Sugar consumption, sugar sweetened beverages and Attention Deficit Hyperactivity Disorder: A systematic review and meta-analysis.

BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) is a significant neurobehavioral disorder in children and adolescence which may be affected by diet. OBJECTIVE: To evaluate the possible relationship between sugar consumption and the development of symptoms of ADHD. METHODS: In March 2020, an exhaustive systematic literature search was conducted using Google Scholar, PubMed, and Scopus. In this meta-analysis of observational studies, odds ratios, relative risks, hazard ratios, and their 95% confidence intervals, which was reported for ADHD regarding SSBS, soft drink consumption, and dietary sugars, were used to calculate ORs and standard errors. At first, a fixed-effects model was used to drive the overall effect sizes using log ORs and SEs. If there was any significant between-studies heterogeneity, the random-effects model was conducted. Cochran's Q test and I2 were used to measure potential sources of heterogeneity across studies. The Newcastle-Ottawa scale was used to assess the quality of the included articles. RESULTS: Seven studies, two cross-sectional, two case-control, and three prospective with a total of 25,945 individuals were eligible to include in the current meta-analysis. The association between sugar and soft drink consumption and the risk of ADHD symptoms were provided based on the random-effects model (pooled effect size: 1.22, 95%CI: 1.04-1.42, P = 0.01) (I² = 81.9%, P heterogeneity< 0.0001). CONCLUSION: This meta-analysis indicated a positive relationship between overall sugar and sugar-sweetened beverages consumption and symptoms of ADHD; however, there was heterogeneity among included studies. Future well-designed studies that can account for confounds are necessary to confirm the effect of sugar on ADHD.

Effect of Garcinia cambogia supplement on obesity indices: A systematic review and dose-response meta-analysis.

OBJECTIVE: Several trials have examined the effect of Garcinia cambogia supplement on the weight and body composition, but their results are conflicting. This systematic review and dose-response meta-analysis was designed to determine the effect of Garcinia cambogia supplement on the obesity indices in human randomized controlled trials (RCTs). METHODS: PubMed/Medline, Scopus, Cochrane library, and Web of Science databases were searched up to 1th January, 2020, to screen relevant trials. The mean changes in the weight, body mass index (BMI), percentage of fat mass (PFM), and waist circumference (WC) from the baseline were used to conduct the present dose response meta-analysis. RESULTS: In the current study, eight trials (including 530 subjects) were included. Garcinia cambogia supplement significantly reduced the weight by -1.34 kg (95% CI: -2.62 to -0.07, P = 0.03), BMI by -0.99 kg/m2 (95% CI: -1.48 to -0.49, P < 0.001), PFM by -0.42% (95% CI: -0.77 to -0.06, P = 0.02), and WC by -4.16 cm (95% CI: -7.83 to -0.49, P = 0.02) compared with the placebo group. Dose-response analysis revealed that there is a nonlinear association between Garcinia cambogia dosage and changes in the body weight (Pnonlinearity = 0.04) and BMI (Pnonlinearity < 0.001) not PFM (Pnonlinearity = 0.68). There was no publication bias among the studies. CONCLUSION: Our results suggested that Garcinia cambogia supplement had a significant effect on the body weight, BMI, PFA, and WC as compared with the placebo.

Effect of soy protein containing isoflavones on endothelial and vascular function in postmenopausal women: a systematic review and meta-analysis of randomized controlled trials.

IMPORTANCE: The beneficial role of soy protein in cardiovascular health has been well documented in observational studies. However, evidence from clinical trials on effects of soy protein on endothelial function in postmenopausal women has been conflicting. OBJECTIVE: We aimed to systematically review and conduct a meta-analysis of randomized controlled trials (RCTs) investigating the impact of soy protein supplement containing isoflavones on endothelial function in postmenopausal women. EVIDENCE REVIEW: We searched PubMed-Medline, SCOPUS, Embase, and Google Scholar until March 2020 to find RCTs evaluating the impact of soy protein supplementation on endothelial function parameters. Random effects model (using DerSimonian-Laird method) was applied to synthesize quantitative data. We performed the leave-one-out method for sensitivity analysis. To quantitatively assess heterogeneity, the I index was applied. FINDINGS: From a total of 267 studies identified from the initial search 15 and 5 studies were considered appropriate for inclusion into the systematic review and meta-analysis, respectively. In the meta-analysis, an insignificant enhancement in flow-mediated dilation (FMD) after soy protein supplementation (0.882%; 95% CI: -1.059 to 2.822; P = 0.373) was found. However, subgroup analysis showed that supplementation of isolated soy protein had significant effect on FMD (3.39%; 95% CI: 0.733-6.01; P = 0.01). CONCLUSIONS AND RELEVANCE: Our findings suggest that soy protein supplementation does not lead to meaningful improvement in FMD in postmenopausal women. However, this finding is based on a limited number of studies. Additional high-quality large-scale RCTs are warranted.

