Association between alcohol dehydrogenase polymorphisms (rs1229984, rs1573496, rs1154460, and rs284787) and susceptibility to head and neck cancers: A systematic review and meta-analysis

OBJECTIVE

Head and neck cancer (HNC) is a prevalent and complex group of malignancies with increasing incidence globally. Alcohol dehydrogenases (ADHs) play a crucial role in alcohol metabolism, and their polymorphisms have been linked to HNC risk. This systematic review and meta-analysis aims to evaluate the association between ADH polymorphisms and susceptibility to HNCs, incorporating additional analyses and adding more studies to increase power and accuracy of the results.

DESIGN

Subgroup analysis, meta-regression analysis, and sensitivity analyses were conducted to explore potential differences within the data and assess the stability of pooled odds ratios (ORs). To mitigate the risk of false conclusions from meta-analyses, a trial sequential analysis was performed.

RESULTS

For ADH1B rs1229984, the pooled OR (95 % confidence interval (CI)) was 0.73 (0.65, 0.82), 0.42 (0.35, 0.50), 0.57 (0.44, 0.73), 0.56 (0.50, 0.62), and 0.80 (0.73, 0.88), as well as for ADH7 rs1573496, the pooled OR was 0.72 (0.62, 0.85), 0.36 (0.17, 0.74), 0.76 (0.64, 0.91), 0.80 (0.71, 0.91), and 0.38 (0.18, 0.78) with a p < 0.05 in all allelic, homozygous, heterozygous, recessive, and dominant models, respectively. However, no significant association was found between the ADH7 rs1154460 and rs284787 polymorphisms and the risk of HNC with pooled ORs of 1.11 (p = 0.19) and 1.09 (p = 0.24) for the recessive model, respectively. The ethnicities, tumor subsites, control sources, sample sizes, quality scores, and Hardy-Weinberg equilibrium statuses were confounding factors.

CONCLUSION

The ADH1B rs1229984 and ADH7 rs1573496 polymorphisms are significantly associated with a reduced risk of HNC.

The association between healthy beverage index and sarcopenia in Iranian older adults: a case-control study

BACKGROUND

Sarcopenia is a progressive disease with age-related loss of skeletal muscle mass, strength, and function. No study has investigated the association between healthy beverage index (HBI) and sarcopenia in older adults. Therefore, the present study aimed to investigate the association between HBI and sarcopenia in Iranian older adults.

METHODS

In the present case-control study, 80 sarcopenic and 80 non-sarcopenic participants matched in sex were included. Body composition was measured using bioelectrical impedance analysis. Handgrip strength (HGS), skeletal muscle mass index (SMI), and gait speed were utilized to confirm sarcopenia. Also, a food frequency questionnaire was used to evaluate food intake. HBI score was calculated based on ten sub-components of the total beverages. Moreover, logistic regression was applied to assess the association between HBI and sarcopenia.

RESULTS

In the crude model, we observed no significant association between HBI and the odds of sarcopenia. Still, after adjusting the confounders, the odds of developing sarcopenia decreased significantly in the second and last tertiles (T) (T2- odds ratio (OR) = 0.04, 95% confidence interval (CI): 0.01-0.25 and T3- OR = 0.10, 95% CI: 0.01-0.60).

CONCLUSIONS

Our findings indicated that HBI is inversely related to the chance of sarcopenia. Therefore, to reduce the odds of sarcopenia, it is recommended to consume healthy drinks such as fruit juices and milk.

Association between oxidative balance score and sarcopenia in older adults

Sarcopenia is a progressive skeletal muscle disease in which oxidative stress has been proposed as one of the primary markers. The oxidative balance score (OBS) represents the oxidative balance of a person's dietary pattern using the merged intake of anti-oxidants and pro-oxidants. Therefore, the present study assessed the association between OBS and sarcopenia in Iranian older adults. In the current study, 80 people with sarcopenia and 80 without it were considered the case and control groups, respectively. All controls were matched by sex with cases. To confirm sarcopenia, skeletal muscle mass index (SMI), handgrip strength (HGS) measurement, and gait speed were used. Also, body composition was measured by bioelectrical impedance analysis (BIA). A valid and reliable food frequency questionnaire (FFQ) was used to assess all participants' dietary intake of pro-oxidants and anti-oxidants. Conditional logistic regression was applied to assess the association between OBS and sarcopenia. In the bivariate model, we observed lower odds of sarcopenia in the second and last tertile of OBS in comparison to the first tertile (T) (T2 - odds ratio (OR) = 0.414, 95% confidence interval (CI) : 0.186-0.918 and T3 - OR = 0.101, 95% CI: 0.041-0.248). After adjusting for potential confounders, the association was not significant in second and last tertile of OBS in comparision to the first one. The present study's findings demonstrated that overcoming exposure to anti-oxidants over pro-oxidants, as illustrated by a higher OBS, is not related to lower odds of sarcopenia in older adults.

Curcumin effects on glycaemic indices, lipid profile, blood pressure, inflammatory markers and anthropometric measurements of non-alcoholic fatty liver disease patients: A systematic review and meta-analysis of randomized clinical trials

OBJECTIVES

Curcumin has antioxidant properties and has been proposed as a potential treatment for NAFLD. The aim of current systematic review and meta-analysis was to evaluate previous findings for the effect of curcumin supplementation on glycaemic indices, lipid profile, blood pressure, inflammatory markers, and anthropometric measurements of NAFLD patients.

METHODS

Relevant studies published up to January 2024 were searched systematically using the following databases: PubMed, SCOPUS, WOS, Science Direct, Ovid and Cochrane. The systematic review and meta-analysis were conducted according to the 2020 PRISMA guidelines. The quality of the papers was assessed the using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist. Pooled effect sizes were calculated using a random-effects model and reported as the WMD and 95% CI. Also, subgroup analyses were done to find probable sources of heterogeneity among studies.

RESULTS

Out of 21010 records initially identified, 21 eligible RCTs were selected for inclusion in a meta-analysis. Overall, 1191 participants of both genders, 600 in the intervention and 591 in the control group with NAFLD were included. There are several limitations in the studies that were included, for instance, the results are weakened substantially by potential bias or failure to account for potential adulteration (with pharmaceuticals) or contamination (with other herbs) of the curcumin supplements that were tested. However, previous studies have reported curcumin to be a safe complementary therapy for several conditions. Our study indicated that curcumin supplementation in doses of 50-3000 mg/day was associated with significant change in FBG [WMD: -2.83; 95% CI: -4.61, -1.06), I2 = 51.3%], HOMA-IR [WMD: -0.52; 95% CI: -0.84, -0.20), I2= 82.8%], TG [WMD: -10.31; 95% CI: -20.00, -0.61), I2 = 84.5%], TC [WMD: -11.81; 95% CI: -19.65, -3.96), I2 = 94.6%], LDL [WMD: -8.01; 95% CI: -15.79, -0.24), I2 = 96.1%], weight [WMD: -0.81; 95% CI: -1.28, -0.35), I2= 0.0%] and BMI [WMD: -0.35; 95% CI: -0.57, -0.13), I2= 0.0%] in adults with NAFLD. There was no significant change in HbA1C, plasma insulin, QUICKI, HDL, SBP, DBP, CRP, TNF-α and WC after curcumin therapy. Subgroup analysis suggested a significant changes in serum FBG, TG, SBP, WC in RCTs for intervention durations of ≥ 8 weeks, and SBP, TG, LDL, HDL, BMI, WC in RCTs with sample size > 55 participants.

CONCLUSION

Curcumin supplementation in doses of 50-3000 mg/day over 8-12 weeks was associated with significant reductions in levels of FBG, HOMA-IR, TG, TC, LDL, weight and BMI in patients with NAFLD. Previous studies have reported curcumin as a safe complementary therapy for several diseases. We would suggest that should curcumin supplements be used clinically in specific conditions, it should be used with caution. Also, difference in grades of NAFLD may effect the evaluated outcomes, so it is suggested that future studies be conducted with an analyses on subgroups according to their NAFLD grade. Furthermore, because of the failure to conduct independent biochemical assessment of the turmeric/curcumin product used in most studies as well as potential sources of bias, results should be interpreted with caution.

