Antiviral Mechanisms of Curcumin and Its Derivatives in Prevention and Treatment of COVID-19: A Review.

The COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has now plagued the world for almost 3 years. Although vaccines are now available, the severity of the pandemic and the current dearth of approved effective medications have prompted the need for novel treatment approaches. Curcumin, as a food nutraceutical with anti-inflammatory and antioxidant effects, is now under consideration for the prevention and treatment of COVID-19. Curcumin has been demonstrated to retard the entrance of SARS-CoV-2 into cells, interfere with its proliferation inside cells, and curb the hyperinflammatory state caused by the virus by modulating immune system regulators, minimizing the cytokine storm effect, and modulating the renin-angiotensin system. This chapter discusses the role of curcumin and its derivatives in the prevention and treatment of COVID-19 infection, considering the molecular mechanisms involved. It will also focus on the molecular and cellular profiling techniques as essential tools in this research, as these can be used in the identification and development of new biomarkers, drug targets, and therapeutic approaches for improved patient care.

Efficacy of synbiotic interventions on blood pressure: a systematic review and meta-analysis of clinical trials.

PURPOSE: The present systematic review and meta-analysis aimed to evaluate the effect of synbiotic interventions on blood pressure levels in adults. METHODS: A systematic literature search was conducted in the databases of MEDLINE, Scopus, Web of Science, and Cochrane through March 2020 to identify all randomized control trials (RCTs) investigating the effects of synbiotic interventions on blood pressure parameter, including systolic (SBP) and diastolic blood pressure (DBP). Grading of Recommendations Assessment, Development and Evaluation (GRADE) scale was used to assess the certainty of evaluated outcomes and determine the strength of recommendations. RESULTS: Eleven RCTs were included in the meta-analysis. Synbiotic interventions significantly reduced SBP (-3.02 mmHg; 95% CI: -4.84, -1.21; I2 = 55%) without changing DBP levels (-0.57 mmHg; 95% CI: -1.78, 0.64; I2 = 50%). Subgroup analyses revealed that the SBP-lowering effects of synbiotic interventions were more pronounced wherein trials were longer (≥12 weeks), synbiotic interventions were administrated as a supplement, and participants were younger (<50 years old). Also, a significant improvement in both SBP and DBP levels was evident in subgroups with a lower (<30 kg/m2) body mass index. CONCLUSIONS: Synbiotic interventions may significantly improve SBP levels in adults.

The effect of nigella supplementation on blood pressure: A systematic review and dose-response meta-analysis.

This study was performed to assess the effect of nigella supplementation on blood pressure levels among the adult population. A comprehensive search was carried out through PubMed, Scopus, Web of Science, and Cochrane Library by using relevant keywords to find out the randomized clinical trials evaluating the effect of nigella administration on systolic blood pressure (SBP) and diastolic blood pressure (DBP). A random-effect model was applied to achieve the overall effect size. Subgroup analysis and meta-regression were used to explore the source of heterogeneity and the effects of the possible moderators. Of the twenty-two trials that were eligible for the present study, seventeen studies consisting of 1048 participants were included in the meta-analysis. The results indicated that nigella administration could significantly reduce both SBP (-4.58 mmHg; 95%CI: -6.22, -2.94) and DBP (-3.08 mmHg; 95%CI: -4.62, -1.55). Subgroup analysis did not show any superiority between subgroups of variables. Dose-response analysis detected a nonlinear association between dose and duration of administration and change in blood pressure outcomes, highlighting that maximum SBP and DBP reduction was experienced at 2000 mg/day and 8 weeks of nigella administration, respectively. The present study suggests that nigella supplementation can be beneficial for managing blood pressure.

Sodium and potassium intakes and adiposity among Iranian pre-adolescents and adolescents: a cross-sectional study.

