Association of dietary phytochemical index with cardiometabolic risk factors

Objective(s): Cardio-metabolic risk factors are becoming a global health concern. To address this problem, one of the proposed ways is to focus on phytochemical-rich foods consumption. Therefore, we aimed to summarize the results of observational studies (cohorts, case-control, and cross-sectional) that investigated the association between dietary phytochemical index (PI) as a new index for evaluating phytochemical-rich food intake and various risk factors of cardio-metabolic disorders. Methods: We conducted a comprehensive systematic review through PubMed, Scopus, and Web of Science databases. The literature search was performed up to August 2021 with no publication year restriction on observational studies investigating the association between PI and cardiometabolic risk factors on adults and children. A random-effect meta-analysis was used. Results: Overall, 16 articles (cross-sectional, case-control, cohort) were eligible for this systematic review and 8 studies with 99771 participants were included in the meta-analysis. Random effect meta-analysis showed that adherence to higher dietary PI decrease the odds of abdominal obesity (OR: 0.73, 95% CI: 0.58, 0.88, I2: 84.90), generalized obesity (OR: 0.84, 95% CI: 0.69, 0.98, I2: 68.10), hypertriglyceridemia (OR: 0.81, 95% CI: 0.73, 0.89, I2: 0.00), hypertension (OR: 0.86, 95% CI: 0.73, 0.99, I2: 7.02), and MetS (OR: 0.79, 95% CI: 0.69, 0.88, I2: 84.90). However, results considering the associations between dietary PI with glycemic indices, and low high-density lipoprotein cholesterol (HDL-C) were not significant (p<0.05). Conclusion: Evidence showed adverse associations between dietary PI and some cardio-metabolic risk factors such as obesity, hypertriglyceridemia, hypertension and metabolic syndrome.

The effects of pro-, pre-, and synbiotics supplementation on polycystic ovary syndrome: an umbrella review of meta-analyses of randomized controlled trials

Background

Synbiotics, refer to a combination of probiotics and prebiotics in a form of synergism that beneficially affect the host's health by alternating the composition and/or function of the gut microbiota. Numerous meta-analyses of randomized clinical trials have proven that pro, pre-, and synbiotics supplementation has health outcomes in women with polycystic ovary syndrome (PCOS). However, the strength and quality of this evidence in aggregate have not yet been synthesized in great detail.

Methods

PubMed, Scopus, Web of Sciences, and Google Scholar were searched up to March 2023. We pooled the mean difference and its 95% confidence interval (CI) by applying a random-effects model.

Results

Overall, nine meta-analyses including a total of 12 trials were identified. The results of the present study indicated that probiotic supplementation significantly reduced the homeostatic model assessment for insulin resistance (HOMA-IR; WMD: -0.29, 95% CI: -0.57 to -0.02, p = 0.03, n = 4; moderate certainty) and fasting glucose concentration (FGC; WMD: -7.5 mg/dL, 95% CI: -13.60 to -0.51, p = 0.03; n = 4; low certainty). Moreover, synbiotic supplementation had beneficial effects on glycemic control, lipid profile, and hormonal parameters, but the certainty of the evidence was rated as low to very low. However, supplementation with pro-/synbiotics did not affect inflammation and oxidative stress in women with PCOS. Furthermore, waist/hip circumference, fasting glucose concentration, lipid profile, dehydroepiandrosterone sulfate, high-sensitivity C-reactive protein, and hirsutism score were significantly reduced after prebiotics supplementation with low certainty of evidence.

Conclusion

Although pro-, pre-, and synbiotics supplementation had beneficial effects on some PCOS-related outcomes, the certainty of the evidence was rated as low to very low. Therefore, further well-designed RCTs might help to confirm our findings in women with PCOS.

Association of healthy beverage index with circadian rhythm and quality of sleep among overweight and obese women: a cross-sectional study

PURPOSE

Circadian rhythm is a behavioral, physiological, and molecular change with a cycle length of approximately 24 h. Changes to the circadian rhythm can result in sleep difficulty. The healthy beverage index (HBI) is a holistic concept for evaluating the quality of overall beverage intake and its association with health-related outcomes in nutritional epidemiological studies. This study aimed to assess the relationship of HBI with circadian rhythm and sleep quality among overweight/obese women.

METHODS

The current study was conducted among 208 overweight and obese women between 18-48 years in Tehran, Iran. We evaluated potential HBI with a valid food frequency questionnaire. Following standard procedures, trained personnel assessed anthropometric measures, blood samples, and other baseline characteristics. The Pittsburgh Sleep Quality Index and the morning-eveningness questionnaire were applied to evaluate sleep quality and circadian rhythm respectively.

