The effects of conjugated linoleic acid supplementation on glycemic control, adipokines, cytokines, malondialdehyde and liver function enzymes in patients at risk of cardiovascular disease: a GRADE-assessed systematic review and dose-response meta-analysis.

BACKGROUND: The present systematic review and meta-analysis sought to evaluate the effects of conjugated linoleic acid (CLA) supplementation on glycemic control, adipokines, cytokines, malondialdehyde (MDA) and liver function enzymes in patients at risk of cardiovascular disease. METHODS: Relevant studies were obtained by searching the PubMed, SCOPUS and Web of Science databases (from inception to January 2023). Weighted mean differences (WMD) and 95% confidence intervals (CIs) were pooled using a random-effects model. Heterogeneity, sensitivity analysis, and publication bias were reported using standard methods. RESULTS: A pooled analysis of 13 randomized controlled trials (RCTs) revealed that CLA supplementation led to a significant increment in fasting blood glucose (FBG) (WMD: 4.49 mg/dL; 95%CI: 2.39 to 6.59; P < 0.001), and aspartate aminotransferase (AST) (WMD: 2.54 IU/L; 95%CI: 0.06 to 5.01; P = 0.044). Moreover, CLA supplementation decreased leptin (WMD: -1.69 ng/ml; 95% CI: -1.80 to -1.58; P < 0.001), and interleukin 6 (IL-6) (WMD: -0.44 pg/ml; 95%CI: -0.86 to -0.02; P = 0.037). However, there was no effect on hemoglobin A1c (HbA1c), homeostatic model assessment for insulin resistance (HOMA-IR), C-reactive protein (CRP), tumor necrosis factor alpha (TNF-α), and alanine aminotransferase (ALT) adiponectin compared to the control group. CONCLUSION: Our findings showed the overall favorable effect of CLA supplementation on the adipokines and cytokines including serum IL-6, and leptin, while increasing FBG and AST. It should be noted that the mentioned metabolic effects of CLA consumption were small and may not reach clinical importance. PROSPERO REGISTERATION COD: CRD42023426374.

Vitamin D Receptor (VDR) Allelic Variants Correlating with Response to Vitamin D3 Supplementation in Breast Cancer Survivors.

We investigated how vitamin D receptor (VDR) allelic variants affect breast cancer survivors' responses to vitamin D3 supplementation to increase circulating 25-hydroxy vitamin D (25(OH)D) levels. Two hundred and fourteen patients who were diagnosed with breast cancer at least 6 mo, prior to the study and had completed all treatment regimens were assigned to consume 4000 IU of vitamin D3 daily for 12 weeks. Linear and multinomial logistic regression analyses were used to analyze the association of VDR single nucleotide polymorphism (SNPs) with changes in circulating 25(OH)D. The TaqI and BsmI VDR sequence variants modified the effect of vitamin D3 treatment on the plasma 25(OH)D changes (P value = 0.008 for TaqI and P value = 0.0005 for BsmI). Patients with the bb [Q4 vs. Q1 odds ratio(OR) 8.04, 95% confidence interval (CI) 1.55-41.57] and tt [Q4 vs. Q1 OR 4.64 95%CI 1.02-21.02] genotype of BsmI and TaqI had larger increases in plasma 25(OH)D levels compared to those with BB and TT genotype respectively after adjustment for potential confounders. Haplotype analyses suggested the existence of specific combination of alleles that might be associated with circulating 25(OH)D changes. VDR allelic variants modulate vitamin D3 supplementation to increase plasma 25(OH) levels in breast cancer survivors.

Adherence to Lifelines Diet Score (LLDS) is associated with better sleep quality in overweight and obese women.

