Association of Vitamin D with Suicide Behaviors: A Systematic Review and Meta-Analysis.

Objective: Research findings on the relationship between vitamin D and suicide are not consistent; therefore, the objective of the present paper is to assess the relationship between vitamin D and suicide behaviors using a systematic review and meta-analysis. Method : A search strategy was developed using keywords including "Vitamin D", "Vitamin D deficiency", "suicide" "attempted suicide", "completed suicide", "Suicide, Attempted", "Suicidal Ideation." We searched databases including Scopus, Medline, Web of Science, and Google Scholar by July 7, 2022. We examined the titles, abstracts, and full texts of the articles to select eligible ones. To pool the results of the selected studies, we used the random-effect method and mean difference as the effect size. The quality of the articles was evaluated by the Newcastle-Ottawa Scale (NOS). Moreover, heterogeneity and bias of reporting were evaluated by the I2 statistic and Egger's and Begg's tests, respectively. Results: Out of 149 studies retrieved in the databases, 11 studies were included in the final phase. Among these, the pooled findings of seven studies included in the meta-analysis phase showed that low levels of vitamin D are related to increased probability for suicide behaviors (P < 0.05). Moreover, subgroup analysis showed a significant relationship between vitamin D and suicide ideation and suicide attempt (P < 0.05). In addition, the I2 statistic indicated moderate heterogeneity (58%) and Egger's and Begg's tests did not show any evidence of publication bias (P > 0.05). Conclusion: This study provides evidence in favor of the relationship between vitamin D and suicide behaviors. It suggests that insufficient levels of vitamin D play a role in suicidal behaviors. However, it should be noted that further and stronger evidence is needed to establish this role. Finally, incorporating vitamin D-rich foods into the diet or taking vitamin D supplements is recommended to reduce the risk of suicide.

The association between food insecurity status and COVID-19 in an Iranian population: a case-control study.

Aim: The 2019 novel coronavirus epidemic (COVID-19) is a highly contagious viral disease with a high rate of morbidity and mortality. Food insecurity has frequently been linked to the emergence of infectious diseases. The present study was conducted to determine the association of food insecurity and socioeconomic status with COVID-19 in the Iranian population. Subject and methods: The study was a case-control study including 248 participants (124 COVID-19-infected people with a positive PCR test and a history of clinical symptoms of COVID-19 and 124 non-infected people with a negative PCR test and no history of clinical symptoms of COVID-19 infection) aged 20 to 60 years. The participants in the two groups were matched based on age, sex, and BMI. Anthropometric and socioeconomic data were collected. Individuals' food insecurity status during the previous 12 months (before the disease for the case group) was assessed using a validated 18-item USDA questionnaire. Results: About 44% of the controls and 76% of the case group were food-insecure (P < 0.001). After controlling for any possible confounders, only food insecurity and poor economic level increased the risk of COVID-19, by about three times (OR = 3.10; 95% CI = 1.44-6.68; P = 0.004) and 9.5 times (OR = 9.53; 95% CI = 3.73-24.30; P < 0.001), respectively. Conclusion: Food insecurity and poor economic status are linked to an increased risk of COVID-19. Future prospective studies are needed to confirm these outcomes and identify the underlying mechanisms.

The assessment of risk factors and risk perception status of breast cancer in Northern Iran.

BACKGROUND: Breast cancer (BC) is the most common malignancy in women. Identifying and avoiding the preventable risk factors of BC reduces its occurrence effectively. So, this study aimed to assess BC's risk factors and risk perception status in Babol, Northern Iran. METHODS: This cross-sectional study was conducted on 400 women aged 18 to 70 in Babol, Northern Iran. According to the eligibility criteria, the selected participants completed the demographic characteristics and researcher-made valid and reliable questionnaires. The statistical software was SPSS20. RESULTS: The significant risk factors related to BC were old age (60 years old and more) (30.2%), obesity (25.8%), history of radiation (10%), and familial history of BC (9.5%), respectively (P < 0.05). Suspected symptoms of BC were observed in 78 (19.5%) women, including indentations in 27 (6.75%), redness in 15 (3.75%), pain in 16 (4%), and enlargement of lymph nodes in 20 (5%). The BC risk perception score was 107.72±13.22. CONCLUSION: Most participants had at least one risk factor for BC. It is essential to implement intervention programs to control obesity and BC screening programs in obese and overweight women to prevent BC and its complications. Further studies are needed.

