectively) were not significantly different between the groups, but a significant effect was observed in diurnal FI after Risperidone treatment in patients with psychiatric comorbidities (P < 0.001)., Conclusion: Risperidone, when used along with other non-pharmacological interventions, may be helpful in treating FI in pediatric patients with psychiatric comorbidities., (© 2023. The Author(s).)

Background: Considering the role of adipokine on diseases related to metabolic syndrome and even chronic diseases, it seems necessary to investigate effective interventions on these factors. This study aimed to comprehensively investigate the effects of metformin on adipokines., Methods: A comprehensive search was conducted in five databases using established keywords. The purpose of this search was to uncover controlled studies that have examined the impact of metformin on adipokines, specifically leptin, adiponectin, and resistin. The random-effects model analysis was used to provide pooled weighted mean difference and 95% confidence intervals., Results: Forty-nine studies were included in this article. The pooled findings showed that that the administration of metformin significantly decreases leptin (WMD: -3.06 ng/ml, 95 % CI: -3.81, -2.30, P < 0.001) and resistin (WMD: -1.27 µg/mL, 95 % CI: -2.22, -0.31, P = 0.009) levels in different populations compared to the control group. However, no significant effect of this antidiabetic drug on adiponectin levels was reported. The results obtained from the subgroup results in the present study also showed that metformin in people with a BMI greater than 30 kg/m 2 compared to a BMI ≤ 30 kg/m 2 causes a significant decrease in leptin levels and an increase in adiponectin levels. Also, metformin in lower doses (≤1500 mg/day) and younger people (<30 years) causes a significant increase in adiponectin levels., Conclusions: In general, considering the role of adipokines on metabolic disease and even chronic disease, this drug can be used as a potentially useful drug, especially in obese people, to improve these factors., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Background: There are contradictory effects regarding the effect of NAD+ precursor on blood pressure and inflammation. In order to obtain a better viewpoint from them, this study aimed to comprehensively investigate the effects of NAD+ precursor supplementation on blood pressure, C-reactive protein (CRP) and carotid intima-media thickness (CIMT)., Methods: PubMed/MEDLINE, Web of Science, SCOPUS and Embase databases were searched using standard keywords to identify all controlled trials investigating the effects of NAD+ precursor on blood pressure, CRP and CIMT. Pooled weighted mean difference (WMD) and 95% confidence intervals (95% CI) were achieved by random-effects model analysis for the best estimation of outcomes., Results: Twenty-nine articles (with 8664 participants) were included in this article. Results from meta-analyses of RCTs from random-effects models indicated a significant reduction in systolic (SBP) (weighted mean difference (WMD): -2.54 mmHg, p < .001) and diastolic blood pressure (DBP) (WMD: -2.15 mmHg, p < .001), as well as in CRP (WMD: -.93 mg/L, 95% CI -1.47 to -.40, p < .001) concentrations and CIMT (WMD: -.01 mm, 95% CI -.02 to -.00, p = .005) with the NAD+ precursors supplementation compared with the control group. In addition, a greater effect of supplementation with NAD+ precursors in reducing blood pressure (BP) were observed with the highest dose (≥2 g) and duration of the intervention (>12 weeks), as well as with NA supplementation when compared to NE., Conclusions: Overall, these findings suggest that NAD+ precursor supplementation might have a beneficial effect on cardiovascular risk factors such as BP, CRP concentration and CIMT., (© 2023 Stichting European Society for Clinical Investigation Journal Foundation. Published by John Wiley & Sons Ltd.)

Background: To improve knowledge on endoscopic retrograde cholangiopancreatography (ERCP) in children, we aimed to study the proportion of indications, success rate and complication of ERCP., Methods: We performed a systematic search of all articles published up to December 2022 in the following databases: Cochrane Library, PubMed (MEDLINE) and Scopus. The meta-analysis was performed using a random-effects model. Heterogeneity was determined by the I 2 statistics and the Cochrane Q test. The included data were analyzed to identify the proportion of indications, success rate and complications of ERCP in children., Results: Based on data from 52 studies with a total of 5624 participants, the most common indications for ERCP in children were biliary [48% (95% CI: 0.40 - 0.57; I 2 = 98.17%, P < 0.001)] and both biliary and pancreatic [41% (95% CI: 0.33 - 0.49; I 2 = 98.27%, P < 0.001)]. The success rate of ERCP was 95% (95% CI: 0.94 - 0.96; I 2 = 82.53%, P < 0.001) with the overall complication rate of 7% (95% CI: 0.05 - 0.09; I 2 = 82.06%, P < 0.001). The pooled estimate for the incidence of post ERCP pancreatitis was 4% (95% CI: 0.03 - 0.06; I 2 = 85.46%, P < 0.001) and the bleeding was 0% (95% CI: 0.0 - 0.0; I 2 = 28.21%, P = 0.03)., Conclusions: ERCP appears to be performed safely in children with a similar success rate as in the adult population., (© 2023. The Author(s).)

