Sleep duration and quality are associated with health-related quality of life in adults aged 60 years and older.

BACKGROUND: The current study aimed to determine the association between sleep duration and quality with health-related quality of life (HRQoL) among the Iranian older persons. METHODS: This study was conducted on a representative sample of 3452 Iranian older people (≥ 60 years) who participated in the Iranian Longitudinal Study on Ageing (IRLSA) launched in Neyshabur (Razavi Khorasan province, northeastern Iran). The Persian versions of 12-Item Short Form Survey (SF-12) and Pittsburgh Sleep Quality Index (PSQI) were utilized to measure the level of HRQoL and the level of sleep duration and quality, respectively. Multiple linear regression model was performed to analyze the data and clarify the independent association of sleep duration and quality with HRQoL. RESULTS: More than half of the study population (52.4%) suffered from poor sleep quality. 57.3% and 3.9% of individuals were short sleepers (< 7 h) and long sleepers (equal or more than 9 h), respectively. The total score of HRQoL was achieved 65.87 ± 20.55. After adjusting the covariates, the results indicated that short sleep duration was negatively associated with HRQoL (P < 0.05), whereas no significant associations were found between long sleep duration and HRQoL (P > 0.05). Interestingly, the results of multiple linear regression model revealed a significant negative association between poor sleep quality and HRQoL (P < 0.001). CONCLUSION: The current study confirmed that short sleep duration and poor sleep quality were independently associated with lower HRQoL in the older persons. Therefore, interventional courses should be planned to enrich sleep-related healthcare and general HRQoL in the older persons.

Effects of purified anthocyanins supplementation on serum concentration of inflammatory mediators: A systematic review and dose-response meta-analysis on randomized clinical trials.

Anthocyanins, due to their antioxidant effects, are candidates to reduce inflammation and the risk of inflammatory diseases. Therefore, through conducting a systematic review and meta-analysis, we tried to find the effect of purified anthocyanins on serum levels of C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α). Databases including, ISI Web of Science, Scopus, ClinicalTrials.gov, PubMed, and Cochrane Library were searched up to June 2023. The meta-analysis was done by calculating mean differences and their standard deviations. Calculating the statistical heterogeneity of intervention effects was performed through I-squared statistics and Cochran's Q test. The pooled estimate showed a significant decrease in serum levels of CRP, TNF-α, and IL-6 (weighted mean difference (WMD) = -0.12 mg/L, 95% confidence interval (CI) = -0.21 to -0.02, p = 0.013; WMD = -1.37 pg/mL, 95% CI = -1.79 to -0.96; p < 0.001; WMD = -1.43 pg/mL, 95% CI = -1.87 to -1.00; p < 0.001, respectively). Subgroup analysis results revealed purified anthocyanins significantly decreased serum levels of CRP among participants with serum levels of CRP≥1.52 mg/L, at-risk/unhealthy status, and in trials with intervention duration ≥84 days, anthocyanins dose ≥320 mg/day, and sample size ≥85 subjects. Regarding TNF-α and IL-6, out results showed that there was a significant effect of purified anthocyanins on serum levels of TNF-α and IL-6 in most subgroups. The results of our study indicated that purified anthocyanins significantly decreased serum levels of CRP, TNF-α, and IL-6. However, further high-quality studies are needed to firmly establish the efficacy of purified anthocyanins.

Is poor sleep quality associated with lipid profile in elderly population? Finding from Iranian Longitudinal Study on Ageing.

