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Objectives: The current cross-sectional study intended to provide a comparative evaluation of nutritional status in the intensive care unit (ICU)-hospitalized patients according to the reasons for admission. Methodology: A total of 258 patients hospitalized for >24-hour in the ICU between February 2020- July 2021 were included. The subjects were categorized into five categories: burned injury (n=27), COVID-19 or other respiratory disorders (n=64), post coronary artery bypass graft surgery (post-CABG) (n=50), trauma (n=57), and miscellaneous causes (n=60). A modified Nutrition Risk in Critically Ill (mNUTRIC) score was applied to explore the nutritional status of the patients. Results: On average, the patients were 58± 16 years old that 46% (n=119) of them were females. The mean± SD of mNUTRIC score among patients with burned 2±1 and COVID-19 or other respiratory disorders 2±1 tended to be significantly lower than the others, including post-CABG 3±0 and patients with miscellaneous causes 3±2 (p-value=0.001). According to mNUTRIC score classifications, the majority of those who were transferred to ICU with burn or COVID-19 or other respiratory disorders were at low nutritional risk (mNUTRIC score:0

Although the available evidence emphasizes the beneficial effects of probiotics in normalizing various cardiometabolic markers, there is still substantial uncertainty in this regard. Thus, we set out to determine the effect sizes of probiotics on blood lipid parameters more coherently. A systematic literature search of the Medline (PubMed) and Scopus databases was conducted from inception to 12 February 2021, applying both MeSH terms and free text terms to find the relevant randomized controlled trials (RCTs). The meta-analysis was conducted based on a random-effect model to calculate the mean effect sizes demonstrated as weighted mean differences (WMDs) and the 95% confidence intervals (95% CIs). To explore the heterogeneity, the Cochrane χ2 test, and analysis of Galbraith plots were performed. Meta-analysis of data from 40 RCTs (n = 2795) indicated a significant decrease in serum/plasma triglyceride [WMD (95% CI) = –12.26 (–17.11 to –7.41) mg/dL; P-value

The relationship between the intestinal microbiota dysbiosis, inflammation, and cardiovascular disorders (CVDs) has become evident, based on a growing body of literature from animal models and human studies. On the other hand, probiotics are believed to have promising effects on modifying dysbiosis and protecting against CVDs.This narrative review provides an overview of the link between gut microbiota, inflammation, endothelial dysfunction, and atherosclerosis. The influences of probiotic supplementation on biomarkers contributing to these conditions as the primary underlying risk factors for developing CVDs are also discussed.An up-to-date review was performed of the available evidence from experimental studies, clinical trials, and meta-analyses, considering their challenges and limitations. It also aimed to provide mechanistic insight into the likely mechanisms of probiotics that could prevent atherosclerosis initiation and progression.Probiotic supplementation seems to be associated with reduced levels of inflammation and oxidative stress biomarkers (C-reactive protein, tumour necrosis factor-α, interleukin (IL)-6, IL-12, and malondialdehyde). Further, these agents might enhance antioxidant factors (IL-10, total antioxidant status, total antioxidant capacity, glutathione, and nitric oxide). Probiotics also appear to improve intestinal barrier integrity, reduce leakage of harmful metabolites (e.g., lipopolysaccharides), inhibit pro-inflammatory signalling pathways, and possibly suppress the formation of trimethylamine/trimethylamine oxide. Probiotics have also been found to enhance endothelial function and halter thrombosis.The current clinical evidence underlines belief that probiotics might be associated with reduced levels of inflammation biomarkers. Experimental evidence reports that the beneficial effects of probiotics seem to be mainly imposed by triggering the secretion of short-chain fatty acids and bile acids, in addition to suppressing the NF-κB signalling pathway. However, the current studies are still in their infancy and it is of high priority to design further research on the topic.

This cross-sectional study evaluated patients' satisfaction with hospital meals in seven urban public hospitals using a validated questionnaire. The quality of food services based on the hospital standards was assessed using a checklist prepared by Iran's ministry of health. Of 800 subjects, the quality and quantity aspects of hospital meals, in general, were nearly satisfactory to the patients (mean score: 2.13, range: 1-3, SD: 0.39, 40% good and 36% moderate). The mean score of hospitals' food service quality based on hospital standards was 2.17 (range: 0-4, SD: 0.59). Females, younger patients and those with higher education level reported to be less pleased with hospital meal services. No relationship between patients' satisfaction and hospital food quality assessment based on hospital standards was found.

