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Introduction: Numerous clinical trials have investigated the effects of fenugreek, a traditional herbal medicine, on type 2 diabetes mellitus (T2DM). However, the results from these studies have been inconsistent. Therefore, we aimed to perform a meta-analysis on the effects of fenugreek supplementation on weight, body mass index (BMI), lipid profile, and glycemic indices in patients with T2DM. Methods: We searched PubMed, Scopus, Embase, ISI Web of Science, and Cochrane Library databases to identify clinical trial studies until October 2023. The data were analyzed using a random-effects model and presented as the weighted mean difference (WMD) along with the associated 95 % confidence interval (CI). Results: A total of 19 studies were included in the meta-analysis. The results indicated a significant impact of fenugreek supplementation on lowering fasting plasma glucose (FPG) (WMD: 20.32 mg/dl; 95 % CI: 26.65 to −13.99), hemoglobin A1C (HbA1c) (WMD: 0.54 %; 95 % CI: 0.80 to −0.28), homeostatic model assessment of insulin resistance (HOMA-IR) (WMD: 0.36; 95 % CI: 0.67 to −0.05), total cholesterol (TC) (WMD: 33.10 mg/dL; 95 % CI: 64.31 to −1.88), low-density lipoprotein cholesterol (LDL-C) (WMD: 29.14 mg/dL; 95 % CI: 55.45 to −2.83), BMI (WMD: 0.73 kg/m2; 95 % CI: 1.40 to −0.07), and increasing the high-density lipoprotein cholesterol (HDL-C) (WMD: 5.68 mg/dL; 95 % CI: 3.51 to 7.85). However, the effect on fasting insulin, triglycerides, and weight was not significant. Conclusions: Fenugreek supplementation has been shown to improve FPG, HbA1C, HOMA-IR, TC, LDL-C, HDL-C, and BMI in patients with T2DM. The overall results suggest that fenugreek may have protective and therapeutic effects on T2DM parameters.

The gut microbiome plays a significant role in the pathogenesis of pancreatic ductal adenocarcinoma (PDAC), influencing oncogenesis, immune responses, and treatment outcomes. Studies have identified microbial species like Porphyromonas gingivalis and Fusobacterium nucleatum, that promote PDAC progression through various mechanisms. Additionally, the gut microbiome affects immune cell activation and response to immunotherapy, including immune checkpoint inhibitors and CAR-T therapy. Specific microbes and their metabolites play a significant role in the effectiveness of immune checkpoint inhibitors (ICIs). Alterations in the gut microbiome can either enhance or diminish responses to PD-1/PD-L1 and CTLA-4 blockade therapy. Additionally, bacterial metabolites like trimethylamine N-oxide (TMAO) and lipopolysaccharide (LPS) impact antitumor immunity, offering potential targets to augment immunotherapy responses. Modulating the microbiome through fecal microbiota transplantation, probiotics, prebiotics, dietary changes, and antibiotics shows promise in PDAC treatment, although outcomes are highly variable. Dietary modifications, particularly high-fiber diets and specific fat consumption, influence microbiome composition and impact cancer risk. Combining microbiome-based therapies with existing treatments holds potential for improving PDAC therapy outcomes, but further research is needed to optimize their effectiveness.