Educational intervention based on the extended parallel process model improves adherence to diabetic diet and glycaemic control indices: a randomised, double-blind, controlled, factorial field trial

Nutritional education is pivotal in the medical nutritional therapy of type 2 diabetes mellitus (T2DM). The extended parallel process model (EPPM) is a health education method for inducing desirable health behaviours. The present study aimed to investigate the effect of nutritional education based on the EPPM in T2DM patients on knowledge, attitude, practice, anthropometric indices, glycaemic factors, lipid profile and adherence to the diabetic diet. A randomised, double-blind, controlled, factorial field trial was designed for T2DM patients aged 30-59 years (n 88). Participants were randomly allocated into four groups to receive EPPM-based nutritional education through gain framed message (GFM), loss framed message (LFM), their combination (G\LFM) or usual diabetic education in the control group (CG). Participants were assessed before and after the study duration. After 3 months of intervention, eighty participants finished the study. The EPPM-based intervention increased participants' knowledge, behavioural intention, perceived sensitivity, severity, self-efficacy (P < 0·001 for all) and response efficacy (P = 0·029) in comparison with CG. GFM (P = 0·004) and G\FLM (P = 0·034) reduced carbohydrate intake and LFM (P = 0·034) and G\LFM (P = 0·047) decreased fat intake. Between-group analysis indicated interventions reduced weight (P = 0·046), BMI (P = 0·038), fasting blood sugar (P = 0·030), 2-hour postprandial blood glucose (P = 0·027) and TAG (P = 0·002) in comparison with the CG. Results were NS for protein intake, waist and hip circumference, waist:hip ratio, HbA1c, total cholesterol, LDL and HDL. Nutritional education based on EPPM could increase the knowledge and awareness of T2DM patients. Also, it could be beneficial for blood glucose amendment. Further investigations are recommended.

The effects of powdered drinks enriched with curcumin and probiotics on lipid profile and atherogenic indices in patients with metabolic syndrome: A randomized, double-blinded, placebo-controlled clinical trial

Cardiovascular disease is prevalent globally and is the most common complication of metabolic syndrome (MetS). Previous studies have suggested that curcumin and probiotics may improve the lipid profile, so we aimed to investigate the effects of the edible powder enriched with these substances on lipid profile level and atherogenic indices such as Atherogenic Coefficient (AC), Castelli Risk Index-I (CRI-I), Castelli Risk Index-II (CRI-II), and Atherogenic Index of Plasma (AIP). In the present parallel randomized double-blinded placebo-controlled clinical trial, 124 people with MetS with overweight or obesity were randomly allocated to 4 groups and were followed up for 8 weeks. The participants received a low-calorie diet and a daily sachet of enriched powder drink. The sachets contained either 109 CFU of probiotics or 1 g of curcumin, or probiotic + curcumin (pro + cur), or placebo, respectively. The fasting lipid profile and atherogenic indices were measured at the beginning and end of the study. One hundred and fourteen participants completed the study. At the end of the study, the within- and between-group comparisons showed no significant differences in lipid profile and atherogenic indices (p > .05). Based on the results of the current study, taking an oral powder containing 1 g curcumin and 109 CFU probiotics for 8 weeks had no effect on the lipid profile level and atherogenic indices; however, more studies are recommended.

Does the Grape Products Intake has an Effect on Body Weight in Adults: A Systematic Review and Meta-analysis of Randomized Controlled Trials

INTRODUCTION

There is a growing interest in the considerable benefits of grape products intake, as some studies have indicated that they may improve cardiometabolic risk factors. However, the widespread impact of grape products on the anthropometric indices is not fully resolved.

METHOD

The purpose of this systematic review and meta-analysis was to examine the effects of grape products intake on anthropometric indices in adults. Randomized controlled trials (RCT) examining the effects of grape products intake on anthropometric indices, published up to December 2021, were identified through PubMed, SCOPUS, and ISI Web of Science databases. 30 studies with 35 effect sizes, including 1284 participants (708 cases and 576 controls), were included and analyzed using a random-effects model to calculate weighted mean differences (WMDs) with 95% confidence interval (CI).

RESULT

The outcomes have revealed grape products intake to significantly decrease body weight (p = 0.001) and body mass index (p = 0.004) in obese participants, and also, a greater effect was observed when grape seed extract was used.

CONCLUSION

Our study suggests that grape products intake may help to decrease body weight in obese participants. Future large RCTs with longer duration and obese populations are needed to expand our findings.

A Systematic Review and Meta-Analysis of Vitamin D Status of Patients with Severe Obesity in Various Regions Worldwide

INTRODUCTION

Managing nutritional deficiencies is an essential component in the treatment of severe obesity. Vitamin D deficiency is often reported in investigations in severely obese cohorts. However, no prior study has summarized findings on this topic. Consequently, the aim of this systematic review and meta-analysis was to investigate the 25-hydroxyvitamin D [25(OH)D] status in individuals with severe obesity in different regions worldwide. We also evaluated levels of calcium, parathyroid hormone (PTH), and magnesium as secondary outcome measures.

METHODS

We searched Medline, PubMed, Scopus, the Cochrane Library, and EMBASE for relevant observational studies published in English from 2009 to October 2021. The heterogeneity index among the studies was determined using the Cochran (Q) and I2 tests. Based on the heterogeneity results, the random-effect model was applied to estimate the prevalence of vitamin D deficiency.

RESULTS

We identified 109 eligible observational studies. Overall, 59.44% of patients had vitamin D deficiency [25(OH)D <20 ng/mL], whereas 26.95% had vitamin D insufficiency [25(OH)D 20-30 ng/mL]. Moreover, the mean 25(OH)D level was 18.65 ng/mL in 96 studies. The pooled mean estimate of the serum calcium, PTH, and magnesium was 9.26 mg/dL (95% confidence interval [CI]: 9.19-9.32, I2 = 99.7%, p < 0.001), 59.24 pg/mL (95% CI: 54.98, 63.51, I2 = 99.7%, p < 0.001), and 0.91 mg/dL (95% CI: 0.84, 0.98, I2 = 100.0%, p < 0.001), respectively. The results of the subgroup analysis indicated that the mean estimates of 25(OH)D were highest in North America (21.71 ng/mL [19.69, 23.74], [I2 = 97.2%, p < 0.001]) and lowest in Southeast Asia (14.93 ng/mL [14.54, 15.33], [I2 = 0.0%, p = 0.778]).

CONCLUSION

The results obtained showed a significant prevalence of vitamin D deficiency among severely obese individuals in various geographical regions, whereas the highest and lowest mean estimates were reported for North America and Southeast Asia, respectively.