Purpose It is argued that COVID-19 patients show various neuropsychiatric symptoms, including fatigue, depression and anxiety. On the other hand, epidemiological and experimental evidence indicated that green tea could potentially have antiviral effects and ameliorate psychiatric disorders. However, there is a lack of clinical evidence. The purpose of this study was to investigate whether drinking green tea can clinically improve psychiatric complications of COVID-19 infection. Design/methodology/approach This study included 40 patients with laboratory confirmed mild-to-moderate COVID-19 disorder in the current randomized open-label controlled trial. Patients were instructed to include three cups/day of green tea (intervention) or black tea (control) to their usual diet for four weeks immediately after diagnosis of the disease. At the study baseline and after the intervention, the enrolled patients’ fatigue, depression and anxiety were assessed by the Chalder Fatigue Scale, Beck Depression Inventory-Fast Screen and State-Trait Anxiety Inventory questionnaires. Findings A total of 19 COVID-19 cases in the intervention group (mean age = 52 years) and 14 cases (mean age = 50 years) in the control group completed the study. Analysis of covariance adjusted for baseline levels, and confounders revealed that those who consumed three cups/day of green tea compared to the patients who received black tea experienced significantly lower fatigue, depression and state and trait anxiety levels (adjusted means for fatigue = 12.3 vs 16.2 (P = 0.03), depression = 0.53 vs 1.8 (P = 0.01), 37.4 vs 45.5 (P < 0.01) and 37.9 vs 45.2 (P < 0.01)). Research limitations/implications The open-label design may bias the evaluation of the self-reported status of fatigue, depression or anxiety as the main outcomes assessed. Moreover, as this study did not include patients with severe COVID-19, this might affect the generalizability of the present results. Thus, the recommendation of daily drinking green tea may be limited to the subjects diagnosed with mild-to-moderate type of infection or those with long-term neuropsychiatric complications owing to COVID-19. Besides, considering the ethical issues, this study could not exclude the drug therapy’s confounding effects; thereby, this point should be considered when interpreting the current results. Besides, it is worth noting that Guilan province in the north of Iran is recognized as a tea (and particularly green tea) producing region; thereby, it is an available and relatively inexpensive product. Considering this issue, the recommendation to consume this medicinal plant in adjunct to the routine treatment approach among patients with mild-to-moderate COVID-19 based on its beneficial effects may be widely accepted. Practical implications Green tea consumption could be considered an option to combat COVID-19 associated psychological complications, including fatigue, depression and anxiety among patients suffering from mild-to-moderate type of this viral infection. Originality/value To the best of the authors’ knowledge, in this study, for the first time, the effects of green tea compared to black tea on COVID-19 associated fatigue, depression and anxiety status within an open-label controlled trial have been investigated.

Food behavior and dietary pattern are major parameters affecting the health status of people. The objective of this study was investigation of food behaviors in people inhabited in North of Iran to find out association of the effective indices (related to salt and fried foods) with hypertension and other cardiovascular diseases (CVDs). This large cross-sectional study was conducted on 10,520 participants and their sociodemographic, medical, and food behavior information were evaluated. Association of salt intake with CVDs and stroke was studied by portfolio at risk (PAR) formula. Association of food behavior with hypertension and CVDs was surveyed by chi-square test. Differences were significant at P≤0.05. Analysis of medical information revealed that 43.18% and 8.18% of the participants had hypertension and CVDs, respectively; mostly in women. Significant association was observed between salt-related behaviors and hypertension in the participants. Regarding salt intake, higher PARs were calculated in women than men (2.26 vs. 1.88 for PARCVDs and 3.66 vs. 3.05 for PARstroke), and urban than rural inhabitants (4.56 vs. 3.66 for PARCVDs and 7.27 vs. 5.88 for PARstroke). No significant contribution was observed between oil-related behaviors and CVDs. The majority of participants were well-informed about appropriate preparation and consumption of fried foods but not a healthy behavior about salt intake. Considering the significant association of salt-related behaviors with hypertension, conducting educational programs by healthcare practitioners in the population is suggested.

Background Dietary diversity score (DDS) is an indicator for assessing nutritional adequacy. Food security is another important measure in nutrition field which can be associated with several cardiovascular risk factors. Considering the importance of nutrition in heart failure (HF) patients, this study was designed to evaluate the DDS and food security of patients with HF. Methods A total of 200 HF patients were enrolled. DDS was evaluated using valid and reliable food frequency questionnaire and was calculated by scoring food intakes as 5 main groups. Household food insecurity access scale was applied to assess food security status. Data were analyzed using descriptive statistics, Chi-square and Kruskal-Wallis tests and multiple logistic regression models. Results The mean age of patients was 65 (standard deviation: 12) years and 59% of patients were male. Median of DDS was 1.96 (range: 0.29 to 6.12). Adjusted odds of greater DDS (> = median of 2) was 2.58 times higher for patients without hypertension than for patients with hypertension (95%CI: 1.31–5.08, P = 0.006). Also, odds of greater DDS were more in ex-smokers’ patients when compared to non-smokers (adjusted odds ratio (AOR): 2.70, 95%CI: 1.27–5.75, P = 0.010), patients with supplement use (AOR: 2.42, 95%CI: 1.16–5.05, P = 0.019), patients with lower total cholesterol level (AOR: 1.01, 95%CI: 1.00–1.02, P = 0.051), and patients with higher ejection fraction (AOR: 1.03, 95%CI: 1.00–1.05, with borderline. P = 0.073). About 57% of patients had experienced degrees of food insecurity as mild (26%), moderate (16%) and severe (15%). On the other hand, women (AOR: 1.90, 95%CI: 0.90–3.71, with borderline P = 0.061) and patients with middle (AOR: 3.48, 95%CI: 1.79–6.76, P P = 0.004) socio-economic status were more likely to be food secure or mild insecure. Also, no relation between DDS and food security was found (r = − 0.08, P = 0.262). Conclusion This study found that HF patients had a low DDS and more than half of the patients were food insecure to some extents.