Health literacy and fear among Iranian medical students due to COVID-19: An observational study.

INTRODUCTION: The coronavirus disease of the 2019 (COVID-19) pandemic has created a sense of fear due to uncertainties in medical students' personal and professional lives. Medical education is challenging and poses a more significant academic and emotional rigor when compared with other professional programs. With the COVID-19 having limited treatment options, health literacy (HL) is crucial for managing and responding to the pandemic. This research aims to examine the impact of HL on COVID-19-associated fear among Iranian medical students. METHODS: A cross-sectional study was conducted measuring the HL and fear of COVID-19 using validated scales. Two hundred and seventy-eight survey responses were received and analyzed descriptively by using SPSS software inferential statistics. RESULTS: Mean age of participants was 22.93 ± 5.427 years. The correlation between students' total health literacy (HELIA) scores and their fear of COVID-19 (FCV-19S) scores was -0.279 (p value = .019). The FCV-19S has a negative correlation with total HELIA in the group of females and males, single and married people, bachelor and MD students, and students living in rural areas and urban areas. The negative correlation of FCV-19S with total HELIA in males and students who reside in rural areas was the only one that was not significant. In associate degree students, the correlation between FCV-19S and total HELIA was positive but not significant. Education grades had a significant impact on FCV-19S. Furthermore, the place of residence also had a significant impact on FCV-19S. However, the gender and marital status did not significantly impact FCV-19S. CONCLUSIONS: The present study showed that students with higher HL scores had lesser fear of COVID-19. The key stakeholders require several positive strategies to reduce fear and improve health, and such vital policies will assist in improving the students' health and achieving the sustainable developmental goals.

Association between the food security status and dietary patterns with polycystic ovary syndrome (PCOS) in overweight and obese Iranian women: a case-control study.

BACKGROUND: Polycystic ovary syndrome (PCOS), as one of the significant endocrine disorders, is common among women worldwide. Food insecurity (FI) and unhealthy dietary patterns can negatively affect reproductive health. The effects of the lifestyle modifications, especially dietary components, on PCOS are contradictory. The aim was the assessment of association between PCOS with food security status and dietary patterns among overweight or obese women. METHODS: This case-control study was performed on 240 overweight and obese women with and without PCOS (ratio 1:1) referred to the infertility clinic of Arash Hospital, Tehran, Iran. The general and socioeconomic characteristics, anthropometrics (weight, height, body mass index (BMI), waist circumference, hip circumference), physical activity, food security status, and dietary intakes (or patterns) were assessed using valid questionnaires, scales, stadiometer, and tape meter. The significant p-value was < 0.05. RESULTS: The prevalence of FI was 60% in women with PCOS and 30% in healthy women. PCOS risk was positively related to FI, quasi-western dietary patterns, low economic levels, waist circumference, and menstrual age and negatively with physical activity and healthy dietary patterns, even after controlling the potential confounders (P <  0.05). PCOS women had a higher intake of saturated fats, monounsaturated fats, oleic acid, fluorine, sucrose, and caffeine and a lower intake of vitamins A, B5, B6, B12, C, and D, potassium, proteins, carbohydrates, cholesterols, docosahexaenoic acid, potassium, carotenes, lutein, beta-cryptoxanthin, lycopene, calcium, iron, thiamine, riboflavin, niacin, tetra- and dihydrofolate, biotin, phosphorus, magnesium, zinc, copper, fiber (total, insoluble, and crude), glucose, galactose, fructose, and lactose compared to the healthy women (P <  0.05). CONCLUSIONS: FI, quasi-western dietary patterns, low economic levels, and waist circumference were significantly associated with the higher risk of PCOS. The lifestyle changes, especially dietary patterns, may be an essential strategy for reducing PCOS. Further studies are warranted to confirm these findings and to identify the underlying mechanisms.