PURPOSE: Previous studies have shown the connection between diet quality to sleep quality and weight status, although the relationship between Lifelines Diet Score (LLDS)-a fully food-based score that uses the 2015 Dutch Dietary Guidelines and underlying international literature-and sleep quality has not been evaluated in overweight and obese individuals yet. This observational study was conducted on overweight and obese adult females to assess the relationship between adherence to a LLDS pattern and sleep quality in Iran. METHODS: A cohort of 278 overweight and obese women aged above 18 years was enrolled and their dietary intake was assessed using a 147-item, semi-quantitative, validated food frequency questionnaire. Pittsburgh Sleep Quality Index (PSQI), a self-reported questionnaire including 19-items, was applied to estimate sleep quality among the target population. Diet quality indices (LLDS) were calculated using the P.C. Vinke, et al. method, based on the 2015 Dutch Dietary Guidelines and the underlying literature. RESULTS: Subjects in the highest LLDS tertile (those who had adhered closely to the food-based score) were older, compared to the lowest tertile (37.57 ± 7.77 versus 34.57 ± 9; p = 0.01). It was shown that about 25.5% of our subjects have poor quality sleep and 39% have better sleep quality which were mostly in the third tertile with greater LLDS. The parallel values in the first tertile were 29.9% and 46.8%, respectively (p = 0.02). Binary logistic regression was applied to evaluate the association between adherence of LLDS and sleep quality. The result has shown that the LLDS were correlated with lower risk poor sleep quality, wherein those who were in higher tertile (higher adherence to LLDS) had better sleep quality (odds ratio [OR]:0.586, 95% confidence interval [CI] (0.285-1.207), p = 0.009) and the result was not affected by adjusting for potential cofounders including age, education levels, and economic levels, sleep quality remained significantly associated with [OR]: 0.531, 95% confidence interval [CI] (0.248-1.138, p = 0.014). CONCLUSIONS: From this observational study, the higher LLDS can be related with better sleep quality in overweight and obese women. LEVEL OF EVIDENCE: Level IV, evidence obtained from multiple time series with or without the intervention, such as case studies.

Higher dietary total antioxidant capacity is inversely associated with Helicobacter pylori infection among adults: A case-control study.

INTRODUCTION: Antioxidants appear to hinder the actions of Helicobacter pylori (H. pylori). The aim of this research was to evaluate the association between dietary total antioxidant capacity (DTAC) and H. pylori infection. METHODS: A case-control study was carried out among 200 patients with  H. pylori infection and 402 healthy subjects (18-55 years). Dietary data were collected using a validated 168-item quantitative food frequency questionnaire. DTAC was calculated based on the oxygen radical absorbance capacity of each food (except for coffee) reported by the US Department of Agriculture. RESULTS: Compared with participants in the lowest tertile of DTAC, those in the highest tertile had a significantly lower odds ratio (OR) in the crude model (OR, 0.29; 95% CI, 0.14-0.61; p for trend = 0.001), model 1 (adjustment for age and sex) (OR, 0.37; 95% CI, 0.24-0.58; p for trend < 0.001), and model 2 (adjustment for model 1 plus body mass index, waist circumference, physical activity, smoking, dietary intake of energy and fat) (OR, 0.20; 95% CI, 0.10-0.40; p for trend ≤ 0.001). CONCLUSIONS: A high DTAC is associated with a reduced risk of H. pylori infection in adults. Further studies are mandatory to elucidate the mechanisms and a dose-effect relationship.

The Relationship between Empirical Dietary Inflammatory Pattern with Anthropometric Measures in Women with Overweight and Obesity: A Cross-Sectional Study.

Background: The increasing trend of obesity prevalence is a serious health warning for people worldwide. Evaluation of anthropometric measures is essential for explaining individual's health status. Studies have investigated the effect of diet on inflammation. Empirical Dietary Inflammatory Pattern (EDIP) was recently developed to empirically create a score for overall inflammatory potential of diet. This study aimed to investigate the relationship between EDIP with anthropometric measures in women with overweight and obesity. Methods: In a cross-sectional study, the EDIP score was calculated for 301 participants from their food frequency questionnaire, who referred to health centers in Tehran, Iran in 2018. Anthropometric measures was assessed through multi-frequency bioelectrical impedance analyzer. Results: 49% (95% CI: 40.8 - 57.2) had positive EDIP score. A significant relationship was found between EDIP quartiles with weight (P=0.004), BMI (P=0.012), FM (P=0.013), WC (P=0.003) and WHR (P=0.031). Those individuals in the lowest group of EDIP score had significantly lower weight, Body Mass Index, Fat Mass, Waist Circumference and Waist to Hip Ratio, compared to those with highest inflammation score. Conclusion: A significant relationship was found between EDIP with anthropometric measures in women with overweight and obesity, supporting the hypothesis that an anti-inflammatory diet is associated with decreasing trend of weight, Body Mass Index, Fat Mass, Waist Circumference and Waist to Hip Ratio.

High carbohydrate intakes may predict more inflammatory status than high fat intakes in pre-menopause women with overweight or obesity: a cross-sectional study.

