The role of ultra-processed food consumption in protein-energy wasting and sarcopenia development in patients with chronic kidney diseases.

BACKGROUND: The effect of ultra-processed foods (UPFs) on chronic kidney disease (CKD) has been studied in some studies. The present study aimed to investigate the association between UPF consumption and the risk of protein-energy wasting (PEW) and sarcopenia in patients with CKD in the Iranian population. METHODS: The current cross-sectional study included 110 patients with CKD referred to two clinics in Shiraz, Iran. The International Society of Renal Nutrition and Metabolism (ISRNM) criteria and the Asian Working Group for Sarcopenia (AWGS) guideline were considered for the diagnosis of PEW and sarcopenia, respectively. The valid semi-quantitative food frequency questionnaire was used to assess participants' dietary intake. The logistic regression was used to examine the association of UPFs with PEW and sarcopenia. RESULTS: We observed no significant association between sarcopenia and PEW with UPFs in the crude model. After adjusting for confounders, we observed a significantly higher odds of sarcopenia in the upper versus lower median of UPF intake (odds ratio (OR) = 3.59, 95% confidence interval (CI): 1.02-12.62, P = 0.046). CONCLUSIONS: Our findings suggest a positive relationship between UPF intake and sarcopenia among CKD patients. Therefore, reducing the intake of UPFs may decrease the odds of sarcopenia in patients suffering from CKD.

Is variety more important than quantity of fruits and vegetables in relation to cardiovascular disease incidence and mortality? Results from a prospective cohort study.

We aimed to prospectively assess the association between variety and quantity of fruits and vegetables (FV) and cardiovascular diseases (CVD) incidence and mortality due to the limited evidence. Our analysis included 2,918 adults with a follow-up period of 29,559 person-years. An inverse association was detected between fruit intake and the risk of incidence and mortality from CVD. We found no association between diversity scores of fruits, vegetables, and FV with CVD risk. Subjects with high quantity-high variety, high quantity-low variety, and low quantity-high variety of fruits, vegetables, or FV exhibited no difference in CVD risk compared to the subjects with low quantity-low variety intake. Increasing the variety of FV was associated with increases in the intake of ß-carotene, lycopene, lutein, vitamin C, selenium, fibre, fat, and protein after adjustment for the quantity and covariates. We detected an inverse association between fruit intake and the incidence and mortality rates of CVD.

The effects of soymilk plus probiotics supplementation on cardiovascular risk factors in patients with type 2 diabetes mellitus: a randomized clinical trial.

OBJECTIVE: Type 2 diabetes mellitus (T2DM) is associated with an increased risk of cardiovascular diseases. This study aimed to assess the effects of soymilk plus probiotics co-administration on cardiovascular risk factors in T2DM patients. METHODS: One hundred patients with T2DM (aged 40-75 years old) were randomly assigned into 4 groups (soymilk + probiotics supplement, soymilk + placebo, conventional milk + placebo, and probiotics supplement) for 6 weeks. Standard protocols were followed for the collection of fasting blood samples, dietary intakes, and anthropometric measurements. RESULTS: It was shown that soymilk + probiotics consumption significantly decreased diastolic blood pressure (DBP) (p = 0.001), triglycerides (TG) (P < 0.001), total cholesterol (TC) (p < 0.01), and insulin (P < 0.003) levels and significantly increased high-density lipoprotein cholesterol (HDL-C) (P = 0.002) levels. Soymilk + placebo administration significantly decreased DBP (p = 0.01), insulin (p = 0.006), and TG (p = 0.001) levels and significantly increased HDL-C (p = 0.03) levels. A significant decrease in insulin (p = 0.003) and systolic blood pressure (SBP) (p = 0.01) levels and an increase in HDL-C (p = 0.04) levels were observed after supplementation with probiotics. Findings from between-group comparisons showed a significant decrease in SBP levels in the probiotics supplement group compared to conventional milk group (p < 0.05). CONCLUSION: Soymilk and probiotics consumption might improve some cardiovascular risk factors in patients with T2DM. However, possible synergic effects while consumption of soymilk plus probiotics supplement didn't show in this study which warranted further research.