Recent studies have demonstrated the effect of probiotics, prebiotics, and synbiotics on adiponectin and leptin levels; however, those findings remain contested. The present study aimed to explore the impact of probiotics/synbiotics on appetite-regulating hormones and the desire to eat.A systematic review was conducted by searching the Medline (PubMed) and Scopus databases from inception to December 2021, using relevant keywords and MeSH terms, and appropriate randomized controlled trials (RCTs) were extracted. The standardized mean differences (SMD) and 95% confidence intervals (95%CIs) were calculated as part of the meta-analysis using a random-effect model to determine the mean effect sizes. Analysis of Galbraith plots and the Cochrane Chi-squared test were conducted to examine heterogeneity.Meta-analysis of data from a total of 26 RCTs (n = 1536) showed a significant decrease in serum/plasma leptin concentration following probiotic/synbiotic supplementation (SMD: -0.38, 95%CI= -0.638, -0.124); P-value= 0.004; IOur meta-analysis indicates a favorable impact of probiotic/synbiotic supplementation on regulating leptin and adiponectin secretion.

Background: Considering the close link between metabolic syndrome (MetSyn) and cardiovascular diseases, considerable attention has been devoted to the identification of their shared underlying pathological mechanisms in recent decades. Objectives: This study aimed to investigate the association between pro-inflammatory factors and newly-diagnosed MetSyn. Methods: This case-control study recruited obese and nonobese individuals who were newly diagnosed with MetSyn (cases, n = 84) and healthy individuals (controls, n = 83). The medical and sociodemographic data of the participants were collected on enrollment. Serum analysis was performed to ascertain the concentrations of tumor necrosis factor-alpha (TNF-α), C-reactive protein (CRP), fasting blood sugar (FBS), total cholesterol, triglyceride, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and atherogenic coefficient (AC). Multiple regression analysis was carried out to explore the relationship between inflammatory markers and AC with MetSyn odds. The Pearson correlation test was also performed to investigate the correlations between metabolic and inflammatory parameters. Results: Positive relationships were observed between the serum levels of TNF-α and CRP with the odds of MetSyn following controlling for confounders (adjusted odds ratio [AOR] = 1.32; 95% confidence interval [CI]: 1.01 - 1.72; AOR = 1.29; 95% CI: 1.18 - 1.41; respectively, P ≤ 0.03). Additionally, higher AC was accompanied by increased odds of MetSyn (AOR = 1.98; 95% CI: 1.31 - 2.98; P = 0.001). The Pearson correlation analysis also showed positive correlations between TNF-α levels and serum metabolic abnormalities, including elevated LDL-C, FBS, and AC and lowered HDL-C levels (P ≤ 0.02). Conclusions: The present results revealed that higher serum concentrations of pro-inflammatory and atherogenic indices, including CRP, TNF-α, and AC, might be associated with elevated odds of newly diagnosed MetSyn regardless of potential confounders, particularly body mass index. The obtained findings might be moderated by the positive correlations observed between serum TNF-α, as the chronic inflammatory state indicator, and impaired lipid and glycemic markers.

Background: Hypertension is an important health problem and one of the most important causes of disability and mortality. Objective This study aims to evaluate the effect of an educational program based on the Theory of Planned Behavior (TPB) on self-care behaviors in hypertensive patients. Materials and Methods: This is a clinical trial conducted on 180 patients with hypertension referred to health centers in Rasht, Iran in 2014. They were divided into two intervention (n=75) and control (n=75) groups. Data collection tools included a demographic form, the Global Physical Activity Questionnaire, the Food Frequency Questionnaire, and a TPB questionnaire with five constructs including attitude, subjective norms, perceived behavior control, and behavioral intention related to hypertension. Collected data were analyzed in SPSS v. 18 software using descriptive and inferential statistics. Results: Before intervention, two groups were similar in terms of the scores TPB constructs. After intervention, the mean scores of attitude changed from 4.51 to 4.58; mean scores of subjective norms changed from 4.16 to 4.19; mean scores of perceived behavior control changed from 3.64 to 4.23; and mean scores of behavioral intention changed from 3.88 to 4.24. These differences were statistically significant (P