BACKGROUND: Abnormal lipid profile as one of reversible cardiovascular disease risk factors might be affected by poor sleep quality. AIM: This study aimed to assess the association between poor sleep quality and serum concentration of lipid profile in Iranian elderly population. METHODS: The study was performed on a representative sample of 3452 Iranian older people (≥60 years) who contributed in the Iranian Longitudinal Study on Ageing (IRLSA). Sleep quality was measured through the validated Persian version of Pittsburgh Sleep Quality Index (PSQI). Fasting blood samples were collected from the participants to measure plasma levels lipid profile. We used multiple linear regression model to evaluate the independent association of poor sleep quality with lipid profile. RESULTS: The mean age of participants was 68.0±6.7 years and 52.5% of them were male. In total, 52.4% of study population reported poor sleep quality (PSQI>5). Mean serum concentration of triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) was 143.2±74.2 mg/dl, 195.6±43.2 mg/dl, 112.9±31.0 mg/dl, and 57.3±12.4 mg/dl, respectively. Poor sleep quality was significantly associated with serum levels of TG (ß=17.85; P=0.006), LDL-C (ß=5.45; P=0.039) and HDL-C (ß=-2.13; P=0.039) after adjusting for studied covariates. CONCLUSION: Our study illustrates that poor sleep quality is a risk factor for poorer lipid profile. Therefore, early behavioral or pharmacological interventions that improve sleep quality are necessary to modify lipid profile in elderly population.

The Effect of Parenteral Selenium Therapy on Serum Concentration of Inflammatory Mediators: a Systematic Review and Dose-Response Meta-Analysis of Randomized Clinical Trials.

Selenium can protect against inflammation through its incorporation in selenoenzymes; therefore, in this study, we assessed the effect of parenteral selenium on C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α) through a systematic review and meta-analysis on randomized controlled trials (RCTs). A systematic search was performed in the databases, including PubMed, Scopus, Cochrane, clinicaltrials.gov, and ISI Web of Science, up to October 2022, with no limitation in study location or publication time. We calculated the effect size by the mean change from baseline in serum concentration of selected inflammatory mediators and their standard deviations. DerSimonian and Laird random effects model was used to estimate the heterogeneity and summary of the overall effects. Included studies in this systematic review and meta-analysis were 10 and 8 RCTs, respectively. Our results revealed parenteral selenium significantly decreased serum IL-6 (Weighted Mean Difference (WMD) = -3.85 pg/ml; 95% confidence interval (CI) = -7.37, -0.34 pg/ml; p = 0.032) but did not significantly change serum levels of CRP (WMD = 4.58 mg/L; 95% CI = -6.11, 15.27 mg/L; P = 0.401) compared to the comparison groups. According to our results, parenteral selenium supplementation might reduce serum levels of inflammatory mediators.

A systematic review and dose-response meta-analysis of the effect of selenium supplementation on serum concentration of C-reactive protein.

BACKGROUND: Despite conducting new studies on the potential effect of selenium in reducing inflammation; results held contradictory weights and turns into an intriguing area of research. Concerns have been raised on this matter on hand to reach conclusive/consistent results. Therefore, this study seeks to address this scientific gap by assessing randomized controlled trials (RCTs) investigating the effect of selenium intake on C-reactive protein (CRP). METHOD AND MATERIALS: To find all the relevant English-language RCTs, databases including SCOPUS, Web of Science, Clinical Trials.gov, PubMed, and Cochrane Library were searched with no time limit (up to June 2022). Based on the mean changes for both comparison and intervention groups, the effect sizes were calculated. Further, DerSimonian and Laird random-effects model was performed to determine the summary of overall effects and their heterogeneity. RESULTS: Fifteen studies were selected for systematic review and thirteen studies were known to be eligible for meta-analysis. Meta-analysis results indicated a significant effect in serum CRP concentrations compared to the control group (weighted mean difference (WMD)= -0.22 mg/L 95 % confidence interval (CI): - 0.39, - 0.04; p = 0.014). CONCLUSION: In conclusion, our study confirms the downward effect of selenium on the serum concentration of CRP. On a wider level, further research is also needed to assess the selenium effect on other inflammatory mediators.

Is a spot urine sample a good substitution to estimate 24-h urinary sodium excretion in a population ≥ 50 years old? A validation study.