Background: Several randomized controlled trials (RCTs) have explored the impact of melatonin on body composition and blood pressure (BP). However, the findings from these studies remain a topic of debate. This systematic review and meta-analysis of RCTs sought to evaluate the effects of melatonin consumption on body composition (body weight (BW), body mass index (BMI), waist circumference (WC), hip circumference (HC)) and asleep/daytime BP (systolic blood pressure (SBP) and diastolic blood pressure (DBP)) in adults. Methods: In order to identify eligible RCTs, a systematic literature search was carried out up to June 2024 in PubMed, Embase, Scopus, and Web of Science without any language restrictions. The I2 statistic was used to perform heterogeneity tests on the selected studies. After evaluating random effects models based on heterogeneity tests, the weighted mean differences (WMD) with a 95 % confidence interval (CI) were calculated using pooled data. Results: Overall, 28 studies (n = 1,543 participants) met our inclusion criteria. A pooled analysis of studies demonstrated that melatonin consumption led to a significant reduction in HC (WMD: 1.21 cm; 95 % CI: 1.94 to −0.49; P = 0.001), and daytime DBP (WMD: 1.40 mmHg; 95 % CI: 2.46 to −0.34; P = 0.009) in comparison with the control group. However, no substantial effects were observed on BW, BMI, WC, and SBP compared to the control group. Conclusion: The current meta-analysis of RCTs shows that treatment with melatonin reduces HC and daytime DBP levels in adults. However, further well-designed RCTs with large sample sizes and long durations are necessary to determine the effect of this supplement on body composition and BP.

Abstract Background Women with polycystic ovary syndrome (PCOS) have higher intestinal mucosal permeability, leading to the lipopolysaccharide (LPS) leakage and endotoxemia. This, in turn, leads to oxidative stress (OS) and neuro-inflammation caused by the gut-brain axis, affecting the neurotrophic factors levels such as brain-derived neurotrophic factor (BDNF) and S100 calcium-binding protein B (S100 B) levels. In this study, it was hypothesized that the thylakoid membranes of spinach supplementation along with a hypocaloric diet may have improved the LPS levels, neurotrophic factors, and OS in PCOS patients. Methods In this double-blind, randomized, placebo-controlled, and clinical trial, 48 women with obesity and diagnosed with PCOS based on Rotterdam criteria were randomly assigned to thylakoid (N = 21) and placebo groups (N = 23). A personalized hypocaloric diet with 500 calories less than the total energy expenditure was prescribed to all patients. The participants were daily supplemented with either a 5 g/day thylakoid-rich spinach extract or a placebo (5 g cornstarch) for 12 weeks along with a prescribed low-calorie diet. Anthropometric measurements and biochemical parameters were assessed at baseline and after the 12-week intervention. Results A statistically significant decrease in the LPS levels (P 0.05). Conclusions In sum, the thylakoid membranes of spinach supplemented with a hypocaloric diet reduced the LPS levels, increased the BDNF levels, and improved the glycemic profile and sex-hormone levels; however, they had no effects on the OS markers levels after 12 weeks of intervention.

Background: Clinical studies, investigating the effect of β-Alanine (BA) supplementation on recovery biomarkers in physically active individuals, have generated inconsistent results. This systematic review and meta-analysis study aimed to clarify the clinically relevant dietary effects of BA supplementation. Methods: A comprehensive search was done in the electronic databases of Scopus, PubMed, ISI Web of Science and Embase from inception to 2022. Meta-analysis was done using the random-effects model. Pooled effect size was evaluated using standard mean difference (SMD) and 95% confidence intervals (CI). Heterogeneity of between-study was evaluated according to Cochran’s Q test and I2 . Subgroup analysis was conducted to identify the potential sources of heterogeneity. Results: Overall, 32 studies were included in the current study. The results suggested that BA supplementation increases carnosine level significantly (SMD: 0.22mmol/L, 95%CI: -0.17, 0.61, P=0.27) but no effect was shown about lactate, fatigue, VO2 , pH and bicarbonate (HCO3 - ) (P>0.05). Subgroup analysis revealed a significant association of VO2, carnosine and fatigue with supplementation dosage, gender and duration of administration respectively. Conclusion: BA supplementation emerged its beneficial effects on enhancing carnosine level which highlights its ergogenic effects. In contrast, no significant effects had been shown in term of fatigue delay and blood levels of lactate, HCO3 - , pH, and VO2 value. These results warrant more investigation in a prospective design to clarify the exact mechanism in this way.