RESULTS

The mean (SD) BMI for this study was 30.8 (4.2) kg/m². We observed that subjects in the least tertile had significantly high levels of triglyceride (p = 0.04) and low-density lipoprotein (p = 0.009). High-density lipoprotein was significantly different across the tertiles (p = 0.003). After adjusting for potential covariates, subjects in the second tertile of HBI had 5.07 odds of having the worst quality of sleep as compared to those in the third tertile, p < 0.05. We also observed a significant inverse association between the HBI and the "moderately evening type" participants (OR 0.86; 95% CI 0.68-0.99; p: 0.02) after adjusting for potential confounders.

CONCLUSION

Healthy beverage consumption may have the potential of improving sleep quality among overweight and obese subjects.

LEVEL OF EVIDENCE

Level IV, evidence obtained from a descriptive study.

The Association Between Dietary Diversity Score and Odds of Diabetic Nephropathy: A Case-Control Study

A dietary diversity score (DDS) may be a useful strategy for monitoring risks associated with chronic diseases. Few studies have investigated the relationship between DDS and the progression to chronic kidney disease (CKD). A better understanding of the relationship between DDS and diabetic nephropathy (DN) may provide insight for monitoring the overall diet and clinical outcomes. This case-control study included 105 women with DN and 105 controls with age and diabetes duration-matched to evaluate the extent to which DDS is associated with DN. Dietary intake was assessed using the food frequency questionnaire (FFQ). DDS was calculated based on the method using five food groups: bread/grains, vegetables, fruits, meats, and dairies. Conditional logistic regression was performed to examine the association between DDS and odds of DN. Anthropometric measures and physical activity levels were evaluated using standard protocols. In a fully adjusted model [controlled for age, body mass index (BMI), energy intake, physical activity, diabetes duration, cardiovascular disease history, and drug usage], greater adherence (the third vs. the first tertile) to DDS [odds ratio (OR) = 0.13; 95% CI (0.05–0.35)], vegetables group [OR = 0.09; 95% CI (0.02–0.36)], and fruits group [OR = 0.05; 95% CI (0.01–0.20)] were significantly associated with lower odds of DN. However, we did not observe any significant relationship between other DDS components and the odds of DN. Our findings showed that higher DDS might be associated with reduced odds of DN. However, more prospective studies are warranted to confirm these findings.

Associations between mother-child dyad dietary patterns and child anthropometric measures among 6-year-old children

The goals of this study were to study relationships between maternal and children's dietary patterns (DPs) and to assess how children's DP was associated with child anthropometry. This cross-sectional study included 788 pairs of 6-year-old girls and mothers in health centers in Tehran, Iran. Information on dietary intake was collected with a 168-item food frequency questionnaire. Principal component factor analysis was performed to label different data-driven dietary patterns. Three different binary logistic regression models were used to evaluate the associations between child's DPs and child anthropometry. A positive correlation was found between all maternal patterns and child's Western DP (p < 0.001). Maternal prudent and Western DPs were correlated with child's high-protein DP (p < 0.001). Children's high-protein DP was negatively correlated with maternal high fat DP (p < 0.001). Maternal prudent and high fat DPs were correlated with prudent DP in children (p < 0.001). In adjusted models, a child being in the highest compared to the first quartile of the high-protein DP was associated with decreased odds of underweight and wasting (OR 0.43; 95% CI 0.23-0.80).Conclusion: The present study showed inverse associations between a high-protein DP in children and being underweight and wasted. Also, a positive correlation was found between all maternal DPs and children's Western DPs. This correlation should be taken into account while managing child nutrition by means of educating parents on the influence of their own dietary pattern on their children. Moreover, getting enough protein through a balanced diet should be considered in children. What is Known: • Some research exists on the intake of specific foods in relation to risk of abnormal growth in children. • Less is known about the relationship between mothers' and children's food intake. What is New: • Better adherence to a high-protein dietary pattern was significantly associated with lower risk of being both underweight and wasted. • This study suggests that correlation between mothers' and their children's dietary patterns exists, which should be taken into consideration when managing child nutrition.