PURPOSE: A variety of prediction equations have been able to estimate 24-h urinary sodium excretion from spot urine samples; however, Iranians over the age of 50 have not been compared and verified. Using spot urine samples as a substitute for 24-h urine samples to estimate 24-h urine sodium excretion among the population age 50 and older are the purpose of this study. METHODS: A 24-h urinary sodium excretion was studied by well-known Kawasaki, INTERSALT, Tanaka, and World Health Organization/Pan American Health Organization (WHO/PAHO) formulas. On 360 individuals, the mean bias, agreements between estimated and measured values, correlation, absolute and relative differences, and misclassification rates were evaluated for four equations. RESULTS: As a result, the mean urinary sodium excretion for a 24-h period was 136.3 ± 52.21 mmol/24-h, which corresponds to a calculated intake of 9.1 ± 3.8 g of salt per day. According to the WHO/PAHO formula, the mean bias between measured values and estimated 24-h urinary sodium excretion is - 21.6 mg/day (95% confidence interval (CI) - 144.8, 101.6 mg/day), which is the smallest difference compared with the other three formulas. The lowest rate of individual misclassification of salt intake was 40% for WHO/PAHO, especially for those who consumed less than 9 g/day, while Kawasaki had the lowest misclassification rate at higher levels of salt intake. CONCLUSION: As a result of our research, the WHO/PAHO equations accurately predict 24-h urinary sodium excretion among Iranians aged ≥ 50 more than other equations, both at the population level and at the individual level. However, further study is needed in regard to different ages in Iran.

A systematic review and meta-analysis of almond effect on C-reactive protein and interleukin-6 in adults.

BACKGROUND: The previous articles have shown that the almond might reduce the serum concentration of inflammatory mediators. Therefore, the studies reported in this article aimed to assess the almond effect on serum concentration of C-reactive protein (CRP) and interleukin-6 (IL-6) in adults. METHOD AND MATERIALS: To find the related English-language studies, an electronic search was run in databases including Web of Science, PubMed, SCOPUS, ClinicalTrials.gov, and Cochrane library with no time limit (up to August 2022). The effect sizes were calculated based on the mean changes for both intervention and comparison groups. DerSimonian and Laird random-effects model was used to determine the summary of overall effects and their heterogeneity. Cochran's Q test and I-squared statistic were used to explore the statistical heterogeneity. RESULTS: In total, eleven studies were included in this study. The overall estimate indicated that the almond consumption had no significant effect on serum CRP level (weighted mean difference (WMD) = -0.28 mg/l, 95 % confidence interval (CI): - 0.81, 0.25; p = 0.29). Regarding IL-6, almond consumption significantly decreased serum IL-6 level (WMD = -0.1 pg/ml, 95 % CI: -0.15, -0.05; p < 0.001). CONCLUSION: The overall results support the beneficial effects of almond consumption on serum concentration of IL-6; but even so, our study revealed that the almond consumption non-significantly reduced serum concentration of CRP. We still need more well-designed trials to confirm the beneficial effects of almond.

Effect of soy isoflavones on C-reactive protein in chronic inflammatory disorders.

New evidence suggests that soy products might reduce chronic systemic inflammation. Therefore, we aimed to summarize the effect of soy isoflavones on serum concentration of C-reactive protein (CRP) among participants with chronic inflammatory disorders by conducting this study. Cochrane Library, Scopus, ISI Web of Science, clinicaltrials.gov, and PubMed were searched to identify randomized clinical trials (RCTs) published up to December 2020. The effect size was calculated by the mean change from baseline in concentrations of CRP and its standard deviation for both intervention and comparison groups. DerSimonian and Laird random-effects model was used when the heterogeneity test was statistically significant. In total, thirteen RCTs involving 1213 participants and ten RCTs involving 1052 participants were eligible for our systematic review and meta-analysis respectively. Study duration ranged from 4 to 96 weeks and soy isoflavones dose varied from 33 to 132 mg/day. Overall effect size indicated a non-significant effect on serum concentration of CRP following soy isoflavones intake (weighted mean differences (WMD)=-0.15 mg/L, 95% confidence interval (CI): -0.54, 0.23; p=0.430). Subgroup analysis revealed that soy isoflavones significantly reduced serum concentration of CRP in studies among participants with age >57 years and baseline CRP levels >3.75 mg/L. The present study proposed that soy isoflavones could not significantly reduce serum CRP levels. It seems more RCTs on participants with age more than 57 years and higher levels of CRP is necessary.