Evaluating the effect of cow's milk fortified with albumin powder on malnutrition and anthropometric indices in primary-school children with mild-to-moderate underweight: A randomized double-blinded clinical trial.

Background: A proper diet plan is one of the necessary conditions for maintaining the children's health. The aim of this study was to evaluate the effect of consumption of pasteurized cow's milk fortified with albumin protein in primary-school children, in Yasuj, Iran. Materials and Methods: In this double-blind randomized clinical trial with 12 weeks of duration, 60 children aged 7-13 years, mild to moderate underweight (-1≥ weight-for-age z-score ≥-3), were randomly assigned to control and albumin groups. The albumin group and the control group received 200 cc of milk with 10 g of albumin powder and 200 cc of milk with 10 g of cornstarch powder, respectively. At the beginning and end of the study, food intake and anthropometric indices were measured. Results: After 12 weeks of intervention, none of the anthropometric indices (weight, weight-for-age z-score, body mass index (BMI), BMI-for-age z-score, and waist circumference) showed significant changes as compared to baseline in the control group, but weight-for-age z-score and BMI-for-age z-score showed significant increase as compared to baseline in the albumin group (before: -2.25 ± 0.40, after: -1.98 ± 0.35, P = 0.001 and before: -3.48 ± 0.86, after: -3.06 ± 0.71, P = 0.009, respectively). The comparison of the mean changes between the two groups showed significant difference regarding weight-for-age z-score (control group: -1.70 ± 0.31 in comparison with albumin group: -1.98 ± 0.35, P = 0.002), BMI (control group: 12.08 ± 1.96 in comparison with albumin group: 12.13 ± 1.49, P = 0.03), and BMI-for-age z-score (control group: -3.11 ± 0.91 in comparison with albumin group: -3.06 ± 0.71, P = 0.02). Conclusion: The consumption of albumin powder with milk can improve weight-for-age z-score and BMI-for-age z-score indices in children with mild-to-moderate underweight. Larger controlled interventional studies with longer duration are recommended.

Comparing the risk of cardiovascular diseases and all-cause mortality in four lifestyles with a combination of high/low physical activity and healthy/unhealthy diet: a prospective cohort study.

BACKGROUND: In this study, we assessed the risk of cardiovascular diseases (CVDs) and all-cause mortality in subjects having an only physical activity or a healthy diet or both compared to those having none of these healthy behaviors in the Golestan Cohort Study (GCS). METHODS: A total of 50,045 participants aged ≥ 40 years were recruited from Golestan Province, Iran, from 2004 to 2008 and followed for a median of 13.9 years. Four lifestyles were compared: healthy diet and active (HDA), healthy diet but inactive (HDI), unhealthy diet but active (UDA), and unhealthy diet and inactive (UDI), with UDI being considered as the reference group. Diet quality was assessed by the Dietary Approaches to Stop Hypertension diet score, which was calculated based on a validated food frequency questionnaire. The primary outcomes were death from any cause and CVDs. Adjusted Cox models were used to estimate the hazards ratio (HR) and 95% confidence intervals (CI) for overall and CVDs mortality. RESULTS: During 467,401 person-years of follow-up, 6,256 overall deaths and 2,043 confirmed CVDs deaths were reported. After adjustment for potential confounders, there was a significant lower risk for all-cause mortality in participants with both healthy behaviors (HR = 0.79, 95% CI = 0.73 to 0.86) or only one healthy behavior [HDI: HR = 0.84, 95% CI = 0.78 to 0.90)] and [UDI: HR = 0.91, 95% CI = 0.85 to 0.97] compared to those with both unhealthy behaviors. For CVDs mortality, the HDA lifestyle (HR = 0.74, 95%CI = 0.65 to 0.86), as well as the UDA lifestyle (HR = 0.83, 95%CI = 0.74 to 0.94) indicated a significant lower risk compared to the UDI lifestyle. The HDI lifestyle was not more effective than UDI. CONCLUSION: The greatest reduction in all-cause and CVDs mortality was related to the HDA. For all-cause mortality, both HDI and UDA lifestyles were associated with a decreased risk in comparison to UDI, but for CVDs mortality, only UDA but not HDI decreased the risk.