This systematic review and meta-analysis of randomized controlled trials (RCTs) sought to evaluate the effects of quercetin on the components of (MetS) such as waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG), triglyceride (TG), and high-density lipoprotein cholesterol (HDL-C). A systematic literature search up to December 2023 was completed in Scopus, PubMed, Embase, and Web of Science, to identify eligible RCTs. Altogether, 20 studies with a total sample size of 1,164 subjects were included in the analysis. A pooled analysis showed that quercetin consumption led to a significant reduction in FBG (WMD: −1.03 mg/dL; 95 % CI: −1.87 to −0.19), and SBP (WMD: −1.96 mmHg; 95 % CI: −3.11 to −0.81). However, there were no significant effects on TG, HDL-C, WC, and DBP. It was found that quercetin intake can decrease FBG and SBP significantly without significant effects on other components of MetS.

Introduction and Aim: Research on the effects of propolis consumption on body composition, and blood pressure (BP) has produced inconsistent results. This systematic review and dose-response meta-analysis was carried out to compile the data from the randomized controlled trials (RCTs) on how propolis supplementation affects body composition, and BP level in adults. Materials and Methods: A systematic literature search was conducted using electronic databases, including PubMed, Embase, Scopus, Web of Science, and Cochrane library, up to January 2024. The RCTs, evaluating the effects of propolis consumption on weight, body mass index (BMI), waist circumference (WC), hip circumference (HC), waist-hip ratio (WHR), fat mass (FM), systolic BP (SBP), and diastolic BP (DBP), were included in the study. We used the random-effects model to establish the pooled effect size. Results: A total of 22 RCTs involving 1082 participants were included in the study. Propolis supplementation demonstrated significant reductions in weight (weighted mean difference [WMD]: –0.37 kg; 95% confidence interval [CI]: –0.63 to –0.12), and BMI (WMD: –0.11 kg/m2; 95% CI: –0.13 to –0.09). However, there were no significant effects on WC, WHR, FM, HC, SBP, and DBP levels. The dose-response analysis revealed a significant nonlinear relationship between propolis dosage and WC (P = 0.020). Moreover, the BMI (P = 0.047) and WC (P = 0.004) reduction trend continues until 8 weeks of intervention and then this impact plateaued. Conclusions: Supplementation with propolis seems to be effective in reducing weight and BMI. However, it should be noted that the anti-obesity properties of propolis supplementation were small and may not reach clinical importance. Therefore, future well-designed studies with a large sample size are needed to investigate the effect of propolis on body composition and BP in adults.

Background. During pregnancy, it is crucial to minimize maternal anxiety to maintain the mental and physical health of both the mother and fetus, especially in high-risk pregnancies. This study aimed to investigate the effect of family support on decreasing depressive and anxiety symptoms in women hospitalized with high-risk pregnancies in their third trimester. Methods. This randomized controlled clinical trial was performed on 70 high-risk pregnant women in their third trimester. Samples were randomly divided into intervention and control groups. The intervention group walked for five weeks, five days a week, with their spouse or a family member for half an hour a day in the hospital. The control group received routine care. Participants completed the Spielberger Anxiety and Beck Depression Inventory once before and once a week during the intervention. Data were analyzed using SPSS.21 software using ANCOVA, independent t-test, and Mann-Whitney U. Results. Results showed that the subjects were homogeneous in terms of mean overall score of anxiety before the intervention, and there is no significant difference between the intervention group 43.2 (±2.93) and the control group 42.63 (±3.3) (P=0.53). Statistical tests showed that, three weeks after the intervention, the mean anxiety score in the study group decreased significantly, and there was a significant difference in the mean anxiety score of women in the intervention 41.3(±3.07) and control 42.12(±3.6) groups (P=0.032). On the other hand, the level of state anxiety in the study group decreased (P=0.03). The results showed that the depression score after the intervention in the study group decreased significantly (P=0.001). Conclusion. Anxiety level and depression score decreased after the intervention. Practical Implications. The current study's results showed that talking to a spouse or relatives during pregnancy can increase women's peace of mind, and social support during hospitalization can reduce the anxiety and depression of the pregnant mother. Therefore, using such methods will be beneficial for the pregnant mother.