Metabolic and clinical responses to Bunium Persicum (black caraway) supplementation in overweight and obese patients with type 2 diabetes: a double-blind, randomized placebo-controlled clinical trial.

BACKGROUND: Diabetes mellitus is the most common metabolic disorder worldwide. We aimed to determine the metabolic and clinical responses to Bunium Persicum (Black Caraway) supplementation in overweight and obese patients with T2DM. METHODS: Participant recruitment took place in the diabetic clinic of Bu-Ali hospital in Zahedan. Due to the eligibility criteria, 60 participants were randomly placed into two groups, namely placebo (n = 30) and BP (n = 30). The supplementation was considered one 1000 mg capsule 2 times /day BP by meals (lunch and dinner) for 8 weeks. Physical activity levels, dietary intakes, anthropometric measurements [weight, height, and waist circumference], glycemic indices [fasting blood glucose (FBG) and insulin (FBI)], blood lipids [triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-c), and low-density lipoprotein cholesterol (LDL-c)], and serum nesfatin-1 level were determined. Homeostasis model assessment-insulin resistance (HOMA-IR), Quantitative insulin sensitivity checks index (QUICKI), and Body Mass Index (BMI) were computed. RESULTS: In comparison with placebo, BP significantly decreased FBG, HOMA-IR, and BMI (P <  0.05). The differences in the FBI, QUICKI, TG, TC, LDL, HDL, WC, and Nesfatin-1 were not significant (P > 0.05). CONCLUSION: BP supplementation improved serum glucose indices and BMI among overweight and obese T2DM patients. Further trials are needed to confirm results. TRIAL REGISTRATION: Iranian Registry of Clinical Trials (IRCT), IRCT20181207041876N1, Registered 18/01/2019, https://irct.ir/trial/35752.

Vitamin D supplementation improves SIRT1, Irisin, and glucose indices in overweight or obese type 2 diabetic patients: a double-blind randomized placebo-controlled clinical trial.

BACKGROUND: Vitamin D (VD) may increase sirtuin 1 (SIRT1) and subsequently PPAR-γ coactivator 1α (PGC-1α) and irisin levels and these improvements may reduce insulin resistance (IR). The aim was to assess the effects of vitamin D supplementation on SIRT1, irisin, and IR in overweight/obese type 2 diabetes (T2D) patients. METHODS: Ninety T2D males and females were recruited as a clinical trial study (mean of age and body mass index (BMI) of intervention and placebo groups were 50.05 ± 10.17 and 50.36 ± 10.2 yrs. and 31.37 ± 3.4 and 30.43 ± 3.2 kg/m2, respectively). The inclusion criteria were T2D, VD deficient, BMI > 25 kg/m2, and serum HbA1c < 8.5%. The exclusion criteria were using vitamin and mineral supplements, having any acute disease, recent modifying dose or type of drugs. The supplementation was 50,000 IU/week VD or placebo for 8 weeks. The demographic characteristics, anthropometrics, dietary intakes and physical activity status, sun exposure status, fasting blood sugar (FBS) and insulin, glycosylated hemoglobin (HbA1c), irisin, SIRT1, 25-hydroxy D3 (25(OH)VD), homeostasis model assessment of insulin resistance (HOMA-IR), and quantitative insulin sensitivity check index (QUICKI) were determined. The significant P-value was ≤0.05. RESULTS: The increase of serum VD, SIRT1, and irisin in the intervention group was significant (p < 0.001). HbA1c was decreased significantly by 1%. The changes in the other glucose indices (FBS, insulin, and IR) were non-significant. CONCLUSIONS: VD supplementation may improve T2D by decreasing HbA1c and increasing SIRT1 and irisin in VD deficient T2D patients. Further trials are suggested. TRIAL REGISTRATION: Iranian Registry of Clinical Trials, IRCT201604202365N11. Registered 21/08/2016, http://en.irct.ir/trial/2019.