Whey Protein Supplementation with or without Vitamin D on Sarcopenia-Related Measures: A Systematic Review and Meta-Analysis

The effects of supplementation with whey protein alone or with vitamin D on sarcopenia-related outcomes in older adults are unclear. We aimed to assess the effect of whey protein supplementation alone or with vitamin D on lean mass (LM), strength, and function in older adults with or without sarcopenia or frailty. We searched PubMed, Web of Science, and SCOPUS databases. Randomized controlled trials (RCT) that investigated the effect of whey protein supplementation with or without vitamin D on sarcopenia outcomes in healthy and sarcopenic or frail older adults were included. Standardized mean differences (SMDs) were calculated for LM, muscle strength, and physical function data. The analysis showed that whey protein supplementation had no effect on LM and muscle strength; nevertheless, a significant improvement was found in physical function (SMD = 0.561; 95% confidence interval [CIs]: 0.256, 0.865, n = 33), particularly gait speed (GS). On the contrary, whey protein supplementation significantly improved LM (SMD = 0.982; 95% CI: 0.228, 1.736; n = 11), appendicular lean mass and physical function (SMD = 1.211; 95% CI: 0.588, 1.834; n = 16), and GS in sarcopenic/frail older adults. By contrast, co-supplementation with vitamin D enhanced LM gains (SMD =0.993; 95% CI: 0.112, 1.874; n = 11), muscle strength (SMD =2.005; 95% CI: 0.975, 3.035; n = 11), and physical function (SMD = 3.038; 95% CI: 2.196, 3.879; n = 18) significantly. Muscle strength and physical function improvements after whey protein supplementation plus vitamin D were observed without resistance exercise (RE) and short study duration subgroups. Moreover, the combination of whey protein and vitamin D with RE did not enhance the effect of RE. Whey protein supplementation improved LM and function in sarcopenic/frail older adults but had no positive effect in healthy older persons. By contrast, our meta-analysis showed that co-supplementation with whey protein and vitamin D is effective, particularly in healthy older adults, which is likely owing, we propose, to the correction of vitamin D insufficiency or deficiency. The trial was registered at https://inplasy.com as INPLASY202240167.

Effects of Kefir Consumption on Cardiometabolic Risk Factors: A Systematic Review and Meta-analysis of Randomized Controlled Trials

BACKGROUND

Fermentation of lactose in milk by bacteria and yeasts naturally present in kefir grains produces a beverage that has been suggested to have cardiovascular benefits. This systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to evaluate the effects of this kefir beverage on cardiometabolic risk factors.

METHODS

Literature search utilised PubMed, Scopus, ISI Web of Science, and Google Scholar for articles published from inception until June 2021. Cardiometabolic risk indices extracted included insulin and insulin resistance (HOMA_IR), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), fasting blood sugar (FBS), haemoglobin A1c (HbA1c) and body weight (BW). In total, six RCTs (314 subjects) were selected for the meta-analysis. Inverse-variance weighted mean difference (WMD) with a 95% confidence interval (CI) was calculated for the mean changes in TC, TG, HDL-C, LDL-C, FBS, HbA1c and BW compared to baseline. A random effects model was used to estimate the pooled WMD.

RESULTS

Kefir intake significantly reduced fasting insulin (WMD: -3.69 micro-IU/mL,95% CI: -6.30 to -1.07, p = 0.006, I2 = 0.0%) and HOMA-IR (WMD: -2.56, 95% CI: -3.82 to -1.30, p<0.001, I2 = 19.4%). No effect on TC (p = 0.088), TG (p = 0.824), HDL-C (p = 0.491), LDL-C (p = 0.910), FBS (p = 0.267), HbA1c (p = 0.339) or body weight (p = 0.439) were found for kefir treatment.

CONCLUSION

Kefir has a beneficial effect in decreasing insulin resistance; however, no effect was seen on BW, FBS, HbA1C, and lipid profile.

Body perception in pregnant women: a qualitative study

BACKGROUND

Dramatic body changes in pregnancy cause severe concerns among pregnant women about their appearance. Therefore, this study aimed to explore body perception in pregnant women.

MATERIALS AND METHODS

The qualitative study, using the conventional content analysis approach, was conducted on Iranian pregnant women who were in their second or third trimester of pregnancy. Participants were selected through purposeful sampling method. In-depth and semi-structured interviews were held with 18 pregnant women aged 22 to 36 years, using open-ended questions. Sampling was performed until data saturation was reached.

RESULTS

Three main categories were extracted from 18 interviews: (1) "symbols," with two subcategories, including 'motherhood' and 'vulnerability,' (2) "feelings toward body changes," with five subcategories, including 'negative feelings toward skin changes,' 'feeling unfit,' 'attention-drawing body shape,' 'the ridiculous body shape' and 'obesity,' and (3) "attraction and beauty," with two subcategories, including 'sexual attraction' and 'facial beauty.'

CONCLUSION

The results showed that pregnant women's body perception could be described as maternal feelings and feminine attitudes toward changes during pregnancy compared to mental ideals of facial and body beauty. It is recommended that Iranian women's body perception during pregnancy be evaluated using this study results and that counseling interventions be implemented for women with negative body perceptions.

Ultra-Processed Food Intake and Risk of Colorectal Cancer: A Matched Case-Control Study

Colorectal cancer (CRC) is the third most prevalent and the second fatal cancer in the world. Ultra-processed foods (UPFs) are suggested to be related to various non-communicable diseases including cancers. However, studies on the relationship between UPFs and CRC are scarce. The aim of this study was to determine the association between consumption of UPFs and CRC. In a case-control study conducted in four hospitals in Tehran, Iran, consumption of UPFs in 71 CRC patients and 142 controls (patients with non-neoplastic diseases) were compared. Using 125-item semi-quantitative food frequency questionnaire, dietary intakes were assessed. We used Multivariate logistic regression to estimate the association between UPFs intake and risk of CRC. Intake of nondairy beverages (P = 0.009), processed meat and fast food (P = 0.04) was significantly higher in those in the highest tertile of UPFs intake compared to the lowest tertile. In addition, intake of UPFs was associated with higher risk of CRC. The association remained constant after adjustment for BMI, income, smoking, type of job, educational level, and physical activity (OR, 3.32; 95% CI, 1.44-7.61; P = 0.003). Results of this study indicate that the intake of UPFs is associated with increased odds of CRC.

The effect of folic acid supplementation on body weight and body mass index: A systematic review and meta-analysis of randomized controlled trials

BACKGROUND AND OBJECTIVE

Several trials have evaluated the effects of folate supplementation on obesity indices. However, their results were inconsistent. Therefore, the current meta-analysis was conducted to summarize data from available randomized clinical trials (RCTs) about the impact of folate supplementation on weight and body mass index (BMI).

METHOD

Medline/PubMed, Scopus, Embase, and ISI web of science were searched to identify relevant articles up to December 2020. The effect sizes were expressed as weighted mean difference (WMD) and 95% confidence intervals (CI) using the random-effects model.

RESULTS

Pooled data from nine studies showed that folic acid supplementation did not change body weight (WMD: -0.16 kg, 95%CI: -0.47 to 0.16, P = 0.32) and BMI (WMD: -0.23 kg/m², 95%CI: -0.49 to 0.03, P = 0.31), but there was significant heterogeneity between the included studies for BMI (I² = 90.1%, P < 0.001). Moreover, subgroup analyses in level of homocysteine and health status indicated significant effect of folic acid supplementation on BMI in those with homocysteine level ≥15 μmol/L (WMD: -0.17 kg/cm2, -0.33 to -0.01, p = 0.03) and in women with polycystic ovary syndrome (PCOS) (WMD: - 0.30kg/cm2, -0.54 to -0.06, p = 0.01).

CONCLUSION

Our outcomes demonstrated that folic acid improves BMI in those with homocysteine levels ≥15 μmol/L and women with PCOS.

Evaluating the effect of digital game-based nutrition education on anemia indicators in adolescent girls: A randomized clinical trial

Iron deficiency anemia is the most common type of micronutrient deficiency in the world. Adolescence represents a period of increased risk of iron deficiency. Therefore, we aimed to determine the impact of nutrition education by a digital game on markers of iron-deficient anemia in adolescent girls. In this study, 176 adolescent girls were randomly dichotomized into the intervention and control groups. At the beginning and the end of the intervention, knowledge, attitude, and practice of both groups were assessed by a questionnaire. Girls in the intervention group received the necessary education through a digital game during a 14-week period, while those in the control group received basic nutritional education through PowerPoint and pamphlets. Additionally, serum transferrin, serum iron, transferrin saturation, ferritin, CBC difference, and total iron binding capacity (TIBC) tests were checked. In this study, nutrition education significantly increased the level of knowledge, attitude, and practice of adolescent girls regarding their diet (p ˂ .05). Hemoglobin level was also significantly raised (p ˂ .05). However, no significant effect was observed on other markers of iron-deficient anemia, such as serum iron, TIBC, and hematocrit, in the intervention group compared with the control group (p ˃ .05). The results of this study indicated the positive impact of nutrition education based on digital game on knowledge, attitude, and practice scores, as well as a significant difference in hemoglobin. It is recommended that educational games be designed for students in the future to promote health and nutrition information.