BACKGROUND: High sodium and low potassium intakes are associated with the early development of chronic diseases (e.g., hypertension, obesity). Taking into account the limited data on sodium and potassium intakes by 24-h excretion in urine in pre-adolescents and adolescents, we wished to determine baseline salt intake in Iranian subjects aged 11-18 years. METHODS: This was an observational study involving 374 pre-adolescents and adolescents (154 boys and 220 girls). Sodium and potassium intakes were ascertained by measuring sodium and potassium excretion in urine over 24 h. Creatinine level was used to validate the completeness of the urine collections. The association between sodium and potassium intake and adiposity was determined based on body fat percentage. RESULTS: The mean 24-h urine sodium concentration was 3130 ± 2200 mg/day, equal to 7.961 ± 5.596 g/day salt intake. Approximately half of the study participants exceeded the upper limit of Na intake. The mean potassium intake was estimated 1480 ± 1050 mg/day. There was a positive association between urinary sodium excretion and adiposity in crude (OR 1.79; 95% CI: 1.08-2.74) and full adjusted model (OR: 3.15; 95% CI: 2.28-4.63). Also, in subsample analysis, there was a positive correlation between urinary sodium and adiposity in both pre-adolescents (OR: 2.71; 95% CI: 2.29-3.93) and adolescents (OR: 3.55; 95% CI: 2.17-4.74). However, no significant association was found between 24-h urinary potassium and adiposity. CONCLUSION: Sodium intake, as estimated by 24-h urinary excretion, was higher than recommended and it was positively associated with adiposity. Also, this study reported low compliance of potassium intake recommendations in 11-18 years' Iranian pre-adolescents and adolescents. Health promotion interventions are needed in order to broaden public awareness of high sodium intake and potassium inadequacy to reduce chronic diseases.

The relationship between animal flesh foods consumption and rheumatoid arthritis: a case-control study.

BACKGROUND: Rheumatoid arthritis (RA) is a chronic, systemic inflammatory, and debilitating autoimmune illness. The objective of the present study was to evaluate the relationship between animal flesh foods consumption and rheumatoid arthritis. METHODS: Meat consumption was assessed by using a semi-quantitative Food Frequency Questionnaire (168 items) in a case-control study of 297 subjects (100 newly diagnosed cases and 197 healthy controls). An expert rheumatologist diagnosed patients based on the American College of Rheumatology definitions, 2010. Multivariate logistic regression, adjusted for lifestyle and nutritional confounders, was used to evaluate the relationship between dairy consumption and rheumatoid arthritis. RESULTS: Participants with greater consumption of fish and seafood were less likely to have RA (OR 0.52; 95% CI 0.27-0.98). Conversely, a higher processed meat intake was associated with increased odds of RA (OR 3.45; 95% CI 1.78-6.68). However, no significant association was found between red meats and poultry consumption and the risk of RA in the fully adjusted model. CONCLUSIONS: The present study suggests an inverse association between fish and seafood consumption and the risk of RA. On the contrary, a higher amount of processed meat intake was associated with increased odds of RA. However, further studies are warranted to confirm the veracity of our findings.

The Effect of Green Coffee Bean Extract on Cardiovascular Risk Factors: A Systematic Review and Meta-analysis.

BACKGROUND AND AIM: Cardiovascular disease remains the primary cause of noncommunicable disease- related death. The present systematic review and meta-analysis was performed to assess the possible benefit of the green coffee bean extract on cardio-metabolic markers. METHODS: PubMed, Scopus, Web of Science, and Cochrane Library were systematically searched to identify clinical trials that examined the effect of green coffee bean extract on cardio-metabolic risk factors including serum lipid profiles, glycemic status-related markers, blood pressure, and anthropometric indices. Since the included RCTs were carried out in different settings, random effect models were used to conduct all meta-analyses. RESULTS: Fifteen studies (19 arms) consisting of 637 participants were included. The results indicated that green coffee bean extract significantly reduced levels of total cholesterol (-5.93 mg/dl; 95% CI: -9.21, -2.65; I2: 0%), fasting plasma glucose (-2.21 mg/dl; 95% CI: -3.94, -0.48; I2: 32%), systolic blood pressure (-3.08 mmHg; 95% CI: -4.41, -1.75; I2: 26%), diastolic blood pressure (-2.27 mmHg; 95% CI: -3.82, -0.72; I2: 61%), body weight (-1.24 kg; 95% CI: -1.82, -0.66; I2: 15%), and BMI (-0.55 kg/m2; 95% CI: -0.88, -0.22; I2: 73%). Although the pooled effect size of LDL-C, fasting insulin, and waist circumstance were significant, the results were significantly influenced by individual studies. No significant effect was detected for triglycerides, HDL-C, HbA1C, and HOMA-IR. However, the nonsignificant pooled effect size for triglyceride levels was influenced by one individual study. CONCLUSION: The present study suggests that green coffee been extract consumption can improve total cholesterol, triglycerides, body weight, blood pressure, and fasting plasma glucose.

