Effects of different dietary interventions in multiple sclerosis: a systematic review of evidence from 2018 to 2022.

BACKGROUND: Nutrition is an important risk factor for both Multiple sclerosis (MS) development and post-diagnosis disease prognosis. However, it is important to evaluate the diet as a whole instead of considering the effects of nutrients individually. AIMS: In this systematic review, it was aimed to evaluate the effect of different dietary interventions in MS patients and to determine the most appropriate dietary model for this group. METHODS: The search was carried out between February 2022 and March 2022 in three different databases, 'PubMed', 'Web of Science' and 'The Cochrane Library' over the university access network. After the search for the determined keywords, a total of 269 studies conducted between 2018 and 2022 were identified, but only 17 of them were found to be suitable for inclusion criteria. RESULTS AND CONCLUSION: Although there are studies reporting positive health outcomes for energy-restricted/intermittent fasting diets, ketogenic diet, and modified paleolithic diet, these diets may not be applicable diets in the long-term as they may cause deficiencies of various nutrients. No current study was found for low-fat diets, gluten-free diet and Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet applied to individuals with MS. The Mediterranean diet, on the other hand, is more recommendable than other diet models due to the positive health results reported in long-term studies and the absence of any side effects. However, more studies are needed to reach a definite conclusion.

Estimated exposure to bisphenol A in breastfed and breastfed plus formula-fed infants in Turkey: a comparison study.

This study aimed to estimate and compare dietary exposure to bisphenol A (BPA) in exclusively breastfed (EBF) and breastfed plus formula-fed (BF + FF) infants. A total of 70 mothers and their 0-6 month-old infants (40 in the EBF group and 30 in BF + FF group) were included in the study. After the questionnaire form was applied to the mothers, maternal breast milk, infant formula, and infant urine were collected from mother-infant dyads. Total BPA levels in breast milk, infant formula, and infant urine samples were analyzed by the high-pressure liquid chromatography (HPLC). While BPA was detected in 92.5% of the breast milk samples in the EBF group (mean ± SD = 0.59 ± 0.29 ng/mL), BPA was detected in all of the breast milk samples in the BF + FF group (mean ± SD= 0.72 ± 0.37 ng/mL) (p < 0.05). Similarly, 100% of the infant formula samples in the BF + FF group had detectable levels of BPA (mean ± SD = 7.54 ± 1.77 ng/g formula). The mean urinary BPA levels in the EBF infants (4.33 ± 1.89 µg/g creatinine) were not statistically different from the BF + FF infants (5.81 ± 0.11 µg/g creatinine) (p > 0.05). The average daily BPA intake in EBF infants (0.18 ± 0.13 µg/kg body weight (bw)/day) was found to be significantly higher than in BF + FF infants (0.12 ± 0.09 µg/kg bw/day) (p < 0.05). The estimated dietary intakes of BPA for infants in both groups were below the temporary tolerable daily intake (t-TDI) (4 µg/kg bw/day). Consequently, BPA intake of EBF and BF + FF infants were within safe daily limits during the first six months of life.

Evaluation of the relationship between serum ferritin and insulin resistance and visceral adiposity index (VAI) in women with polycystic ovary syndrome.

PURPOSE: There is a relationship between polycystic ovary syndrome (PCOS) and adipose tissue dysfunction (ADD), but this relationship is not clear. It has been recently shown that iron accumulation in adipose tissue is among the causes of adipose tissue dysfunction. Data on adipose tissue dysfunction in women with PCOS are insufficient. In this study, we aimed to evaluate the relationship between serum ferritin levels (iron accumulation biomarker) and visceral adiposity index (an indicator of adipose tissue dysfunction). METHODS: The study is a case-control study. Women with diagnosed PCOS with 2003 Rotterdam Diagnostic Criteria (n = 40) were compared with non-PCOS group (n = 40). In this study, the cholesterol ratios, the homeostatic model evaluation index for insulin resistance (HOMA-IR) and the quantitative insulin sensitivity control index were calculated using biochemical parameters, and the visceral adiposity index (VAI) and the lipid accumulation product (LAP) were calculated using both anthropometric and biochemical parameters. In this study, insulin resistance was evaluated by HOMA-IR and adipose tissue dysfunction was evaluated by VAI index. RESULTS: According to the results of this study, women with PCOS have a worse metabolic status than women without PCOS. However, this has been shown only in overweight and obese women, not in women with normal weight. CONCLUSION: As a result, the presence of obesity in women with PCOS exacerbates metabolic status. LEVEL OF EVIDENCE: Level V, cross-sectional descriptive study.

A New Approach to Polycystic Ovary Syndrome: The Gut Microbiota.