Effect of a multi-disciplinary program on anthropometric and biochemical parameters in obese and overweight elementary school girls: A randomized clinical trial

BACKGROUND AND AIMS

Obesity and overweight in children are associated with an increased risk of several health issues. The present study aimed to assess the effects of a multi-disciplinary program (including nutrition education using a smartphone game, physical activity, and cognitive behavioral therapy [CBT]) on the management of obesity and overweight in elementary school girls.

METHODS AND RESULTS

Sixty-two school girls above the 85th percentile of body mass index (BMI) for age were randomly assigned to two groups. During 10 weeks of study, the intervention group received a multi-disciplinary intervention, including nutrition education using a smartphone game, aerobic exercise, and CBT. The control group received usual traditional nutritional education. Biochemical and metabolic factors were assessed, including fasting blood sugar (FBS), lipid profile, serum leptin, and anthropometric measurements. The Dutch Eating Behavior Questionnaire (DEBQ) and metabolic equivalent test (MET) were also conducted. The intervention group showed more promising results in weight loss, waist circumference (WC), hip circumference (HC), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triglyceride (TG), and FBS compared to the control group (P < 0.05). In addition, MET and DEBQ scores in all three sections of emotions, stimuli, and restriction were better in the intervention group than in the control group (P < 0.05). However, there was no significant difference between groups regarding the results of serum leptin and waist-to-hip ratio (WHR; p > 0.05).

CONCLUSIONS

The results indicated that education through smartphone games could possibly affect performance in real life. In addition, the multi-disciplinary approach to childhood obesity might have better performance in most areas than the single-intervention approach in obesity management.

Importance of TP53 codon 72 and intron 3 duplication 16 bp polymorphisms and their haplotypes in susceptibility to sarcopenia in Iranian older adults

Background

Sarcopenia is described as age-related progressive skeletal muscle failure that results in marked reduction in the patient’s independence and life quality. In this study, we explored the association of TP53 exon 4 Arg72pro (rs1042522) and Intron 3 16-bp Del/Ins (rs17878362) polymorphisms and their haplotypes with sarcopenia, anthropometric, body composition and biochemical parameters.

Methods

A total of 254 older individuals (65 sarcopenic and 189 healthy) were recruited in this research and genotyped by PCR–RFLP. Linear regression was applied to find the correlation between TP53 polymorphism, and biochemical and anthropometric parameters. The correlation between TP53 polymorphism and haplotypes and the risk of sarcopenia was investigated by logistic regression.

Results

Arg/Pro genotype carriers was at a lower (ORadj = 0.175, 95% CI = 0.068 – 0.447; P < 0.001) risk of sarcopenia compared to the Arg/Arg group. In haplotypes analysis, Arg-Ins (ORadj: 0.484, 95% CI = 0.231 – 1.011, P = 0.043) and Pro-Ins (ORadj: 0.473, 95% CI = 0.210 – 1.068, P = 0.022) haplotypes showed decreased risk of developing sarcopenia. Moreover, in the case of codon 72 polymorphism, skeletal muscle mass, appendicular lean mass (ALM), skeletal muscle mass index (SMI), hand grip strength and Triglycerides, for Intron 3 16-bp Del/Ins polymorphism, albumin, calcium, cholesterol, and LDL were different, and for the haplotypes, skeletal muscle mass, SMI, ALM, HDL and triglycerides were significantly different between groups.

Conclusions

We suggested that the Arg/Pro genotype of the codon 72 polymorphism in exon 4 of TP53, and Arginine-Insertion and Proline-Insertion haplotypes might decrease the risk of sarcopenia in Iranian older adults.

Comparison of the Nutritional Status Assessment Methods for Hemodialysis Patients

Protein-energy wasting (PEW) is prevalent among hemodialysis (HD) patients and is associated with poor outcomes. There are various methods for nutritional status evaluation in HD patients. Each method has its own advantages and disadvantages. We aimed at comparing the method validities of normalized protein catabolic ratio (nPCR) and malnutrition universal screening tool (MUST) with subjective global assessment (SGA) in HD patients. We examined 88 HD patients using SGA and MUST questionnaires. The nPCRs were calculated using pre-dialysis and post-dialysis BUN and Kt/v. Also, PEW of patients was assessed based on the criteria of the International Society of Renal Nutrition and Metabolism. Methods' specificity, sensitivity, and precision rates were assessed. Correlations between methods were analyzed using Pearson-correlation. Based on the SGA, MUST, and nPCR methods, almost 41%, 30%, and 60% of patients had malnutrition, respectively. According to the criteria, more than 90% of patients had PEW. SGA was positively and significantly associated with MUST (p ≤ 0.001). Sensitivity for SGA, MUST, and nPCR methods were 100%,100%, 1.8%, and their specificity were 98%, 98%, and 4%, and their precision rates were 99.7%, 98.7%, and 3%, respectively. From various methods of nutritional assessment (SGA, MUST, and nPCR), compared to SGA as the common method of nutrition assessment in hemodialysis patients, MUST had the nearest specificity, sensitivity, and precision rate and nPCR method had the lowest ones. nPCR seems to be a flawed marker of malnutrition and it should be more investigated if MUST can be used instead of SGA.

Effects of 6 Months of Soy-Enriched High Protein Compared to Eucaloric Low Protein Snack Replacement on Appetite, Dietary Intake, and Body Composition in Normal-Weight Obese Women: A Randomized Controlled Trial

(1) Background: The favorable effects of high protein snacks on body composition and appetite status in lean and athletic populations have been illustrated previously. However, the effects of soy-enriched high protein snacks have not been investigated in women with normal-weight obesity (NWO). Consequently, we aimed at comparing the effects of six months of soy-enriched high protein snack replacement on appetite, body composition, and dietary intake in women with NWO. (2) Methods: One hundred seven (107) women with NWO [(age: 24 ± 3 yrs, BMI: 22.7 ± 2.3 kg/m², body fat percentage (BFP): 38 ± 3.2%)] who were assigned to one of two groups; high protein snack (HP, n = 52) containing 50 g soybean or isocaloric low-protein snack (protein: 18.2 g, carbohydrate: 15 g, fat: 10 g, energy: 210 kcal) or isocaloric low protein snack (LP, n = 55) containing 3.5 servings of fruit (protein: <2 g, carbohydrate: ≈50 g, fat: <1 g, energy: ≈210 kcal) as part of their daily meals (as a snack at 10 a.m.), successfully completed the study interventions. Body mass (BM), body mass index (BMI), waist circumference (WC), BFP, skeletal muscle mass, dietary intake, and appetite levels were evaluated prior to and after the six-month intervention. (3) Results: Appetite (HP = -12 mm and LP = -0.6 mm), energy intake (HP = -166.2 kcal/day and LP = 91.3 kcal), carbohydrate intake (HP = -58.4 g/day and LP = 6.4 g/day), WC (HP = -4.3 cm and LP = -0.9 cm), and BFP (HP = -3.7% and LP = -0.9%) were significantly (p < 0.05) reduced, while skeletal muscle mass (HP = 1.2 kg and LP = 0.3 kg) significantly increased in the HP compared to the LP group, respectively. (4) Conclusions: Six months of a soy-enriched high protein snack replacement decreased appetite and improved body composition in women with NWO. Our findings suggest that soy-enriched high protein snacks are an efficacious strategy for body composition improvement.