Coenzyme Q10 is a potent antioxidant and is necessary for energy production in mitochondria. Clinical data have suggested that coenzyme Q10 (CoQ10) has some beneficial effects on liver function. However, these results are equivocal. This systematic review and meta-analysis aimed to clarify the effect of coenzyme Q10 supplementation on the serum concentration of liver function enzymes. We searched the online databases using relevant keywords up to April 2022. Randomized clinical trials (RCTs) investigating the effect of CoQ10, compared with a control group, on serum concentrations of liver enzymes were included. We found a significant reduction following supplementation with CoQ10 on serum concentrations of alanine aminotransferase (ALT) based on 15 effect sizes from 13 RCTs (weighted mean difference [WMD] = -5.33 IU/L; 95% CI: -10.63, -0.03; p  = .04), aspartate aminotransferase (AST) based on 15 effect sizes from 13 RCTs (WMD = -4.91 IU/L; 95% CI: -9.35, -0.47; p  = .03) and gamma-glutamyl transferase (GGT) based on eight effect sizes from six RCTs (WMD = -8.07 IU/L; 95% CI: -12.82, -3.32; p  = .001; I 2  = 91.6%). However, we found no significant effects of CoQ10 supplementation on alkaline phosphatase concentration (WMD = 1.10 IU/L; 95% CI: -5.98, 8.18; p  = .76). CoQ10 supplementation significantly improves circulating ALT, AST, and GGT levels; therefore, it might positively affect liver function. Further high-quality RCTs with more extended intervention periods and larger sample sizes are recommended to confirm our results., Competing Interests: Authors declared no personal or financial conflicts of interest., (© 2023 The Authors. Food Science & Nutrition published by Wiley Periodicals LLC.)

Background: Evidence from clinical trial studies suggests that docosahexaenoic acids (DHA) may have greater potential effects on improving cardiovascular risk factors than eicosapentaenoic acid (EPA). However, this evidence has not yet been meta-analyzed and quantified. The aim of this study was to evaluate and compare the effect of DHA and EPA monotherapy on cardiovascular risk factors based on paired and network meta-analysis., Methods: Relevant articles published up to January 2022 were systematically retrieved from relevant databases. We included all Randomized Controlled Trials (RCTs) on adults that directly compared the effects of DHA with EPA and RCTs of indirect comparisons (DHA and EPA monotherapy compared to control groups). Data were pooled by pairwise and network meta-analysis and expressed as mean differences (MDs) with 95% CIs. The study protocol was registered with PROSPERO (Registration ID: CRD42022328630)., Results: Network meta-analysis of comparisons of DHA and EPA suggested significant comparable effects only on LDL-C (MD EPA versus DHA = -8.51 mg/L; 95% CI: -16.67; -0.35). However, the Network meta-analysis not show a significant effect for other risk factors. Furthermore, pairwise meta-analysis of direct comparisons of DHA and EPA showed significant difference in their effects on plasma glucose (MD EPA versus DHA  = -0.31 mg/L; 95% CI: -0.60, -0.02), Insulin (MD EPA versus DHA  = -2.14 mg/L; 95% CI: -3.26, -1.02), but the results were not significant for risk factors., Conclusion: Our findings suggest that both EPA and DHA act similarly on the markers under study, with slight changes in plasma glucose, insulin, and LDL-C., Competing Interests: Declaration of competing interest We, the authors, declare that we had no competing interests., (Copyright © 2022 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.)

Purpose: The present study was conducted to determine the effect of motion-graphic video-based training on the performance of operating room nurse students in cataract surgery using phacoemulsification at Kermanshah University of Medical Sciences in Iran., Methods: This was a randomized controlled study conducted among 36 students training to become operating room nurses. The control group only received routine training, and the intervention group received motion-graphic video-based training on the scrub nurse’s performance in cataract surgery in addition to the educator’s training. The performance of the students in both groups as scrub nurses was measured through a researcher-made checklist in a pre-test and a post-test., Results: The mean scores for performance in the pre-test and post-test were 17.83 and 26.44 in the control group and 18.33 and 50.94 in the intervention group, respectively, and a significant difference was identified between the mean scores of the pre- and post-test in both groups (P=0.001). The intervention also led to a significant increase in the mean performance score in the intervention group compared to the control group (P=0.001)., Conclusion: Considering the significant difference in the performance score of the intervention group compared to the control group, motion-graphic video-based training had a positive effect on the performance of operating room nurse students, and such training can be used to improve clinical training.

