Dietary Magnesium Intake in Relation to Depression in Adults: A GRADE-Assessed Systematic Review and Dose-Response Meta-analysis of Epidemiologic Studies.

CONTEXT: The relation of magnesium (Mg) intake with depression was previously investigated by meta-analyses. However, due to limited data, a dose-response analysis was not performed. OBJECTIVE: Considering the recently published articles, a systematic review and dose-response meta-analysis was conducted to summarize the relation of dietary Mg intake with depression in adults. DATA SOURCES: Medline (PubMed), ISI Web of Science, Scopus, and Google Scholar were comprehensively searched up to August 2023. DATA EXTRACTION: Observational studies that reported the relation of dietary Mg intake and depression in adults were included and their data were extracted. DATA ANALYSIS: A total of 63 214 participants from 10 cross-sectional and 3 cohort studies were included in the current study. Pooling 15 effect sizes from 12 studies (including 50 275 participants) revealed that individuals with the highest Mg intake had a 34% lower risk of depression, compared with those with the lowest Mg intake (RR: 0.66; 95% CI: 0.57, 0.78). Moreover, the linear dose-response analysis revealed that each 100-mg/d increment in Mg intake was associated with a 7% reduced risk of depression (RR: 0.93; 95% CI: 0.90, 0.96). Additionally, based on nonlinear dose-response analysis, increasing Mg intake from 170 to 370 mg/d was associated with a reduced risk of depression. Analyses were also conducted on 9 studies (49 558 participants) with representative populations, and similar results were found in the meta-analysis (RR: 0.71; 95% CI: 0.61, 0.83) and linear (RR: 0.93; 95% CI: 0.90, 0.96) and nonlinear dose-response analysis. CONCLUSION: The current study shows an inverse dose-dependent association between dietary Mg intakes and risk of depression in both a general and representative population of adults in a dose-response manner. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no. CRD42024506570.

The association between serum vitamin D levels and abnormal lipid profile in pediatrics: A GRADE-assessed systematic review and dose-response meta-analysis of epidemiologic studies.

CONTEXT: Several studies have investigated the relationship between serum vitamin D and dyslipidemia in children and adolescents, but the findings have been contradictory. OBJECTIVE: The current systematic review and dose-response meta-analysis investigated the serum vitamin D - dyslipidemia relationship in children and adolescents. DATA SOURCES: ISI Web of Science, Scopus, MEDLINE (PubMed), EMBASE databases, and Google Scholar, were searched up to December 2022. DATA EXTRACTION: Observational studies that investigated the odds of dyslipidemia in categories of serum vitamin D levels in children were included, and their data were extracted. DATA ANALYSIS: Pooling of 17 effect sizes from 15 studies (39 342 participants) showed that subjects with higher serum vitamin D had 27% lower odds of hypertriglyceridemia (odds ratio [OR] = 0.73; 95% confidence interval [CI]: 0.60, 0.88). A meta-analysis of 18 effect sizes from 16 studies (39 718 participants) illustrated that highest vs lowest serum vitamin D was related to 22% lower odds of low high-density lipoprotein cholesterol (HDL-c) (OR = 0.78; 95% CI: 0.66, 0.91). Also, a nonlinear association between serum vitamin D and odds of abnormal lipid profile was found: elevating values of 25-hydroxyvitamin D from 35 nmol/L to 55 nmol/L was associated with a decreasing trend in odds of hypertriglyceridemia, hyper low-density lipoprotein cholesterolemia, hypercholesterolemia, and hypo HDL-cholesterolemia. However, no significant linear association was observed. Based on the Grading of Recommendations, Assessment, Development and Evaluations (GRADE), the certainty of all evidence was rated as high. CONCLUSION: This meta-analysis revealed that the level of 25-hydroxyvitamin D was inversely related to odds of abnormal serum triglycerides and HDL-c in children and adolescents. Increasing serum vitamin D from 35 nmol/L to 55 nmol/L was associated with a decreasing trend in the odds of abnormal serum triglycerides, HDL-c, low-density lipoprotein cholesterol, and total cholesterol in children. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no. 42023400787.

Dietary intake of methyl donor nutrients in relation to metabolic health status, serum levels of brain-derived neurotrophic factor and adropin.