The association between TP53 rs1625895 polymorphism and the risk of sarcopenic obesity in Iranian older adults: a case-control study

Background

Aging and obesity are the two major global health concerns. Sarcopenia, an age-linked disease, wherein a progressive loss of muscle volume, muscle strength, and physical activity occurs. In this study we evaluated the association of TP53 rs1625895 polymorphism with the susceptibility to sarcopenic obesity in Iranian old-age subjects.

Methods

Total of 176 old individuals (45 sarcopenic and 131 healthy) were recruited in this research and genotyped by PCR–RFLP. BMI, Skeletal Muscle Mass Index, body composition, Handgrip Strength, Gait Speed (GS), and biochemical parameters were measured. Chi-square test was done for genotypes and alleles frequency. Linear regression was applied to find the correlation between TP53 rs1625895 polymorphism, and biochemical and anthropometric parameters. The correlation between TP53 rs1625895 and the risk of sarcopenia and sarcopenic obesity was investigated by logistic regression.

Results

G allele was significantly higher in sarcopenic obesity group [P = 0.037, OR (CI 95%) = 1.9 (1.03–3.5)] compared to A allele. BMI (P = 0.049) and LDL (P = 0.04) were significantly differed between genotypes when GG was compared to AA/AG genotype. The results revealed when GG genotype compared to AA/AG genotype in adjusted model for age, the risk of sarcopenic obesity [P value = 0.011, OR (CI 95%); 2.72 (1.25–5.91)] increased. Similarly, GG/AG genotype increased the risk of sarcopenic obesity [P value = 0.028, OR (CI 95%); 2.43 (1.10–5.36)] in adjusted model for age compared to AA genotype.

Conclusions

We suggested that TP53 rs1625895 polymorphism may increase the risk of sarcopenic obesity in Iranian population.

Muscle mass and function are related to respiratory function in chronic obstructive pulmonary disease

Background: Chronic obstructive pulmonary disease (COPD), as an airway limitation condition, is accompanied by alteration of muscle mass and function. We aimed to determine the relationship between disease severity and body composition, muscle function, and nutritional status in COPD patients. Methods: This cross-sectional study was conducted on 129 COPD participants. Muscle strength, body composition, and calf circumference (CC) were measured using a hydraulic hand dynamometer, bioelectrical impedance analysis (BIA), and a tape measure, respectively. Furthermore, fat-free mass index (FFMI), body mass index (BMI) and muscle mass value were calculated by equations. Forced expiratory volume in one second (FEV1) was assessed as well. Nutritional status was also evaluated by subjective global assessment (SGA) questionnaire. SPSS software (version 21 ) was used, chi-square, fisher's exact test, univariate and multivariate linear regression models were used for statistical analysis. P-values less than 0.05 were considered significant. Results: Based on FEV1 classification, 52.7% of the patients had severe conditions. The reports indicated that the prevalence of low CC was 54.2%, low muscle mass 38.7%, low FFMI 34.8%, low right handgrip strength 61.2% and low left handgrip strength 64.3%. Furthermore, there was an increasing trend based on FEV1 in low CC (p=0.032), low muscle mass (p=0.005), low FFMI (p=0.002), low right handgrip strength (p=0.004) and low left handgrip strength (p=0.014). The results of univariate analysis showed muscle mass (p=0.036), total protein (p=0.043), FFM (p=0.047), FFMI (p=0.007), SGA (p=0.029), right handgrip strength (p=0.004) and left hand grip strength (p=0.023) were associated with FEV1. In addition, the results of multivariate analysis demonstrated low values of FFMI (p=0.005) and right handgrip strength (p=0.042) were the main detrimental factors for FEV1. The results of multivariate analysis were confirmed by stepwise model. Conclusion: Low values of muscle mass and function are prevalent among COPD patients. The present study revealed that low FFMI and handgrip strength were closely related to disease severity.

Soy intake is associated with lowering blood pressure in adults: A systematic review and meta-analysis of randomized double-blind placebo-controlled trials

BACKGROUND

Soy has several beneficial effects on cardiovascular disease (CVD); however, results of clinical trial studies are equivocal. Thus, the present study sought to discern the efficacy of soy intake on blood pressure.

METHODS

The search process was conducted in PubMed, Scopus, Web of Science, and Cochrane Library, to ascertain studies investigating the efficacy of soy intake on blood pressure in adults, published up to June 2020. A random-effects model was applied to pool mean difference and 95 % confidence interval (CI). Begg's and Egger's methods were conducted to assess publication bias.

RESULTS

Pooled effects from 17 effect sizes revealed a significant improvement in systolic blood pressure (SBP) (-1.70; -3.34 to -0.06 mmHg; I² = 45.4 %) and diastolic blood pressure (DBP) (-1.27; -2.36 to -0.19 mmHg, I² = 43.9 %) following soy consumption, in comparison with controls. Subgroup analysis demonstrated a reduction in both SBP and DBP in younger participants with lower baseline DBP and intervention durations of <16 weeks.

CONCLUSION

Our results suggest that soy intake is associated with an ameliorating effect on blood pressure in adults.

Adverse effects of conjugated linoleic acids supplementation on circulating lipoprotein (a) levels in overweight and obese individuals: results of a systematic review and meta-analysis of randomized controlled trials

Conjugated Linoleic Acids (CLA) may have beneficial effects on the prevention of atherosclerosis, but their net effects on circulating levels of lipoprotein (a) [Lp (a)] are unclear. The present study aimed to systematically review and analyze the Randomized Clinical Trials (RCTs) assessing the effects of CLA on circulating Lp (a) concentrations. A literature search of SCOPUS, PubMed-Medline, ISI, Web of Science, and Cochrane library databases was conducted for the relevant RCTs investigating the effects of CLA supplementation on circulating Lp (a) levels, which had been published up to 20 August 2020. Weighted Mean Difference (WMD) and 95% Confidence Intervals (CI) were reported as the summary statistics. Statistical analysis were done with Comprehensive Meta-Analysis (CMA) V2 software (Biostat, NJ). Totally, six studies with 13 treatment arms including 752 subjects were included in the meta-analysis. The results showed a significant increase in circulating Lp (a) levels after CLA supplementation (WMD: 16.68 mg/L, 95% CI: 5.43-27.93; P=0.004) with no evidence of heterogeneity across the studies. In the subgroup analysis, a more significant elevation of Lp (a) levels was observed in the trials lasting for six months or more (WMD: 21.61 mg/L, 95% CI: 9.85-33.37, P<0.001) as well as in those with a supplementation dosage of ≥3.5 g/d (WMD: 26.13 mg/L, 95% CI: 7.02-45.24, P=0.007). These findings were sensitive to one study. It can be concluded that CLA supplementation with a dose of ≥3.5 g/d over a six-month period might significantly increase the circulating Lp (a) concentrations.

A Novel Fortified Dairy Product and Sarcopenia Measures in Sarcopenic Older Adults: A Double-Blind Randomized Controlled Trial

OBJECTIVES

To evaluate the efficacy of daily consumption of fortified yogurt with beta-Hydroxy beta-Methyl Butyrate (HMB) and vitamins D and C on measures of sarcopenia, inflammation, and quality of life in sarcopenic older adults.

DESIGN

In this 12-week randomized double-blind controlled trial, participants received either yogurt fortified with 3 g HMB, 1000 IU vitamin D, and 500 mg vitamin C in the intervention group (n = 33) or plain yogurt in the control group (n = 33).

SETTING AND PARTICIPANTS

A total of 66 older adults with sarcopenia recruited from the community in Shiraz, Iran.

MEASURES

Body composition, muscle strength, and functionality were measured using Dual-energy-X-ray Absorptiometry (DXA), hydraulic handgrip dynamometer, and usual gait speed, respectively. Serum concentrations of vitamin D, insulin-like growth factor-1 (IGF-1), C-reactive protein (hs-CRP), malondialdehyde, and insulin were measured at baseline and after 12 weeks. Health-related quality of life (HRQoL) was also evaluated using SF-12 questionnaire.