OBJECTIVE: The associations between dietary carbohydrate, fat intake, and inflammation are controversial. Most existing data are from industrialized societies which low-carbohydrate and high-fat diet is common and so their attribution to other populations remains unclear. We evaluated the association of fat and carbohydrate intakes with inflammatory markers in pre-menopause women with overweight or obesity in Iran. RESULTS: Three hundred and sixty women with body mass index (BMI) ≥ 25 were included to this study. The levels of monocyte chemoattractant protein-1 (MCP-1) indicated a trend towards significance across tertiles of total dietary carbohydrate. We found that the levels of galectin-3 were negatively associated with dietary carbohydrate in adjusted model. In addition, the levels of MCP-1 and transforming growth factor beta (TGF-ß) were positively correlated to dietary carbohydrate. No significant relationship was demonstrated between inflammatory parameters and total fat intake). However, there was a borderline significant negative association between total fat intake and TGF-ß level in adjusted model. Therefore, a total dietary carbohydrate were related to elevated inflammation risk, while a total fat intake were not associated to higher inflammation. This study suggests reconsideration of applying global dietary guidelines in societies with high carbohydrate diet.

The interaction between the dietary inflammatory index and MC4R gene variants on cardiovascular risk factors.

BACKGROUND: Previous studies have shown that the minor allele (C allele) for melanocortin 4 receptor (MC4R) rs17782313, may be associated with incidence of obesity and the risk of cardiovascular diseases (CVDs). Moreover, inflammation caused by the diet has been shown to have, potentially, unfavorable effects on CVD risk. This study used a linear regression model to investigate the interactions between the dietary inflammatory index (DII) and MC4R gene variants on markers of CVD. METHODS: This comparative cross-sectional study was conducted on 266 Iranian women with overweight and obesity. A food frequency questionnaire (FFQ) with 147 items was used to assess dietary intakes. Individuals were categorized into three groups based on rs17782313 genotype. Participants were also divided into four groups based on DII score. RESULTS: Higher quartiles of DII were associated with lower levels of high density lipoproteins (HDL) (p = 0.01) and higher levels of triglycerides (TG) (p = 0.04). There was a significant difference between genotypes for insulin (p < 0.001), HOMA index (p < 0.001), total body mineral content (p = 0.03), and bone mineral content (BMC) (p = 0.04). Our findings also showed significant interactions between DII score and rs17782313 polymorphism on total cholesterol, total body mineral content, BMC, soft lean mass (SLM), fat free mass (FFM) (p = 0.03), skeletal muscle mass (SMM), and basal metabolic rate (BMR). CONCLUSION: Higher DII scores were associated with lower HDL levels and higher TG levels, respectively; whilst significant differences were observed between the genotypes of rs17782313 for insulin and HOMA index, total body mineral content, and BMC. These results highlight that dietary compositions, gene variants, and their interaction, should be considered in CVD risk assessment.

Assessment the effect of vitamin D supplementation on plasma vitamin D levels, inflammation, and oxidative stress biomarkers based on vitamin D receptor genetic variation in breast cancer survivors: a protocol for clinical trial.

BACKGROUND: Both human genes and environmental exposures, due to complex interplay, play important role in the cancer etiology. Vitamin D is associated with a reduced risk of incidence and mortality of several human cancers. This study will aim to investigate the possible effects of individual polymorphisms in vitamin D receptor (VDR) as well as effects of VDR haplotypes on response to vitamin D supplementation in breast cancer survivors. METHODS: This is an interventional study in which the effects of vitamin D supplementation on plasma vitamin D levels, inflammatory and antioxidant biomarkers and factors associated with cell proliferation, differentiation, damage, and apoptosis will be investigated stratified by variations in VDR genotype. The present study will be conducted on breast cancer survivors referred to the Shohadaye Tajrish hospital and its associated clinics. One hundred ninety-eight breast cancer survivors will receive 4000 IU of vitamin D3 daily for 12 weeks. VDR Fok1, ApaI, TaqI, BsmI, and Cdx-2 genotype will be determined at the end of the study and responses to vitamin D supplements (inflammatory, antioxidant, cell proliferation, differentiation, damage, and apoptosis biomarkers) will be compared between the three subgroups of each VDR polymorphism as well as different VDR haplotype categories. DISCUSSION: Genetic variation is a fundamental factor influencing individuals' divergent responses to diet, nutritional status, metabolic response, and diet-related health disorders. Furthermore, studies of gene and environment interactions will provide a precise and accurate assessments of individuals' dietary requirements by considering both the genetic and environmental aspects simultaneously. The results of the current study, to some extent, will highlight the discrepancies existing in the findings of different studies regarding vitamin D, VDR, and cancer by considering both the genetic and environmental aspects simultaneously. If responses to vitamin D supplementation could be modified by VDR SNPs, determining the distribution of VDR polymorphisms in both breast cancer survivors and healthy populations will provide a new insight into the vitamin D requirements of individuals to prevent cancer and its related mortality based on their genotypes. Trial registration This trial has been registered on Iranian Registry of Clinical Trials (IRCT) under the identification code: IRCT2017091736244N1, registration date: 2017-11-10, http://www.irct.ir/trial/27153.