Dietary components and the risk of non-melanoma skin cancer: A systematic review of epidemiological studies

Non-melanoma skin cancer (NMSC) is the most common cancer among white-skinned people. The main environmental risk factor for all types of skin cancer is ultraviolet (UV) exposure to the sun. However, significant modifiable risk factors, such as diet, have been studied about NMSC risk. Several original studies have been conducted on the link between various dietary components and the risk of NMSC in the past decade, but have not been systematically reviewed. This review focuses on the potential impact of dietary components in the prevention of NMSC and evaluates the findings of epidemiologic evidence for dietary factors. We conducted a systematic search of three databases, including Scopus, ISI Web of Science, and PubMed, to identify relevant epidemiological studies published between 2000 and July 6, 2021. Finally, forty-three articles were included. Because of the inherent limitations of epidemiological studies, no definitive conclusions can be drawn; however, the links between folate, citrus, caffeine, and alcohol with BCC are notable; thus, high dietary folate intake, as well as citrus and alcohol consumption, are associated with an increased risk of basal cell carcinoma (BCC), whereas caffeine is associated with a lower risk. More research is required to reach a definitive conclusion.

Associations between empirically derived dietary patterns and cardiovascular risk factors among older adult men

Cardiovascular disease (CVD) remains the leading cause of death globally, and epidemiological studies have suggested a link between diet and cardiometabolic risk. Currently, the prevalence of CVD is rapidly increasing with an aging population and continues to contribute to the growing economic and public health burden. However, there is limited evidence available regarding dietary patterns and cardiometabolic risk factors in older adults. We conducted a cross-sectional study to assess dietary patterns and cardiometabolic risk factors in males ≥60 years. Factor analysis identified a "healthy" diet and an "unhealthy" diet as the two primary dietary patterns. Multivariable logistic regression was used for estimating the associations of identified dietary patterns and cardiometabolic risk factors including anthropometric measures, blood pressure, glycemic biomarkers, lipid profile, and inflammatory biomarkers. A healthy dietary pattern was significantly associated with decreased odds of high serum fasting blood sugar (FBS) (OR: 0.32; 95% CI: 0.15-0.67; P_trend=0.002), but increased odds of high serum low-density lipoprotein cholesterol (LDL-C) (OR: 1.82; 95% CI: 1.02-3.24; P_trend=0.04). In comparison, an unhealthy diet was associated with increased odds of obesity (OR: 2.33; 95% CI: 1.31-4.15; P_trend=0.004) and high LDL-C (OR: 2.00; 95% CI: 1.10-2.61; P_trend=0.02). Thus, in older adults, adherence to an unhealthy dietary pattern has a significant impact on clinically relevant risk factors for cardiometabolic risk.

Dietary Intake of Linoleic Acid, Its Concentrations, and the Risk of Type 2 Diabetes: A Systematic Review and Dose-Response Meta-analysis of Prospective Cohort Studies

BACKGROUND

Earlier evidence on the association between dietary polyunsaturated fatty acids and risk of diabetes has been conflicting.

PURPOSE

To quantitatively summarize previous studies on the association between dietary LA intake, its biomarkers, and the risk of type 2 diabetes mellitus (T2DM) in the general population.

DATA SOURCES

Our data sources included PubMed/MEDLINE, Scopus, and ISI Web of Science until 24 October 2020; reference lists of all related articles; and key journals.

STUDY SELECTION

We included prospective cohort studies that examined the associations of linoleic acid (LA) with the risk of T2DM in adults.

DATA SYNTHESIS

The inverse variance method was applied to calculate summary relative risk (RR) of LA intake and its biomarkers, and dose-response associations were modeled using restricted cubic splines. Twenty-three publications, covering a total of 31 prospective cohorts, were included; these studies included 297,685 participants (22,639 incident diabetes cases) with dietary intake assessment and 84,171 participants (18,458 incident diabetes cases) with biomarker measurements. High intake of LA was associated with a 6% lower risk of T2DM (summary relative risk [RR] 0.94, 95% CI 0.90, 0.99; I ² = 48.5%). In the dose-response analysis, each 5% increment in energy from LA intake was associated with a 10% lower risk of T2DM. There was also evidence of a linear association between LA intake and diabetes, with the lowest risk at highest intakes. The summary RR for diabetes per SD increment in LA concentrations in adipose tissue/blood compartments was 0.85 (95% CI 0.80, 0.90; I² = 66.2%). The certainty of the evidence was assessed as moderate.

LIMITATIONS

A limitation of our work was the observational design of studies included in the analyses.

CONCLUSIONS

We found that a high intake of dietary LA and elevated concentrations of LA in the body were both significantly associated with a lower risk of T2DM. These findings support dietary recommendations to consume dietary LA.

Dietary protein sources and risk of diabetic nephropathy in women: A case-control study

BACKGROUND

Several studies have investigated the association between dietary protein and the risk of diabetic nephropathy (DN); however, there is no agreement on the type of dietary protein sources that might increase the risk of DN. This study was conducted to investigate the associations between different protein sources and the odds of DN developing in Iranian women with existing type 2 diabetes.