Objective: The current study aimed to comprehensively evaluate the potential effects of mulberry consumption on cardiometabolic risk factors in adults., Methods: Relevant articles published up to January 2021 were systematically retrieved from SCOPUS, PubMed/MEDLINE, EMBASE, and Web of Science databases. We included all randomized controlled trials (RCTs) investigating the impact of mulberry consumption on various cardiometabolic risk factors., Results: The quantitative meta-analysis of 12 eligible RCTs demonstrated a significant reducing effect of mulberry consumption on haemoglobin A1c (HbA1c) (weighted mean difference [WMD]: -0. 55, 95% CI: -1.08, -0.02, p = 0.044), serum total cholesterol (TC) (WMD: -13.13 mg/dl, 95% CI: -19.06, -7.20, p < 0.001), low-density lipoprotein levels (LDL-C) (WMD: -8.84 mg/dl, 95% CI: -13.26, -4.42, p < 0.001), triglycerides (TG) (WMD: -19.67 mg/dl, 95% CI: -30.13, -9.22, p < 0.001) and C-reactive protein (CRP) (WMD: -1.60, mg/L, 95% CI: -3.07, -0.12, p = 0.034). Also, >300 mg daily intake of mulberry exhibited a favourable effect on serum high-density lipoprotein levels (HDL-C). However, there were no significant differences between mulberry intervention and control groups for other factors., Conclusion: The current systematic review and meta-analysis revealed that incorporating mulberry into the diet may favourably affect several cardiometabolic risk factors., (© 2022 John Wiley & Sons Ltd.)

Conflicting findings have been reported regarding the effects of almond consumption on inflammatory markers. This study aimed to summarize the current literature to determine whether almonds can affect inflammatory markers. A systematic search was carried out in PubMed, Scopus, and ISI Web of Science up to March 2021. Randomized clinical trials that compared almond with no almond consumption were included. The outcomes of interest were changes in circulating C-reactive protein (CRP), IL-6, TNF-α, intercellular adhesion molecule-1 (ICAM-1), and vascular cell adhesion molecule-1 (VCAM-1) concentrations. The random-effects model was used to find the mean differences. In total, 18 trials with 847 participants were eligible for the current analysis. Participants' ages ranged from 26.3 to 69.6 y. Combining 16 studies, almond consumption significantly reduced serum concentrations of CRP [weighted mean difference (WMD): -0.25 mg/L; 95% CI: -0.43, -0.06 mg/L; I2 = 0.0%; P-heterogeneity = 0.633]. However, the beneficial effect of almond intake only occurred at doses <60 g/d. Pooling 11 effect sizes, almond interventions significantly decreased circulating IL-6 concentrations (WMD: -0.11 pg/mL; 95% CI: -0.21, -0.01 pg/mL; I2 = 19.9%; P-heterogeneity = 0.254). In subgroup analyses, effects on CRP and IL-6 were nonsignificant in unhealthy participants or those with obesity. In addition, almond consumption had no significant effect on TNF-α (WMD: -0.05 pg/mL; 95% CI: -0.11, 0.01 pg/mL; I2 = 0.0%; P-heterogeneity = 0.893; n = 6), ICAM-1 (WMD: 6.39 ng/mL; 95% CI: -9.44, 22.22 ng/mL; I2 = 66.6%; P-heterogeneity = 0.006; n = 7), or VCAM-1 (WMD: -8.31 ng/mL; 95% CI: -35.32, 18.71 ng/mL; I2 = 58.8%; P-heterogeneity = 0.033; n = 6). In conclusion, almond consumption beneficially affects CRP and IL-6 concentrations in adults. However, it has no beneficial effect on TNF-α, ICAM-1, or VCAM-1. More trials are needed to determine the effects of almonds on inflammation., (© The Author(s) 2021. Published by Oxford University Press on behalf of the American Society for Nutrition.)

Background: Chitosan is one of dietary fiber that has received great attention in improving obesity-related markers, but little is known on its effects on adolescents., Objectives: To analyze the effects of chitosan supplementation on obesity-related cardiometabolic markers and appetite-related hormones in adolescents with overweight or obesity., Methods and Analysis: A randomized clinical trial was performed on 64 adolescents with overweight and obesity, who were randomly allocated to receive chitosan supplementation (n = 32) or placebo as control (n = 32) for 12 weeks. Anthropometric measures, lipid and glycemic profiles, and appetite-related hormones were examined., Results: Sixty-one participants completed study (chitosan = 31, placebo = 30). Chitosan supplementation significantly improved anthropometric indicators of obesity (body weight: - 3.58 ± 2.17 kg, waist circumference: - 5.00 ± 3.11 cm, and body mass index: - 1.61 ± 0.99 kg/m 2 and - 0.28 ± 0.19 Z-score), lipid (triglycerides: - 5.67 ± 9.24, total cholesterol: - 14.12 ± 13.34, LDL-C: - 7.18 ± 10.16, and HDL-C: 1.83 ± 4.64 mg/dL) and glycemic markers (insulin: - 5.51 ± 7.52 μIU/mL, fasting blood glucose: - 5.77 ± 6.93 mg/dL, and homeostasis model assessment of insulin resistance: - 0.24 ± 0.44), and appetite-related hormones (adiponectin: 1.69 ± 2.13 ng/dL, leptin - 19.40 ± 16.89, and neuropeptide Y: - 41.96 ± 79.34 ng/dL). When compared with the placebo group, chitosan supplementation had greater improvement in body weight, body mass index (kg/m 2 and Z-score), waist circumference, as well as insulin, adiponectin, and leptin levels. Differences were significant according to P-value < 0.05., Conclusion: Chitosan supplementation can improve cardiometabolic parameters (anthropometric indicators of obesity and lipid and glycemic markers) and appetite-related hormones (adiponectin, leptin, and NPY) in adolescents with overweight or obesity., (© 2022. The Author(s).)