Abstract Polycystic ovary syndrome (PCOS) is one of the most common endocrine diseases in the women at their reproductive age. Nowadays, the use of herbal compounds for lesser side effects, as compared to drug treatments, has become popular for the prevention and reduction of the complications of this disease. Evidence suggests that cinnamon, given its antioxidant and anti-inflammatory properties, can be associated with reduced metabolic complications from chronic non-communicable diseases. This systematic review aimed to determine the potential effect of cinnamon on the metabolic status in the PCOS. PICO framework for current systematic review was Population (P): subjects with PCOS; Intervention (I): oral cinnamon supplement; Comparison (C): the group as control or administered placebo; and Outcome (O): changed inflammatory, oxidative stress, lipid profile, glycemic, hormonal and anthropometric parameters and ovarian function. PubMed, Scopus, EMBASE, ProQuest and Google Scholar were searched from their very inception until January, 2020, considering specific keywords to explore the related studies. Out of 266 studies retrieved by the search strategy, only nine were eligible for evaluation. All clinical trials, animal studies, and published English-language journal studies were eligible for this review. The results showed that increased high-density lipoprotein and insulin sensitivity were increased by the cinnamon supplementation while low-density lipoprotein, triglyceride, and blood glucose were decreased in patients with PCOS. However, the results related to the potential effects of cinnamon on body weight and body mass index were inconsistent, thus calling for further studies. Also, despite improved results regarding the effect of cinnamon on oxidative stress and ovarian function, further studies are required to explore the precise mechanisms. Overall, the effects of cinnamon on the improvement of metabolic status in PCOS were promising. However, to observe clinical changes following cinnamon supplementation in PCOS, more clinical trials with higher doses of cinnamon and a longer duration of intervention are needed.

Abstract Background Polycystic ovary syndrome (PCOS), as the most common endocrine disorder in reproductive-aged women, is characterized by oxidative stress and ovarian tissue inflammation. Green tea extract (GTE) potentially possesses therapeutic effects for PCOS because of the antioxidant and anti-inflammatory compounds. This systematic review evaluates the potential roles of GTE on metabolic variables, hormone levels, and ovarian function in PCOS. Methods A systematic review was conducted of published studies reporting the effects of GTE on PCOS. Several major databases, including PubMed, SCOPUS, and Google Scholar, were searched up from inception to April 2021. Clinical trials and animal studies that assessed the effects of GTE on PCOS were eligible for inclusion. Results Of 314 articles found in the search, four human studies and four animal studies were included. All studies in humans showed the effects of GTE on weight loss. GTE’s effect on decreasing testosterone levels in humans and LH levels in animals were also reported. In addition, increases in FSH and progesterone levels in animal models were observed. Although GTE improved fasting blood sugar and insulin levels, the effect of GTE on inflammatory parameters, such as TNF-alpha and IL-6 and antioxidant status, was limited to animal studies. Conclusion Therefore, this review suggests that GTE could be considered a potential agent to attenuate PCOS complications mainly due to its effect on weight loss and glycemic levels. However, more studies are needed to formulate conclusions about the effects and mechanisms of GTE in PCOS.

Abstract Background There is a promising outlook regarding the potential effect of spinach-derived thylakoids in the management of obesity and its associated metabolic disturbances. This research aimed to evaluate the effects of spinach-derived thylakoids supplementation combined with a calorie-restricted diet on anthropometric and metabolic profiles in obese women with the polycystic ovary syndrome (PCOS). Methods In a 12-week double-blind placebo-controlled randomized clinical trial, 48 females with obesity and PCOS were randomly allocated into either intervention (5 g/day thylakoid) or placebo (5 g/day cornstarch) groups along with calorie-restricted diets. Anthropometric measures, physical activity levels, dietary intakes, insulin resistance markers, as well as serum levels of insulin, fasting blood glucose (FBG), non-esterified fatty acids (NEFA), and sex hormones including dehydroepiandrosterone sulfate (DHEAS), follicle-stimulating hormone (FSH), luteinizing hormone (LH), sex hormone-binding globulin (SHBG), and free androgen index (FAI) were evaluated pre-and post-intervention. Results After the 12-week intervention, there were significant decreases in weight (− 6.97 ± 0.52 vs. -3.19 ± 0.72 kg; P