Polycystic ovary syndrome (PCOS) is a widespread endocrine disease that affects 6% to 20% of women of reproductive age and is associated with high risk of infertility, obesity, and insulin resistance. Although genetic, neuroendocrine, and metabolic causes have been stated to lead to PCOS, the etiology of PCOS remains unclear. Recent studies in humans and rodent models have shown an association between changes in the gut microbiome and the metabolic and clinical parameters of PCOS. In addition, it has been proposed that dysbiosis of gut microbiota may be a potential pathogenetic factor in the development of PCOS. In this context, modification of gut microbiota with probiotic, prebiotic, and synbiotic agents suggests that these products may serve as new treatment options for PCOS. In this review, it is aimed to explain the relationship between PCOS and gut microbiota with possible mechanisms and to examine the new treatment approaches that can be developed in this direction. Key teaching pointsStudies have shown that gut microbiota may be a potential pathogenetic factor in the development of PCOS.Dysbiosis of gut microbiota in women with PCOS appears to be associated with PCOS phenotypes.Studies suggest that insulin resistance, sex hormone concentrations, and obesity may affect the diversity and composition of gut microbiota in women with PCOS.With better understanding of the role of intestinal microbiota in PCOS, interventions including prebiotics, probiotics, and synbiotics can be considered as future treatment options.

Increased risk of eating disorders in women with polycystic ovary syndrome: a case-control study.

Data on eating disorders in women with PCOS is insufficient. The objective of this case study was to examine the hypothesis that women with PCOS exhibit more impaired eating than healthy women. Women diagnosed with PCOS under the 2003 Rotterdam Diagnostic Criteria (n = 40) were compared with a healthy control group (n = 40). The groups also were divided into two as normal body weight and overweight/obese. The Eating Disorders Assessment Questionnaire (EDE-Q) and the Three Factor Eating Questionnaire (TFEQ-R21), were completed by all participants in order to evaluate eating behaviors in addition to eating disorders. Among the overweight/obese group, the average total and subscale scores of the EDE-Q as well as the total and sub-factor scores of the TFEQ-R21 were higher in women with PCOS compared to controls (p < .05). However, this statistically significant result was not shown among the women with normal weight (p > .05). In comparison to the controls, the PCOS women displayed higher values of the tool scores indicating abnormal restraint eating, body shape concern and weight concern subscale scores (p < .05). This result suggests that the evaluation of eating disorders should be added to routine screening and the monitoring of women with PCOS.

Nutritional Factors Related to Male Fertility: Turkish Sample.

This study aimed to investigate the difference between infertile men and healthy (normozoospermic) men in terms of demographic characteristics, dietary habits, anthropometric measurements, and body composition. We included 80 males (40 subfertile and 40 healthy normozoospermic) between the ages of 25 and 54 years. Information was obtained from the participants regarding their socio-demographic characteristics, health status, dietary habits, and food intake. Food frequency questionnaires, food records, anthropometric measurements, body composition, and sperm analysis were statistically evaluated using IBM SPSS Statistics 20 programme. The findings of this study showed that the mean BMI of the subfertile group was significantly higher than that of the normozoospermic group. The frequency of eating out was significantly higher in the subfertile group than in the normozoospermic group. It was also determined that the consumption of fish was significantly lower; in contrast, consumption of sugar sweetened beverages, and alcohol was significantly higher in the subfertile group than in the normozoospermic group. Moreover, it was found that sugar sweetened bevareges, red meat, organ meats consumption are negatively; and that fish, egg, nut consumption are positively correlated with sperm parameters. In summary, in men receiving infertility treatment, excessive consumption of meat and sugary drinks should be considered cautiously. However, fish, nuts and eggs consumption should be provided in line with the nutrition guidelines.

The Relationship Between Female Reproductive Functions and Vitamin D.

Nonclassical target organs recently defined for vitamin D, a major regulator of calcium phosphorus homeostasis and bone health, include reproductive ones. This compilation study focuses on the potential effects of vitamin D on female reproductive functions. Vitamin D receptor enzymes that metabolize vitamin D are expressed in both central and peripheral reproductive organs. Most studies suggest that vitamin D may be directly or indirectly related to gonadal functions. Vitamin D's effects on reproductive functions may be indirectly related to diseases such as polycystic ovary syndrome (PCOS), uterine leiomyomas, and endometriosis. In case of vitamin D deficiency during infertility treatment, vitamin D supplementation can be recommended especially for women who have PCOS, insulin resistance, or low anti-Mullerian hormone levels. Supplementation, however, should take into account possible toxic effects of high-dose vitamin D. To be able to recommend measuring vitamin D as a routine screening test and to better understand the effects of vitamin D and its supplementation on female reproductive functions, larger randomized controlled prospective studies are needed.

Effect of Pollen, Pit Powder, and Gemmule Extract of Date Palm on Male Infertility: A Systematic Review.