Aims: Although some evidence suggests that omega-3 polyunsaturated fatty acids (PUFAs) supplementation influences enzymes involved in forming homocysteine (Hcy) and improving hyperhomocysteinemia, these findings are still contradictory in humans. The aim of this systematic and meta-analysis study was to investigate the effects of omega-3 supplementation on Hcy using existing randomized controlled trials (RCTs)., Data Synthesis: Available databases, including PubMed/MEDLINE, Web of Science, Scopus, Cochrane Library, and Embase, were searched to find relevant RCTs up to June 2021. The effect size was expressed as weighted mean difference (WMD) and 95% confidence interval (CI)., Conclusion: A total of 20 RCT studies with 2676 participants were included in this article. Our analyses have shown that omega-3 supplementation significantly reduced plasma Hcy levels (WMD: 1.34 μmol/L; 95% CI: 1.97 to -0.72; P < 0.001) compared to the control group. The results of subgroup analysis showed that omega-3 supplementation during the intervention <12 weeks and with a dose ≥3 gr per day causes a more significant decrease in Hcy levels than the intervention ≥12 weeks and at a dose <3 gr. In addition, omega-3 supplements appear to have more beneficial effects in individuals with high levels of normal Hcy. This meta-analysis showed that omega-3 supplementation significantly improved Hcy. However, further studies are needed to confirm the findings., (Copyright © 2022 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.)

Objectives: Despite the widespread use of complementary and alternative medicine by patients and physicians alike, there is no accurate evidence regarding the effects of vitamin D supplementation on treatment-induced pain in cancer patients. Thus, the aim of this systematic review of randomized controlled trials (RCTs) was to evaluate the impact of vitamin D administration on therapy-related pain in subjects diagnosed with malignant disorders., Review Analysis Methods: We searched the Web of Science, Scopus, PubMed/Medline, Embase, and Google Scholar databases up to October 2020 to identify published RCTs that investigated the use of vitamin D in the management of treatment-induced pain in individuals with cancer., Results: Nine RCTs were detected. The median duration of the intervention was of 24 weeks (range 12-52 weeks) and dose of vitamin D employed was 2000-50000 IU of vitamin D3 weekly orally each day. Six RCTs reported a significant reduction in pain, whereas three did not detect a notable decrease of this variable. Of the six studies that reported an alleviation of pain, an RCT which recruited 60 participants and lasted for 24 weeks consisted of supplementation with high doses of vitamin D2 weekly for 8 weeks in women receiving anastrozole as adjuvant therapy, then supplementation with vitamin D2 monthly for 4 months, effectively alleviated the aromatase inhibitor-associated musculoskeletal syndrome (AIMSS). The results of the same RCT also suggested a beneficial effect of vitamin D on musculoskeletal pain., Conclusions: Our results suggest that the supplementation with high doses of vitamin D in cancer patients with low serum levels of vitamin D, can be effective in reducing treatment-related pain., Competing Interests: Declarations of Competing Interest None., (Copyright © 2022 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.)

Background: There is evidence of inconsistency in sequelae of exclusive enteral nutrition (EEN) as induction therapy in paediatric patients with Crohn's disease (CD)., Aim: To investigate the potential effects of EEN on paediatric Crohn's disease activity index (PCDAI), inflammation and biochemical parameters in paediatric patients with CD., Methods: We performed a comprehensive systematic search of PubMed/MEDLINE, Web of Science, SCOPUS and Embase until 8 January 2022 regardless of the time of publication or language. Random-effects model was applied to combine the datasets. The main outcomes were analysed through mean difference (MD) and its 95% confidence interval (CI)., Results: Forty six studies met eligibility criteria and were included in the meta-analysis. Pooled findings indicated that PCDAI score (MD of -27.24; 95% CI -31.84 to -22.64), calprotectin (MD of -842.83 mg/kg; CI -1018.24 to -667.42), CRP (pooled MD of -2.36 mg/dl; CI -2.68 to -2.03), and ESR (MD of -21.09 mm/h; CI -23.79 to -18.38), albumin (MD of 0.65 g/dl; CI 0.58 to 0.72), haemoglobin (MD of 1.12 g/dl; CI 0.87 to 1.37), weight (MD of 4.30 kg; CI 3.39 to 5.22), and height (MD of 0.98 cm; CI 0.35 to 1.62) improved significantly with EEN., Conclusions: Adherence to EEN can have significant, beneficial effects as induction therapy in paediatric patients with CD., (© 2022 John Wiley & Sons Ltd.)