Background/objective: In the current study, we aimed to explore the effects of rice bran oil (RBO) in adjunct to conventional medical therapy on left ventricular ejection fraction (LVEF), cardiometabolic risk factors, and inflammatory mediators in male patients with coronary artery disease (CAD). Subjects/methods: The present randomized controlled trial included 40 men diagnosed with CAD (mean age = 55.76 years) who were randomly allocated into two groups to receive either 30 grams per day of RBO (intervention group) or sunflower oil (control group) plus a standard diet for eight weeks. At the initial visit, demographic and anthropometric data and blood samples were collected. LVEF levels and serum concentrations of lipid profile, glucose, uric acid, hs-CRP, and TNF-α were investigated. Results: A total of 37 participants completed the study (n = 18 in the intervention group, n = 19 in the control group). Analysis of covariance (ANCOVA) adjusted for baseline values, age and body mass index revealed that RBO significantly improved LVEF (51.34%) and reduced triglyceride (125.01 mg dl−1), blood sugar (110.4 mg dl−1), total cholesterol (123.01 mg dl−1) and low density lipoprotein (56.88 mg dl−1) levels compared to sunflower oil ((45.56%), (155.93 mg dl−1), (128.94 mg dl−1), (163.93 mg dl−1) and (83.79 mg dl−1), respectively) following a 8-week trial (P-values < 0.05). Additionally, the test demonstrated that RBO consuming patients had significantly lower levels of serum uric acid (4.60 mg dl−1), TNF-α (6.99 ng L−1) and hs-CRP (2.11 mg L−1) compared to the control group ((5.92 mg dl−1), (15.23 ng L−1), (4.47 mg L−1), respectively) (P-value < 0.05). However, no significant changes were found regarding weight, blood pressure or serum HDL levels throughout the trial. Conclusion: Consumption of 30 grams per day RBO within a standard diet could be considered an effective non-pharmacological approach in improving LVEF, cardiometabolic risk factors, and inflammatory state in CAD. However, future trials are recommended for more clarification.

Background: As nutritional needs increase in adolescence, dairy consumption can play a key role in health and disease prevention; however, unfortunately, inadequate consumption of milk and dairy products has often been reported in adolescents. Aim: The purpose of this study was to investigate the relation between decisional balance, self-efficacy, and the processes of change with the stages of change for dairy consumption in female high school students in Shaft county located in the west of Gilan Province, Iran. Methods: A total of 385 female high school students in Shaft County were studied through the census method in 2019. The data collection instrument was a valid and reliable questionnaire consisting of demographic information, stages of change and items of transtheoretical model constructs including the processes of change (cognitive process: consciousness-raising, dramatic relief, self-reevaluation, environmental reevaluation, and social liberation; behavioral process: self-liberation, counter conditioning, reinforcement management, stimulus control and helping relationships), decisional balance and self-efficacy. Data were analyzed using SPSS 21 software. Results: A total of 208 (54%), 53 (13.8%), 56 (14.5%), 32 (8.3%) and 36 (9.4%) students were in the pre-contemplate, contemplation, preparation, action and maintenance stages, respectively. As the subjects progressed through the stage of change for dairy consumption, an increase in the mean score of self-efficacy, decisional balance, and processes of change was observed ( P

High blood pressure, diabetes, hyperlipidemia and obesity are risk factors for cardiovascular diseases. With regard to the significant role of a healthy diet in the prevention and even treatment of diseases together with the high cost and side effects of drugs, finding foods effective in the treatment of metabolic disorders has been widely considered. This study aimed to evaluate the effect of oxymel – an Iranian traditional syrup with vinegar base – on cardiovascular risk indicators in obese and overweight people. Candidates were selected based on a set of inclusion criteria and were divided into two groups of control and test. The control group received 250 cc of water, while the test group received 250 cc water containing 30 cc of the oxymel for 30 days. Anthropometric and biochemical indicators were measured at the beginning and end of the study. The results showed that there were no significant changes in the body mass index, waist circumference, hip circumference, waist to hip ratio, HDL, LDL, Triglycerides, systolic and diastolic blood pressure, and blood glucose level. However, weight (P = 0.053) and cholesterol (P = 0.083) decreased relatively significantly in the test group compared to the control group. This study shows that consumption of oxymel has positive cardiovascular effects such as lowering the blood cholesterol level and can contribute to weight loss; however, studies with a larger sample size are recommended.

Background and aims Premature ventricular contraction (PVC) as one of the most common arrhythmias could worsen the morbidity of cardiovascular events, particularly concurrent with other risk factors. Considering the probable side effects of antiarrhythmic drugs chronic use, prescribing herbal medicines for such conditions is on the rise. Melissa officinalis (MO) is widely identified as an antiarrhythmic and cardioprotective agent but there is limited evidence for its clinical use. This research, thus, aimed to investigate the effects of MO tea among patients with PVCs. Methods The present 12-week randomised controlled trial enrolled 60 patients with confirmed diagnosis of moderate to low-grade PVCs. The patients in intervention group received MO teabags (containing 2-g dried leaves/250 mL in hot water) two times/day in addition to lifestyle modification recommendations, while control group only received lifestyle modification recommendations. After collecting the data, blood samples were gathered to explore serum concentrations of glucose and lipid markers. The number of premature ventricular beats and heart rates was determined by 24-hour rhythm Holter monitoring. Results On average, the patients aged 47 years and approximately 67.8% (n = 40) were women. The ANCOVA adjusted for baseline values and confounders revealed that patients in the MO tea group had significantly lower concentrations of triglyceride (adjusted mean (AM) = 144.75 mg/dL), total cholesterol (AM = 155.35 mg/dL), and fasting blood sugar (AM = 90.85 mg/dL), compared with the controls (AM = 174.27, 171.99, 99.84 mg/dL, respectively (P-value ≤.042). However, the intervention failed to affect LDL-C and HDL-C levels significantly. Significantly reduced frequency of 24-hour premature ventricular beats in the MO tea group (AM = 2142.39) was also noted compared with the controls (AM = 3126.05); (P-value = .017). The 24-hour heartbeats showed only a significant decrease within the intervention group (P-value Conclusion Together, these results seem to support the higher cardioprotective effects of MO as a medicinal plant than lifestyle modifications alone. Nevertheless, further exploration of this hypothesis is warranted using large-scaled clinical trials.