BACKGROUND AND AIMS: There is a lack of evidence on dietary intake of methyl donor nutrients with metabolic health status and related biomarkers. Thus, this study aimed to assess the relation between methyl donor nutrients intake and metabolic health status with regarding the interactive roles of brain-derived neurotrophic factor (BDNF) and adropin in Iranian adults. METHODS: This cross-sectional survey was conducted among 527 Iranian adults (45.7% female) selected by multistage cluster random-sampling method. A validated food frequency questionnaire was used to evaluate participants' dietary intake. Metabolic unhealthy status was defined by Wildman criteria as having ≥ 2 of hyperglycemia, hypertriglyceridemia, hypo-HDL-cholesterolemia, hypertension, chronic inflammation, and insulin resistance. Concentrations of metabolic parameters, BDNF and adropin were determined using fasting blood samples. RESULTS: An inverse association was found between methyl donor nutrients intake and metabolically unhealthy status in multivariable-adjusted model (ORT3 vs. T1 = 0.30; 95%CI: 0.12-0.75). This association was especially significant among overweight/obese adults and was stronger in women. Additionally, consumption of vitamin B6 and choline was separately related to reduced odds of metabolically unhealthy status. Methyl donor intake was not significantly related to low BDNF (ORT3 vs. T1 = 0.93; 95%CI: 0.60-1.44) and adropin (ORT3 vs. T1 = 0.71; 95%CI: 0.44-1.15). However, the interaction between high methyl donor nutrients intake and high BDNF was related to lower odds of metabolically unhealthy status in multivariable-adjusted model (ORMDNS∗BDNF = 0.27; 95%CI: 0.11-0.67). CONCLUSION: Higher intake of methyl donor nutrients, alone and in interaction with BDNF levels, was associated with decreased odds of metabolically unhealthy status in Iranian adults.

Dietary Phytochemical Index in Relation to Metabolic Health Status, Serum Adropin, and Brain-Derived Neurotrophic Factor Levels in Adults.

Background: Little is known about the relationship between dietary intake of phytochemicals with metabolic health status and underlying mechanisms. Objectives: Little is known about the relationship between dietary intake of phytochemicals with metabolic health status and underlying mechanisms. We hypothesized that dietary phytochemical index (DPI) improves metabolic health status by ameliorating serum concentrations of brain-derived neurotrophic factor (BDNF) and adropin. Methods: A cross-sectional study was performed in 527 adults (286 males and 241 females). The dietary intakes of participants were collected by a 168-item food frequency questionnaire, and DPI was estimated as a percentage of energy intake derived from phytochemical-rich foods. Anthropometric variables, blood pressure, glycemic and lipid profiles, and biochemical variables were assessed. The metabolically unhealthy (MU) phenotype was determined based on the definition presented by Wildman et al. Results: The MU phenotype was identified in 51.4% of male and 32.0% of female participants. Participants in the third tertile of DPI had 59% lower odds of MU than those in the first tertile (OR: 0.41; 95% CI: 0.19, 0.87) after considering potential confounders. Stratified analysis by sex and body mass index indicated that DPI was inversely related to MU phenotype in females (OR: 0.28; 95% CI: 0.08, 0.97) and normal-weight individuals (OR: 0.11; 95% CI: 0.02, 0.62). DPI was also inversely associated with hyperglycemia, hypertriglyceridemia, and chronic inflammation. Nonsignificant reduced odds of low BDNF (OR: 0.87; 95% CI: 0.42, 1.84) and adropin (OR: 0.75; 95% CI: 0.31, 1.79) were observed in individuals in the top tertile of DPI compared with those in the bottom tertile. Conclusions: This study showed that individuals with higher dietary intake of phytochemicals had lower odds of MU, particularly females and normal-weight individuals. No significant relationship was observed between serum BDNF and adropin with phytochemical intake.

Nutrient patterns in relation to insulin resistance and endothelial dysfunction in Iranian women.

Prior studies have mainly focused on the association of one specific nutrient with insulin resistance (IR) and endothelial dysfunction and limited studies have assessed the association with different nutrient patterns (NPs). We examined the association between various NPs and IR and endothelial dysfunction among Iranian women. This cross-sectional study was carried out on a sample of 368 female nurses. A 106-items food frequency questionnaire (FFQ) was applied for dietary assessments. Using factor analysis, the relationships between NPs and markers of insulin resistance (HOMA-IR, HOMA-ß, and QUICKY), and endothelial dysfunction (E-selectin, sICAM-1, and sVCAM-1) were assessed. Mean age and body mass index of participants were respectively 35.21 years and 24.04 kg/m2. Three major NPs were identified. NP1, named as "dairy, fruits, and vegetables" had high values of potassium, folate, vitamins A and C, magnesium, and beta carotene. No significant association was observed between this NP and insulin resistance or endothelial dysfunction indices. The second NP was full of chromium, selenium, copper, vitamin B6, monounsaturated fatty acid (MUFA), thiamin, vitamin D, and iron. Adherence to NP2 (named "legumes, nuts, and protein foods") was associated with lower values of insulin (6.8 ± 1.1 versus 8.4 ± 1.1, P = 0.01), homeostasis model assessment-Insulin resistance (HOMA-IR) (1.3 ± 0.2 versus 1.7 ± 0.2, P = 0.02), and vascular adhesion molecule 1 (VCAM-1) (444.2 ± 27.9 versus 475.8 ± 28.4, P = 0.03). However, adherence to the third NP, rich in saturated fatty acid (SFA), cholesterol, sodium, zinc, vitamin E, and B12, described as "animal fat and meat + vitamin E", was associated with higher amounts of homeostasis model assessment-ß (HOMA-ß) (531.3 ± 176.2 versus 48.7 ± 179.8, P = 0.03). In conclusion, following the NP2, correlated with higher intakes of chromium, selenium, copper, vitamin B6, MUFA and thiamin was associated with lower values of insulin, HOMA-IR, and sVCAM-1. Adherence to NP3, rich in SFA, cholesterol, vitamin E, vitamin B12, and zinc was associated with higher levels of HOMA-ß.