A healthy dietary pattern may be associated with primary insomnia among Iranian adults: A case-control study.

Objective: While it has been reported that both foods and nutrients for individuals are connected with sleep, there is no evidence regarding the association of dietary patterns, identified by factor analysis, with primary insomnia. The present study sought to evaluate the association between major dietary patterns and the chance of having primary insomnia. Methods: The present case-control study was performed using 444 people (111 cases and 333 control), aged 18 to 60 years, referred to Isfahan health centers. Dietary intake was assessed via a food frequency questionnaire in a case-control study in Isfahan, Iran. Principal component analysis was used to determine major dietary patterns. The presence of primary insomnia was measured via the insomnia severity index questionnaire, and the subjects were grouped as healthy or insomniac. Results: Three major dietary patterns were recognized, and named; Western, Iranian Traditional and Healthy, respectively. The cumulative percentage of variance explained by three dietary patterns was 48.2%. Those in second (OR = 0.30; 95%CI: 0.2-0.46) and third (OR = 0.22; 95%CI: 0.15-0.35) tertiles of healthy dietary pattern were less likely suffer with insomnia. This association remained significant only in the highest tertile after adjusting potential confounders (OR = 0.45; 95%CI: 0.32-0.95). We found no significant association between greater adherence to Western or Iranian traditional dietary patterns and primary insomnia. Conclusions: The findings showed that although no statistically significant association was observed between both Western and Iranian traditional dietary patterns with primary insomnia, people with greater adherence to the healthy dietary pattern are less likely to have primary insomnia.

Effects of synbiotic consumption on lipid profile: a systematic review and meta-analysis of randomized controlled clinical trials.

BACKGROUND AND AIMS: Existing evidence on the possible effects of synbiotics on lipid profile is inconclusive. The aim of the present systematic review was to clarify the effects of synbiotics consumption on lipid profile. METHODS: A systematic literature search of online databases PubMed, Scopus, ISI Web of science, Cochrane's library and Google Scholar was conducted up to January 2019. Randomized controlled trials (RCTs) investigating the effects of synbiotics on lipid profile in adults were included. The overall effect was presented as weighted mean difference (WMD) and 95% confidence interval (CI) in a random-effects meta-analysis model. RESULTS: A total of 23 RCTs with 1338 participants were included. Synbiotic consumption resulted in a significant decrease in plasma concentrations of total cholesterol (WMD = - 10.17 mg/dL; 95% CI - 15.74 to - 4.60; p < 0.001), triglyceride (WMD = - 14.30 mg/dL; 95% CI - 25.32 to - 3.28; p = 0.01), low-density lipoprotein cholesterol (WMD = - 8.32 mg/dL; 95% CI - 13.21 to - 3.43; p < 0.001), and an increase in plasma high-density lipoprotein cholesterol (WMD = 1.3 mg/dL; 95% CI 0.03 to 2.56; p = 0.04) levels compared to control (placebo supplements/control foods/conventional products). The effects are more pronounced when synbiotics supplements are consumed for > 8 weeks. CONCLUSION: Synbiotic supplements may be beneficial to improve lipid profile, especially when they are consumed for > 8 weeks.

The association between dietary diversity score and general and abdominal obesity in Iranian children and adolescents.

BACKGROUND: To evaluate the association between diet and disease, the consideration of a whole diet has appeared to be more effective than the examination of single-nutrient intake. This study aimed to examine the relationship between dietary diversity score (DDS) and obesity in Iranian children. METHODS: A cross-sectional study was conducted on 456 children aged 11-18 years, who were selected by random cluster sampling. The usual food intake for each participant assessed using a validated Food frequency questionnaire (FFQ). To calculate the dietary diversity score, food items were categorized into 5 broad groups and 23 subgroups based on the US Department of Agriculture Food Guide Pyramid. Participants were categorized based on the DDS tertile cut-off points. Anthropometric measurements were conducted based on standard protocols. Overweight and obesity were defined as 85th ≤ BMI < 95th, and ≥ 95th percentiles of BMI, respectively. Additionally, abdominal obesity was considered as WC ≥ 85th percentile. RESULTS: Mean and standard deviation (SD) of subjects' Body Mass Index (BMI) and waist circumference were 20.88 (SD 4.22) kg/m2 and 74.27 (SD 10.31) cm, respectively. The probability of overweight and obesity was increased as tertiles of DDS increased (OR among tertiles: 1.00, 1.82 and 2.13 for overweight and 1.00, 2.60 and 3.45 for obesity; this was the same for abdominal obesity: 1.00, 2.22 and 3.45, P <  0.001 for all). However, no statistically significant results were found after adjustment for energy intake. CONCLUSION: Dietary diversity positively affected obesity through higher energy intake. Despite the wide recommendation of having high dietary diversity, public health programs should emphasize to improve dietary diversity only in selective food items.