Background & Aims: Some clinical trial studies have shown the effect of probiotic supplementation on trimethylamine N-oxide (TMAO) levels through regulation of intestinal microbiota. However, the relevant findings in this area are still contradictory. The aim of this systematic study and meta-analysis was to investigate the effects of probiotic supplementation on TMAO levels using randomized controlled trials (RCTs)., Methods: Available databases including PubMed/Medline, Web of Science, Scopus, Cochrane Library, and Embase were searched to find relevant RCTs up to August 2021. In this study, we examined the population over 18 years of age using probiotics as an intervention group compared to the control group to evaluate TMAO as a final outcome. Effect size was expressed as weighted mean difference (WMD) and 95% confidence interval (CI)., Results: 8 RCT studies with 270 participants were included in this article. The results show that probiotic supplementation has no significant effect on TMAO levels compared to the control group (WMD - 0.08 μmol/L; 95% CI - 0.76 to 0.60, P = 0.813). Furthermore, the results of the analysis of the subgroups did not show a significant effect on this metabolite in both groups of healthy and unhealthy individuals following the intervention. However, probiotic supplementation further reduced TMAO in people less than 50 years of age compared to those over 50 years of age., Conclusions: This meta-analysis showed that probiotics did not have a significant effect on TMAO levels. However, further studies are needed to confirm the findings., Competing Interests: Declaration of competing interest There are no conflicts to declare., (Copyright © 2022 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.)

Background: Evidence suggests the role of changing traditional lifestyle patterns, such as Paleolithic, to the modern lifestyle in the incidence and epidemic of chronic diseases. The purpose of this study was to investigate the associations between the Paleolithic diet (PD) and the Paleolithic-like lifestyle and the risk of non-alcoholic fatty liver disease (NAFLD) among an adult population., Materials and Methods: This case-control study was carried out among 206 patients with NAFLD and 306 healthy subjects aged >18 years. PD score was evaluated using a validated 168-item quantitative food frequency questionnaire. In addition, to calculate the Paleolithic-like lifestyle score, the components of physical activity, body mass index (BMI), and smoking status of the participants were combined with the score of the PD., Results: The mean PD and Paleolithic-like lifestyle scores were 38.11 ± 5.63 and 48.92 ± 6.45, respectively. After adjustment for potential confounders, higher scores of adherence to the PD diet conferred a protection for the presence of NAFLD [odds ratio (OR): 0.53; 95% confidence interval (CI): 0.28-0.98; P for trend = 0.021]. Furthermore, PD and healthy lifestyle habits were negatively associated with NAFLD (OR = 0.42, 95% CI 0.23-0.78; P for trend = 0.007)., Conclusion: Our data suggest that the PD alone and in combination with lifestyle factors was associated with decreased risk of NAFLD in a significant manner in the overall population. However, prospective studies are needed to further investigate this association., 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 © 2022 Sohouli, Fatahi, Izze da Silva Magalhães, Rodrigues de Oliveira, Rohani, Ezoddin, Roshan and Hekmatdoost.)

Introduction: Antioxidants appear to hinder the actions of Helicobacter pylori (H. pylori). The aim of this research was to evaluate the association between dietary total antioxidant capacity (DTAC) and H. pylori infection., Methods: A case-control study was carried out among 200 patients with  H. pylori infection and 402 healthy subjects (18-55 years). Dietary data were collected using a validated 168-item quantitative food frequency questionnaire. DTAC was calculated based on the oxygen radical absorbance capacity of each food (except for coffee) reported by the US Department of Agriculture., Results: Compared with participants in the lowest tertile of DTAC, those in the highest tertile had a significantly lower odds ratio (OR) in the crude model (OR, 0.29; 95% CI, 0.14-0.61; p for trend = 0.001), model 1 (adjustment for age and sex) (OR, 0.37; 95% CI, 0.24-0.58; p for trend < 0.001), and model 2 (adjustment for model 1 plus body mass index, waist circumference, physical activity, smoking, dietary intake of energy and fat) (OR, 0.20; 95% CI, 0.10-0.40; p for trend ≤ 0.001)., Conclusions: A high DTAC is associated with a reduced risk of H. pylori infection in adults. Further studies are mandatory to elucidate the mechanisms and a dose-effect relationship., (© 2022. Indian Society of Gastroenterology.)