Food insecurity is an important risk factor for type 2 diabetes: a case-control study of new referrals to the University clinics, Shiraz, Southern Iran.

BACKGROUND: The prevalence of food insecurity (FI) as "the limited or uncertain availability of enough food for an always active and healthy life" and diabetes as "the most common metabolic disease" are rising in Iran. The aim was to assess the FI, depression, and socioeconomic status as risk factors for type 2 diabetes (T2D). METHODS: This case-control study was conducted on 135 patients with T2D as cases (99 females, 36 males, mean age 46.83 years) and 135 subjects without diabetes (89 females, 46 males, mean age 45.93 years) as controls. They had been referred to clinics of Shiraz University of Medical Sciences, Shiraz, Iran. The prior major inclusion criterion for diabetes was fasting blood sugar (FBS) ≥126 mg/dl. General, demographic, and socioeconomic characteristics and FI status were assessed using the general and 18-items United States Department of Agriculture (USDA) household food security questionnaires, respectively. Chi-square, t-test, and uni-and multi-variate logistic regression tests and SPSS16 statistical software were used. RESULTS: The prevalence of FI was 66.7% in cases and 41.5% in controls. According to final analysis model, FI (Odds Ratio [OR] = 1.9, P = 0.016), depression (OR = 2.0, P = 0.018), body mass index (BMI) ≥ 25 kg/m2 (OR = 1.8, P = 0.025), number of children ≥4 (OR = 1.7, P = 0.046), and having children under 18 years. (OR = 2.1, P = 0.011) were significant independent risk factors for T2D. CONCLUSION: The prevalence of FI in patients with T2D was significantly higher compared to the controls. FI was an important risk factor for T2D, even after controlling for the potential confounders. Further studies are suggested.

Green cardamom supplementation improves serum irisin, glucose indices, and lipid profiles in overweight or obese non-alcoholic fatty liver disease patients: a double-blind randomized placebo-controlled clinical trial.

BACKGROUND: Despite the reported health effects of cardamom on dyslipidemia, hepatomegaly, and fasting hyperglycemia, no human research has studied its potency in non-alcoholic fatty liver disease (NAFLD) as the hepatic part of metabolic syndrome. Our aim was determining the effects of green cardamom (GC) on serum glucose indices, lipids, and irisin level among overweight or obese NAFLD patients. METHODS: The place of participant recruitment was the polyclinic of the National Iranian Oil Company (NIOC) central hospital in Tehran. Based on the ultrasonography and eligibility criteria, 87 participants were randomly divided into two groups as cardamom (n = 43) or placebo (n = 44). The supplementation was two 500 mg capsules 3 times/day with meals for 3 months. Serum irisin, fasting blood sugar (FBS), insulin (FBI), total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-c), and high-density lipoprotein cholesterol (HDL-c) were measured. Quantitative insulin sensitivity check index (QUICKI) and homeostasis model assessment-insulin resistance (HOMA-IR) were also calculated. RESULTS: In comparison with placebo, GC significantly increased irisin, HDL-c, and QUICKI and decreased FBI, TG, LDL-c, HOMA-IR, and the grade of fatty liver (P < 0.05). After adjustment for confounders, the changes were similar (P < 0.05) with an exception for LDL-c which had a trend (P = 0.07). The differences in FBS, TC, and body mass index (BMI) were not significant (P > 0.05). CONCLUSION: GC supplement improved the grade of fatty liver, serum glucose indices, lipids, and irisin level among overweight or obese NAFLD patients. The changes in these biomarkers may yield beneficial effects on NAFLD. Further trials on the efficacy of GC for clinical practice are suggested. TRIAL REGISTRATION: Iranian Registry of Clinical Trials, IRCT2015121317254N4 . Registered 27/12/2015.