The association between animal flesh foods consumption and semen parameters among infertile Iranian men: a cross-sectional study.

BACKGROUND: Previous studies have demonstrated the association between dietary patterns and semen quality indicators, but research on the possible association between animal flesh foods consumption and semen quality is limited. Therefore, this study was conducted to investigate the association between animal flesh foods consumption with semen quality. METHODS: In this cross-sectional study, 400 newly-identified (< 6 months) infertile men, as diagnosed by an andrologist, were recruited into the study. Dietary intake was assessed by using a semiquantitative Food Frequency Questionnaire. The total meat consumption was defined as the sum of red meat, poultry, fresh fish, canned fish, processed meats, and organ meats in the diet. A linear mixed model was used to assess the relationship between meat consumption and semen quality indicators of participants. RESULTS: Consumption of canned fish was inversely related to sperm immotility. Compared with the men in the lowest quartile of canned fish intake, those in the highest quartile had a lower sperm immotility [lowest quartile: 52.5%; (95% CI: 47-57) vs 47.4%; (95% CI: 43-51) P-trend = 0.026]. Similarly, a trend toward an inverse significant association between fresh fish intake and sperm immotility was observed (P-trend = 0.074). In contrast, fresh and canned fish intake was unrelated to other outcomes of sperm quality (P-trend > 0.05). No association was found between consumption of processed red meat, red meat, poultry, and organ meat, and semen quality indicators (P-trend > 0.05). CONCLUSIONS: We found that consumption of canned fish is associated with a lower percentage of immotile sperm, whilst a high consumption of fresh fish increased the percentage of immotile sperm in Iranian infertile men. Further studies are recommended in this regard.

Dietary patterns are associated with premenstrual syndrome: evidence from a case-control study.

OBJECTIVES: Premenstrual syndrome (PMS) is a common cyclic psychological and somatic disorder which reduces women's quality of life. Evidence regarding the association between dietary patterns (DPs) and PMS is rare. The study aimed to determine the relationship between dietary patterns and PMS. DESIGN: The case-control study was conducted among women with confirmed PMS and healthy individuals recruited from healthcare centres. SETTING: Dietary data were collected using a validated semi-quantitative food frequency questionnaire and DPs were derived using principal component analysis. The association between DPs and likelihood of PMS was determined using logistic regression. PARTICIPANTS: In total, 225 women with PMS and 334 healthy participants aged 20-46 years took part in the study. RESULTS: Three major DPs were identified: (i) 'western DP' characterized by high intake of fast foods, soft drink, and processed meats; (ii) 'traditional DP' in which eggs, tomato sauce, fruits, and red meat were highly loaded; and (iii) 'healthy DP' high in dried fruits, condiments and nuts. After taking all possible confounders into account, individuals in the highest tertile of the western DP were more likely to experience PMS (odds ratio (OR) = 1·49; 95 % CI: 1·01, 3·52), P < 0·001), whilst both healthy and traditional DP was inversely associated with the syndrome (OR = 0·31; 95 % CI: 0·17, 0·72, P = 0·02; OR = 0·33; 95 % CI: 0·14, 0·77, P = 0·01, respectively). CONCLUSION: The western dietary patterns were positively associated with PMS, whilst the healthy and traditional dietary patterns were inversely associated with it. Further longitudinal studies are required to confirm our findings.

Effect of pycnogenol supplementation on blood pressure: A systematic review and meta-analysis of clinical trials.