Nutrient patterns in relation to metabolic health status and serum levels of brain-derived neurotrophic factor (BDNF) and adropin in adults.

The present study aimed to investigate the association of nutrient patterns (NPs) with metabolic health status and serum levels of brain-derived neurotrophic factor (BDNF) and adropin in Iranian adults. This cross-sectional survey was performed on 527 adults aged 20-60 years in Isfahan, Iran. To evaluate dietary intake, a validated 168-item semi-quantitative food frequency questionnaire (FFQ) was used. Participants were categorized as metabolically healthy (MH) and metabolically unhealthy (MU) according to their glycemic and lipid profile, insulin resistance (IR), and inflammation status. An overnight fasting blood sample was collected from each participant and serum levels of BDNF and adropin were assessed. A total of 42.50% of participants were recognized as MU. Three NPs were recognized by factor analysis that labeled as "high animal protein" (NP1), "high vegetable" (NP2), and "high carbohydrate" (NP3) patterns. Moderate adherence to NP2 was related to a lower risk of MU (ORT2 vs. T1 = 0.38, 95% CI: 0.18-0.76). Moreover, high adherence of NP2 (T3 vs. T1) was inversely associated with hypertriglyceridemia (OR = 0.27, 95% CI: 0.11-0.65; P-trend < 0.001) and high hs-CRP values (OR = 0.29, 95% CI: 0.09-1.00; P-trend = 0.03). No significant association was observed between adherence of NP1 and NP3 with MU in crude and adjusted models. However, negative associations were found between moderate adherence to NP3 and insulin resistance (IR) (OR = 0.23, 95% CI: 0.06-0.91) as well as high adherence to NP1 and hypertension (OR = 0.23, 95% CI: 0.09-0.61; P-trend < 0.001). NPs were not associated with serum BDNF and adropin values.

Adherence to Mediterranean-Dietary Approaches to Stop Hypertension Intervention for Neurodegenerative Delay Diet in Relation to Serum Brain-Derived Neurotrophic Factor Concentrations and Metabolic Health Status in Adults.

Background: There is a lack of data regarding the Mediterranean-Dietary Approaches to Stop Hypertension Intervention for Neurodegenerative Delay (MIND) diet and metabolic health. Objectives: This study assessed the relation between MIND diet and metabolic health status relative to serum brain-derived neurotrophic factor (BDNF) concentrations. Methods: This was a cross-sectional study of 527 adults (286 males and 241 females) recruited from 20 schools in 6 different educational districts of Isfahan, Iran. Dietary intakes of participants were collected by a validated 168-item food frequency questionnaire, and MIND diet score was estimated. Anthropometric indices, blood pressure, biochemical parameters, and BDNF concentrations were assessed for all participants. The metabolically unhealthy (MU) phenotype was determined based on blood pressure, glycemic and lipid profiles, chronic inflammation, and insulin resistance. Results: The frequency of MU phenotype among obese/overweight and normal-weight individuals was 79.5 % and 20.5 %, respectively. After adjustment for confounders, individuals in the top tertile of the MIND diet scores had 58 % lower odds of having the MU phenotype than individuals in the bottom tertile (odds ratios [ORs]: 0.42; 95 % confidence interval [CI]: 0.20, 0.90). In the fully adjusted model, females and normal-weight individuals had 81 % (OR: 0.19; 95 % CI: 0.04, 0.83) and 89 % (OR: 0.11; 95 % CI: 0.02, 0.69) lower chance of developing the MU phenotype, respectively. In addition, significant inverse associations between adherence to the MIND diet and high-blood pressure and hypertriglyceridemia were found. No significant association was found between adherence to MIND diet and odds of low BDNF concentrations. Conclusions: Adherence to MIND diet is inversely associated with odds of MU phenotype, especially among women and normal-weight individuals. BDNF concentration is not associated with MIND diet and MU status.