Nano-curcumin improves glucose indices, lipids, inflammation, and Nesfatin in overweight and obese patients with non-alcoholic fatty liver disease (NAFLD): a double-blind randomized placebo-controlled clinical trial.

BACKGROUND: Since lifestyle changes are main therapies for non-alcoholic fatty liver disease (NAFLD), changing dietary components (nutritional or bioactive) may play a parallel important role. Few studies have assessed the effects of curcumin on NAFLD (mainly antioxidant and anti-inflammatory effects). We aimed to determine the effects of nano-curcumin (NC) on overweight/obese NAFLD patients by assessing glucose, lipids, inflammation, insulin resistance, and liver function indices, especially through nesfatin. METHODS: This double-blind, randomized, placebo-controlled clinical trial was conducted in the Oil Company Central Hospital, Tehran. 84 overweight/obese patients with NAFLD diagnosed using ultrasonography were recruited according to the eligibility criteria (age 25-50 yrs., body mass index [BMI] 25-35 kg/m2). The patients were randomly divided into two equal NC (n = 42) and placebo (n = 42) groups. Interventions were two 40 mg capsules/day after meals for 3 months. Lifestyle changes were advised. A general questionnaire, a 24-h food recall (at the beginning, middle and end), and the short-form international physical activity questionnaire (at the beginning and end) were completed. Also, blood pressure, fatty liver degree, anthropometrics, fasting blood sugar (FBS) and insulin (FBI), glycated hemoglobin (HbA1c), homeostasis model assessment-insulin resistance (HOMA-IR), quantitative insulin sensitivity check index (QUICKI), total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c), tumor necrosis factor-alpha (TNF-α), high sensitive c-reactive protein (hs-CRP), interleukin-6 (IL-6), liver transaminases, and nesfatin were determined at the beginning and end. RESULTS: NC compared with placebo significantly increased HDL, QUICKI, and nesfatin and decreased fatty liver degree, liver transaminases, waist circumference (WC), FBS, FBI, HbA1c, TG, TC, LDL, HOMA-IR, TNF-α, hs-CRP, and IL-6 (P < 0.05). The mean changes in weight, BMI, body composition (BC), and blood pressure were not significant (P > 0.05). After adjustment for confounders, the changes were similar to the unadjusted model. CONCLUSION: NC supplementation in overweight/obese NAFLD patients improved glucose indices, lipids, inflammation, WC, nesfatin, liver transaminases, and fatty liver degree. Accordingly, the proposed mechanism for ameliorating NAFLD with NC was approved by the increased serum nesfatin and likely consequent improvements in inflammation, lipids, and glucose profile. Further trials of nano-curcumin's effects are suggested. TRIAL REGISTRATION: Iranian Registry of Clinical Trials, IRCT2016071915536N3. Registered 2016-08-02.

Green cardamom increases Sirtuin-1 and reduces inflammation in overweight or obese patients with non-alcoholic fatty liver disease: a double-blind randomized placebo-controlled clinical trial.

BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is the hepatic component of metabolic syndrome. Despite the beneficial health effects of cardamom on dyslipidemia, hepatomegaly, and fasting hyperglycemia, no previous human study has been conducted on the efficacy of cardamom in NAFLD. The aim of this study was to assess the effects of green cardamom (GC) on serum Sirtuin-1 (Sirt1), inflammatory factors, and liver enzymes in overweight or obese NAFLD patients. METHODS: The recruitment of subjects was conducted at the polyclinic of the central hospital of National Iranian Oil Company (NIOC), Tehran. Eighty-seven patients who participated were divided randomly into two groups according to the ultrasonography and eligibility criteria as cardamom (n = 43) or placebo (n = 44). The intervention involves taking two 500 mg capsules three times per day with meals for 3 months. General characteristics, dietary intake and physical activity status, weight and height were determined. In addition, serum Sirt1, tumor necrosis factor-alpha (TNF-α), high sensitive c-reactive protein (hs-CRP), interleukin-6 (IL-6), alanine transaminase (ALT), and aspartate transaminase (AST) were measured. The degree of fatty liver was determined at beginning and end of the study. RESULTS: In comparison with placebo, GC significantly increased Sirt1 and decreased hs-CRP, TNF-α, IL-6, ALT, and the degree of fatty liver (P < 0.05). The differences in weight, BMI, and AST were not significant (P > 0.05). CONCLUSION: GC supplementation could improve some biomarkers related to fatty liver including inflammation, ALT, and Sirt1 in overweight/obese NAFLD patients. Further trials on cardamom's potential are suggested. TRIAL REGISTRATION: Iranian Registry of Clinical Trials, IRCT2015121317254N4. Registered 27/12/2015.

Food Insecurity and Primary School Girl Students' Intelligence Quotients: A Case-Control Study.

BACKGROUND: Food insecurity (FI) refers to the lack of sufficient and safe availability of the food. Accumulating studies have suggested associations between dietary intake and Intelligence quotient (IQ). Accordingly, we aimed to examine the association between FI and IQ. STUDY DESIGN: Case-control study. METHODS: In this case-control study, 222 girl students aged 9 to 11 years old were randomly chosen from Bandar-Anzali, Iran in 2013. Students with low and moderate IQ were considered as case (n=111) and control (n=111) group, respectively. General and demographic characteristics were collected using interview. United States Department of Agriculture (USDA) household FI questionnaires were also completed. To determine IQ, Wechsler's revised intelligence test was used. RESULTS: FI was observed in 51% of study participants. The prevalence of FI in case and control group was 58.6% and 22.5%, respectively. The mean IQ was 77.97 ±5.56 in case and 94.6 ±5.47 for control group. It was found that there was an inverse association between FI and low IQ. The results of the multiple variable logistic regression analysis (odds ratio and its 95% confidence interval) showed that, FI 3.46 (1.85, 6.50; P>0.001), natural type of delivery 2.45 (1.30, 4.62; P=0.006), and father's low education level 2.97 (1.43, 6.19; P=0.004) were the risky factors leading to low IQ. CONCLUSIONS: There was an inverse link between FI and IQ. Therefore, it is necessary to pay more attention to FI and its consequences, particularly in mental health of children.

Questionnaire-based Prevalence of Food Insecurity in Iran: A Review Article.

BACKGROUND: Data on the questionnaire-based prevalence of food insecurity are needed to develop food and nutrition security studies and policies. The present study aimed to assess the questionnaire-based prevalence of food insecurity in Iran. METHODS: A systematic search of cross-sectional studies were conducted on databases including PubMed, Google Scholar, Scopus, Magiran, Iranmedex, SID and Medlib up to 29 Oct 2015. Estimation of food insecurity prevalence was according to the instruments including 9-items-HFIAS, 18 and 6-items USDA (US-HFSSM) and Radimer/Cernel food security questionnaires. Pooled effect was estimated using random-effect model and heterogeneity was assessed by Cochran's Q and I2 tests. RESULTS: Thirteen articles included in the study based on screening and assessment of eligibility. The questionnaire-based prevalence of food insecurity was 49.2% (CI95%: 43.8-54.6). The according to sub-groups analysis, the food insecurity without and with hunger was 29.6% (CI95%: 25.7-33.6) and 19.2% (CI95%: 16-22.3), respectively. CONCLUSION: The about half of the population were food insecure. The food insecurity without hunger was more than the food insecurity with hunger. An ongoing food insecurity assessment system is needed to support evidence-informed policy and to plan interventions to increase the food security in different areas.