Association between diet and migraine characteristics: The role of dietary inflammatory index.

Background: Migraine is a neurologic disorder. Although, based on previous evidence, migraine is related with inflammation and oxidative stress, its relationship with the inflammatory potential of the diet is still unknown. Thus, the aim of this study was to show the correlation between Dietary Inflammatory Index (DII) and severity and duration of migraine headache. Methods: In this cross-sectional study, 266 women who suffered from migraine, were included. Demographic and anthropometric data were collected form all participants. 147-item semiquantitative food frequency questionnaire (FFQ) was collected to assess dietary intake and consequently, DII scores were calculated. Migraine Disability Assessment (MIDAS) questionnaire, Visual Analog Scale (VAS), and a 30-day headache diary were also completed by each participant. Results: The DII score ranged between -4.22 and 5.19 and its median [interquartile range (IQR)] was 0.003 (-1.48-1.55). There was no meaningful association between age, occupation, physical activity (PA), weight, height, Body Mass Index (BMI), waist circumference (WC), hip circumference, waist-to-hip ratio (WHR) and DII score classifications (P > 0.050). Subjects with more than 20 days of headache had higher DII score compared to those with less than 10 days per month [odds ratio (OR) = 1.60, 95% confidence interval (CI) = 1.12-2.08, P = 0.001]. There was no association between DII and migraine severity (VAS and MIDAS) in the crude and adjusted model of logistic regression. Although there was a significant association between headache duration and DII (P = 0.020), this relationship was not meaningful after adjusting for age, PA, BMI, and job status (OR = 0.53, 95% CI = 0.28-1.00, P = 0.052). Conclusion: The present study showed a direct association between headache frequency and DII. Nevertheless, any relationship was not found between headache duration or migraine severity and DII score. Future large and prospective studies are needed to explore the effect of inflammatory potential of diet in migraine characteristics.

Effect of vitamin D receptor polymorphisms on plasma oxidative stress and apoptotic biomarkers among breast cancer survivors supplemented vitamin D3.

We investigated whether plasma oxidative stress and apoptotic biomarkers were associated with the VDR polymorphisms in breast cancer survivors supplemented with vitamin D3. Two hundred fourteen breast cancer survivors received 4000 IU of vitamin D3 daily for 12 weeks. Linear regression was used to analyze whether the effect of vitamin D3 supplementation on response variables was associated with the selected VDR single nucleotide polymorphisms executing by 'association' function in the R package 'SNPassoc'. Linear regression analyses adjusted for age, BMI and on-study plasma 25(OH)D changes indicated that the aa genotype of the ApaI [codominant model (aa vs. AA): -0.21 (-0.39 to -0.03); recessive model (aa vs. AA and Aa): -0.20 (-0.37 to -0.03)] and bb genotypes of the BsmI [recessive model (bb vs. BB and Bb): -0.20 (-0.39 to -0.01)] on VDR were associated with greater decrease in plasma Bcl2. Our findings indicated that, the Ff genotype of FokI was accompanied by higher increase in plasma MDA levels [codominant model (Ff vs. FF): 0.64 (0.18-1.11); dominant model (ff and Ff vs. FF): 0.52 (0.09-0.05)]. This observed association was not remained statistically significant after correction for multiple testing. Haplotype score analyses revealed statistically significant association between the FokI BsmI ApaI haplotype and circulating MDA changes (P-value for global score = 0.001) after false-discovery rate correction. Our study suggests that genetic variations in the VDR do not powerfully modify the effects of vitamin D3 intake on biomarkers associated with antioxidant activity, oxidative stress and apoptosis in breast cancer survivors.

Associations of dietary inflammatory index, serum levels of MCP-1 and body composition in Iranian overweight and obese women: a cross-sectional study.

OBJECTIVE: Although, several studies have illustrated that there is a relation between dietary inflammatory index (DII) with obesity-related parameters, and inflammation, their results were controversial. This study aimed to investigate this relationship among Iranian women. RESULTS: Multivariable linear regression showed that fat mass was 0.14 kg lower in the anti-inflammatory diet group, with respect to the pro-inflammatory group, after adjusting covariates such as age, physical activity, economic and job status (ß = - 0.142, 95% CI - 4.44, - 1.71, P = 0.03). Fat-free mass (FFM) was 1.5 kg more in the anti-inflammatory diet group, compared to the pro-inflammatory diet group, after adjusting for potentials cofounders (ß = 1.50, 95% CI 0, 3.01, p = 0.05). Furthermore, after adjusting for potentials cofounders, it was revealed that the subjects with lower DII had lower monocyte chemoattractant protein-1 (MCP-1) levels in serum (ß = - 18.81, 95% CI - 35.84, - 1.79, p = 0.03). These findings suggest an inverse and significant relationship between DII and FFM and also DII is directly related to Fat mass and the level of MCP-1. This finding can be used for developing interventions that aim to promote healthy eating to prevent inflammation and non-communicable disease development among obese females.