Effect of Artemisia extract on glycemic control: A systematic review and meta-analysis of randomized controlled trial.

BACKGROUND AND AIM: Animal and human studies have indicated anti-diabetic effect of Asteraceae. The present study aimed to systematically review and analyse randomized controlled trials assessing the effect of Artemisia extract on glycemic status in patients with impaired glycemic control. METHODS: Web of Science, Cochrane library, EMBASE and PubMed databases were searched from the earliest possible date up to 7th October 2020. RESULTS: Six studies were included in the meta-analysis. Analysis showed that supplementation with Artemisia extract decreased homeostatic model assessment of insulin resistance (HOMA-IR) (-0.734, 95% CI: -1.236 to -0.232, P = .019) in comparison to placebo. However, reductions in fasting blood glucose (FBG) (-0.595, 95% CI: -1.566 to 0.376, P = .164), insulin (-0.322, 95% CI: -1.047 to 0.404, P = .286) and glycated haemoglobin (-0.106, 95% CI: -0.840 to 0.629, P = .678) were not statistically significant. CONCLUSION: Supplementation with Artemisia extract may reduce HOMA-IR, but beneficial effects on other markers such as FBG requires further investigations.

Antihypertensive and antihyperlipemic of spirulina (Arthrospira platensis) sauce on patients with hypertension: A randomized triple-blind placebo-controlled clinical trial.

Systemic arterial hypertension is an independent risk factor for coronary heart disease, stroke, heart failure, and chronic kidney diseases. Spirulina is microalgae with nutritious ingredients and has potential attenuating effects on chronic diseases including hypertension. Spirulina can be added to food products in order to develop functional foods. The aim of this study was to assess the effects of 8-week consumption of a salad dressing containing 2 g of spirulina platensis powder versus a placebo dressing on patients with hypertension. In this triple-blind randomized clinical trial, 48 patients with hypertension were enrolled to receive daily either spirulina-fortified dressing or placebo for 2 months. A total of 41 patients completed this study. We observed that the consumption of spirulina dressing significantly reduced systolic blood pressure (p = .02), diastolic blood pressure (p = .03), serum triglyceride (p = .01), total cholesterol, and low-density lipoprotein (LDL) levels, compared to nonsignificant changes in the placebo group. Significant changes in TAC and hs-CRP levels were observed in none of the groups. According to our findings, spirulina-fortified dressing as a functional food can be used a supportive treatment for patients with hypertension along with standard antihypertensive drugs. However, further investigations are required for a more comprehensive conclusion.

Prudent and traditional dietary patterns are positively and negatively associated with bone mineral density in Iranian adults, respectively.