The relation of dietary protein intake before and during the pregnancy with gestational diabetes mellitus (GDM): A GRADE-assessed systematic review and dose-response meta-analysis of epidemiologic studies.

BACKGROUND: Although previous studies investigated the relation of protein intake and gestational diabetes mellitus (GDM), their findings were controversial. Therefore, we aimed to summarize this association, through a comprehensive systematic review and dose-response meta-analysis. METHODS: Electronic databases including MEDLINE (PubMed), ISI Web of Science, Scopus and motor engineering of Google Scholar were systematically searched up to April 2023. Observational studies which investigated odds of GDM in relation to protein intake were included. RESULTS: A total of 31,005 participants with 3451 cases of GDM from 13 eligible investigations were included in the systematic review and meta-analysis. Comparing the highest and lowest intakes of total, animal, and plant proteins revealed the summary RRs of 1.82 (95% CI: 1.42, 2.33), 1.79 (95% CI: 1.50, 2.14), and 0.98 (95% CI: 0.81, 1.20), respectively, indicating a significant positive association between total and animal protein intake and GDM. In the dose-response analyses, each 5% increment in energy intake from total protein during pregnancy was related to 20% increased odds of GDM (RR = 1.20; 95% CI: 1.09, 1.33). In the non-linear dose-response analyses, we found a non-linear association for animal protein intake during pregnancy (P for non-linearity <0.001); so that, a risk increase was seen from zero to 10% of energy intake from animal proteins, however, a risk reduction was seen after 10% of energy intake. However, there was not any significant non-linear trend between plant protein intake during pregnancy and risk of GDM. Based on the GRADE assessment, the quality of evidence for total, animal and plant protein was rated as "moderate", "moderate" and "very low", respectively. CONCLUSION: We found a significant positive association between total protein intake and GDM; however, the associations of animal and plant protein intake with GDM were dose-dependent.

Diet in relation to Metabolic, sleep and psychological health Status (DiMetS): protocol for a cross-sectional study.

INTRODUCTION: Metabolic disturbances are of major health concerns in the world. In addition to their high prevalence, these disorders have substantial roles in developing other physical and mental diseases. Diet could have a considerable influence on managing the progression of these conditions and their consequent health-related effects. The aim of the 'Diet in relation to Metabolic, sleep and psychological health Status' Project is to explore the association of nutrition with metabolic, sleep and mental health, considering potential mediators including brain-derived neurotrophic factor (BDNF) and adropin. METHODS AND ANALYSIS: This cross-sectional study will be conducted on adults (20-65 years) working in schools of Isfahan, Iran. A multistage cluster random sampling method will be used to select participants. Anthropometric, body composition and biochemical values including fasting blood glucose, lipid profile, 25-hydroxy vitamin D, insulin, BDNF, adropin, malondialdehyde, superoxide dismutase, glutathione peroxidase, uric acid, creatinine and C reactive protein will be measured for each participant. National Cholesterol Education Program and Adult Treatment Panel III will be considered to define metabolic syndrome. Diet will be assessed through a validated Food Frequency Questionnaire. Furthermore, sleep status, mental health, quality of life, physical activity and demographic status of individuals will be assessed by validated questionnaires. The collected data will be analysed using appropriate statistical methods. ETHICS AND DISSEMINATION: The study protocol was approved by the local Ethics Committee of Isfahan University of Medical Sciences. All participants will provide written informed consent. Dissemination will be through conference presentations and publications in peer-reviewed journals.

The effect of flaxseed supplementation on sex hormone profile in adults: a systematic review and meta-analysis.

Inconsistent data suggest that flaxseed supplementation may have a role in sex hormones. We aimed to carry out a systematic review and meta-analysis of randomized controlled trials (RCTs) investigating effects of flaxseed supplementation on sex hormone profile. PubMed, Scopus, Embase, Cochrane Library, Web of Science databases, and Google Scholar were searched up to March 2023. Standardized mean difference (SMD) was pooled using a random-effects model. Sensitivity analysis, heterogeneity, and publication bias were reported using standard methods. The quality of each study was evaluated with the revised Cochrane risk-of-bias tool for randomized trials, known as RoB 2. Finding from ten RCTs revealed that flaxseed supplementation had no significant alteration in follicle-stimulating hormone (FSH) (SMD: -0.11; 95% CI: -0.87, 0.66: p = 0.783), sex hormone-binding globulin (SHBG) (SMD: 0.35; 95% CI: -0.02, 0.72; p = 0.063), total testosterone (TT) levels (SMD: 0.17; 95% CI: -0.07, 0.41; p = 0.165), free androgen index (FAI) (SMD = 0.11, 95% CI: -0.61, 0.83; p = 0.759), and dehydroepiandrosterone sulfate (DHEAS) (SMD: 0.08, 95%CI: -0.55, 0.72, p = 0.794). Flaxseed supplementation had no significant effect on sex hormones in adults. Nevertheless, due to the limited included trials, this topic is still open and needs further studies in future RCTs.