Pollen, pit powder, and gemmule extract of the date palm are rich in flavonoids. Antioxidant characteristics of the flavonoids have a significant effect on prevention and treatment of infertility. The aim of the present study was to review studies investigating the effects of pollen, pit powder, and gemmule extract of the date palm on male infertility. Articles that were published about the topic between 2005 and 2016 were reviewed from different databases in Turkish and English. The search engines used included PubMed, Science Direct, Clinical Key, Google Scholar, Springer, Dergipark, Ulakbim, and Akademik Dizin. The studies found that pollen, pit powder, and gemmule extract of the date palm created positive changes in hormone levels that have a role in male fertility and increased sperm motility and quality, spermatogenesis, and weights of testes and epididymis. Date palm pollen, pit powder, and gemmule extract have a high antioxidant capacity because of phenolic formations in the composition. Such characteristics have a positive effect on prevention and treatment of male infertility. Furthermore, gonadotropic and steroidal compounds within date palm pollen play a role in treatment of male infertility. The limited number of studies conducted on this topic indicates that more research is needed.

Validity and reliability study of the Mediterranean Lifestyle Index: Turkish adaptation.

Objective: The Mediterranean Lifestyle Index (MEDLIFE) differs from similar scales in that it concurrently includes diet and lifestyle. The current study translated MEDLIFE into Turkish, and assessed its reliability and validity. Methods: A questionnaire was administered to 300 individuals 19-65 years of age. The questionnaire was subsequently re-administered to 87 research participants. The questionnaire, asking for general information, MEDLIFE, and information regarding anthropometric measurements, was sent to the users of an online platform. The scale was converted into the applicable Turkish form by an expert group. Test-retest reliability was evaluated with the intraclass correlation coefficient (ICC). In addition, kappa coefficients (k) and Bland-Altman graphs were determined for each item to assess reliability. Results: The mean scores before and after were 14.5 ± 3.68 and 14.3 ± 3.81, respectively, and the intercorrelation coefficient r was 0.817 for test-re-test reliability. Conclusion: The validity and reliability of the scale in the Turkish language was confirmed. This study is the first to translate MEDLIFE into another language and may aid in assessing the scale's adaptability to other languages. Food consumption record and physical activity record studies must be performed to ensure validity.

Examining dietary habits in the context of multiple sclerosis: A comprehensive investigative approach.

AIMS: The aim of this study is to evaluate the nutritional status of patients with multiple sclerosis (MS) and to develop suggestions for changing eating habits in a healthy direction. METHODS: The study was conducted on 171 participants (80.1 % female; 19.9 % male) diagnosed with MS between the ages of 18-60 who applied to Ankara Hacettepe University Hospital Neurology Outpatient Clinic between June 2021 and March 2023. Body weight, height, body composition, waist circumference, upper mid-arm circumference and hand grip strength were measured in accordance with the technique of anthropometric measurements. A three-day food consumption record was taken to evaluate the energy, macro, and micronutrient content of the diet. Mediterranean Diet Assessment Tool was used to assess adherence to diet. RESULTS: Mean age of the participants was recorded as 35.2 ± 10.81 years. According to the body mass index (BMI) classification, 59.9 % of females were in normal limits, while 61.8 % of males were classified as overweight and obese. However, when evaluated in terms of body composition, body fat percentage was found to be above of normal limits in both genders. Also, 70.8 % of participants were sedentary. The percentage of patients who met their daily energy requirements in women with light and moderate activity was higher than in men, but it was not statistically significant. In participants with high activity level, the percentage of patients meeting energy requirements was below 50 % for both genders. Dietary fat and saturated fat intake were higher than the recommendations, while monounsaturated fatty acids and dietary fiber intake were less. The percentages of patients meeting their calcium requirement was below 50 % in both genders. Mean intake amounts of vegetables, fruits, legumes, nuts, and dairy products were below the Türkiye Nutrition Guideline recommendations. CONCLUSION: This study shows the nutritional characteristic of patients with MS in detail with different aspects. Although most of the patients were in normal limits in terms of BMI, body fat percentages were found to be above normal limits in both genders. Total fat and saturated fat intakes were found to be high according to scientific recommendations while the intake of food groups required for a fibre-based diet and intake of dairy products were low.

Acyl ghrelin, desacyl ghrelin and their ratio affect hepatic steatosis via PPARγ signaling pathway.