RESULTS

Consumption of fortified yogurt was associated with improvement in handgrip strength [mean change (95% confidence interval) 4.36 (3.35-5.37) vs. 0.97 (-0.04 to 1.99)] and gait speed [0.10 (0.07-0.13) vs. 0.01 (0.00-0.04)] in the intervention group compared with the control group (P < .001). In addition, the results revealed a significant increase in vitamin D and IGF-1 levels in the intervention group (P < .001). The nutritional intervention significantly prevented any increase in the serum concentration of hs-CRP compared with the control group (P = .033). The results also showed a more significant decrease in the malondialdehyde level in the intervention group compared with the control (P = .008). Moreover, there were significant differences between the 2 groups regarding physical aspects of HRQoL (P = .035).

CONCLUSIONS AND IMPLICATIONS

A novel dairy product fortified with HMB, vitamin D, and vitamin C not only could enhance muscle strength and functionality, but also modulate anabolic and inflammatory conditions as well as quality of life. This study suggested that specific nutritional interventions alone could be beneficial, especially for those who are unable to exercise.

Fortified whey beverage for improving muscle mass in chronic obstructive pulmonary disease: a single-blind, randomized clinical trial

Background

The development of effective nutritional supports for patients with chronic obstructive pulmonary diseases (COPD) is still challenging. This study was conducted to investigate the efficacy of daily consumption of fortified whey on inflammation, muscle mass, functionality, and quality of life in patients with moderate-to-severe COPD.

Methods

A single-blind, randomized trial study was performed on patients with COPD (n = 46). Participants in the intervention group (n = 23) daily received 250 ml of whey beverage fortified with magnesium and vitamin C for 8 weeks. Any changes in inflammatory cytokines (including interleukin- 6 (IL-6) and tumor necrosis factor (TNFα)) were the primary outcomes and the secondary outcomes were fat-free mass, handgrip strength, malnutrition, glutathione and malondialdehyde serum concentrations, and health-related quality of life (HRQoL). Body composition and muscle strength were measured by Bioelectrical Impedance Analysis (BIA) and hydraulic hand dynamometer, respectively. Fat-free mass index (FFMI) was also calculated.

Results

At the end of the study, 44 patients were analyzed. There were significant decreases in IL-6 concentrations in the intervention group compared to the control group. Also, FFMI, body protein, and handgrip strength increased significantly in the intervention group with significant changes between two groups. Moreover, improvement in health-related quality of life was observed in the intervention group compared to the control group. There were no significant changes in other study variables.

Conclusions

This novel nutritional intervention decreased inflammatory cytokines levels, improved indices of skeletal muscle mass and muscle strength, and ultimately, increased HRQoL in patients with moderate-to-severe COPD. Thus, it is suggested to do further studies to assess the effects of nutrition intervention on COPD progression.

Trial registration

IR.SUMS.REC.1396.85 (https://www.irct.ir/).

Serum cytokeratin 18 level is associated with dietary intake and serum triglycerides level in hemodialysis patients

Cell death leads to increase serum cytokeratin 18 (CK-18) in chronic kidney disease. However, few studies have investigated the serum CK-18 level in relation to nutritional and metabolic biomarkers. We examined the association of dietary intake and lipid profile with serum CK18 level among hemodialysis (HD) patients. Ninety HD patients according to inclusion and exclusion criteria were included in the study. An analysis of clinical characteristics, anthropometric indices, dietary intake, and lipid profile revealed a significant association between serum CK-18 and diabetes, metabolic syndrome, body mass index (BMI), triglyceride (TG), aspartate aminotransferase (AST), alanine aminotransferase (ALT), energy intake (EI), protein intake (PI), and saturated fatty acid (SFA). In a multiple stepwise regression model, after adjusting for confounders in three models, the association between serum CK-18 and serum TG level, dietary SFA and EI remained significant. The model 3 adjusted for DM, Mets, BMI, ALT, AST, and PI; model 2 adjusted for model 1 + EI; and model 1 adjusted for model 2 + SFA. Our findings suggest that the development of hypertriglyceridemia and inadequate EI contribute to higher serum CK-18, which is a cell death biomarker.

The effect of synbiotics pomegranate juice on cardiovascular risk factors in PCOS patients: a randomized, triple-blinded, controlled trial

PURPOSE

Polycystic ovarian syndrome (PCOS) is one of the most common metabolic and endocrine disorders. Functional foods like pomegranate and probiotics are those that are considered to have beneficial effects on metabolic diseases beyond their basic nutritional value. So, we aimed to evaluate the effect of synbiotic pomegranate juice (SPJ) on cardiovascular risk factors on PCOS patients.

METHODS

This was a randomized, triple-blinded, 8-week trial. Participants were randomly assigned to receive 300 mL/day of pomegranate juice (PJ), synbiotic beverage (SB), synbiotic pomegranate juice (SPJ), or placebo beverage (PB). Biochemical indices (lipid profile, Total Antioxidant Capacity (TAC), Malondialdehyde (MDA), high sensitive C-Reactive Protein (hs-CRP)) and blood pressure were assessed before and after the intervention.

RESULTS

Participants in the PJ, SB, and SPJ groups experienced improvement in their lipid profile, oxidative stress, inflammation, and blood pressure during the time. Compared to placebo, Total Cholesterol (TC) was lower in the SB group (P < 0.01), LDL-c was lower in the SPJ and SB groups (P < 0.01), and HDL-c was higher in the SPJ and PJ groups (P < 0.01). With regards to oxidative stress and inflammation, when compared with placebo, MDA was lower in the SPJ, SB, and PJ groups (P < 0.001), TAC was increased in the SPJ and PJ groups (P[Formula: see text] 0.001), and hs-CRP was decreased in the PJ group (P = 0.02). Blood pressure (BP) was lower in the SPJ and PJ groups compared to placebo (P < 0.001; P < 0.01, respectively).

CONCLUSIONS

Consuming daily SPJ for 8 weeks improved metabolic, oxidative, inflammatory, and BP outcomes in females with PCOS. This trial was registered in the Iranian Registry of Clinical Trials (IRCT20170207032439N2).

Prenatal body image questionnaire: Development and psychometric evaluation

This study was conducted with the aim of developing and psychometric evaluation of prenatal body image questionnaire in Farsi language. For preparation of the prenatal body image questionnaire, psychometric steps were performed on a questionnaire based on the results of a qualitative study. Construct validity was evaluated in a cross-sectional study of 300 Iranian pregnant women undergoing prenatal care in health centers in Isfahan, Iran. The results of the psychometric evaluation showed that the 30-item prenatal body image questionnaire in seven dimensions has a good validity and reliability, which is applicable to research on body image in pregnancy.

Nutritional status and body fat mass: Determinants of sarcopenia in community-dwelling older adults

BACKGROUND

Sarcopenia is defined as the old age syndrome characterized by profound decline in muscle mass and function. This study aimed to investigate the prevalence of sarcopenia and its risk factors in older adults.

METHODS

Totally, 501 older people aged 65 years and older were recruited. Sarcopenia was defined according to the criteria of the Asian Working Group for Sarcopenia (AWGS). For obtaining Skeletal Muscle mass Index (SMI), body composition was evaluated using Bioelectrical Impedance Analysis (BIA). Muscle strength and physical performance were measured by Handgrip Strength (HGS) and Gait Speed (GS), respectively. Nutritional status, physical activity level, and biochemical indicators were assessed, as well.

RESULTS

The prevalence of sarcopenia was 20.8%. Multiple logistic regression models of the predictors of decline in the components of sarcopenia showed that older age, low Body Mass Index (BMI), and serum albumin level were associated with a higher risk of low SMI. Low serum albumin level and older age were also predictive of low HGS. Besides, old age, high body fat mass, and low BMI were the risk factors of low GS. Conversely, increased Calf Circumference (CC) was protective against low SMI and GS. Finally, older age, male gender, low BMI, decreased mini-nutritional assessment score, low serum albumin level, and high body fat were associated with a higher risk of sarcopenia, whereas higher CC reduced its risk.