Association between dietary insulin index and load with brain derived neurotrophic factor, adropin and metabolic health status in Iranian adults.

The associations of high potential insulinogenic foods with metabolic health (MH) status and brain-derived neurotrophic factor (BDNF) and adropin were not investigated quite enough. We examined the relationship between dietary insulin load (DIL) and dietary insulin index (DII) with MH and serum levels of BDNF and adropin among Iranian adults. This cross-sectional investigation accomplished among 527 Iranian middle-aged adults (54.3% men). Dietary information was obtained by a validated food frequency questionnaire. Anthropometric indices and blood pressure were assessed. For measuring lipid and glycemic profile and serum levels of BDNF and adropin, blood samples were assembled after 12 h of fasting. MH was defined based on lipid and glycemic profile, high blood pressure, insulin resistance and chronic inflammation. After adjustments all confounders, participants in the highest tertile of DII compared to the lowest one had a 115% increased odds for metabolic unhealthy (MU) profile (ORT3 vs. T1 = 2.15, 95% CI 1.03-4.49). However, DIL was not related to MU. Higher DII was additionally associated with high blood pressure, in maximally-adjusted model (ORT3 vs. T1 = 3.57, 95% CI 1.61-7.92). Moreover, moderate DIL was significantly associated with hypertriglyceridemia (ORT2 vs. T1 = 2.56, 95% CI 1.01-6.45). Each tertile increase in DII or DIL was not significantly associated with serum BDNF or adropin values. Greater DII was associated with higher chance of MU and hypertension in Iranian adults; but no association was found between DIL and metabolic health. DIL or DII was not related to circulating BDNF or adropin. To confirm these findings, additional prospective investigations are required.

A meta-analysis of the effect of probiotic administration on age-related sarcopenia.

Global increase in the prevalence of age-related diseases, such as sarcopenia, highlights the need of recognizing agents that improve muscle health; however, the evidence synthesis on the impact of probiotic administration on sarcopenia is scarce. To summarize and evaluate findings regarding the effect of supplementation with probiotics on sarcopenia, this meta-analysis was conducted. Using databases, including PubMed, SCOPUS, ISI-Web of Science, and Cochrane Library, interventional studies were included if they investigate the effect of probiotic administration on at least one of the components of sarcopenia up to 6 October 2022. Risk of bias evaluation was conducted using the Cochrane quality assessment tool. The random-effects model which takes between-study variations into account was used to obtain the overall effect sizes. The STATA version 14.0 was used for statistical analyses. Overall, 17 studies were included. There was high certainty of evidence that probiotic supplementation has a beneficial effect on muscle mass (kg) (WMD: 0.55, 95% CI: 0.05, 1.05; I 2: 0.0%, p = .995), and muscle function (WMD: 0.13, 95% CI: 0.03, 0.23; I 2: 65.6%, p = .05). Moreover, administration of probiotics for more than 12 weeks significantly increased muscle strength (WMD: 1.16, 95% CI: 0.88, 1.44; I 2: 0.0%, p = .77). However, probiotic supplementation had no effect on anthropometric indices, including body mass index. Probiotic supplementation could improve muscle mass and muscle function in adults more than 55 years old. The beneficial effect of probiotics on muscle strength could appear after 12 weeks of supplementation.

Legumes and nuts intake in relation to metabolic health status, serum brain derived neurotrophic factor and adropin levels in adults.