To assess the association of dietary patterns and bone mineral density (BMD), 340 healthy Iranian adults (mean age 41.5 ± 7.7 y; 79.1% female) participated in this cross-sectional study. Lumbar spine and femoral neck BMDs were measured using dual-energy X-ray absorptiometry. Dietary intakes were evaluated by a valid and reliable 168-item food frequency questionnaire, and three major dietary patterns were identified using principal component factor analysis. Mean values for lumbar spine and femoral neck BMDs in participants were 0.96 ± 0.13 and 0.92 ± 0.12 g/cm2, respectively. After controlling for age, body mass index, physical activity, energy intake, sunlight exposure, gender, education, employment status, supplement intake, and smoking in the analysis of covariance models, multivariable adjusted means of femoral neck BMD of participants in the highest tertile of the prudent pattern score (rich in green leafy vegetables, other vegetables, tomatoes, yellow vegetables, fruits and fruit juices, olives, nuts, fish, low-fat dairy products, and Doogh) were significantly higher than those in the lowest tertile (mean difference and 95% CI: 0.043 [0.003; 0.083] g/cm2, P = 0.032). In contrast, multivariable adjusted means of lumbar spine BMD of participants in the highest tertile of the traditional pattern score (high in Abgoosht, vegetable oils, salt, legumes, pickles, cruciferous vegetables, refined grains, potatoes, and organ meats) were significantly lower than those in the lowest tertile (mean difference and 95% CI: -0.057 [-0.098; -0.015] g/cm2, P = 0.003). The Western pattern was not associated with BMD. In conclusion, the prudent and traditional dietary patterns are positively and negatively associated with BMD in Iranian adults, respectively.

Adherence to the dietary approaches to stop hypertension (DASH) dietary pattern and mental health in Iranian university students.

PURPOSE: Examining the association between adherence to the dietary approaches to stop hypertension (DASH) dietary pattern and mental health in Iranian university students. METHODS: This cross-sectional study was conducted among 240 university students (mean age 21.5 years; 86.7% female). Mental health was evaluated using validated Persian versions of the 12-item general health questionnaire (GHQ-12) and the 21-item depression, anxiety, and stress scale (DASS-21). The lower the subjects' scores on these questionnaires, the better their mental health. Usual past-year dietary intakes were assessed by a validated 168-item semi-quantitative food frequency questionnaire. The DASH score was computed based on energy-adjusted intakes of eight major dietary components emphasized or minimized in the DASH pattern. The higher the DASH score of a subject, the greater his/her adherence to the DASH pattern. RESULTS: The Pearson's correlation coefficients of DASH score with GHQ-12 total score, DASS-21 total score, and DASS-21 depression, anxiety, and stress subscale scores were - 0.431, - 0.441, - 0.434, - 0.325, and - 0.408, respectively (all P < 0.001). Compared to those in the lowest tertile, subjects in the highest tertile of DASH score had lower means of GHQ-12 total score (mean difference - 4.6; P < 0.001), DASS-21 total score (mean difference - 9.1; P < 0.001), and DASS-21 depression, anxiety, and stress subscale scores (mean differences for depression, anxiety, and stress - 3.6, - 2.4, and - 3.2, respectively; all P < 0.001). CONCLUSIONS: The findings indicate that greater adherence to the DASH dietary pattern is associated with better mental health in Iranian university students. However, prospective studies of sufficient methodological quality are needed to confirm these findings.

Daily dietary intakes of zinc, copper, lead, and cadmium as determined by duplicate portion sampling combined with either instrumental analysis or the use of food composition tables, Shiraz, Iran.

Estimation of essential and toxic element intakes is crucial to evaluate the risks of deficiency or toxicity. The purpose of this study was to investigate and also to compare the dietary intakes of zinc (Zn) and copper (Cu) by adults living in Shiraz, Iran, determined by two procedures: duplicate portion sampling of 21 hospital meals combined with either instrumental analysis (voltammetric measurement) or the use of food composition tables (FCTs). The level of exposure to lead (Pb) and cadmium (Cd) was evaluated as well. The daily Zn intakes of both methods were not significantly different and were higher than the RDA values except the value measured by the instrumental analysis which was lower than the RDA established for a male adult. Daily intake of Cu determined by instrumental analysis was significantly lower and closer to RDA for adults compared with the value estimated by FCTs. The dietary intakes of Pb and Cd were 313 and 61% of the respective provisional tolerable weekly intakes (PTWIs), respectively. The accuracy of two methods used for estimation of Zn intake was similar. In the case of Cu, the use of FCTs, in which the influence of environmental conditions and dietary habits of meal preparation is not taken into account, overestimated dietary intake. The risk of zinc deficiency was found in adult males. Moreover, the estimated intake of Pb, but not Cd, could be a cause of concern for Shiraz population. Thus, conducting regular periodic studies to assess the dietary intake of mentioned elements are recommended.