Can soy isoflavones in combination with soy protein change serum concentration of adiponectin and resistin? A systematic review and meta-analysis on randomized clinical trials.

Some studies proposed the anti-inflammatory effect of soy protein and soy isoflavones by changing the serum adiponectin and resistin levels. The purpose of this research was to determine the impact of soy isoflavones and soy protein on blood adiponectin and resistin levels in adults. Scopus, PubMed, Cochrane Library, ISI Web of Science, and ClinicalTrials.gov databases were searched until April 2022. The effect size was computed by the mean changes from the beginning for intervention and comparison groups and their standard deviation. In the case of significant heterogeneity, DerSimonian and Laird random-effects model was used. Six and five clinical trials were selected for the systematic review and meta-analysis, respectively. The overall estimate indicated that soy isoflavones in combination with soy protein did not significantly change serum adiponectin level (weighted mean differences (WMD) = 0.36 µg/ml; 95% confidence interval (CI): -0.26, 0.99; p = .25), but significantly increased serum resistin level (WMD = 0.64 ng/ml, 95% CI: 0.25, 1.04; p = .001). In combination with soy protein, soy isoflavones nonsignificantly increased serum adiponectin levels, but significantly increased resistin levels. New intervention studies with a high dose of soy isoflavones and soy protein in different parts of the world and an updated meta-analysis are needed to confirm the results of our study.

The beneficial effect of tart cherry on plasma levels of inflammatory mediators (not recovery after exercise): A systematic review and meta-analysis on randomized clinical trials.

BACKGROUND: Chronic inflammation has been classified as one of the most important threats to health. Scientists suggested that tart cherry (TC) can reduce plasma levels of inflammatory mediators. Therefore, the aim of this study was to summarize the effect of TC on circulating C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α) among adult participants in non-exercise randomized clinical trials (RCTs). METHODS AND MATERIALS: The eligible English-language RCTs were found by searching databases including PubMed, Web of Science, Cochrane Library, Scopus, and clinical Trials.gov up to May 2022, with no time limit. We used the mean change from baseline and its standard deviation for both intervention and comparison groups to calculate the effect size. The random-effects model proposed by DerSimonian and Laird was used to estimate the overall summary effect and the heterogeneity. We used PRISMA 2020 guidelines to report this study. RESULTS: Ten RCTs were included in this study. The results demonstrated that TC had a significant decreasing effect on plasma CRP level compared with the comparison group (weighted mean differences (WMD) = -0.55 mg/L; 95% confidence interval (CI): - 1.03, - 0.06; p = 0.029), but had no significant effect on plasma IL-6 compared with comparison group (WMD = 0.08 pg/mL; 95% CI: -0.02, 0.17; p = 0.10). The effect of TC consumption on plasma TNF-α level was evaluated in only three studies that showed no significant effects (p>0.05). CONCLUSION: Our results confirmed a significant decreasing effect of TC on CRP. Regarding IL-6 and TNF-α, our study did not present any significant effect of TC.

Soy isoflavones plus soy protein effects on serum concentration of leptin in adults: A systematic review and meta-analysis of randomized clinical trials.