Efficacy of nanocurcumin supplementation on insulin resistance, lipids, inflammatory factors and nesfatin among obese patients with non-alcoholic fatty liver disease (NAFLD): a trial protocol.

OBJECTIVES: Different studies have been conducted on the role of curcumin in health since having multiple properties, including antioxidant and anti-inflammatory effects. Due to the lack of studies regarding curcumin effects on obese patients with non-alcoholic fatty liver disease (NAFLD), our protocol was designed to assess nanocurcumin impacts on blood sugar, lipids, inflammatory indices, insulin resistance and liver function, especially by nesfatin. SETTING: This trial will be conducted in the Oil Company central hospital of Tehran, Iran with a primary level of care. PARTICIPANTS: 84 obese patients with NAFLD diagnosed using ultrasonography will be employed according to the eligibility criteria . INTERVENTIONS: The patients will be randomly divided into two equal groups (nanocurcumin and placebo, two 40 mg capsules per day with meals for 3 months, follow-up monthly). Also, lifestyle changes (low-calorie diet and physical activity) will be advised. MEASURES OF THE PRIMARY AND SECONDARY OUTCOMES: A general questionnaire, 24 hours food recall (at the beginning, middle and end) and short-form International Physical Activity Questionnaire will be completed. Blood pressure, anthropometrics, serum sugar indices (fasting blood sugar and insulin, insulin resistance and sensitivity and glycosylated haemoglobin), lipids (triglyceride, total cholesterol and low-density and high-density lipoprotein-cholesterol, inflammatory profiles (interleukin-6, high-sensitivity C-reactive protein, and tumour necrosis factor-alpha), liver function (alanine and aspartate transaminase) and nesfatin will be measured at the beginning and end of the study. CONCLUSION: This trial would be the first experiment to determine nanocurcumin efficacy on certain blood factors among obese patients with NAFLD. Nevertheless, studying the potential consequences of curcumin in various diseases, especially NAFLD, is required for clinical use. TRIAL REGISTRATION NUMBER: IRCT2016071915536N3; pre-results.

The Relationship between Food Insecurity and Esophageal and Gastric Cancers: A Case-Control Study.

BACKGROUND: Food insecurity is defined as the limited or uncertain availability of enough food for permanent active and healthy life. Upper gastrointestinal (GI) cancers (esophagus and stomach) are one of five most common cancers in Iran. This study aimed to determine the association of food insecurity and upper GI cancers in newly diagnosed patients. STUDY DESIGN: Case-control study. METHODS: Overall, 120 patients with upper GI cancers as cases and 120 patients with orthopedic, ear-nose-throat (ENT), and neurologic diseases as controls were recruited from Imam Khomeini Hospital, Tehran, Iran in 2013. The patients were newly diagnosed using endoscopy or imaging or biopsy methods. They were individually matched for age, sex, and residential area. The general and United States Department of Agriculture (USDA) household food security questionnaires were completed. The univariate and multivariate conditional logistic regression tests were applied using the Stata 11SE statistical software. RESULTS: The food insecurity prevalence was 69.2% and 43.3% in cases and controls, respectively. Food insecurity, low economic level and family history of cancer were significantly associated with cancer (P<0.05). CONCLUSIONS: Food insecurity was one of the important risk factors for upper GI cancers that health care providers should consider it.

The effects of green cardamom on blood glucose indices, lipids, inflammatory factors, paraxonase-1, sirtuin-1, and irisin in patients with nonalcoholic fatty liver disease and obesity: study protocol for a randomized controlled trial.