Relations of major dietary patterns and metabolically unhealthy overweight/obesity phenotypes among Iranian women.

OBJECTIVE: No studies have examined the contribution of major dietary patterns to MUH phenotypes in obese and overweight people based on Karelis criteria. This study was conducted to evaluate the association of major dietary patterns with MUHOW/O and MHOW/O phenotypes. METHODS: This cross-sectional study was conducted on 290 overweight and obese women aged 18-50 (BMI≥25 kg/m2). Anthropometric measurements were assessed in all participants. The MH phenotype was defined according to the Karelis criteria. Major dietary patterns were determined using factor analysis of 21 foods groups using a valid and reliable FFQ containing 147 items. Participants' body composition was assessed by BIA. Serum HDL, LDL, TG, insulin, and hs-CRP levels were quantified by ELISA. RESULTS: By the use of factor analysis, 3 major dietary patterns were extracted: healthy dietary pattern (HDP), western dietary pattern (WDP) and unhealthy dietary pattern (UNHDP). Binary logistic analysis showed that participants in the in the upper category of WDP had greater odds of MUH phenotype (OR = 2.33, 95%CI = 1.11-4.91, P = 0.02), after confounder factor control. Individuals with high adherence to the UNHDP score had high odds of MUH phenotype (OR = 1.75, 95%CI = 0.98-3.10, P = 0.05), after adjustment for BMI, age, and total EI, compared to those with low adherence. A positive relation was observed between WDP and levels of hs-CRP, HOMA-IR (OR = 1.94, 95%CI = 0.91-4.10, P = 0.05 and OR = 2.53, 95%CI = 1.26-5.11, P = 0.009) as well as a positive association between UHDP and plasma level of LDL (OR = 1.90, 95%CI = 1.04-3.47, P = 0.03), but an inverse association between HDP and hs-CRP level (OR = 0.56, 95%CI = 0.29-0.92, P = 0.03). CONCLUSIONS: The present evidence indicates various significant associations among major dietary patterns and MUHOW/O phenotypes.

Vitamin D Receptor Genetic Variation and Cancer Biomarkers among Breast Cancer Patients Supplemented with Vitamin D3: A Single-Arm Non-Randomized Before and After Trial.

We investigated whether vitamin D receptor (VDR) polymorphisms were associated with cancer biomarkers, i.e., E-cadherin, matrix metallopeptidase 9 (MMP9), interferon ß (IFNß), soluble intercellular adhesion molecule-1 (s-ICAM-1), soluble vascular cell adhesion molecule-1 (s-VCAM-1), tumor necrosis factorα (TNFα), interleukin 6 (IL6), plasminogen activator inhibitor-1(PAI-1), and human high sensitivity C-reactive protein (hs-CRP), among breast cancer survivors who received vitamin D3 supplementation. In a single-arm non-randomized pre- and post trial, 176 breast cancer survivors who had completed treatment protocol including surgery, radio and chemotherapy were enrolled in the study and received 4000 IU of vitamin D3 daily for 12 weeks. The association between the VDR SNPs (ApaI, TaqI, FokI, BsmI and Cdx2) and response variable changes was assessed using linear regression, utilizing the "association" function in the R package "SNPassoc". We observed that women with AA and GA [codominant model (AA compared to GG) and (GA compared to GG); dominant model (AA & GA compared to GG)] genotypes of Cdx2 showed higher increase in plasma MMP9 levels compared to the GG category. In addition, carriers of BsmI bb showed greater decrease in circulating TNFα levels after vitamin D3 supplementation [recessive model (bb compared to BB & Bb]. Likewise, significant associations were identified between haplotypes of VDR polymorphisms and on-study plasma MMP9 changes. However, our results indicate that VDR genetic polymorphisms were not associated with longitudinal changes in the remaining cancer biomarkers. Overall, our findings suggest that changes in certain inflammatory biomarkers in breast cancer survivors with low plasma 25(OH)D levels, supplemented with vitamin D3, may depend on VDR SNPs and haplotypes.