Background It is well established that left ventricular systolic dysfunction (LVSD), as marked by reduced left ventricular ejection fraction (LVEF), notably worsens the prognosis of ST-elevation myocardial infarction (STEMI). However, the link between cardiometabolic risk markers and LVSD seems unclear. This study aimed to investigate the differences in variables affecting reduced LVEF in STEMI patients. Methods In the current retrospective study, 200 consecutive STEMI patients were enrolled between April 2016 to January 2017. Analysis of serum parameters, anthropometric evaluation, and echocardiography was performed after admission. The participants were categorized according to LVEF levels as follows: group1 (normal: 50–70%, n = 35), group2 (mildly reduced: 40–49%, n = 48); group3 (moderately reduced: 30–39%, n = 94) and group4 (severely reduced: Results Overall, of 200 STEMI patients with a mean age of 62 years, 27%(n = 54) were females. The median of BMI of patients in group4 (31.07 kg/m2) was significantly higher than group3 (26.35 kg/m2), group2 (25.91 kg/m2), and group1 (24.98 kg/m2; P value P value = 0.040). Patients in groups 1 and 2 exerted significantly elevated triglyceride levels than those in group4 (142.00, 142.50, and 95.00 mg/dl; P value = 0.001). WBC count, neutrophil%, and neutrophil to lymphocyte ratio among those in group1 (10,200/m3, 70.00%, and 2.92, respectively) were significantly lower than group4 (12,900/m3, 83.00%, and 5.47, respectively; P value Conclusion These findings highlight higher BMI, FBS, and leucocyte count linked to LVSD, probably through increasing the inflammation and reducing LVEF levels. More extensive studies are needed to clarify the clinical relevance of these results.

OBJECTIVE: This study aimed to assess the effects of soy consumption on glucose metabolism in patients with type 2 diabetes. METHODS: A systematic review was performed in accordance with the Preferred Reporting Items for Systematic Review (PRISMA) principles. Literature published between 1990 and 2019 was searched. Primary outcomes were the effect of soy on fasting plasma glucose (FPG), insulin, and HbA1c. The data were pooled using random effects models. Heterogeneity was assessed using Cochran's Q and I2 statistics. Also, the Cochrane Collaboration's tool for assessing risk of bias was used, and sensitivity analysis and meta-regression were conducted. Publication bias was evaluated using Egger and Begg tests. RESULTS: Sixteen randomized clinical trials (RCTs) with a total of 471 participants were regarded as eligible and included in the study. Soy consumption had no significant effects on FPG, insulin, and HbA1c. After the "trim-and-fill" method was applied, soy revealed a significant effect size on FPG (adjusted Cohen's d: -0.18; p = 0.03). Also, subgroup analyses using studies with parallel design showed a significant improvement (moderate effect size) in FPG and insulin. Sensitivity analysis indicated the robustness of our findings. Among secondary outcomes, the results showed a significant effect of soy on HOMA-IR and total cholesterol levels. CONCLUSIONS: Although this systematic review and meta-analysis indicated no beneficial effects of soy consumption on FPG, insulin, and HbA1c in patients with type 2 diabetes, pooling of parallel studies showed different results from crossover studies. The quality of evidence revealed low levels of confidence for primary outcomes. Therefore, further research is recommended.

Background: Iran has been experiencing an accelerated change in the nutrition and health of its people, which has led to considerable variations in the country’s nutritional status. Little is known about the food insecurity status in the north of Iran. Aim: The present study aimed to investigate the food insecurity status and factors associated with it in a rural area in the north of Iran. Methods: This cross-sectional study was conducted among 573 rural households in Guilan Province in the north of Iran. The food insecurity status of the households was measured using the Household Food Insecurity Access Scale. Data on the demographic characteristics of the households and their depression status were collected by interviewing the heads of the households. The socioeconomic status index of the households was constructed using factor analysis, and a multivariate ordinal logistic regression model was used to estimate the adjusted odds ratio of the independent predictors of food insecurity. Results: The results indicated that approximately half of the households (50.8%) had experienced mild (43.2%), moderate (6.5%) or severe (1.1%) food insecurity. The multivariate model showed that sex, age, depression status of the head of the household and having a patient with a chronic condition in the household were independently associated with food security status. Conclusions: This study showed that food insecurity was highly prevalent among rural households in the north of Iran. The study concludes that interventions with the aim of reducing the prevalence of food insecurity, depression and chronic diseases in the area can be effective in improving the nutritional status of the households.