BACKGROUND: Some studies conducted on soy isoflavones and soy protein reflected that leptin can be reduced by soy isoflavones or soy protein. The aim of present study is to assess the effect of soy isoflavones plus soy protein on serum concentration of leptin among adults. METHODS: To find randomized clinical trails (RCTs) assessing the effect of soy isoflavones containing soy protein on serum concentration of leptin in participants with age ≥18 years old, databases including PubMed, Scopus, ISI Web of Science, Cochrane and ClinicalTrials.gov were searched up to March 2021. We calculated the effect size by the mean change from baseline of leptin concentrations and its standard deviation for intervention and comparison groups. DerSimonian and Laird random effects model was used to estimate the overall summary effect and the heterogeneity. Risk of bias was conducted by Cochrane Collaboration's tool. Study protocol was registered in PROSPERO (No. CRD42021228366). RESULTS: Eight articles with 421 participants and six articles with 336 participants were known to be eligible for systematic review and meta-analysis, respectively. A pooled analysis revealed that the combination of soy isoflavones and soy protein had a borderline non-significant on serum concentration of leptin (weighted mean difference (WMD): -1.03 ng/ml, 95% confidence interval (CI): -2.11, 0.05 ng/ml). This combination reduced serum leptin levels in studies with baseline levels of leptin ≤22 ng/ml, in short-term trials (≤56 days), studies that used soy isoflavones with dose ≤96 mg/day and among subjects with health risk factors or diseases. CONCLUSION: Soy isoflavones plus soy protein had a non-significant decreasing effect on the serum concentration of leptin. However, making firm conclusion needs more studies on participants with different health condition, and different soy isoflavones doses and intervention duration.

National and sub-national trends of salt intake in Iranians from 2000 to 2016: a systematic analysis.

BACKGROUND: One fifth of the global burden of cardiovascular diseases (CVDs) in 2017 was attributable to excessive salt intake. As a member of the World Health Organization (WHO), Iran has committed itself to a 30% reduction in salt intake by 2025. Evidence on the amount and trend of salt intake among the Iranian population at national and sub-national levels is scarce. This study aimed to estimate the Iranian population's salt intake during 2000-2016 at the national and sub-national levels, by sex and age groups. METHODS: Data on national and sub-national mean salt intake was obtained through systematically searching the literature and contacting the research studies' principal investigators. Data collected through various methods were harmonized using the cross-walk method. Bayesian hierarchical and spatio-temporal-age regression models and simulation analysis were used to estimate the mean salt intake and its uncertainty interval across sex, age, year, and province. RESULTS: National age-sex standardized mean salt intake decreased from 10·53 g/day (95% uncertainty interval [UI]: 10·2 to 10·9) in 2000 to 9·41 (9·2 to 10·6) in 2016 (percent change: - 9·8% [- 21·1-3·1]). The age-standardized mean salt intake in women had decreased from 9·8 g/day (95% UI: 9·0-10·6) in 2000 to 9·1 g/day (8·6-9·7) in 2016 (percent change: - 6·6% [- 19·0-7·9]). The same measure in men was 11·1 g/day in 2000 (95% UI: 10·3-11·8) and 9·7 g/day (9·1-10·2) in 2016 (percent change: - 12·7% [- 23·0 - -0·9]). Age-sex standardized mean salt intake at the sub-national level in 2016 varied from 8·0 (95% UI: 7·0-9·0) to 10·5 (10·0-11·1). The difference between the provinces with the highest and the lowest levels of salt intake in 2016 was 31·3%. CONCLUSION: Salt intake decreased in Iran from 2000 to 2016, while persistently exceeding the recommended values. This declining trend was more pronounced between 2010 and 2016, which might be attributed to Iran's compliance to WHO's Action Plan for reducing NCDs.

The efficacy of soy isoflavones combined with soy protein on serum concentration of interleukin-6 and tumour necrosis factor-α among post-menopausal women? A systematic review and meta-analysis of randomized controlled trials.