The effect of probiotic-fortified kefir on cardiovascular risk factors in elderly population: a double-blind, randomized, placebo-controlled clinical trial.

INTRODUCTION: The outbreak of cardiovascular disease (CVD) augments with age. Gut dysbiosis can worsen or initiate systemic disorders such as metabolic diseases and CVDs. Therefore, this research aimed to assess the effect of kefir fortified with Lactobacillus helveticus R0052 and Bifidobacterium longum R017 on CVD risk factors in the elderly population. The subjects of this study were selected from the Motahari Clinic in Shiraz, Iran. METHOD: This study was a double-blind, randomized, and controlled clinical trial that was conducted on 67 elderly people who were randomly divided into two groups: the fortified kefir group (n = 32), which received one bottle of fortified kefir (240 cc), and the placebo group (n = 35), which received one bottle of regular kefir for eight weeks. To analyze the data, SPSS software was applied. RESULTS: After eight weeks, significant differences were seen in atherogenic and Castell's risk index I between the fortified and regular groups (p = 0.048 and p = 0.048, respectively). No significant differences were found in Castelli's risk index II, high-density lipoprotein cholesterol (HDL-C), total cholesterol, triglycerides (TG), non-HDL-C, TG-cholesterol index, and fasting blood sugar by comparing the two groups. CONCLUSION: Our investigation demonstrated that fortified kefir with probiotics did not significantly affect lipid profiles. Still, it could significantly affect some indices, including Castelli's risk index I and atherogenic index. More studies are required to confirm the findings and mechanisms of probiotics' effect on CVD risk factors. TRIAL NUMBER: The present registered at the Iranian Registry of Clinical Trials (IRCT20130227012628N3) at 2023-02-21.

Dietary inflammatory index could increase the risk of sarcopenia in patients with chronic kidney disease.

Using a system that incorporates a variety of food items rather than focusing on individual components can aid in assessing the inflammatory effects of a diet on disease outcomes such as chronic kidney disease (CKD). Therefore, we decided to investigate the association between dietary inflammatory index (DII) and the risk of protein-energy wasting (PEW) and sarcopenia in patients with CKD. In this cross-sectional study, 109 patients with CKD were selected from two clinics in Shiraz, Iran. The intake of individuals' diets was recorded using a validated 168-item food frequency questionnaire. Additionally, Asian Working Group for Sarcopenia (AWGS) guidelines were utilized to evaluate muscles' strength, mass, and function. Also, four International Society of Renal Nutrition and Metabolism (ISRNM) criteria (body mass index, intake of protein, albumin, and urine creatinine) were used  to diagnose PEW. Logistic regression was used to assess the association between DII and sarcopenia as well as PEW. The results showed that the intake of saturated fatty acids, trans fatty acids, niacin, beta-carotene, and vitamin C was significantly different between lower and higher DII groups. In the univariate model, higher odds of sarcopenia was observed by each unit increase in DII (odds ratio (OR) = 1.379, 95% confidence interval (CI): 1.042-1.824) and age (OR = 1.073, 95% CI: 1.017-1.132). Additionally, in the multivariate model, the association between DII and age with odds of sarcopenia remained significant (DII: OR = 1.379, 95% CI: 1.030-1.846 and age: OR = 1.063, 95% CI: 1.007-1.121). The current study suggests the possible role of pro-inflammatory foods in worsening muscle health, specifically sarcopenia, in CKD patients. Future longitudinal studies may reveal the causative nature of these correlations.