CONCLUSION

The prevalence of sarcopenia is high among elderly individuals. This study underlined that sarcopenia might develop in older adults with impaired nutritional status and high body fat mass. Further studies could evaluate the effects of appropriate nutritional interventions on sarcopenia management and prevention.

Analysing cardiovascular risk factors and related outcomes in a middle-aged to older adults population in Iran: a cohort protocol of the Shiraz Heart Study (SHS)

INTRODUCTION

The significant increase in the rate of morbidity and mortality due to cardiovascular diseases has become a health challenge globally. Lack of enough knowledge on the underlying causes in Iran and taking the unique characteristics of the Shiraz metropolitan city (the capital city of Fars Province) into consideration prompted us to conduct the Shiraz Heart Study. The aim of this study is to determine the predisposing elements leading to coronary heart disease, cerebrovascular disease and peripheral arterial disease.

METHODS AND ANALYSIS

In this population-based, prospective study, family physician clinics will become the executive arms. Participants aged 40-70 years old will be recruited to achieve a sample size of 10 000. Socioeconomicta and anthropometric indices supplemented by physical activity, nutritional and psychological questionnaires, as well as routine blood laboratory tests, medical history and electrocardiographic records, will be collected at enrolment in clinics. In addition, blood samples will be obtained to explore the possible role of genetics in outcome occurrence. Follow-up with blood sampling, completion of a lifestyle questionnaire and evaluation of clinical risk factors will be carried out five times in a 2-year interval for all participants. Advanced statistical methods such as mixed model and time-to-event models will be used for data analysis.

ETHICS AND DISSEMINATION

This study is in accordance with the Helsinki Declaration and has been approved by the Research Ethics Committee of Shiraz University of Medical Sciences (No: 2017-358). Signing a written informed consent is the preliminary step. Participants are free to withdraw on their request at any time. Collected data are kept encrypted in a software with authorities' access only. Findings of the study will be published at a national or international scale through peer-reviewed journals.

Effect of synbiotic pomegranate juice on glycemic, sex hormone profile and anthropometric indices in PCOS: A randomized, triple blind, controlled trial

BACKGROUND AND AIMS

Polycystic Ovarian Syndrome is a common reproductive, endocrine, and metabolic disease in women. Pomegranate juice, known as a rich source of phytochemicals with high antioxidant activity, enriched with probiotic may improve PCOS.

METHODS AND RESULTS

A randomized, controlled, triple-blinded, parallel trial study was performed in PCOS patients (n = 92). Three treatment groups (23 patients each) received 2 L of synbiotic pomegranate juice (SPJ), pomegranate juice (PJ), and synbiotic beverage (SB) weekly. The control group (23 patients) received 2 L of placebo beverage weekly. Primary outcome was any change in insulin resistance and secondary outcomes were fasting blood sugar (FBS), insulin sensitivity, testosterone, luteinizing hormone (LH), follicle stimulating hormone (FSH), body mass index (BMI), waist and hip circumference, from baseline to the end of the trial. At the end of the study, 86 patients were analyzed. There was significant change in insulin resistance in the SPJ and SB groups. Insulin sensitivity increased significantly in the SPJ and SB groups. Insulin also changed significantly in the SPJ and SB groups. BMI, weight and waist circumference decreased significantly in the SPJ and SB groups. Testosterone level also decreased significantly in the SPJ and SB groups. There was no significant change in FPG, LH and FSH in any of the groups.

CONCLUSION

SPJ in the form of a new beverage can improve insulin resistance, insulin, testosterone level, BMI, weight and waist circumference in PCOS. This trial was registered in Iranian Registry of Clinical Trials, with number: 25272.

Histologic and Histomorphometric Assessment of Xenograft Bone Substitute versus Synthetic Nonceramic Hydroxyapatite for Canine Tooth-Socket Preservation

This study sought to histologically and histomorphometrically assess and compare application of xenograft bone substitute and synthetic nonceramic hydroxyapatite for tooth-socket preservation in dogs. This split-mouth clinical trial was conducted in five hybrid dogs, using four tooth sockets in each dog, with a total of 20 sockets for evaluation. Group 1 received xenografts, and group 2 received synthetic nonceramic hydroxyapatite in the sockets. In group 3 (positive controls), sockets remained empty. All sockets were covered with collagen resorbable membrane, and the flap was stitched using nonresorbable sutures. In group 4 (negative control), sockets were without membrane, left empty, and sutured. After 12 wk, 8-mm-high bone core biopsies were harvested from inside the sockets, using a trephine bur with an internal diameter of 2 mm. We assessed the tissue in terms of percentage of newly formed viable bone, percentage of remaining particles, degree of inflammation, and type of connective tissue. Data were statistically analyzed. The percentage of newly formed viable bone was 34.98% in group 1 and 41.30% in group 2, and this difference was not statistically significant (p = 0.710). The percentage of remaining particles was 15.95% in group 1 and 14.14% in group 2; this difference was also not statistically significant (p = 0.902). Both synthetic nonceramic hydroxyapatite and xenograft bone substitute showed similar efficacy, histologically and histomorphometrically, when used with resorbable collagen membrane for tooth-socket preservation in dogs.

Risk factors and prevalence of toxocariasis in pregnant women and diabetic patients compared to healthy adults in Ilam province, western Iran

Toxocara is one of the common intestinal nematodes in dogs and cats and is the agent of tissue migratory larvae in humans. Customarily, the prevalence of human toxocariasis hovers around 15.8 % in Iran. Furthermore, other research outcomes demonstrated a tendency for an outbreak of toxocariasis in Iran. Therefore, we carried out a cross-sectional study and assessed the seroprevalence of toxocariasis humans in Ilam Province, western of Iran. A total of 539 serum samples were collected between September 2017 and March 2018 from patients referred to the Health Centers of Ilam province, Iran. Serum samples were investigated for the presence of Toxocara using IgG antibodies, ELISA (Enzyme-Linked Immunosorbent Assay) kit. Risk factors such as contact with cats and dogs, living in rural areas were investigated among the study population. Out of 539 total samples collected, 97 cases (17.99 %) were positive for anti-toxocara IgG antibodies. These antibodies were recovered from serum samples of otherwise healthy adults (15.54 %, 49/296), pregnant women (21.16 %, 40/189) and diabetic patients (14.81 %, 8/54). This study showed significant relationship between toxocariasis and contact with animal pets in all studied groups (P value ≤ 0.05) and a significant relationship between toxocariasis and living in rural areas among pregnant women (P value ≤ 0.05).

Comparing isolated soy protein with flaxseed oil vs isolated soy protein with corn oil and wheat flour with corn oil consumption on muscle catabolism, liver function, blood lipid, and sugar in burn patients: a randomized clinical trial

BACKGROUND

There is controversy regarding whether increasing isolated soy protein (ISP) with or without flaxseed oil (FO), as functional foods, would lead to reduce muscle catabolism and cachexia in burn patients.

METHODS

One hundred and eighty-eight patients were assessed for eligibility in this randomized controlled trial. Of these, seventy-three eligible patients (total burn surface area 20-50%) were randomly assigned to three groups, labeled as Control (wheat flour [WF] + corn oil [CO]), ISP + FO, and ISP + CO, to receive these nutrients for three weeks. Weight, body mass index (BMI), serum hepatic enzymes (alanine transaminase [ALT], aspartate transaminase [AST], alkaline phosphatase [ALP]), systemic inflammatory response syndrome (SIRS), 24-h urinary urea nitrogen excretion (UUN), serum creatinine, 24-h urinary creatinine (UUC) excretion, fasting blood sugar (FBS), triglyceride (TG), and cholesterol were measured.