The post-menopausal stage in women's life is associated with the enhancement of inflammation that may be reduced using soy isoflavones or soy protein. The present study aimed to summarize the effect of soy isoflavones plus soy protein on circulating interleukin-6 (IL-6) and tumour necrosis factor-α (TNF-α) in post-menopausal women. The English-language articles were identified from the databases such as Cochrane Library, clinicaltrials.gov, Web of Science, PubMed, and Scopus until December 2020. The mean change from baseline and its standard deviation (SD) for intervention and comparison groups were used to calculate the effect size. The statistical heterogeneity of the intervention effects was computing by Cochran's Q test and I2 statistic. Nine and seven studies were selected for systematic review and meta-analysis, respectively. The results of our meta-analysis indicated a non-significant effect on the serum concentrations of IL-6 and TNF-α (weighted mean differences [WMD] = 0.07 pg/mL; 95% confidence interval [CI] = -0.03, 0.17 pg/mL; P = 0.190; WMD =0.05 pg/mL; 95% CI = -0.01, 0.12 pg/mL; P = 0.092; respectively). In subgroup analysis, soy isoflavones plus soy protein could increase the serum concentration of IL-6 in studies with soy isoflavones dose ≤87 mg/days, cross-over design, weak quality, and studies on participants who had health risk factors or diseases. The serum concentration of TNF-α increased in studies with cross-over design, intervention duration ≤56 days, and body mass index (BMI) >27, and in studies that were conducted on at-risk or sick participants. In conclusion, our meta-analysis did not confirm any significant effect on serum concentration of IL-6 and TNF-α among post-menopausal women.

The effect of soy protein containing soy isoflavones on serum concentration of cell adhesion molecules: A systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Soy protein in combination with soy isoflavones might reduce the serum concentration of inflammatory mediators. In this study, we attempted to summarize the effect of soy protein combined with soy isoflavones on circulating E-selectin, intercellular adhesion molecule-1 (ICAM-1), and vascular cell adhesion molecule-1 (VCAM-1) in adults. METHODS: Clinicaltrials.gov, Web of Science, Cochrane Library, PubMed, and Scopus were searched for English articles with no time limit regarding publication up to December 2020. Thereafter, the mean changes from baseline and their standard deviations (SDs) for both intervention and comparison groups were used to calculate the effect size. We used DerSimonian and Laird random-effects model if the heterogeneity test was statistically significant. Cochran's Q test and I-squared statistic were also used to calculate the statistical heterogeneity of the intervention effects. RESULTS: Eight articles were found as eligible for this study. The treatment duration was between 6 and 24 weeks. Soy isoflavones dose was in a range of 30-112 mg/day and soy protein dose was in a range of 11.25-52 g/day. Overall, taking soy protein supplements containing soy isoflavones was not associated with changes in cell adhesion molecules, E-selectin, ICAM-1, or VCAM-1 (WMD = 0.65, 95 % CI: -2.58, 3.89; p = 0.692; WMD = 2.68, 95 % CI: -0.98, 6.34; p = 0.151; WMD = 2.66, 95 % CI: -6.28, 11.61; p = 0.559, respectively). CONCLUSION: The combination of soy protein and soy isoflavones was not significantly associated with changes in levels of E-selectin, ICAM-1, and VCAM-1. However, we need more studies with a large sample size and more participants with different age categories in this regard.

The Effect of Curcumin Phytosome on the Treatment of Patients with Non-alcoholic Fatty Liver Disease: A Double-Blind, Randomized, Placebo-Controlled Trial.