Several studies investigated the impact of pycnogenol on blood pressure. Nevertheless, the results are inconclusive. The aim of the present systematic review and meta-analysis was to clarify the effect of pycnogenol supplementation on blood pressure. PubMed, Scopus, Web of Science, and Google Scholar were systematically searched until March 2018 to find clinical trials, which examined the effect of pycnogenol supplementation on systolic and diastolic blood pressure in adults. A subgroup analysis was applied to find out potential sources of interstudy heterogeneity. A total of 12 clinical trials (922 participants) were included in the meta-analysis. Pooled analysis suggested that pycnogenol supplementation can reduced systolic blood pressure (SBP) of (-3.22 mmHg; 95% CI [-5.52, -0.92]) and diastolic blood pressure (DBP; -1.91 mmHg; 95% CI [-3.64, -0.18]). Effect of pycnogenol on SBP was more pronounce in subgroup in which pycnogenol was administered along with other treatments. A significant effect of pycnogenol on DBP in studies with >12-week duration, whereas this favorable effect was not observed in subgroup with ≤12-week supplementation. The present systematic review and meta-analysis suggest that pycnogenol had a favorable effect on SBP and DBP. Further, high quality randomized clinical trials are needed to confirm this result.

The efficacy of sour tea (Hibiscus sabdariffa L.) on selected cardiovascular disease risk factors: A systematic review and meta-analysis of randomized clinical trials.

This study sought to summarize clinical evidence of sour tea (Hibiscus sabdariffa L.) administration on cardiovascular disease risk factors. PubMed, Scopus, Institute for Scientific Information Web of Science, and Google Scholar were systematically searched from inception to June 2019 to identify randomized clinical trials, which assessed the effect of sour tea consumption on lipid profiles, fasting plasma glucose, and blood pressure in adult populations. Mean and standard deviation for each parameter were extracted to calculate effect size. Cochrane Collaboration tools were used to evaluate risk of bias assessment. A total of seven randomized clinical trials consisting 362 participants were included in the meta-analysis. Pooled effect size demonstrated that sour tea consumption significantly reduces fasting plasma glucose (-3.67 mg/dl, 95% confidence interval, CI [-7.07, -0.27]; I2 = 37%), systolic blood pressure (-4.71 mmHg, 95% CI [-7.87, -1.55]; I2 = 53%), and diastolic blood pressure (-4.08 mmHg, 95% CI [-6.48, -1.67]; I2 = 14%). Although no significant effect was observed on triacylglycerol, total cholesterol, and high-density lipoprotein cholesterol following sour tea consumption, a trend toward a significant reduction was found in low-density lipoprotein cholesterol serum concentrations (p = 0.08). This systematic review and meta-analysis suggests that sour tea consumption could have beneficial effect in controlling glycemic status and blood pressure among adult population.

Effects of Melatonin Supplementation On Blood Pressure: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Melatonin is a physiological indoleamine secreted from the pineal gland into the bloodstream. This hormone has antioxidant effects in cardiovascular disease, but the evidence regarding its effects on blood pressure (BP) has not been conclusive. Therefore, we assessed the impact of melatonin supplementation on systolic BP (SBP) and diastolic BP (DBP) through a systematic review and meta-analysis of available randomized controlled trials (RCTs). Medline, Scopus, Web of Science, Cochrane library, and Google scholar (until May 2018) were searched to identify potential RCTs with information on melatonin supplementation and BP. Mean Differences (MD) were pooled using a random-effects model. Standard methods were used for assessment of heterogeneity, sensitivity analysis, and publication bias. Pooling 5 RCTs (6 treatment arms) together identified significant reduction for SBP (MD: -3.43 mmHg, 95% confidence interval (CI): -5.76 to -1.09, p=0.004) and DBP (MD: -3.33 mmHg, 95% CI: -4.57 to -2.08, p<0.001) after supplementation with melatonin compared with control treatment. The sensitivity analysis indicated that the results were robust. We did not observe any evidence regarding publication bias. The findings of this meta-analysis support the overall favorable effect of melatonin supplementation on BP regulation.

The effect of Curcumin/Turmeric on blood pressure modulation: A systematic review and meta-analysis.