BACKGROUND: The relationship between dietary components and nonalcoholic fatty liver disease (NAFLD) needs to be further investigated. The potential health benefits of cardamom have been found in some studies. Cardamom showed beneficial effect on hepatomegaly, dyslipidemia, and fasting hyperglycemia in animals. However, some adverse effects of cardamom have been reported in animals. No previous human study had been conducted on the effects of cardamom in NAFLD. This study aims to determine the effects of green cardamom (Elettaria cardamomum) supplementation on blood glucose indices, lipids, inflammatory profiles, and liver function, especially by examining irisin, paraxonase-1 (PON1) and sirtuin-1 (Sirt1) in obese patients with NAFLD. METHODS: This trial is to be conducted at the polyclinic of the National Iranian Oil Company (NIOC) Central Hospital, Tehran. Eighty obese patients with NAFLD will be selected according to the eligibility criteria. The NAFLD diagnosis method is ultrasonography. Patients will be randomly divided into two groups by a random-number table (cardamom and placebo groups, two 500-mg capsules, three times/day, taken with meals for 3 months, follow-up monthly). General characteristics, dietary intakes (at the beginning, middle, and end), and physical activity (at the beginning and end) will be assessed using a general, 24-h food recall, and short-form International Physical Activity Questionnaires (IPAQ), respectively. Lifestyle advice will be presented to both groups identically. At the beginning and the end, anthropometrics (weight, height, and waist circumference), blood pressure, extent of fatty liver, and blood biomarkers, including serum glucose indices (fasting blood sugar (FBS)) and insulin (FBI), homeostasis model assessment-insulin resistance (HOMA-IR), Quantitative Insulin Sensitivity Check Index (QUICKI)), lipids (triglyceride (TG), low-density lipoprotein-cholesterol (LDL-c), high-density lipoprotein-cholesterol (HDL-c), total cholesterol (TC)), inflammatory markers (highly sensitive C-reactive protein (hs-CRP), tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6)), liver enzymes (alanine transaminase (ALT), aspartate transaminase (AST)), irisin, PON1, and Sirt1, will be determined. DISCUSSION: This trial would be the first to assess the effects of green cardamom on several blood factors, including glucose indices, lipids, inflammatory markers, liver enzymes, irisin, PON1, and Sirt1, and blood pressure and anthropometry in obese patients with NAFLD. Further study of cardamom's potential in improving NAFLD is suggested. TRIAL REGISTRATION: Iranian Registry of Clinical Trials (IRCT), ID number: IRCT2015121317254N4 . Registered on 27 December 2015.

Probiotics Reduce the Risk of Antibiotic-Associated Diarrhea in Adults (18-64 Years) but Not the Elderly (>65 Years): A Meta-Analysis.

BACKGROUND: Antibiotic-associated diarrhea (AAD) is a common problem in adults and elderly patients due to the widespread use of antibiotics in this population. Multiple previous systematic reviews have demonstrated an association between specific probiotics and decrease of AAD, especially in children. As there is no specific analysis concerning the elderly patients, we decided to focus on adults, especially elderly people. METHODS: We performed a systematic review of the literature regarding the use of probiotics in the treatment of AAD in adults (18-64 years old) and elderly subjects (≥65 years old). We identified 436 articles that met the search criteria. Thirty randomized controlled trials met the predefined inclusion criteria and were included in the meta-analysis. RESULTS: There was considerable heterogeneity among the trials (P < .001); thus, subgroup analyses were performed. The meta-analysis resulted in a pooled relative risk (RR) of AAD of 0.69 (95% confidence interval [95% CI]: 0.62-0.76) in a fixed effects model and 0.58 (95% CI: 0.48-0.71) in a random effects model, as compared with placebo. The positive association between intake of probiotic and reduced risk of AAD was observed in adults (RR, 0.47; 95% CI: 0.4-0.56). In contrast, in elderly patients, there was no positive effect (RR, 0.94; 95% CI: 0.76-1.15) of probiotic use and AAD. CONCLUSION: In summary, the results emerging from our meta-analysis suggested that adjunct probiotic administration is associated with a reduced risk of AAD in adults but not in elderly people.