Non-alcoholic fatty liver disease (NAFLD) is a global health problem with increasing prevalence among overweight and obese patients. It is strongly associated with conditions of insulin resistance including type 2 diabetes mellitus (T2DM) and obesity. It has detrimental consequences ranged from simple steatosis to irreversible hepatic fibrosis and cirrhosis. Curcumin is a dietary polyphenol with potential effect in improving NAFLD. Therefore, the aim of this trial was to examine the effect of curcumin supplementation on various aspects of NAFLD. In this trial, a total number of 80 patients were randomised to receive either curcumin at 250 mg daily or placebo for 2 months. Lipid profiles, hepatic enzymes, anthropometric indices and hepatic fat mass were assessed at the baseline and the end of the trial, and compared within the groups. The grade of hepatic steatosis, and serum aspartate aminotransferase (AST) levels were significantly reduced in the curcumin group (p = 0.015 and p = 0.007, respectively) compared to the placebo. There was also a significant reduction in high density lipoprotein (HDL) levels and anthropometric indices in both groups with no significant differences between the two groups. Low dose phospholipid curcumin supplementation each day for 2 months showed significant reduction in hepatic steatosis and enzymes in patients with NAFLD compared to placebo. Further studies of longer duration and higher dosages are needed to assess its effect on other parameters of NAFLD including cardiovascular risk.

Beneficial effect of soy isoflavones and soy isoflavones plus soy protein on serum concentration of C-reactive protein among postmenopausal women: An updated systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Scientists suggest that soy isoflavones or the combination of soy isoflavones and soy protein may have beneficial effects on inflammation. Thus, the present study aims at conducting a systematic review and meta-analysis on randomized controlled trials (RCTs) in which the effect of soy isoflavones and the combination of soy isoflavones and soy protein on serum concentration of C-reactive protein (CRP) among postmenopausal women is assessed. METHODS AND MATERIALS: A literature searching was done to identify a breadth of related references in PubMed, Scopus, ISI Web of Science, Cochrane Library, and Clinicaltrials.gov up to December 2020. The mean change from baseline in the CRP concentrations and its standard deviation (SD) for both intervention and comparison groups were used to calculate the effect size. The summary of the overall effects and heterogeneity was estimated by using the DerSimonian and Laird random effects model. The protocol was registered in PROSPERO (No. CRD42020166053). RESULTS: This study considered 23 articles for systematic review and 19 articles for meta-analysis. The overall effect presented a non-significant effect of soy isoflavones on serum CRP concentrations (WMD = 0.08 mg/L, 95 % CI: -0.08, 0.24; p = 0.302) and the overall effect of the combination of soy isoflavones and soy protein indicated non-significant effect in serum levels of CRP (WMD= -0.02 mg/L 95 % CI: -0.12, 0.08; p = 0.715). CONCLUSION: Published RCTs did not provide strong evidence regarding beneficial effect of soy isoflavones or the combination of soy isoflavones and soy protein on serum CRP concentration among postmenopausal women.

The effect of soy isoflavones and soy isoflavones plus soy protein on serum concentration of tumor necrosis factor-α? A systematic review and meta-analysis of randomized controlled trials.

In this study, we summarized the effect of soy isoflavones and soy isoflavones plus soy protein on serum concentration of tumor necrosis factor-alpha (TNF-α) among adult participants. We systematically searched Scopus, ISI Web of Science, Cochrane Library, PubMed, and clinicaltrials.gov for articles published up to May 2020. Effect size was calculated by mean change from baseline of TNF-α concentrations and its standard deviation (SD) for intervention and comparison groups. If the heterogeneity test was statistically significant, DerSimonian and Laird random effects model was used to estimate the summary of the overall effects and its heterogeneity. Nineteen and fourteen randomized clinical trials were included in our systematic review and meta-analysis, respectively. The result of overall effect size indicated a non-significant effect in serum concentration of TNF-α following soy isoflavones intake (WMD = 0.2 pg/ml, 95% CI: -0.13, 0.53; p = .226) and the combination of soy isoflavones and soy protein intake (WMD = 0.02 pg/ml, 95% CI: -0.02, 0.06; p = .286). Subgroup analyses revealed no significant change in circulatory levels of TNF-α following soy isoflavones plus soy protein intake. In conclusion, the present systematic review and meta-analysis found insufficient evidence that soy isoflavones or the combination of soy isoflavones and soy protein significantly reduce serum concentration of TNF-α.

Curcumin and Piperine Combination for the Treatment of Patients with Non-alcoholic Fatty Liver Disease: A Double-Blind Randomized Placebo-Controlled Trial.