The Effects of Resveratrol on Oxidative Stress Markers: A Systematic Review and Meta-Analysis of Randomized Clinical Trials.

OBJECTIVE: Recent trial studies have found that resveratrol supplementation beneficially reduces oxidative stress marker, but, there is no definitive consensus on this context. The present systematic review and meta-analysis aimed to investigate the effect of resveratrol supplementation on oxidative stress parameters. METHODS: We searched databases of Pubmed, Scopus and Cochrane Library up to December 2018 with no language restriction. Studies were reviewed according to preferred reporting items for systematic reviews and meta-analyses (PRISMA) and Cochrane handbook. To compare the effects of resveratrol with placebo, weighted mean difference (WMD) with 95% confidence intervals (CI) were pooled based on the random-effects model. RESULTS: Among sixteen clinical trials, we found that resveratrol supplementation increased GPx serum levels significantly (WMD: 18.61; 95% CI: 8.70 to 28.52; P<0.001) but had no significant effect on SOD concentrations (WMD: 1.01; 95% CI: -0.72 to 2.74; P= 0.25), MDA serum levels (WMD: -1.43; 95% CI: -3.46 to 0.61; P = 0.17) and TAC (WMD: -0.09; 95% CI: -0.29 to 0.11; P = 0.36) compared to placebo. Finally, we observed that resveratrol supplementation may not have a clinically significant effect on oxidative stress. CONCLUSION: However, the number of human trials is limited in this context, and further large prospective clinical trials are needed to confirm the effect of resveratrol supplement on oxidative stress markers.

Food Insecurity is positively related to Dietary Inflammatory Index in Iranian high school girls.

Aim: To determine the association between food insecurity and Dietary Inflammatory Index (DII) in high school girls. Methods: This cross-sectional study was conducted on 525 students aged 14-18 years in northern Iran. Dietary assessment was performed using a validated and reliable 147-food item questionnaire. DII was calculated on the basis of 30 available food parameters from this FFQ based on the standard means. The USDA 18-item standard food security questionnaire was used to assess the food security status. Linear regression was performed to determine the association between DII and food insecurity, with DII considered as an outcome and food security score as an exposure. Results: The average age of students was 16.13 ± 0.97 year. Mean BMI and menarche age was 22.64 ± 4.62 kg/m2 and 12.59 ± 1.09 year. The mean value of DII was -0.003 ± 1.72. Food insecurity prevalence was 40.8%. Protein, and vitamin D and B12 intake were lower in the food insecure group (P < 0.05). Energy intake, total fat and saturated fatty acid (SFA) were higher in the highest tertile vs. the lowest tertile of DII (P < 0.05). Carbohydrate, protein, fiber, magnesium, zinc, folate, selenium, vitamin A, B6, and C, thiamin, riboflavin, niacin and tea intake were lower in the highest tertile vs. the lowest tertile of DII (P < 0.05). There was a positive significant association between DII and food security status. Conclusion: It seems there is an association between DII and food security status. However, further well-designed studies in a different population are suggested.

Effects of vitamin D supplementation on advanced glycation end products signaling pathway in T2DM patients: a randomized, placebo-controlled, double blind clinical trial.