METHODS

In this case-control study, 105 women with DN and 105 controls, matched for age and diabetes duration, were selected from the Kowsar Diabetes Clinic in Semnan, Iran. Dietary intake was assessed using a validated and reliable food frequency questionnaire. Dietary protein patterns were estimated using the factor analysis method. Multivariate logistic regression was performed to examine the association between protein patterns and the odds of developing DN.

RESULTS

Two patterns were identified: the Mediterranean-based Dietary Protein Sources (MDPS) pattern which is rich in low-fat dairy, fish, poultry, soy, and legumes, and the Western-based Dietary Protein Sources (WDPS) pattern, rich in red and processed meats, eggs, and high-fat dairy. After adjusting for several confounders, greater adherence (third vs. the first tertile) to the MDPS pattern was associated with lower odds of DN (OR = 0.03; 95 % CI: 0.00, 0.10). In contrast, a strong positive association was observed between adherence to the WDPS pattern and DN (OR = 2.81; 95 % CI: 1.09-7.21).

CONCLUSIONS

Our results show that there is a potential association between the type of protein sources consumed and the odds of DN development in women with type 2 diabetes. Further studies are needed to confirm these findings.

The Association between Dietary Diversity Score and Risk of Prostate Cancer: (A Case-Control Study)

There are few studies that evaluated the relationship between dietary diversity score (DDS) and risk of cancer. The purpose of this study was to examine the association of DDS with the risk of prostate cancer (PC) among Iranian men. This case-control study was performed among 60 cases with prostate cancer and 60 hospital-based controls. Anthropometric measurements were done and demographic information was recorded using standard protocols. A validated 160-item semi-quantitative food frequency questionnaire (FFQ) was used to assess usual dietary intakes. Also, Binary logistic regression was performed to estimate the risk of PC in relation to DDS. After controlling for several confounders (age, body mass index, physical activity, energy intake, job, education, and antihypertensive drugs usage) higher adherence to DDS (OR = 0.33; 95% CI (0.11-0.97)), fruits group (OR = 0.19; 95% CI (0.06-0.63)), and vegetables group (OR = 0.17; 95% CI (0.05 - 0.58)) were significantly associated with lower risk of PC. In contrast, greater adherence to the meat group (OR = 3.88; 95% CI (1.32-11.42)) was significantly associated with increased PC risk. Our results showed that adherence to a diet with higher DDS, especially higher amounts of fruits and vegetables and a lower amount of meat could decrease the risk of PC.

The association between Healthy Beverage Index and anthropometric measures among children: a cross-sectional study

PURPOSE

Several studies evaluated the associations between specific beverages and cardio-metabolic risks among children. However, the evidence on the association between patterns of the beverage consumption and children's anthropometric indices is rare. Therefore, this study was conducted to examine the association between Healthy Beverage Index (HBI) and anthropometric measures among 6-year-old girl children.

METHODS

In this cross-sectional study, 788 children selected from health centers in Tehran, Iran. Data on beverage intake, socio-demographic, physical activity, and anthropometric characteristics were evaluated using reliable and validated standard protocols. The predefined HBI was calculated based on the previous research.

RESULTS

After controlling for several confounders [mother age, mother body mass index, mother physical activity, socioeconomic status, children physical activity and energy intake, total oils (all kinds of oils like animal and plant oils), and total sweet foods (sweet foods except sweetened beverages)], being in the third compared to the first tertile of HBI among children was associated with increased odds of wasting (OR: 5.16; 95% CI 1.5-17.79) and underweight/wasting (OR: 1.81; 95% CI 1.07-3.07). Among the HBI components, just being in the third compared to the first tertile of high-fat milk was inversely associated with decreased odds of wasting (OR: 0.18; 95% CI 0.04-0.73).

CONCLUSIONS

The HBI among children was associated with higher odds of wasting and underweight/wasting. In addition, high-fat milk consumption decreased the odds of wasting among children. Further prospective studies need to confirm these results.

LEVEL OF EVIDENCE

Level V, descriptive cross-sectional study.