There is controversial evidence about the relationship between consumption of legumes and nuts with metabolic disturbances. The present study was undertaken to explore the association of legumes and nuts intake with metabolic health status among Iranian adults. This cross-sectional study was conducted on 527 adults (45.7% female, aged 20-65 years) chosen through a multistage cluster random-sampling approach. Dietary intakes of individuals were assessed using a validated food frequency questionnaire. Fasting blood samples were gathered to evaluate biochemical parameters. Metabolic health status of subjects was determined according to the criteria defined by Wildman. Data of covariates were collected using pre-tested procedures. The overall prevalence of metabolic unhealthy (MU) phenotype was 42.5%. After controlling all confounders, participants with highest intake of legumes and nuts had lower odds of MU status, compared with the lowest intake (OR 0.35; 95% CI 0.18-0.71). This association was stronger in normal-weight rather than overweight/obese adults and also in women rather than men. Higher consumption of legumes and nuts was additionally related to decreased odds of hyperglycemia, hypertriglyceridemia, and hypertension. A marginally inverse association was observed between legumes and nuts intake with low brain-derived neurotrophic factor (BDNF) levels, in fully-adjusted model (ORT3 vs. T1 0.50; 95% CI 0.25-1.01). Each tertile increase in legumes and nuts intake was marginally related to higher adropin levels ([Formula: see text] = 4.06; P = 0.07). In conclusion, this study demonstrated that higher intake of legumes and nuts is associated with lower chance of MU both in normal weight and overweight/obese adults. The association may be facilitated through serum BDNF and adropin.

Association between Mediterranean dietary pattern with sleep duration, sleep quality and brain derived neurotrophic factor (BDNF) in Iranian adults.

Data on the association between Mediterranean diet, sleep and brain-derived neurotrophic factor (BDNF) were limited in Middle Eastern populations. We examined the association between Mediterranean dietary pattern with sleep quality/quantity, and serum BDNF in Iranian adults. This cross-sectional study was performed among 535 middle-aged adults (54% men), selected by multistage cluster random sampling method. The Pittsburgh sleep quality index and a validated food frequency questionnaire were used to assess sleep quality, sleep quantity, and Mediterranean diet score (MDS). Twelve-hour fasting blood samples were taken to evaluate serum BDNF values. Participants in the highest tertile of MDS, in comparison to those in the lowest tertile, had lower odds of having short sleep (OR = 0.44, 95%CI: 0.21-0.91) and poor sleep quality (OR = 0.48, 95%CI: 0.22-0.96), after adjustment for potential confounders. Among specific domains of sleep quality, lower odds of subjective sleep quality, sleep latency, and daytime dysfunction were associated with increased MDS. Higher adherence to MDS among individuals with overweight or obesity reduced the odds of having short sleep; this relation was not seen among individuals with normal weight. In contrast, the association between sleep quality and the MDS was significant in individuals with normal weight, but not those with overweight or obesity. Participants with higher adherence to MDS had lower odds for low BDNF values; however, this relation was not statistically significant. Overall, Iranian adults with a higher adherence to MDS had considerably lower odds of having short sleep and poor sleep quality. BDNF would not be an intermediate molecule for this connection.

Effects of sumac supplementation on metabolic markers in adults with metabolic syndrome: a triple-blinded randomized placebo-controlled cross-over clinical trial.

BACKGROUND: Despite the prior evidence of the impacts of sumac on glycemic indices, lipid profile and visceral fat, there is a lack of evidence regarding the efficacy of sumac in cases with metabolic syndrome (MetS). Therefore, we aimed to assess the effect of sumac supplementation on MetS markers among adults with this syndrome. METHODS: In this triple-blinded randomized placebo-controlled cross-over clinical trial 47 adults with MetS were randomly assigned to receive 500 mg sumac or placebo (lactose) capsule, twice a day. Each phase took 6 weeks and there was a 2-week washout between phases. All clinical evaluations and laboratory tests were conducted before and after each phase. RESULTS: At the baseline of the study, mean (± SD) age, weight, and waist circumference of participants were respectively 58.7 (± 5.8) yr, 79.9 (± 14.3) kg, and 107.6 (± 10.8) cm. Intention to treat analysis (ITT) analyses revealed that sumac supplementation decreased systolic blood pressure by 5 mmHg (128.8 ± 21.4 at the baseline vs. 123.2 ± 17.6 after 6 weeks intervention, P = 0.001). The comparison of changes in two trial arms showed that sumac supplementation significantly reduced systolic blood pressure (sumac group -5.59 ± 10.6 vs. control group 0.76 ± 10.5, P = 0.004), but did not change anthropometric indices or diastolic blood pressure. Similar results were also found in the per-protocol analyses. CONCLUSIONS: This cross-over trial revealed that sumac supplementation could reduce systolic blood pressure in men and women with MetS. Daily intake of 1000 mg sumac, as an adjuvant therapy, may be beneficial in management of MetS in adults.

Association of legumes and nuts consumption with metabolic health status in Iranian overweight and obese adolescents.