BACKGROUND: Experimental and clinical studies have revealed that curcumin may be an effective therapy for non-alcoholic fatty liver disease (NAFLD). Hence, the aim of this study was to assess the effect of curcumin plus piperine administration on NAFLD. METHODS: Adults 18-65 years-old diagnosed with NAFLD by liver sonography were randomly allocated to curcumin (500 mg/day) or placebo groups for 2 months. All participants received both dietary and exercise advice. Anthropometric and biochemical measurements as well as hepatic ultrasound were performed at baseline and final conditions. RESULTS: Seventy-nine participants were recruited and randomly allocated into the curcumin (n = 39) or placebo (n = 40) groups. There were no significant differences between placebo and curcumin groups for demographic and clinical characteristics and NAFLD grade at baseline. After the treatment period, the curcumin group exhibited lower alkaline phosphatase (-16.2 ± 22.8 versus -6.0 ± 22.5 mg/dL, p = 0.04) concentrations and severity of NAFLD compared with the placebo group (p = 0.04). CONCLUSION: Results of this clinical trial suggest that short-term treatment with curcumin plus piperine administration improves NAFLD severity.

L-arginine effect on inflammatory mediators: A systematic review of randomized controlled clinical trials.

L-arginine is an important factor in several physiological and biochemical processes. Recently, scientists studied L-arginine effect on inflammatory mediators such as C-reactive protein (CRP), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6). We conducted a systematic review on randomized controlled trials assessing L-arginine effect on inflammatory mediators. We searched data bases including Google scholar, ISI web of science, SCOPUS, and PubMed/Medline up to April 2019. Randomized clinical trials assessing the effect of L-arginine on inflammatory mediators in human adults were included. Our search retrieved eleven articles with 387 participants. Five articles were on patients with cancer and 6 articles were on adults without cancer. L-arginine was applied in enteral form in 5 articles and in oral form in 6 articles. Eight articles were on both genders, two articles were on women, and one article was on men. L-arginine could not reduce inflammatory mediators among patients with and without cancer except one article which indicated that taking L-arginine for 6 months decreased IL-6 among cardiopathic nondiabetic patients. Our results indicated that L-arginine might not be able to reduce selected inflammatory mediators, but for making a firm decision more studies are needed to be conducted with longer intervention duration, separately on male and female and with different doses of L-arginine.

Can soy isoflavones plus soy protein change serum levels of interlukin-6? A systematic review and meta-analysis of randomized controlled trials.

In the present review, we aimed to summarize the effect of soy isoflavones plus soy protein on circulating interlukin-6 (IL-6) in adult participants. Databases including ISI Web of Science, PubMed, Scopus, Cochrane Library, and clinicaltrials.gov were searched up to 23 March 2020. The mean change from baseline of IL-6 concentrations and its SD for intervention and comparison groups were used to calculate the effect size. If the heterogeneity test was statistically significant, DerSimonian and Laird random effects model was used. Cochran's Q test and I-squared statistic were also used to compute the statistical heterogeneity of the intervention's effects. Eighteen studies were known to be eligible for systematic review and 14 studies were selected for meta-analysis. Our meta-analysis results indicated a non-significant effect in serum IL-6 concentrations compared to the comparison group (WMD = 0.03 pg/ml, 95% CI: -0.06, 0.12; p = .459). In subgroup analysis, based on soy isoflavones dosage, it was observed that this combination could reduce IL-6 levels in studies that used isoflavones with dose >84 mg/day (WMD = -0.12 pg/ml 95% CI: -0.24, -0.004; p = .042, I2 = 82.7%) and in articles with a good quality (WMD = -0.15 pg/ml 95% CI: -0.24, -0.05; p = .003, I2 = 62.3%). Performing well-designed intervention studies using a high dose of soy isoflavones is recommended to confirm the beneficial effects of soy ingredients on IL-6.