Plant-based diets and risk of disease mortality: a systematic review and meta-analysis of cohort studies

We aimed to examine the association between adherence to plant-based diets (PBDs) and the risk of mortality among the general population. Relevant investigations were identified through PubMed, Scopus, Embase, and ISI Web of Knowledge. Data were pooled using a random-effects or a fixed-effects model. Twelve prospective cohort studies with 42,697 deaths among 508,861 participants were included. The hazard ratios (HRs) for the highest compared to the lowest category of adherence to the PBDs were 0.90 (95% confidence interval [CI]: 0.82, 0.99; I² = 91%, n = 12) for all-cause and 0.77 (95% CI: 0.70, 0.86; I² = 36%, n = 8) for coronary heart disease (CHD) mortality. Among PBDs subtypes, there was an inverse association between healthy plant-based 0.92 (95% CI: 0.88, 0.96; I² = 0%, n = 2), Pesco-vegetarian 0.81 (95% CI: 0.70, 0.92; I² = 0%, n = 2), and Pro-vegetarian 0.74 (95% CI: 0.55, 0.88; I² = 61.2%, n = 2) diets and the risk of all-cause mortality. A vegetarian diet was also associated with lower risk of mortality due to cardiovascular 0.92 (95% CI: 0.85, 0.99; I² = 0%, n = 5) and CHD 0.76 (95% CI: 0.68, 0.85; I² = 35%, n = 7). Our findings show the potential protective role of PBDs against chronic disease mortality. As there were certain limitations in some of the studies included in this systematic review and meta-analysis, further research is necessary to confirm our findings.

The effect of Alpha-lipoic acid supplementation on endothelial function: A systematic review and meta-analysis

There is evidence that alpha-lipoic acid (ALA) supplementation plays an important role in preventing cardiovascular diseases. However, its effect, specifically, on endothelial function (EF) is unclear. Therefore, this systematic review and meta-analysis aimed to evaluate the effects of ALA supplementation on EF. Databases including PubMed/Medline, Scopus, and ISI Web of Science were searched to identify eligible publications from inception up to April 2020. Randomized controlled trials assessing the effect of ALA supplementation on flow-mediated dilation (FMD) levels in adults were included. The pooled results were obtained using the random-effects model and are expressed as weighted mean differences (WMD) with 95% confidence intervals (CI). Five studies including six effect sizes and 300 participants were included. ALA supplementation significantly increased FMD levels by 2.36% (95% CI: 1.21-3.51; p < .001), compared with the control. Subgroup analyses suggested that the effects of ALA on FMD could be changed by age and health status of the participants. Dose-response analysis also showed that ALA dosage had a significant non-linear effect on FMD levels. The results showed that ALA supplementation appears to improve the EF. However, the role of ALA supplementation in improving other biomarkers of EF requires further research.

The association of dietary choline and betaine and anthropometric measurements among Iranian children: a cross-sectional study

Background

Previous studies have suggested that choline and betaine are associated with improved anthropometric measures including, BMI and waist circumference however, results are largely inconsistent and limited studies exist in children. Our objective was to investigate the relationship between dietary choline and betaine, and anthropometric measurements among Iranian children.

Methods

In this cross-sectional study, dietary information was collected for 788 six-year-old children, who attended Tehran health centers in 2018. We measured dietary intakes using a valid and reliable semi-quantitative food frequency questionnaire. The USDA database was used to calculate dietary choline and betaine. We assessed anthropometric characteristics, physical activity, and socio-demographic status based on a reliable and valid protocol. Logistic regression adjusted for energy, physical activity, socio-economic status, and maternal age, physical activity, BMI, and HEI2015 was used to assess this association.

Results

Free choline, glycero-phospho-choline, phospho-choline, phosphatidyl-choline, total choline, and total betaine, and choline were not related to overweight, obesity, underweight and wasting in the crude and adjusted model after controlling for children’s energy intake, children’s physical activity, socio-economic status, maternal physical activity, and BMI. Betaine intake was associated with mid-arm circumference and risk of overweight.

Conclusions

We did not find any evidence to support the association between dietary choline with anthropometric measurements among Iranian children. Further prospective studies with a large sample size in different populations are needed.

Dietary energy density and risk of prostate cancer: (A case-control study)

OBJECTIVE

Some observational studies investigated the association between dietary energy density (DED) and risk of cancers with inconstant results. In addition, there is no study on such association among patients with prostate cancer (PC). The present study was performed to evaluate the association between dietary energy density (DED) and PC risk.

METHODS

In this case-control study, one hundred and twenty-five participants were enrolled (62 cases and 63 controls). Dietary intakes were assessed using 160-item semi-quantitative food frequency questionnaire. In addition, demographic characteristics were collected using a general questionnaire and anthropometric indices were measured based on the available guidelines. The association between DED and PC risk was evaluated using multivariable logistic regression.

RESULTS

The results showed that higher DED score was associated with increased risk of PC (OR = 2.59; 95% CI= (1.24-5.40)). Interestingly, after adjusting for potential confounders ((smoking, physical activity, energy intake, education, ethnicity, job, anti-hyperlipidemic drugs, antihypertensive drugs, and aspirin) the results remained significant (OR = 2.87; 95% CI= (1.17-7.05)).