Evidence suggests that dietary pattern is related to incidence and grades of nonalcoholic fatty liver disease (NAFLD). The aim of this study was to investigate the relationship between major dietary patterns and hepatic histologic features of newly diagnosed patients with NAFLD.This cross-sectional study included 260 newly diagnosed NAFLD patients. Hepatic fibrosis and steatosis were diagnosed using Fibroscan. Dietary information was obtained using a validated 168-item semiquantitative food frequency questionnaire. The association between dietary patterns and odds ratio of the grade of fibrosis and steatosis was examined by multinomial logistic regression.The mean ± SD age participant was 46.53 ± 11.71 years. Fifty-seven percent of the participants were women. Two major dietary patterns were recognized: "Western dietary pattern" and "Mediterranean dietary pattern." After adjustment for various confounders, adherence to the two extracted dietary patterns was not associated with odds of fibrosis and steatosis (The major dietary patterns of NAFLD patients living in Gilan were not related to the severity of their disease. More precise study design such as cohort or interventional studies is suggested to reveal the strength of this study findings.

Background Identifying the non-survived patients’ characteristics compared to survived subjects and introducing the critical risk factors of COVID-19 mortality would help enhance patients’ prognosis and treatment. Methods In the current case-control study, medical records of 103 non-survived COVID-19 patients (cases) and 147 sex-matched survivors (controls) who admitted to Razi University Hospital in Rasht, Guilan, Northern Iran from April 21 to August 21, 2020, were explored. Data on demographic, anthropometric, clinical, and laboratory assessment was extracted from the electronic medical records. To estimate the association between variables of interest and mortality odds due to COVID-19 logistic regression was carried out. Results The patients who died (mean age = 62.87 years) were older than the discharged patients (57.33 years; P value = 0.009). According to the results of multivariable regression adjusted for potential confounders, elevated BMI (OR = 2.49; 95% CI = 1.15–5.41), higher CRP levels (OR = 2.28; 95% CI = 1.08–4.78), increased FBS levels (OR = 2.88; 95% CI = 1.35–6.17), higher levels of total cholestrol (OR = 2.55; 95% CI = 1.19–5.45) and LDL (OR = 2.27; 95% CI = 1.07–4.79), elevated triglyceride (OR = 5.14; 95% CI = 2.28–11.56), and raised levels of D-dimer (OR = 5.68; 95% CI = 2.22–14.49) were identified as independent risk factors of COVID-19 mortality. No significant association was detected regarding HDL level, QTc interval or heart size, and COVID-19 fatality odds. Conclusion The present findings demonstrated that obesity, higher levels of CRP, blood sugar, D-dimer, and lipid markers were likely to be predictive factors of COVID-19-related mortality odds.

Purpose Recent studies have shown that hyperuricemia is a predictor of non-communicable disease and an increment of mortality rate. Also, elevated serum uric acid may be associated with obesity in the adult population. This study aims to evaluate the association between serum uric acid levels with metabolic parameters and risk of obesity in the Iranian population. Design/methodology/approach The cross-sectional study was done on 550 participants, who were referred to a hospital for elective angiography in Rasht, Iran; anthropometric indices (waist circumference (WC) and body mass index (BMI)) and hematological factors were measured using the standard approaches. Based to the angiography results, the severity of atherosclerosis was defined. Findings The mean (SD) concentration of serum uric acid for all participants was 5.15 (1.37) mg/dl. Individuals who were at the highest tertile had higher mean (SD) of weight (p = 0.004), creatinine and blood urea nitrogen (p < 0.001) lower fasting blood sugar (FBS) (p = 0.000) and HbA1c (p = 0.016), and they were mostly men compared with those in the lowest tertile. After adjusting for confounders, FBS (ß = –0.145, p = 0.001) and HbA1c (%) (ß = –0.130, p = 0.019) had inverse and weight (ß = 0.156, p = 0.001) had direct association with serum uric acid. After adjustment for additionally potential confounders subjects in the highest tertile of serum uric acid had 92 per cent higher chance of obesity compared with subjects in the lowest tertile (OR 1.92; 95 per cent CI 1.13, 3.23). Originality/value The present study has concluded that increase serum uric acid related to high risk of obesity and low mean of FBS and HbA1c.

Objective: To evaluate the relationship between platelet count after primary percutaneous coronary intervention (p-PCI) and left ventricular aneurysm (LVA) in patients with acute anterior ST-elevation myocardial infarction(STEMI). Methodology: This descriptive study was performed on a population of patients with acute anterior STEMI, who had undergone p-PCI. Sampling was carried out by a consecutive survey of patients, who were admitted to the Medical Center in summer and fall of 2018. Blood samples were collected intravenously from all the patients at admission to the emergency department before and after p-PCI. Echocardiographic examinations were routinely performed by a specialist assistant as the co-author 8 to 12 hours after p-PCI and at follow-up (10 to 14 months after acute MI). The TIMI flow was observed immediately after p-PCI. In all the patients undergoing p-PCI, the location of left anterior descending (LAD) artery involvement during coronary arteries angiography was divided into three sections based on LAD artery length. Results: The mean WBC and PMN before p-PCI were statistically higher in the group of patients with LVA compared to individuals without LVA (p