Limited data are available on the association of legumes and nuts consumption with health status in pediatrics. So, we assessed the relation of legumes and nuts intake with metabolic health status in Iranian adolescents. A random sample of overweight/obese adolescents aged 12 to 18 years was included in this cross-sectional study. Dietary intakes were gathered using a validated 147-item food frequency questionnaire (FFQ). We measured metabolic indices including blood pressure, lipid profile, glycemic and anthropometrics indices. Two strategies were used for classification of adolescents to metabolically healthy obese (MHO) or unhealthy obese (MUO): International Diabetes Federation (IDF) and combination of IDF with Homeostasis Model Assessment Insulin Resistance (HOMA-IR). Information on 203 overweight/obese adolescents (50.2% girls and 49.8% boys) with an average age of 13.98 (± 1.61) years and a mean weight of 73.48 (± 11.60) kg/m2 was evaluated. Based on the IDF and IDF/HOMA-IR definition, higher consumption of legumes and nuts consumption was related to a 66% and 61% decreased odds of MUO in crude model (OR = 0.34, 95%CI 0.17-0.69), (OR = 0.39, 95%CI 0.19-0.80); but in fully-adjusted model, these relations disappeared. After adjustment for potential cofounders, an inverse association was found between legumes and nuts consumption and odds of hyperglycemia (OR = 0.35, 95%CI 0.16-0.78). Moreover, although inverse significant associations were found between legumes and nuts consumption and odds of MUO in girls and overweight subjects in crude models, these associations disappeared after adjustment for all confounders. After taking potential confounders into account, no significant association was found between consumption of legumes and nuts and MUO in Iranian adolescents. The findings should be affirmed by further prospective studies.

Total fat and omega-3 fatty acids intake in relation to serum brain-derived neurotrophic factor (BDNF) levels and psychological disorders in Iranian adults.

Considering contradictory findings of previous investigations and growing prevalence of psychological disorders, we investigated association between dietary total fat and omega-3 fatty acids intake with serum brain-derived neurotrophic factor (BDNF) levels, depression, anxiety and psychological distress in Iranian adults. Using a multistage cluster random sampling method, 533 middle-aged adults were included in this cross-sectional study. A validated semi-quantitative 168-item food frequency questionnaire was used to examine dietary intakes. A 12-h fasting blood sample was drawn to measure serum BDNF. Serum BDNF values in the first decile were considered low level. Hospital Anxiety and Depression Scale (HADS) and General Health Questionnaire (GHQ) were used to assess depression, anxiety and psychological distress. A U-shaped relationship between fat intake and prevalence of anxiety and distress was found. The third quartile of fat intake compared to the first quartile was significantly related to 80% decreased odds of depression (OR = 0.20, 95% CI 0.05-0.80), in fully-adjusted model. Participants in the third quartile of fat intake compared to those in the first quartile had significantly 45% lower odds for distress, in the crude model (OR = 0.55, 95% CI 0.33-0.92); however, this association disappeared after considering confounders. There was no significant association between omega-3 fatty acids intake and odds of depression, anxiety or distress. Prevalence of low-BDNF values was higher in participants with depression, as compared to non-depressed subjects (14.9 vs. 9%; P = 0.06). This cross-sectional study illustrated a U-shaped relationship between fat intake and prevalence of anxiety and distress. Moderate intake of fat was related to lower odds of depression. Prevalence of low-BDNF values was slightly higher in subjects with depression compared to non-depressed individuals.

The effect of sumac supplementation on insulin resistance, inflammation, oxidative stress, and antioxidant capacity in adults with metabolic syndrome: A randomized crossover clinical trial.

The impact of sumac supplementation was not previously examined in patients with metabolic syndrome (MetS). So, we investigated the influence of sumac supplementation on insulin resistance, inflammation, oxidative stress, and antioxidant markers in adults with MetS. The current study was a single-center, triple-blind, randomized, placebo-controlled crossover clinical trial that was conducted on 47 patients with MetS. Participants were randomly divided into two groups of intervention and control in the first phase. They received capsules containing 500 mg sumac or placebo (lactose) twice a day, after lunch and dinner, for 6 weeks. After a 2-week washout period, the subjects crossed over to the alternate arm. In both arms, fasting venous blood samples were obtained at baseline and at the sixth week of the intervention to determine glycemic status, high-sensitivity C-reactive protein (hs-CRP), malondialdehyde (MDA), total antioxidant capacity (TAC), and antioxidant enzymes activity. The mean (±SD) age, weight, and body mass index of participants were respectively 58.7 ± 5.83 years, 79.9 ± 14.35 kg, and 31.6 ± 4.6 kg/m2 ; 80.9% of subjects were females (n = 38). Based on per-protocol analyses, the serum fasting insulin concentration was unexpectedly decreased in the placebo group (change in sumac vs. control: 0.95 ± 3.9 vs. -1.17 ± 3.9 mU/L; p = 0.04). Sumac supplementation, compared to control, has marginally enhanced catalase activity (change in sumac vs. control: 2.91 ± 9.5 vs. -1.07 ± 9.1 nmol/min/ml; p = 0.06). This supplementation has also increased serum TAC and the activity of superoxide dismutase, but these changes were not significant. This intervention did not affect other insulin resistance, inflammatory, or oxidative stress markers. We found that 1 g/day sumac consumption for 6 weeks, as adjuvant therapy, could improve the antioxidant defense system in adults with MetS but did not affect insulin resistance, inflammation, or oxidative stress.