CONCLUSION

Our findings suggest that DED may increase the risk of PC. However, more prospective studies are warranted to confirm these results.

The lack of association between dietary antioxidant quality score with handgrip strength and handgrip endurance amongst Tehranian adults: A cross-sectional study from a Middle East country

OBJECTIVE

The association between dietary antioxidant quality score (DAQS) and handgrip strength (HS) and handgrip endurance (HE) is still unclear. We aimed to investigate whether adherence to dietary antioxidant quality score (DAQS) is associated with handgrip strength (HS) and handgrip endurance (HE) amongst adults in Tehran.

METHODS

This cross-sectional study was conducted on 270 (43.7% males, mean age 37 years and 56.3% females, mean age 35 years) apparently healthy adult subjects (53.2% were married) selected from different parts of Tehran, Iran. Dietary intake was assessed using a 168-item validated food frequency questionnaire. DAQS was calculated using antioxidant-nutrient intake. Body composition was measured using a body composition analyser. Handgrip strength and endurance were measured by a digital handgrip dynamometer. Relative muscle strength was expressed as the ratio of handgrip strength by body mass index (BMI).

RESULTS

The results showed that DAQs had no significant association with HS (P = .67, adjusted R²  = .60) and HE (P = .19, adjusted R²  = .08) after adjusting for potential confounders. However, a significant positive association was found between selenium intake and HE even after adjusting for potential confounders (P = .01, adjusted R²  = .10). After controlling for potential confounders no differences in the mean of HS (P = .29) and also HE (P = .61) amongst tertiles of DAQS was found. Positive linear association was found between vitamin C (P = .02, adjusted R²  = .53) and vitamin E (P = .03, adjusted R²  = .55) intake with relative muscle strength.

CONCLUSION

Our results revealed that no significant association between DAQS and HE and HS. It was found that more intake of selenium was positively linked to HE. Dietary intake of vitamin C and vitamin E are associated with higher relative muscle strength. It is evident that more prospective studies are needed to confirm the veracity of our results.

The Nordic diet and the risk of non-communicable chronic disease and mortality: a systematic review and dose-response meta-analysis of prospective cohort studies

We aimed to investigate the association between adherence to the Nordic diet (ND) and the risk of chronic disease. PubMed, Scopus, and ISI Web of Science were searched to February 2020 to find prospective cohort studies. The relative risks (RRs) were calculated using a fixed-effects/random-effects model. The certainty of evidence was rated using the GRADE approach. Thirteen prospective cohort studies with 930,153 participants were included. The RRs for the highest compared to the lowest category of adherence to the ND were 0.78 (95%CI: 0.69, 0.87; I² = 51%, n = 6) for all-cause mortality, 0.78 (95%CI: 0.74, 0.83; I² = 70%, n = 4) for cardiovascular mortality, 0.86 (95%CI: 0.80, 0.93; I² = 83%, n = 4) for cancer mortality, 0.88 (95%CI: 0.79, 0.98; I² = 3%, n = 3) for stroke, 0.80 (95%CI: 0.68, 0.95; I² = 47%, n = 3) for myocardial infarction, and 0.90 (95%CI: 0.82, 0.99; I² = 33%, n = 4) for type 2 diabetes. There was an inverse linear association between the ND score and the risk of mortality, and an inverse monotonic association for type 2 diabetes. The certainty in the estimates ranged from very low to low.

Association between sugar-sweetened beverages and waist circumference in adult populations: A meta-analysis of prospective cohort studies

BACKGROUND & AIM

Based on previous studies, Sugar-Sweetened beverages (SSB) can increase the risk of obesity and obesity-related disorders. However, findings are conflicting. The aim of the present study was to summarize the association between the intake of SSB and waist circumference (WC) in adult populations.

METHODS

Four electronic databases including PubMed/Medline, Web of Knowledge, Scopus, and EMBASE were considered to collect eligible papers until 31 January 2019 with English language.

RESULTS

Finally, we reached 7 eligible cohort studies for both qualitative and quantitative synthesis. Based on the pooled 10 effect sizes, we found that the consumption of SSB can increase WC by 14%. However, it was not statistically significant and the between-study heterogeneity was high (95%CI: 0.86, 1.51; I²: 90.8%). We also observed that soda drink can increase WC by 31% (95%CI: 1.03, 1.66; I²:0%).