OBJECTIVE This study was conducted to assess the prevalence of central and general obesity and compare nine anthropometric indices as predictors of the risk factors for cardiovascular disease (CVD) in Iranian adults. METHODS A total of 10,520 adults between ages 35 and 70 years old who were referred to the PERSIAN Guilan Cohort Study were included in this study. Anthropometric indices, including body mass index (BMI), waist circumference (WC), waist to height ratio (WHtR), waist to hip ratio (WHR), conicity index, hip circumference (HC), waist to hip to height ratio (WHHR), body adiposity index, and a body shape index (ABSI), were measured using the standard methods. The risk factors for CVD (diabetes mellitus, hypertension, and out of range lipid profiles) were defined by laboratory tests and medical history. The odds ratio of the risk factors based on a unit increase in anthropometric indices was examined by an adjusted logistic model. RESULTS The mean of all anthropometric indices was higher in women than in men (p

INTRODUCTION: The aim of study was to assess the reliability and validity of the14-point Mediterranean Diet Adherence Screener (MEDAS) among Iranian high risk population. METHODS: Study was conducted in north of Iran a country with a Shiite majority with religious constraints, so we modified the MEDAS in the Farsi version. We applied reliability analysis using the Kuder – Richardson 20 and the alpha coefficient of Cronbach, with SPSS to interpret the effects of each item of MEDAS in its internal consistency. RESULTS: After correcting the item scores, coefficients of Kuder-Richardson-20 was calculated 0.559. The mean±SD of 13 items MEDAS was 5.73±1.88. None of Corrected Item-Total Correlation coefficients were negative. 43%, 53% and 4% participants had low, medium and high adherence to a Mediterranean diet respectively. CONCLUSION: In spite of making a few changes in questions, the coefficients of Kuder-Richardson-20 did not decrease in reliability analysis. The MEDAS was translated for the first time into Farsi. Administering this tool in future researches will help to understand how Iranian adhere to the mediterranean diet, aiming at improving cardiovascular health.

Objective As a popular beverage, there has been much interest in studying the effects of tea intake on hypertension (HTN), a particular risk factor for cardiovascular disorders (CVDs). We have thus aimed to isolate the randomized controlled trials investigating the efficacy of black or green tea as a beverage in subjects with elevated blood pressure (BP), or HTN. Methods PubMed, Scopus, Web of Science, and ProQuest dissertations and theses databases were searched from February 1, 1995, up to July 20, 2019, to identify relevant studies. Results The search strategy generated 1119 trials, of which finally five trials fulfilled the criteria for being included in the current study. Three out of 5 articles showed a low risk of bias. According to nine measurements derived from 5 trials on 408 individuals, it was found that regular tea intake resulted in the reduction in SBP (weighted mean difference (WMD): −4.81 mmHg, 95 %CI: −8.40 to −1.58, P = .004) and DBP (WMD:-1.98 mmHg, 95 %CI: −3.77 to −0.20, P = .029); however, excluding the most heterogeneous trials showed that regular tea intake might reduce SBP and DBP by about −3.53 and −0.99 mmHg, respectively. Based on meta-regression findings, we found the longer the duration of tea intake (≥3months), the higher the decrease in both SBP and DBP. Categorized studies, according to the tea type, revealed that the hypotensive effects of green tea were more pronounced compared to black tea. None of the studies reported any side effects. Conclusion These results suggest the positive effects of regular tea intake on BP in subjects with elevated BP or HTN. Hence, it may be applicable to physicians, health care providers, and particularly HTN patients.

Background: High blood pressure is a major health threat and self-control has great importance in its management. Hence, a nutrition model is presented based on dietary approach to stop hypertension (DASH) diet. The present study aimed to investigate the effect of training on adherence to DASH diet on blood pressure among hypertensive patients in Rasht, North of Iran. Methods: A total of 150 hypertensive patients visiting health care centers were randomly divided into education intervention and control groups. Food frequency questionnaire were completed before and 2.5 months after the intervention. Patients’ blood pressure was measured at the same time interval. The post-baseline DASH diet components and blood pressure between the two study groups were compared using analysis of covariance. Results: Participants’ mean age was 56.08 ± 6.1 years and 76% of them were female. At baseline, the daily intake of dairies, fruits, and nuts and beans were significantly lower than the recommended DASH values in both groups. In contrast of fat, tea and salty food, all post-baseline DASH diet components in the intervention group were significantly higher than the control group. The intervention group had a significantly lower systolic blood pressure compared to control group 2.5 months after of the intervention. Conclusion: Our results indicated that training nutrition based on DASH diet can be considered as a useful strategy to control high blood pressure among hypertensive patients.