Aim: To compare the ability of anthropometric indices [waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), neck-to-height ratio (NHR), conicity index (CI), body adiposity index (BAI), tri-ponderal mass index (TMI) and body mass index (BMI)] and,measuerments like neck(NC), hip(HC) and waist circumferences to predict overweight and obesity in Iranian preschool children., Materials and Methods: A total of 498 Iranian preschool children were included in this case-control study conducted in Tehran, Iran. The participants were selected using the stratified random sampling procedure based on gender and school. Using sex-based receiver operating curve (ROC) analysis, we compared the area under the curve and defined the cut-off points for detecting central and general obesity for each index in order to identify the most suitable tools in predicting obesity., Results: Boys had significantly higher values for NC, WC, WHR, NHR, CI, TMI and BMI as compared to girls, whereas BAI and HC were higher in girls. The area under the curve was calculated for all the possible predictors of central obesity, i.e., NC (0.841-0.860), WC (0.70-0.679), HC (0.785-0.697), WHR (0.446-0.639) and CI (0.773-0.653) in boys and girls, respectively. And according to the ROC curve analysis, BMI (0.959-0.948), TMI (0.988-0.981), WHtR (0.667-0.553) and NHR (0.785-0.769) were predictors of general obesity and NC (0.841-0.860) as predictor of central obesity in boys and girls, respectively. The optimal cut-off points for TMI (13.80-15.83), NC (28.68-27.5) and for other anthropometric indices were estimated in both boys and girls., Conclusion: TMI and NC seem to predict general and central obesity in Iranian preschool children., (© 2022. The Author(s).)

Background: Probiotic supplementation has been used to alleviate abdominal pain in children and adolescents with irritable bowel syndrome (IBS), but the evidence is not compelling. Thus, a systematic review and meta-analysis of randomized clinical trials (RCTs) were performed to investigate the effects of probiotic supplementation on abdominal pain in pediatric patients with IBS., Methods: PubMed/MEDLINE, Web of Science, Scopus, Cochrane Library, and Embase were the available databases searched to find relevant randomized clinical trials up to April 2021. The effect size was expressed as weighted mean difference (WMD) and 95% confidence interval (CI)., Results: Seven RCTs with 441 participants were included, from which the meta-analysis demonstrated that probiotic supplementation has a significant effect on reducing abdominal pain in pediatric patients with IBS (WMD = - 2.36; 95% CI - 4.12 to - 0.60; P = 0.009). Although our study involved children and adolescents (≤ 18 years), the effects of probiotic supplementation seem to be more potent in patients under 10 years old (WMD = - 2.55; 95% CI - 2.84 to - 2.27) compared to patients aged 10-18 years (WMD = - 1.70; 95% CI - 2.18 to - 1.22). The length of supplementation longer than four weeks was more effective (WMD = - 2.43; 95% CI - 2.76 to - 2.09)., Conclusion: Probiotic supplementation can reduce abdominal pain in pediatric patients with IBS., (© 2022. Children's Hospital, Zhejiang University School of Medicine.)

According to studies, there are many inconsistencies in how IGF-1 levels change after bariatric surgery compared to before surgery, as well as its effects. These discrepancies can be attributed to various factors such as age, body mass index (BMI), and duration of intervention. Therefore, the aim of this study was to evaluate the level of insulin-like growth factor-1 (IGF-1) after bariatric surgery. A systematic review and meta-analysis based on the PRISMA guidelines was conducted from inception until 2021. From 1871 articles initially selected, 24 studies with 28 treatment arms met the eligible criteria and were included. Pooled findings from the random-effects model indicated that IGF-1 levels increased significantly [weighted mean difference (WMD) = 8.84 ng/ml; 95% confidence interval (CI) 0.30-17.39; p = 0.043] after bariatric surgery compared to before surgery. No significant heterogeneity was noted among the studies (Cochran Q test, p = 0.90, I 2  = 0.0%). In subgroup analysis, bariatric surgery significantly increased IGF-1 levels at age <40 years but not at age ≤40 years. Bariatric surgery is capable of increasing the IGF-1 levels compared to the period prior to surgery but with a modest clinical magnitude., (© 2021. The Author(s), under exclusive licence to Springer Nature Limited.)