CONCLUSION

The current systematic review and meta-analysis revealed that the consumption of SSB can increase WC by 14% in adult populations. However, this value was not statistically significant. However, more prospective studies are necessary to make a decision on the link between the consumption of SSB and abdominal obesity.

Association between protein-rich dietary patterns and anthropometric measurements among children aged 6 years

AIM

The associations between types of dietary protein intake and child anthropometric measurements have not been fully studied. Therefore, we examined dietary protein pattern in relation to anthropometric indicators among 6-year-old children.

METHODS

We carried out a cross-sectional study of 788 randomly selected children from health centres in Tehran, Iran. Dietary intake was assessed using a food frequency questionnaire completed by the mothers. Anthropometric measurements were based on standard protocols. Principle component analysis was performed to identify different dietary protein patterns. We used multivariate logistic regression to evaluate how these patterns were associated with child anthropometry.

RESULTS

Three dietary protein patterns were identified: pattern 1 (rich in red and processed meats, dairy products and eggs), pattern 2 (rich in fish and poultry) and pattern 3 (rich in soy and legumes). After adjusting for potential confounders (energy intake, socioeconomic status and physical activity), being in the third compared to the first tertiles of pattern 2 was associated with increased (OR = 1.57; 95% CI: 1.09-2.27; P = .01) and decreased (OR = 0.54; 95% CI: 0.32-0.92; P = .02) risk of overweight/obesity and underweight/wasting, respectively. There was no association between other dietary patterns and risk of overweight/obesity or underweight/wasting.

CONCLUSIONS

The present study showed inverse association between the fish/white meat pattern and underweight/wasting and also a positive association between higher fish/white meat protein intake and higher risk of overweight/obesity. Further studies are needed to confirm these results.

A Systematic Review of Nutrition Recommendation Systems: With Focus on Technical Aspects

Background:

Nutrition informatics has become a novel approach for registered dietitians to practice in this field and make a profit for health care. Recommendation systems considered as an effective technology into aid users to adjust their eating behavior and achieve the goal of healthier food and diet. The purpose of this study is to review nutrition recommendation systems (NRS) and their characteristics for the first time.

Material and Methods:

The systematic review was conducted using a comprehensive selection of scientific databases as reference sources, allowing access to diverse publications in the field. The process of articles selection was based on the PRISMA strategy. We identified keywords from our initial research, MeSH database and expert’s opinion. Databases of PubMed, Web of Sciences, Scopus, Embase, and IEEE were searched. After evaluating, they obtained records from databases by two independent reviewers and inclusion and exclusion criteria were applied to each retrieved work to select those of interest. Finally, 25 studies were included.

Results:

Hybrid recommender systems and knowledge-based recommender systems with 40% and 32%, respectively, were the mostly recommender types used in NRS. In NRS, rule-based and ontology techniques were used frequently. The frequented platform that applied in NRS was a mobile application with 28%.

Conclusion:

If NRS was properly designed, implemented and finally evaluated, it could be used as an effective tool to improve nutrition and promote a healthy lifestyle. This study can help to inform specialists in the nutrition informatics domain, which was necessary to design and develop NRS.

Protective effects of synbiotic soymilk fortified with whey protein concentrate and zinc sulfate against bile duct ligated-induced hepatic encephalopathy

AIM

This study aimed to compare the effects of synbiotic soymilk fortified with whey protein concentrate and zinc sulfate with lactulose on bile duct ligated-induced HE.

BACKGROUND

Hepatic encephalopathy (HE) is seriously associated with neuromuscular and cognitive alterations.

METHODS

Eighty-two Sprague Dawley rats were randomly assigned into seven groups (sham, bile duct ligation (BDL), BDL + lactulose, BDL + soymilk (SM), BDL + Synbiotic soymilk (SSM), BDL + SSM + whey protein concentrate (WPC), BDL + SSM + WPC + ZnSO4). Different SM products, lactulose, and normal saline were administered via oral gavage (2 mL/rat/day). The serum and liver markers as well as liver histopathology were assessed after 28 days.

RESULTS

The SM products significantly reduced the serum alanine aminotransferase, albumin, and ammonia (P < 0.05). The levels of aspartate aminotransferase, endotoxin, and liver interleukin-6 improved significantly in all treatments, except for those receiving SM. SSM and SSM + WPC + ZnSO4 were the only effective products in reducing serum alkaline phosphatase (P < 0.05). Furthermore, the liver total antioxidant capacity was greater (P<0.05) in the SSM + WPC and SSM + WPC + ZnSO4 groups. The histopathological examinations confirmed the efficiency of all SM products in reducing liver fibrosis. Liver bile duct proliferation diminished only in the SSM + WPC and SSM + WPC+ ZnSO4 groups (P<0.05).