BACKGROUND AND OBJECTIVE: Considering the relationship between abdominal (central) obesity and chronic diseases and disorders of biochemical factors, as well as the role of ethnicity and geographical area on the relationship between obesity and chronic diseases, this study aims to determine the prevalence of abdominal obesity and its relationship with biochemical and blood pressure indices in candidates for angiography. METHODS: This cross-sectional study was performed on 610 subjects aged 25-75 years who were candidates for elective angiography and were referred to Heshmat Hospital in Guilan province in 2016. Data were collected by interview, medical records, blood pressure measurements and anthropometric indicators, including weight, height, body mass index and waist circumference. Fasting blood samples were used for biochemical indices. Abdominal obesity was determined based on waist circumference more than 102 cm in men and more than 88 cm in women. FINDINGS: In this study, 348 (57%) patients had abdominal obesity. 29% of men (101 patients) and 71% of women (248 patients) had abdominal obesity and there was a significant relationship between gender and abdominal obesity (p=0.0001). There was a significant different between patients with abdominal obesity and non-obese subjects in terms of total cholesterol (161±40 vs. 153±41 mg/dl, p=0.04), HDL cholesterol (44±8.6 vs. 43±8.2 mg/dl, p=0.01) and hematocrit (39±4.1 vs. 41±4.4 mg/dl, p=0.001). The variables of age, gender, and BMI were independent predictors of abdominal obesity. The incidence of abdominal obesity was 37 times higher in women and increased significantly with age. The chance of obesity increased by 1.25 per unit body mass index increase. CONCLUSION: The results of this study demonstrate the prevalence of abdominal obesity in candidates for elective angiography and its association with some blood factors.

Background and Objective: Living without mobility and physical inactivity considered as one of the main modifiable causes of heart (cardiac) diseases. This study aimed to implement an educational program by using the theory of planned behavior to improve the physical activity of hypertensive patients. Methods: This quasi-experimental study was conducted among 150 patients with hypertension, referred to centers number 13 and 14 of Rasht in two intervention and control groups. The study tools were standardized GPAC questionnaire and physical activity related questionnaire based on the theory of planned behavior. Data analysis was done by using SPSS software. Results: The mean age of participants was 56.08 years, of which 76% were female and 24% were male. The mean and standard deviation of physical activity MET / MIN / WEAK were evaluated in five sections of total physical activity, physical activity at work, physical activity in displacement, physical activity of leisure and sitting state. The results showed that there was no significant difference in two groups before the intervention, and after that, there was a significant increase in total physical activity, physical activity at work and physical activity during sitting position in the intervention group, and decreased systolic and diastolic blood pressure in patients (p

Background Subjects who have cardiovascular diseases (CVDs) share a variety of common characteristic including increased blood pressure (BP), disrupted glycemic control, and augmented levels of atherogenic lipids in the serum (i.e., total cholesterol (TC), triglycerides (TG), low‐density lipoprotein cholesterol (LDL‐C) or reduced serum levels of high‐density lipoprotein cholesterol (HDL‐C). The intestinal microbiota dysbiosis could play an essential role in the pathophysiology of chronic metabolic disorders mainly through inducing immune dysfunction, triggering inflammation, dysregulation in energy metabolism, and epithelial barrier dysfunction. Interestingly, these changes are believed to be fully resolved by restoring symbiosis mainly using probiotics. In the present review, we aimed to collect the recent evidence on the effects of probiotics on certain cardiometabolic risk factors. Methods The literature searching was conducted through MEDLINE and ScienceDirect databases including articles published between January 2014 to October 2020. Thirty-four meta-analysis of clinical trials investigating the efficacy of probiotics on cardiometabolic markers are included. Results Probiotics supplementation for at least 8 weeks might be promising in reducing BP, blood glucose, HbA1c, insulin resistance, TC, LDL-C, and TG and elevating HDL-C levels. It seems, younger subjects ( Conclusion The present review further emphasizes the crucial effects of probiotics as a complementary therapeutic strategy in enhancement of cardiometabolic risk markers.

Objective This study investigated the effects of garlic on brachial endothelial function and THP-1 macrophage cholesterol efflux (CE) and examined whether garlic modulates ATP-binding cassette (ABC) A1 and ABCG1 mRNA expressions in peripheral blood mononuclear cells (PBMCs) isolated from patients with coronary artery disease (CAD). Methods In this randomized, placebo-controlled trial, patients with CAD were randomly divided into two groups: those receiving garlic powder or placebo tablets twice daily for 3 months. Brachial flow-mediated dilation (FMD) was assessed using ultrasound. Fasting blood samples were collected before and after period and PBMC and plasma were isolated. Human THP-1 monocytes were differentiated into macrophages, labeled with 3H-cholesterol, and incubated with plasma samples, and CE was assessed. ABCA1 and ABCG1 mRNA expressions were determined in PBMCs. Results After 3 months, brachial FMD values significantly improved (50.7%) in the garlic group compared with those in the placebo group (p=0.016). High-sensitive C-reactive protein (hs-CRP) levels significantly decreased in the garlic group, but the difference between the two groups was not statistically significant. No significant difference was observed with regard to CE and ABCA1 and ABCG1 mRNA expressions in PBMCs. CE was negatively correlated with hs-CRP levels. Conclusion Short-term treatment with garlic may improve the endothelial function and may affect hs-CRP levels; however, it could neither significantly improve THP-1 macrophage CE nor affect ABCA1 or ABCG1 expressions in PBMCs.