BACKGROUND AND AIM: Hypertension is a chronic condition that can lead to several health problems, such as cardiovascular diseases, myocardial infarction, stroke, retinopathy and renal failure. In the present study, a systematic review and meta-analysis was undertaken with the main aim of estimating the quantitative effect of curcumin/turmeric supplementation on blood pressure (BP). METHODS: A systematic search was undertaken in Medline, Embase, Scopus, ISI Web of Science, Google Scholar and Cochrane library up to May 2019 to identify randomized clinical trials assessing the effect of curcumin/turmeric on systolic BP (SBP) and diastolic BP (DBP). A random-effects model was used to analyze the impact of combined trials. Cochrane Risk of Bias Tool was applied to assess potential risks of bias. RESULTS: A total of 11 studies comprising 734 participants were eligible and included in the meta-analysis to estimate pooled effect size. Results of the meta-analysis did not indicate any significant effect of curcumin/turmeric on SBP (-0.69 mmHg; 95% CI: -2.01, 0.64; I2 = 18%) and DBP (0.28 mmHg; 95% CI: -1.12, 1.68; I2 = 53%). However, subgroup analysis revealed a significant reduction only in SBP levels (-1.24 mmHg; 95% CI: -2.26, -0.22; I2 = 0%) but not DBP (0.29 mmHg; 95% CI: -0.65, 1.22; I2 = 1%) in studies with ≥12-week supplementation. No favorable effect of curcumin administration on SBP or DBP levels was found after stratification according to either participant's condition or type of intervention (turmeric, crude curcumin and high-absorption curcumin). CONCLUSION: The present meta-analysis suggests that consuming curcumin/turmeric may improve SBP when administered in long durations. However, more studies are needed to confirm these results.

Clinical evidence on the effects of saffron (Crocus sativus L.) on cardiovascular risk factors: A systematic review meta-analysis.

Cardiovascular disease is a one of most common causes of mortality around the world. This meta-analysis aims to summarize and conclude the clinical evidence regarding the use of saffron and its constituents, in particular crocin, on cardiovascular risk factors. A systematic review was conducted with PubMed, Scopus, Web of Science, Cochrane library and Google Scholar up to 24 May 2018. Randomized controlled trials (RCTs) that assessed the clinical effects of saffron and/or its constituents on blood lipid profile, glycemic parameters, blood pressure and anthropometric indices in human subjects were included. Eleven publication from ten studies comprising 622 participants included in quantitative analysis. Pooling of results showed significant effect of saffron on diastolic blood pressure (-1.24 mmHg; 95% CI: -1.51 to -0.96; I2 = 0%), body weight (-1.29 kg; 95% CI: -2.14 to -0.44; I2 = 70%) and waist circumstance (-1.68 cm; 95% CI: -3.31 to -0.04; I2 = 51%). When subgroup analysis was performed based on quality of studies, a significant reduction in fasting plasma glucose levels was observed in subgroup with high quality studies (-10.14 mg/dl; 95% CI: -13.80 to -6.48; I2 = 0%). Meta-analysis did not reveal any significant change in lipid profile, fasting insulin, systolic blood pressure and body mass index following saffron consumption. Present meta-analysis suggests that saffron might be beneficial in several outcomes related with cardiovascular disease. However, further RCTs with long term intervention with different dose of administration are needed.

Dietary Patterns and Attention Deficit Hyperactivity Disorder Among Iranian Children: A Case-Control Study.

OBJECTIVE: Associations between nutritional/dietary factors and mental disorders have been suggested. This study was conducted to assess the relation of major dietary patterns determined by factor analysis with attention-deficit/hyperactivity disorder (ADHD) in a group of Iranian preschool- and school-aged children. METHODS: This case-control study was conducted with 500 preschool- and school-aged children (4-12 years old) matched by age and sex, in Isfahan, Iran. Dietary intake was identified by a 168-item questionnaire, and major dietary patterns were identified by factor analysis. The multivariable logistic regression is used for the association of dietary patterns with the diagnosis of ADHD. ADHD diagnosis was carried out with the criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. RESULTS: Two major dietary patterns were identified: healthy and Western. The healthy dietary pattern was rich in fruits, vegetables, vegetable oils, whole grains, legumes, and dairy products. The Western pattern was rich in processed meat, red meat, pizza, eggs, snacks, animal fat, hydrogenated fat, and salt. After controlling for potential confounders, children in the top quintile of the Western dietary pattern score had greater odds having ADHD, compared with those in the lowest quintile (odds ratio [OR] = 3.45; 95% confidence interval [CI], 1.17-18.3; ptrend = 0.03). The healthy pattern was inversely associated with ADHD (OR = 0.46; 95% CI, 0.38-0.91; ptrend = 0.01). CONCLUSIONS: A significant independent association was found between the Western dietary pattern and the odds of ADHD. The healthy dietary pattern was associated with lower odds of having ADHD. Prospective studies are needed to confirm these findings.

The efficacy of propolis on markers of glycemic control in adults with type 2 diabetes mellitus: A systematic review and meta-analysis.