CONCLUSION

This study showed the positive effects of different SM products, especially SSM + WPC and SSM + WPC + ZnSO4, on HE. Further studies are required to confirm our findings.

Association between Dietary Inflammatory Index and Prostate Cancer in Shiraz Province of Iran

Background: Dietary components like food items and nutrients have been implicated to play a role in modulating inflammation and the development of prostate cancer. Studies examining this association have not been extensively explored in Middle Eastern Countries. Material and Methods: We examined the association between the dietary inflammatory index (DIITM) and prostate cancer in the Shiraz province of Iran. A total of 60 incident cases and 60 controls attending the same hospital as the cases were recruited. The energy adjusted DII (E-DIITM) was computed based on dietary intake assessed using a validated food frequency questionnaire (FFQ). Logistic regression was used to estimate odds ratios. Results: Men with higher E-DII (>0.96) were at higher risk of prostate cancer (OR = 2.55; 95% CI =1.04–6.23) compared to men with E-DII ≤0.96. Conclusion: These data suggest a pro-inflammatory diet, as indicated by increasing DII score, may be a risk factor for prostate cancer in Iranian men.

Effect of Conjugated Linoleic Acid on Leptin Level: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

The results of human clinical trials examining the effects of conjugated linoleic acid (CLA) on leptin concentration are inconsistent. Our objective was to elucidate the role of conjugated linoleic acid supplementation on leptin through a systematic review and a meta-analysis of available randomized placebo-controlled trials (RCTs). We searched the PubMed, SCOPUS, and ISI web of science up to February2017, in English, to identify RCTs investigating the effect of CLA supplements on plasma leptin concentrations. Weighted mean differences (WMDs) and their respective 95% confidence intervals (CIs) were calculated to assess the efficacy of CLA on leptin concentration by using random effects. Statistical heterogeneity, study quality, meta-regression and publication bias were used based on standard methods. Nineteen RCTs (comprising 26 treatment arms) with 1045 subjects were included in this meta-analysis. Random-effect meta-analysis found a slight but not significant reduction in plasma leptin concentrations (WMD: -0.38 ng/ml, 95% CI: -1.08, 0.32, p=0.286); I2=53.24%, p=0.001), following CLA supplementation. The pooled effect size was robust and remained non-significant in the leave-one-out sensitivity analysis. Subgroup analysis based on BMI status showed that the CLA supplementation significantly reduces leptin when used for obese subjects (WMD: -1.47 ng/ml, 95% CI: -2.15, -0.79, p<0.001) and in the subset of trials lasting<24 weeks of duration (WMD: -0.76 ng/ml, 95% CI: -1.40, -0.12, p=0.019). CLA supplementation might moderately decrease circulatory leptin levels only among obese adults for shorter than 24 weeks. Additional high-quality studies are needed to replicate our results.

Healthy Plant Foods Intake Could Protect Against Prostate Cancer Risk: A Case-Control Study

Background:

Several studies have investigated the association between healthy plant foods intake and prostate cancer risk with inconsistent results. So this study was conducted to examine the existence of any possible association between healthy plant foods and prostate cancer risk.

Materials and Methods:

Sixty newly diagnosed prostate cancer cases and 60 controls engaged in a hospital-based case-control study. A validated 16o-items semi-quantitative FFQ was used to assess usual dietary intakes. Energy-adjusted amounts of healthy plant foods intake were calculated using the residual method. Logistic regression model was also used to derive beta estimates and odds ratios.

Results:

Cases were older and more likely to be inactive. In crude model, individuals in the highest tertile vs lowest tertile of total healthy plant foods (OR= 0.12; 95 % CI 0.04, 0.34), total fruits (OR= 0.11; 95 % CI 0.04, 0.30), total vegetables (OR= 0.08; 95 % CI 0.03, 0.24), fresh fruits (OR= 0.11; 95 % CI 0.04, 0.30), and raw vegetables (OR= 0.06; 95 % CI 0.02, 0.18) had significantly lower risk of prostate cancer. After controlling for potential confounders (age, BMI, total energy intake, job, education, smoking, physical activity, some drug usage, and also dietary intakes), just total healthy plant foods (OR= 0.12; 95 % CI 0.02, 0.55), total vegetables (OR=0.03; 95 % CI 0.00, 0.25), and raw vegetables (OR= 0.01; 95 % CI 0.00, 0.12) were associated with lower prostate cancer risk.

Conclusions:

The results of this study suggest that a diet rich in healthy plant foods and especially total or raw vegetable may protect against prostate cancer.