BACKGROUND: Several researches have recommended vitamin D possible health benefits on diabetic complications development, but a few number of studies have been accomplished on the molecular and cellular mechanisms. Certain cellular pathways modification and also some transcription factors activation may protect cells from hyperglycemia condition induced damages. This study purpose was to determine the vitamin D supplementation effect on some key factors [advanced glycation end products (AGEs) signaling pathway] that were involved in the diabetic complications occurrence and progression for type-2 diabetes participants. METHODOLOGY: 48 type-2 diabetic patients (T2DM) randomly divided into two groups (n = 24 per group), receiving: 100-µg vitamin D or placebo for 3 months. At this study beginning and the end, the receptor expression for advanced glycation end products (RAGE) and glyoxalase I (GLO1) enzyme from peripheral blood mononuclear cells (PBMCs) and AGEs and tumor necrosis factor-α (TNF-α) serum levels were measured by the use of real-time PCR and ELISA methods, respectively. RESULTS: This study results demonstrated that vitamin D supplementation could down-regulate RAGE mRNA [fold change = 0.72 in vitamin D vs. 0.95 in placebo) P = 0.001)]. In addition, no significant changes were observed for GLO1 enzyme expression (P = 0.06). This study results also indicated that vitamin D serum level significantly increased in vitamin D group (P < 0.001). Moreover, AGES and TNF-α serum levels significantly reduced in vitamin D group, but they were remained unchanged in the placebo group. CONCLUSION: In conclusion, vascular complications are more frequent in diabetic patients, and vitamin D treatment may prevent or delay the complications onset in these patients by AGEs serum level and RAGE gene expression reducing.Trial registration NCT03008057. Registered December 2016.

Effects of vitamin D supplementation on depressive symptoms in type 2 diabetes mellitus patients: Randomized placebo-controlled double-blind clinical trial.

AIM: Diabetes increases the odds of depression and depression is often associated with poor glycemic control and complications of diabetes. Vitamin D is also believed to improve glycemic control and ameliorate depressive symptoms. Therefore, we examined effects of vitamin D monotherapy (without antidepressant drugs) on depressive symptoms in Type 2 diabetic patients with mild to moderate depressive symptoms. METHODS: We conducted 12 weeks, placebo-controlled, double-blind, randomized trial on 68 subjects with T2DM and mild to moderate depressive symptoms. Subjects received 100 µg (4000 IU) vitamin D (n = 32) or placebo (n = 34) daily. Beck Depression Inventory-II (BDI-II-PERSIAN) was applied for assessment of the severity of depression. Depression scores and metabolic profiles were measured at the beginning and end of trail. RESULTS: after 3 months of vitamin D supplementation, mean values of 25(OH) D increased from 15.5 ±â€¯8.8 to 32.2 ±â€¯8.9 ng/ml (p-value <0.001) in the vitamin D group. Moreover, BDI-II scores decreased from 15.2 ±â€¯9.6 to 9.8 ±â€¯7.2 (p-value <0.001) in the vitamin D group and 15.5 ±â€¯11.2 to 13.7 ±â€¯11.5 (p-value = 0.03) in placebo group. This decrease in BDI-II scores were significant (27.6% vs 10.8%) compared with placebo (p-value = 0.02). In term of metabolic profiles, mean change in level of Hemoglobin A1c (HbA1c), insulin and triglycerides (TG) were significantly higher in response to the treatment with vitamin D compared to placebo (p-value <0.02). CONCLUSIONS: In conclusion, supplementation of vitamin D in T2DM patients may protect these patients against the onset of major depressive disorder (MDD), with noticeable favorable effects on measures of metabolic profiles. TRIAL REGISTRATION: NCT03008057.

Effects of vitamin D supplementation on circulatory YKL-40 and MCP-1 biomarkers associated with vascular diabetic complications: A randomized, placebo-controlled, double-blind clinical trial.