Abstract Polycystic ovary syndrome (PCOS) is a polygenic endocrine disorder and the most common gynecological endocrinopathy among reproductive-aged women. Current remedies are often used only to control its signs and symptoms, while they are not thoroughly able to prevent complications. Quercetin is an herbal bioactive flavonoid commonly used for the treatment of metabolic and inflammatory disorders. Thus, this systematic review was conducted to evaluate the efficacy of quercetin supplementation in subjects with PCOS. Databases until March 2019 were searched. All human clinical trials and animal models evaluating the effects of quercetin on PCOS women were included. Out of 253 articles identified in our search, 8 eligible articles (5 animal studies and 3 clinical trials) were reviewed. The majority of studies supported the beneficial effects of quercetin on the ovarian histomorphology, folliculogenesis, and luteinisation processes. The effects of quercetin on reducing the levels of testosterone, luteinizing hormone (LH), and insulin resistance were also reported. Although quercetin improved dyslipidemia, no significant effect was reported for weight loss. It is suggested that the benefits of quercetin may be more closely related to antioxidant and anti-inflammatory features of quercetin rather than weight-reducing effects. Therefore, this review article provides evidence that quercetin could be considered as a potential agent to attenuate PCOS complications. However, due to the paucity of high-quality clinical trials, further studies are needed.

Background: There are few studies on the vitamin D status in preeclamptic women. The objective of this case-control study was to determine vitamin D status, in preeclamptic women and compare it with that of healthy pregnant controls. Methods: Forty preeclamptic women, aged 18 to 45yr and forty age- and pregnancy weight-matched healthy controls participated in the study. Serum 25-hydroxy vitamin D (25(OH)D) levels were meas­ured and its levels of 90 nanogram per milliliter (ng/ml) were considered as vitamin D deficiency, insufficiency, sufficiency, and toxicity, respectively. Results: Sixty and forty percent of preeclamptic women were vitamin D deficient and insufficient, while in the control group they were 10% and 90%, respectively. No significant difference was found in the median intake of vitamin D between preeclamptic and non preeclamptic women (1.45 and 1.20µg/day respectively), but serum 25(OH)D concentration was significantly lower in preeclamptic cases compared to controls (10.09 ± 6.66 and 15.73 ± 5.85ng /ml respectively, P= 0.002). Conclusion: Vitamin D deficiency is common among preeclamptic and non-preeclamptic pregnant women in the north-west of Iran. Preeclampsia can cause decreasing of serum level of 25(OH)D.

Background: Metabolic syndrome (MetS) is a clustering of factors known to increase the risk for cardiovascular disease (CVD) and diabetes mellitus. Polycystic ovary syndrome (PCOS), the most common endocrine disorder among reproductive-aged women, is also closely linked to MetS. Limited information is available pertaining to the prevalence of MetS in Iranian PCOS women; therefore this study assesses the frequency of MetS and its components among PCOS women from Tabriz, Iran. Materials and Methods: In this cross-sectional study, we evaluated a total of 200 women with PCOS who referred to the only specialty and subspecialty gynecological center in Northwestern Iran. PCOS was diagnosed according to Rotterdam criteria. This study defined clinical and biochemical parameters for MetS by the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria. Statistical analyses were performed with descriptive-analytical methods using SPSS software version 16. Results: MetS was identified in 39.5% of PCOS women. The frequencies of individual components of MetS among studied subjects were: high-density lipoprotein cholesterol level (HDL-C)