RESULTS

Using analysis of covariance models in the intention-to-treat population (n = 73), we found that at three weeks, patients in the ISP groups had lost significantly less in weight and BMI compared to those in the control group (all P < 0.01). Nitrogen retention and serum creatinine (primary outcomes) increased significantly in the ISP groups compared with the control group. Even after controlling for potential covariates in ANCOVA models, changes in these indices were still statistically significant (P = 0.008 and P = 0.005 for nitrogen balance and serum creatinine, respectively). However, no such significant differences were found between the ISP groups. On the other hand, 24-h UUN, and UUC excretion, serum hepatic enzymes, FBS, TG, and cholesterol were not significant between the groups (P > 0.05).

CONCLUSION

ISP and FO compared to WF and CO reduced muscle catabolism and increased body weight in burn patients.

TRIAL REGISTRATION

Iranian Registry of Clinical Trials, IRCT2014051817740N1 . Registered on 27 June 2014.

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.

Intradialytic Oral Protein Supplementation and Nutritional and Inflammation Outcomes in Hemodialysis: A Randomized Controlled Trial

BACKGROUND

Malnutrition is a common finding in hemodialysis patients and can increase oxidative stress and inflammation levels.

STUDY DESIGN

A randomized, controlled, nonblinded, parallel trial.

SETTING & PARTICIPANTS

92 hemodialysis patients from a single center with malnutrition according to subjective global assessment (SGA) score (SGA score > 7).

INTERVENTION

3 treatment groups (23 patients each) received 220mL of fermented vitamin E-fortified whey beverage (15g of whey protein concentrate + 600IU of vitamin E) or 220mL of fermented whey beverage (15g of whey protein concentrate) or vitamin E (600IU) 3 times a week for 8 weeks. The control group (23 patients) received no intervention.

OUTCOME & MEASUREMENTS

Primary outcomes were change in SGA score and malnutrition-inflammation score (MIS) from baseline to the end of the trial.

RESULTS

At the end of the study, 83 patients were analyzed (2, 3, 1, and 3 patients left the study in the vitamin E-fortified whey beverage, whey beverage, vitamin E, and control groups, respectively). Changes in SGA scores were -3.48 (95% CI, -4.90 to -2.00), -3.22 (95% CI, -4.13 to -2.30), -1.70 (95% CI, -3.20 to -0.24), and 1.56 (95% CI, 0.60 to 2.50) for the vitamin E-fortified whey beverage, whey beverage, vitamin E, and control groups, respectively (overall P<0.001; P≤0.001 for each treatment group vs control). Changes in MISs were -3.17 (95% CI, -4.40 to -1.90), -1.83 (95% CI, -2.50 to -1.10), -2.30 (95% CI, -3.50 to -1.10), and 1.48 (95% CI, 0.65 to 2.30) for the vitamin E-fortified whey beverage, whey beverage, vitamin E, and control groups, respectively (overall P<0.001; P<0.001 for each treatment group vs control). Few adverse effects were reported in any group.

LIMITATIONS

Lack of blinding, small sample size, and short duration.

CONCLUSIONS

Whey protein in the form of a new fermented whey beverage and vitamin E supplementation may improve SGA score and MIS in the short term.

Malnutrition-inflammation score and quality of life in hemodialysis patients: is there any correlation?

Background:

Malnutrition, inflammation and poor quality of life are prevalent among hemodialysis (HD) patients. Health-related quality of life is an important determinant of hospitalization and mortality in HD patients.

Objectives:

The aim of this study was to assess the correlation between quality of life and malnutrition-inflammation status according to subjective global assessment (SGA) and malnutrition-inflammation scores (MIS) in HD patients.

Patients and Methods:

We randomly selected 87 of 180 stable HD patients from two HD centers. Those on hemodialysis for at least three months and with malnutrition according to the SGA scores were included in this study. They were divided into two groups of mild to moderate malnutrition (n = 39) and severe malnutrition (n = 49) based on the SGA scores. Serum levels of transferrin, albumin, blood urea nitrogen, creatinine, kt/v, body mass index and malnutrition-inflammation scores were measured in all patients. Health-related quality of life was assessed by validated short form-12 (SF-12) questionnaire for each patient. These values were compared between the two groups of patients by independent sample t-test and Mann-Whitney U test. The correlations of nutritional variables with SGA and MIS scores were determined by Pearson and Spearman correlation tests.

Results:

There were no differences in measured parameters between the two groups except for MIS scores. Those with severe malnutrition showed higher MIS scores. All quality of life aspects and total scores (PCS, MCS) (rather than social functioning (SF) aspect) were significantly different between the two groups, which showed lower physical and mental scores in severely-malnourished patients. Physical functioning (PF), role limitations due to physical heath (RP), general health (GH), mental health (MH), SF, role limitation due to emotional health (RE), vitality (VT) aspects and total scores (PCS and MCS) had negative significant correlations with MIS and SGA scores (All P values < 0.05). No correlation was found between MIS and SGA scores and other measured variables.

Conclusions:

This study focused on important effects of malnutrition and inflammation on health-related quality of life aspects, both physically and mentally in HD patients. SGA and MIS are highly correlated with quality of life in HD patients.

Nutrition knowledge: application and perception of food labels among women

Knowing the level of consumers' nutritional knowledge is useful for promoting dietary habits. The aim of this study was to assess women's nutritional knowledge and their food label perception and their correlates. Three hundred and eighty Women referring to four large supermarkets in Shiraz were selected for this study. Data were collected through face-to-face interview. The NKQ questionnaire was used for designing the study questionnaire. The first part contained demographic characteristics and the second section encompassed questions related to nutritional knowledge of consumers about food components. The third part consisted of questions about labeling. Data were analyzed using SPSS 16. ANOVA and t-test were used for analyzing multi-variant variables. Chi-square test was used for evaluating the relationship between variables. 49.7% of the participants were healthy and others had chronic diseases. The mean score of the women's nutrition knowledge was 20.13 (from 24) and the average knowledge of women about food components were near 50%. Consumers' information about food labels application was less than 50% for all situations. The lowest use of labels was about low-salt labels and the highest for calorie content of foods. There was a significant relationship between educational status and food label use and also a significant relationship between information about added sugar and using low-sugar labels and between knowledge about low-salt foods and using low-salt labels. A significant relationship was also seen between knowledge about fat and cholesterol use for low fat foods. So, label application was correlated with educational level and nutritional knowledge of women.

Adiponectin as a novel indicator of malnutrition and inflammation in hemodialysis patients

INTRODUCTION

Protein-energy malnutrition and inflammation are common and overlapping conditions in hemodialysis patients, which are associated with increased risk of morbidity and mortality. Adiponectin is an adipocytokine exclusively produced by adipose tissue. The aim of this study was to further elucidate the association between serum adiponectin levels and the nutritional status of hemodialysis patients.

MATERIALS AND METHODS

Seventy-three patients on hemodialysis for at least 3 months, three times weekly, without any acute illness, were divided into 2 groups of well-nourished (n = 25) and malnourished (n = 48) based on their nutritional status, measured by the subjective global assessment. Serum levels of adiponectin, albumin, blood urea nitrogen, and creatinine; body mass index; and the malnutrition-inflammation score were measured in all patients. These values were compared between well-nourished and malnourished patients. The correlations of nutritional variables with serum levels of adiponectin were determined, as well.

RESULTS

Except for the malnutrition-inflammation score, which was significantly higher in the malnourished patients compared to the well-nourished ones (11.1 +/- 3.6 versus 4.2 +/- 2.0, P < .001), no other significant differences were found between the two groups. A weak but significant positive correlation was found between the serum levels of adiponectin and subjective global assessment scores (r = 0.25, P = .03).

CONCLUSIONS

The results of our study point to potential utility of serum adiponectin level as an indicator of nutritional status in hemodialysis patients. Further studies are needed to clarify the role of adiponectin in the pathogenesis of malnutrition in hemodialysis patients.