A meta-analysis of effects of vitamin E supplementation alone and in combination with omega-3 or magnesium on polycystic ovary syndrome.

Vitamin E supplementation might have favorable effects on risk factors of polycystic ovary syndrome (PCOS). This systematic review and meta-analysis aimed to summarize the effects of vitamin E supplementation or vitamin E in combination with omega-3 or magnesium on PCOS. PubMed, Scopus, ISI Web of Science, Cochrane, Embase electronic databases, and Google scholar were searched for all available articles up to September 2022. Randomized controlled trials (RCTs) that examined the effect of vitamin E supplementation or vitamin E in combination with omega-3 or magnesium on lipid and glycemic profiles, anthropometric measurements, biomarkers of inflammation and oxidative stress, hormonal profile, and hirsutism score in patients with PCOS were included. Ten RCTs (with 504 participants) fulfilled the eligible criteria. Vitamin E supplementation or vitamin E in combination with omega-3 or magnesium in comparison to placebo could significantly reduce serum levels of TG (weighted mean difference: - 18.27 mg/dL, 95% CI - 34.68 to - 1.87), VLDL (- 5.88 mg/dL, 95% CI - 8.08 to - 3.68), LDL-c (- 12.84 mg/dL, 95% CI - 22.15 to - 3.52), TC (- 16.30 mg/dL, 95% CI - 29.74 to - 2.86), TC/HDL-c ratio (- 0.52, 95% CI - 0.87 to - 0.18), hs-CRP (- 0.60 ng/mL, 95% CI - 0.77 to - 0.44), hirsutism score (- 0.33, 95% CI - 0.65 to - 0.02) and significantly increase nitric oxide levels (2.79 µmol/L, 95% CI 0.79-4.79). No significant effect was found on HDL-c, glycemic indices, hormonal profile, anthropometric measurements, and other biomarkers of inflammation or oxidative stress. This meta-analysis highlights the potential anti-hyperlipidemic, anti-oxidant, and anti-inflammatory properties of vitamin E supplementation alone or in combination with omega-3 or magnesium on PCOS patients.

Dietary insulin index and insulin load in relation to hypertriglyceridemic waist phenotype and low brain derived neurotrophic factor in adults.

Background: The evidence about the relation of the insulinemic potential of food with visceral obesity and brain-derived neurotrophic factor (BDNF) was limited. We aimed to investigate the relation of dietary insulin index (DII) and dietary insulin load (DIL) with hypertriglyceridemic waist phenotype (HTGW) and serum BDNF in Iranian adults. Methods: This cross-sectional study included 528 middle-aged adults (45.6% women), using a multistage cluster random-sampling method. Dietary intakes were assessed using a validated semi-quantitative 168-item food frequency questionnaire. Blood samples were collected after 12 h of fasting for assessing the serum BDNF and triglyceride concentrations. HTGW was defined as triacylglycerol ≥ 150 mg/dL plus enlarged waist circumference. The values less than the first decile of serum BDNF were considered as the low level. Results: Individuals in the top tertile of DIL, in comparison to those in the bottom tertile, had higher odds of HTGW in both crude (OR = 1.96, 95% CI: 1.14-3.37) and fully adjusted model (OR = 6.10, 95% CI: 1.58-23.53). However, the relation between DII and odds of HTGW was statistically insignificant in crude (OR = 1.30, 95% CI: 0.78-2.16) and maximally adjusted model (OR = 1.25, 95% CI: 0.65-2.40). After considering confounders, participants in the top tertile of DIL had marginally higher odds of having low BDNF values (OR = 2.00, 95% CI: 0.95-4.21). Nevertheless, the association between DII and odds of low BDNF values was statistically insignificant. Conclusion: This population-based study demonstrated that adults with higher DIL had significantly higher chance of HTGW phenotype and slightly higher chance for low BDNF level. DII was not associated with HTGW phenotype or BDNF values.