Background and Aims: During the last decades, there has been a burst of scientific literature hypothesizing the antioxidant effect of probiotics. However, the results of these studies are inconsistent and a final conclusion has yet to be reached. Thus, the aim of this study was to assess the effects of probiotic/synbiotic supplementation on serum total antioxidant capacity (TAC), glutathione (GSH), malondialdehyde (MDA) and nitric oxide (NO) levels in adults., Methods and Results: The following online databases were searched until August 26th 2020: PubMed/Medline, Scopus, Clarivate Analytics Web of Science, Cochrane Central Register of Controlled Trials, Science Direct, Google Scholar and Igaku Chuo Zasshi. The effect sizes were expressed as the weighted mean difference (WMD) with 95% confidence intervals (CI). A total of 31 eligible trials with 1681 participants (839 cases and 842 controls) were included in this meta-analysis. The results revealed that the supplementation with probiotics/synbiotics, significantly increased serum TAC (WMD: 54.14 mmol/L, 95% CI: 27.87, 80.40, P < 0.001), GSH (WMD: 40.38 μmol/L, 95% CI: 20.72, 60.03, P < 0.001) and NO (WMD: 3.54 μmol/L, 95% CI: 1.73, 5.34, P < 0.001) levels. In addition, MDA levels were significantly reduced (WMD: -0.45 μmol/L, 95% CI: -0.58,-0.32, P < 0.001) following probiotic/synbiotic supplementation. None of the variables showed a significant change in the sensitivity analysis., Conclusion: Available evidence suggests that probiotic/synbiotic supplementation can significantly increase serum TAC, GSH and NO, as well as reduce MDA levels in adults. Therefore, probiotic/synbiotic supplementation may play a role in improving antioxidant indices and reducing oxidative stress in the body.

Dyslipidemia/hyperlipidemia is recognized among the risk factors for lifestyle related diseases. A healthy diet, rich in vegetable oils such as rice bran oil (RBO), may aid to improve serum lipid levels. Thus, the aim of this study was to assess the effects of rice bran oil (RBO) consumption on serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c) and triglyceride (TG) levels in adults. The following online databases were searched for manuscripts published until October 7 th 2020: PubMed/Medline, Scopus, Clarivate Analytics' Web of Science, Cochrane Central Register of Controlled Trials, and Google Scholar. The effect sizes were expressed as weighted mean difference (WMD) with 95% confidence intervals (CI). A total of 8 eligible trials with 14 effect sizes were included in this meta-analysis. Our analysis revealed that the consumption of RBO significantly decreased serum TC (WMD: -7.29 mg/dL, 95% CI: -11.32, -3.25, P = 0.000), LDL-c (WMD: -7.62 mg/dL, 95% CI: -11.10, -4.14, P = 0.000) and TG (WMD: -9.19 mg/dL, 95% CI: -17.99, -0.38, P = 0.041) levels. So, available evidence suggests that RBO consumption can significantly decrease serum TC, LDL-c and TG levels. Hence, it may play a role in reducing dyslipidemia/hyperlipidemia risk.

This systematic review and meta-analysis aims to summarize and conclude the clinical evidence regarding the use of cinnamon among patients with metabolic diseases. A comprehensive literature search without any limitation on language was conducted using the following bibliographical databases: ISI Web of Science, Embase, Scopus, PubMed, and Google Scholar. Search was conducted up to 23 January 2020. A total of 35 clinical trials were included for final analysis. Pooling of results showed a significant reducing effect of cinnamon on total cholesterol (TC) (weighted mean difference (WMD) = -11.67 mg/dL; P = 0.010), triglyceride (TG) (WMD = -16.27 mg/dL; P < 0.001), low density lipoprotein-cholesterol (LDL-C) (WMD = -6.36 mg/dL; P < 0.001), serum glucose (WMD = -11.39 mg/dL; P < 0.001), serum insulin (WMD = -1.27 μIU/mL; P = 0.028), and waist circumstance (WC) (WMD = -1.68 cm; P = 0.016). These lowering effects on TG, TC, LDL-C, and serum glucose levels were robust in studies that used cinnamon supplementation dose ≤1.5 g. Also, our findings of the present meta-analysis showed that cinnamon supplementation could have favorable effects on high density lipoprotein-cholesterol (HDL-C, WMD = 1.35; P = 0.038) as well as systolic (WMD = -3.95 mmHg; P = 0.018) and diastolic (WMD = -3.36; P = 0.001) blood pressure among patients with metabolic diseases. The present meta-analysis suggests that cinnamon might exert beneficial effects on various cardiometabolic risk factors among patients with metabolic diseases.

Objective: Several randomized clinical trials (RCTs) have investigated the effects of the Paleolithic diet (PD) in adult patients suffering from metabolic disorders. However, the results of these RCTs are conflicting. Therefore, we conducted a systematic review and meta-analysis to assess the effects of the PD in patients with metabolic disorders., Methods: We searched the PubMed/Medline, Scopus, Cochrane Databases, Google Scholar, Web of Science, and Embase databases up to June, 2020. The data were pooled using a random-effects model. From the eligible publications, 10 articles were selected for inclusion in this systematic review and meta-analysis. The meta-analysis was performed using a random-effects model. The heterogeneity was determined using the I 2 statistics and the Cochrane Q test., Results: The pooled results from the random-effects model showed a significant reduction of the homeostatic model assessment of insulin resistance (HOMA-IR) (weighted mean difference, WMD: -0.39, 95% CI: -0.70, -0.08), fasting insulin (WMD: -12.17 μU/mL, 95% CI: -24.26, -0.08), total cholesterol (WMD: -0.32 mmol/l, 95% CI: -0.49, -0.15), triglycerides (WMD: -0.29 mmol/L, 95% CI: -0.42, -0.16), low-density lipoprotein cholesterol (WMD: -0.35 mmol/L, 95% CI: -0.67, -0.03), blood pressure (BP)(WMD - 5.89 mmHg; 95% CI - 9.973 to - 1.86 for the systolic BP and WMD - 4.01 mmHg; 95% CI - 6.21 to - 1.80 for the diastolic BP values) and C-reactive protein (CRP) levels (WMD: -0.84, mg/L, 95% CI: -1.62, -0.06) in the PD group versus control group., Conclusions: Our findings provide better insights into the effect of the PD on the modulation of the glucose and lipid metabolism factors in patients with metabolic disorders, providing comprehensive information for the development of future RCTs with a high quality design.