BACKGROUND AND STUDY AIMS: Ghrelin is an appetite hormone-containing 28-amino acid and has 4 different forms in the body. Ghrelin forms have different physiological functions in the body. This study aims to analyze the effect of acyl and desacyl ghrelin hormone on hepatic steatosis and biochemical findings in 36 male Wistar rats. MATERIALS AND METHODS: Rats were split into 6 equal groups, consisting of control, acyl ghrelin, desacyl ghrelin, acyl/desacyl 3:1, acyl/desacyl 1:1, and acyl/desacyl 1:3 groups, and administered placebo or 200 ng/kg hormone subcutaneous twice a day for 14 days. Oral Glucose Tolerance Test (OGTT) was performed on Day 15, Insulin Tolerance Test (ITT) on Day 16, and scarification procedure on Day 17. Certain biochemical data and liver diacylglycerol (DAG), glycogen, protein kinase C and PPAR-γ levels were detected in the blood. Histological analyses were also conducted on the liver tissues. RESULTS: The highest plasma total cholesterol and VLDL-K levels were found in the acyl/desacyl 1:3 group, and lower insulin, and HOMA-IR levels were found in groups where acyl and desacyl were administered together (p < 0.05). PPAR-γ gene expression level increased in acyl ghrelin and acyl/desacyl 1:3 groups compared to the control group. Protein kinase C gene expression was highest in the acyl/desacyl 1:3 group. The most severe degenerative findings compliant with steatosis in the liver were observed in the acyl ghrelin group (p < 0.05). CONCLUSION: It was determined that administering rats acyl alone and acyl/desacyl by 1:3 caused the highest PPAR-γ gene expression, serum total cholesterol, HDL-K, and VLDL-K levels in the body. Besides, it is shown that desacyl ghrelin effectively regulates the blood glucose level when administered alone.

Comparison of melamine exposure by feeding practices in babies aged 0-6 months.

This study was conducted to estimate the daily dietary intakes of melamine for human milk-fed (HMF) babies and mixed-fed (MF) babies. It was carried out in 70 mother-baby pairs (40 babies in the HMF group and 30 babies in the MF group). Human milk, formula milk, and baby urine samples were collected to assess the dietary exposure of babies. Melamine concentrations were analyzed by using a competitive enzyme-linked immunosorbent assay. Melamine was determined in 82.5 % of the human milk samples in the HMF group (median: 0.75 µg/L) while it was present in 96.7 % of human milk samples (median: 1.25 µg/L) and 96.7 % in formula milk samples (median: 0.95 µg/kg) in the MF group. The mean urinary melamine concentration of HMF babies (1.20 ± 0.21 µg/L) was not significantly different than MF babies (1.35 ± 0.49 µg/L). Melamine exposure was calculated as 0.12 µg/kg bw/day and 0.24 µg/kg bw/day in HMF and MF babies, respectively. Melamine exposure in both groups was below the tolerable daily intake. There were no significant associations between melamine exposure and various features of babies and mothers. As a result, it can be suggested that Turkish babies (aged 0-6 months) are not at risk for high melamine exposure through the diet.

Effect of Antioxidant Supplementation on Endometriosis-Related Pain: A Systematic Review.

PURPOSE OF REVIEW: This study was conducted to determine the effects of antioxidant supplementation on endometriosis-related chronic pelvic pain, dysmenorrhea, and dyspareunia. METHODS: PubMed/MEDLINE, Scopus, and Cochrane Library databases and the Google Scholar search engine were searched from early 2012 to 2022 using appropriate keywords for clinical trials receiving antioxidant supplements and reporting endometriosis-related pelvic pain (PROSPERO registration number CRD42022318924). The qualities of the included studies were evaluated using the Joanna Briggs Institute (JBI) Checklists Critical Appraisal Tools and the National Institutes of Health (NIH) quality assessment tool for before-after (Pre-Post) study with no control group. This systematic review was reported according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guideline. RESULTS: In this systematic review, 8 studies (5 RCTs and 3 non-comparative trials) published in 2012-2022 were included. CONCLUSIONS: The studies we included showed promising results in the use of antioxidants in endometriosis-related pain. However, many scientific studies are needed for clear statements.

The association between trans fatty acids, infertility and fetal life: a review.

Trans fatty acids (TFAs) are thought to affect reproductive health by causing adverse effects on sperm morphology and ovum quality as a result of changing membrane lipid composition which, in turn, leads to impairment in metabolic pathways. This literature review examines the evidence for the effects of dietary TFAs on male and female infertility. Studies conducted between 2007 and 2017 on the effect of dietary TFAs on human reproductive health and fetal life have been included. They indicate that TFA intakes are inversely proportional to sperm concentration and total sperm count and exhibit a positive correlation with asthenospermia, as well as an adverse association on sperm concentration and semen quality. In the female TFAs intakes are associated with an increase in the risk of ovulatory infertility, adversely affect the length of gestation leading to fetal developmental defects and fetal loss. The findings suggest that high TFA intake (more than 1% of energy consumption) constitute a risk factor for infertility in both sexes.