AIM: Diabetic patients predispose to vascular diseases such as nephropathy, and retinopathy. Poor adherence to medical treatment and dietary recommendations in uncontrolled diabetes leads to vascular damages. Vitamin D has been extensively studied and found to be protective against diabetes mellitus. YKL-40 and Monocyte chemoattractant protein-1 (MCP-1) are considered to exert crucial role in diabetes and its complications. Therefore, this study was designed to investigate effects of vitamin D supplementation on serum levels of YKL-40 and MCP-1 involved in the development of diabetic complications. METHODS: For 12 weeks, 48 type 2 diabetic patients enrolled in the trial and randomly were divided into two groups (n = 24 per group), receiving one of the following: 100 µg (4000 IU) vitamin D or placebo. Before and after intervention, serumYKL-40, MCP-1, insulin, IL-6, TNF-α, 25- (OH) vitamin D and HbA1c were measured. RESULTS: Our results revealed that serum levels of 25 (OH) vitamin D significantly increased in vitamin D group (p < 0.001). Vitamin D supplementation also significantly reduced serum YKL-40 levels (-22.7 vs. -2.4 ng/ml; (p-value = 0.003)). There was a significant decline in MCP-1 concentration in intervention group at the end of the study (-45.7 vs. -0.9 pg/ml; (p = 0.001)). Furthermore, there was a significant decrease in IL-6, fasting insulin and HOMA-IR in intervention group after 3 months supplementation. CONCLUSIONS: Daily vitamin D supplementation effectively reduced circulatory YKL-40 and MCP-1 levels in patients with type-2 diabetes and vitamin D deficiency. Vitamin D might contribute in reducing diabetic complications via modulating YKL-40 and MCP-1 signaling pathways.

Dairy intake and acne development: A meta-analysis of observational studies.

BACKGROUND & AIMS: In the past, some observational studies have been carried out on the relationship between milk and dairy intake and risk of acne occurrence; however, their results were conflicting. This study is a meta-analysis and dose-response analysis designed to evaluate the relationship between milk and dairy products and acne development. MATERIALS & METHODS: Data of the study were searched and collected from Pubmed/Medline, Scopus, Web of Science, and Embase databases. Study design, sex, age, exposure (i.e. dairy, milk, yogurt, cheese), dietary assessment method, acne ascertainment, total sample size, number of total subjects and cases in each category of exposure intake, OR, RR and PR with 95% CI in each category of exposure intake and adjusted variables were extracted. RESULTS: Highest compared with lowest category of dairy (OR: 2.61, 95% CI: 1.20 to 5.67), total milk (OR: 1.48, 95% CI: 1.31 to 1.66), low-fat milk (OR: 1.25, 95% CI: 1.10 to 1.43) and skim milk (OR: 1.82, 95% CI: 1.34 to 2.47) intake significantly was associated with the presence of acne. Results of dose-response analysis revealed a significant linear relationship between dairy, whole milk and skim milk and risk of acne and nonlinear association between dairy, milk, low-fat milk and skim milk intake and acne. CONCLUSION: In this meta-analysis we found a positive relationship between dairy, total milk, whole milk, low-fat and skim milk consumption and acne occurrence. In contrary, no significant association between yogurt/cheese and acne development was observed.

Nutritional status of women with gestational hypertension compared with normal pregnant women.

BACKGROUND: Some evidence indicated the role of nutrition in the development of hypertensive disorders of pregnancy. METHODS: This case-control study was conducted on 113 women with gestational hypertension and 150 healthy pregnant women referred to Shahid Akbarabadi Hospital in Tehran. A demographic questionnaire was filled out for all participants. A validated semi-quantitative food frequency questionnaire was used to assess the dietary intakes of the study subjects. All nutrients were adjusted for total energy intake. Logistic regression was used to find the association of energy and nutrient intakes with gestational hypertension. RESULTS: We found that higher intakes of energy (OR, 1.33; 95% CI: 1.17-1.52), monounsaturated fatty acids (OR, 1.34; 95% CI: 1.03-1.74) and polyunsaturated fatty acids (OR, 1.26; 95% CI: 1.00-1.54) were positively associated with the risk of gestational hypertension after adjustment for confounders. We also observed decreased odds of gestational hypertension with increased intakes of vitamin C (OR, 0.87; 95% CI: 0.81-0.94), potassium (OR, 0.45; 95% CI: 0.28-0.71) and magnesium (OR, 0.68; 95% CI: 0.51-0.89). CONCLUSION: This study demonstrates higher intakes of energy, monounsaturated fatty acids and polyunsaturated fatty acids as well as lower intakes of vitamin C, potassium and magnesium are positively correlated with the risk of developing gestational hypertension.