BACKGROUND AND OBJECTIVES: The impetus for the current study was to evaluate the efficacy of propolis supplementation on markers of glycemic status in adults with type 2 diabetes mellitus (T2DM). METHODS: A comprehensive search was conducted in PubMed, Scopus, Cochrane Library, Web of Science, and Google Scholar up to August 2018, identifying randomized controlled trials investigating the effect of propolis supplementation on glycemic markers in adults with T2DM. Cochrane Collaboration tool was used to evaluate the risk of bias assessment. A random-effects model was applied in the meta-analysis to compensate for potential heterogeneity among the included studies. RESULTS: Six randomized controlled trials comprising 373 participants were included in the systematic review and meta-analysis. The results of the meta-analysis revealed significant reductions in fasting plasma glucose (-13.51 mg/dl; 95% CI [-24.98, -2.04]) and hemoglobin A1C (-0.52%; 95% CI [-0.94, -0.10]) concentrations following propolis supplementation. However, no significant lowering effect was observed in fasting insulin levels (-0.53 pmol/L; 95% CI [-1.69, 0.63]) or homeostasis model assessment of insulin resistance (-0.543; 95% CI [-1.72, 0.64]). CONCLUSION: This systematic review and meta-analysis suggested that propolis supplementation may be effective in controlling glycemic levels for T2DM patients. Further studies are needed to confirm these results.

The impact of pycnogenol supplementation on plasma lipids in humans: A systematic review and meta-analysis of clinical trials.

The effects of pycnogenol on plasma lipids are controversial. A systematic review and meta-analysis of clinical trials were conducted to obtain a conclusive result in humans. PubMed, Scopus, and Google Scholar were systematically searched until March 2018, to explore the clinical trials that examined the effect of pycnogenol supplementation on lipid parameters among adult human. Methodological quality of the eligible studies was evaluated using the Cochrane Collaboration's tool. To estimate the effect size, changes in blood lipids were implemented. Results were pooled using a random effects model. Potential sources of heterogeneity were explored by subgroup analysis. A systematic review and meta-analysis of 14 clinical trials with 1,065 participants suggested a significant increase in plasma concentration of high density lipoprotein cholesterol (HDL-C; 3.27 mg/dL; 95% CI [0.19, 6.36]; p = 0.038). In contrast, plasma levels of total cholesterol (TC; -4.45 mg/dL, 95% CI [-11.24, 2.34]; p = 0.199), triacylglycerol (TAG; -3.64 mg/dL; 95% CI [-17.89, 10.61]; p = 0.616), and low density lipoprotein cholesterol (LDL-C; -3.61 mg/dl; 95% CI [-8.76, 1.55]; p = 0.171) were not altered. Adjustment for confounding variables was poor in included studies. Also, these studies did not assess dietary lipid intake. The results indicate that pycnogenol supplementation improves levels of HDL-C; however, the changes in TC, TAG, and LDL-C were not clinically relevant. Since there are few phytochemicals that have a significant increasing effect on HDL-C levels, pycnogenol may have important role in prevention of cardiovascular diseases.

Effect of purslane on blood lipids and glucose: A systematic review and meta-analysis of randomized controlled trials.

Despite a history of purslane usage as a herbal treatment for dyslipidemia and hyperglycemia management, existing evidence from clinical trials is controversial. The aim for the current study was to evaluate the efficacy of purslane supplementation on lipid parameters and glycemic status in adult populations. A systematic review was conducted in PubMed, Scopus, ISI Web of Science, and Google Scholar up to January 15, 2018, searching for randomized controlled trials that assessed the impact of purslane on fasting blood glucose (FBG), triglycerides, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C). Based on the detected heterogeneity between studies, a random- or fixed-effect model was applied in the meta-analysis. The findings from six randomized controlled trials, comprising 352 participants, indicated that purslane can reduce FBG (-4.54 mg/dl, 95% CI [-7.54, -1.53]; I2  = 0.53%) and triglycerides (-19.16 mg/dl, 95% CI [-38.17, -0.15]; I2  = 0%) levels. Changes in TC, LDL-C, and HDL-C concentrations did not reach a statistically significant level. Subgroup analysis showed a favorable effects of purslane on FBG, triglycerides, TC, and LDL-C in a subset of studies in which purslane was administered >1.5 g/day. Categorization based on gender showed that purslane was more effective in improving FBG, TC and LDL-C in females compared with males. This systematic review and meta-analysis suggested that the purslane might be effective on the improvement of blood lipid and glucose levels. Further robust studies with sufficient durations and dosages of supplementation are needed to confirm these results.