Background and Aims: Due to inconsistent data about WP supplementation on inflammatory markers, present systematic review and meta-analysis was done to summarize its effect on TNF-α and IL-6., Methods: Our search was done in Pubmed, Scopus, Embase, and Cochrane up to June 2021. Weighted mean difference (WMD) and 95% confidence intervals (CI) was used to indicate the effect sizes. Conceivable sources of heterogeneity were detected by subgroup analysis., Results: Overall, 11 eligible RCTs were included. The pooled results showed that WP supplementation had no significant effect on TNF-α and IL-6 status compare to those receiving carbohydrate and other types of proteins as placebo. Results from subgroup analysis based on health status, study duration, WP dosage and sex, expressed no favorable effect of WP on TNF-α and IL-6 levels., Conclusion: It can be concluded that whey supplementation had no favorable effects on inflammatory biomarkers including TNF- α and IL-6., Competing Interests: Declaration of competing interest No conflict of interest declared., (Copyright © 2022 Diabetes India. Published by Elsevier Ltd. All rights reserved.)

Cardiovascular disease (CVD) is the greatest cause of premature death and disability globally. Numerous therapeutic strategies have been developed to improve and prevent the adverse cardiovascular events, including nutritional approaches. This systematic review and meta-analysis summarized the evidence on orange juice consumption on CVD risk factors. Four databases were searched up to September 2020. Ten randomized controlled trials were included in the final analysis. Pooled results demonstrated a significant effect of orange juice on glucose (WMD: -2.92 mg/dl, 95% CI: -5.327, -0.530, p = 0.017), insulin (WMD: -1.229 μU/ml, 95% CI: -2.083, -0.374, p = 0.005), HOMA-IR (WMD: -0.464, 95% CI: -0.747, -0.181, p = 0.001), total cholesterol (WMD: -9.84 mg/dl, 95% CI: -15.43, -4.24, p = 0.001), LDL-C (WMD: -9.14 mg/dl, 95% CI: -15.79, -2.49, p = 0.007), and CRP (WMD: -0.467 mg/l, 95% CI: -0.815, -0.120, p = 0.008) compared to control group. However, the effect of orange juice on body composition factors and other CVD risk factors was not significant compared to control group. These lowering effects of glucose, HOMA-IR, total cholesterol, and LDL-C were robust in subgroups with orange juice consumption ≥500 ml/day. This meta-analysis suggests that orange juice may be beneficial in improving several CVD risk factors.

Background: Hyperinsulinaemia is considered as a major risk factor for the development of a myriad of chronic diseases. We examined the association between the dietary insulinaemic potential and the odds of non-alcoholic fatty liver disease (NAFLD) among Iranian adults., Methods: After being subjected to a liver ultrasound, 166 patients with NAFLD and 200 controls were included in the study. The dietary intakes and the physical activity levels of the participants were evaluated using a validated semi-quantitative food frequency questionnaire and the International Physical Activity Questionnaire (short IPAQ), respectively. The insulinaemic potential of the diet was assessed by computing the scores of the Empirical Dietary Index for Hyperinsulinemia (EDIH) and the Empirical Dietary Index for Insulin Resistance (EDIR)., Results: Compared with the control subjects, patients with NAFLD were significantly older; had higher values for body mass index, fasting blood sugar, triglycerides, low-density lipoprotein cholesterol, total cholesterol and alanine transaminase; and were more likely to smoke. Moreover, NAFLD patients had significant lower levels of high-density lipoprotein cholesterol and were less likely to perform physical activity. The risk of NAFLD was higher in the individuals in the highest tertile of the EDIH (odds ratio [OR] = 2.79; 95% confidence interval [CI] = 1.32-5.90; p value for trend < 0.05) and EDIR (OR = 2.42; 95% CI = 1.22-4.79; p value for trend < 0.05) compared to those in the lowest tertile of these scores., Conclusions: Our study indicates that a higher dietary insulinaemic potential is associated with an increased risk of NAFLD., (© 2021 The British Dietetic Association Ltd.)