Curcumin effects on glycaemic indices, lipid profile, blood pressure, inflammatory markers and anthropometric measurements of non-alcoholic fatty liver disease patients: A systematic review and meta-analysis of randomized clinical trials.

OBJECTIVES: Curcumin has antioxidant properties and has been proposed as a potential treatment for NAFLD. The aim of current systematic review and meta-analysis was to evaluate previous findings for the effect of curcumin supplementation on glycaemic indices, lipid profile, blood pressure, inflammatory markers, and anthropometric measurements of NAFLD patients. METHODS: Relevant studies published up to January 2024 were searched systematically using the following databases: PubMed, SCOPUS, WOS, Science Direct, Ovid and Cochrane. The systematic review and meta-analysis were conducted according to the 2020 PRISMA guidelines. The quality of the papers was assessed the using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist. Pooled effect sizes were calculated using a random-effects model and reported as the WMD and 95% CI. Also, subgroup analyses were done to find probable sources of heterogeneity among studies. RESULTS: Out of 21010 records initially identified, 21 eligible RCTs were selected for inclusion in a meta-analysis. Overall, 1191 participants of both genders, 600 in the intervention and 591 in the control group with NAFLD were included. There are several limitations in the studies that were included, for instance, the results are weakened substantially by potential bias or failure to account for potential adulteration (with pharmaceuticals) or contamination (with other herbs) of the curcumin supplements that were tested. However, previous studies have reported curcumin to be a safe complementary therapy for several conditions. Our study indicated that curcumin supplementation in doses of 50-3000 mg/day was associated with significant change in FBG [WMD: -2.83; 95% CI: -4.61, -1.06), I2 = 51.3%], HOMA-IR [WMD: -0.52; 95% CI: -0.84, -0.20), I2= 82.8%], TG [WMD: -10.31; 95% CI: -20.00, -0.61), I2 = 84.5%], TC [WMD: -11.81; 95% CI: -19.65, -3.96), I2 = 94.6%], LDL [WMD: -8.01; 95% CI: -15.79, -0.24), I2 = 96.1%], weight [WMD: -0.81; 95% CI: -1.28, -0.35), I2= 0.0%] and BMI [WMD: -0.35; 95% CI: -0.57, -0.13), I2= 0.0%] in adults with NAFLD. There was no significant change in HbA1C, plasma insulin, QUICKI, HDL, SBP, DBP, CRP, TNF-α and WC after curcumin therapy. Subgroup analysis suggested a significant changes in serum FBG, TG, SBP, WC in RCTs for intervention durations of ≥ 8 weeks, and SBP, TG, LDL, HDL, BMI, WC in RCTs with sample size > 55 participants. CONCLUSION: Curcumin supplementation in doses of 50-3000 mg/day over 8-12 weeks was associated with significant reductions in levels of FBG, HOMA-IR, TG, TC, LDL, weight and BMI in patients with NAFLD. Previous studies have reported curcumin as a safe complementary therapy for several diseases. We would suggest that should curcumin supplements be used clinically in specific conditions, it should be used with caution. Also, difference in grades of NAFLD may effect the evaluated outcomes, so it is suggested that future studies be conducted with an analyses on subgroups according to their NAFLD grade. Furthermore, because of the failure to conduct independent biochemical assessment of the turmeric/curcumin product used in most studies as well as potential sources of bias, results should be interpreted with caution.

Plant-based diets could ameliorate the risk factors of cardiovascular diseases in adults with chronic diseases.

Adherence to plant-based diets is recommended to prevent and control chronic diseases. However, not all plant-based foods are healthy for this purpose. This study investigated the relationship between plant-based diets and risk factors for cardiovascular diseases (CVDs) in adults with chronic diseases. This cross-sectional study was performed on 3678 males and females (age range: 40-70 years) with chronic diseases who participated in the Kharameh cohort study. A validated semiquantitative food-frequency questionnaire was used to calculate the plant-based diet index (PDI), healthy plant-based diet index (hPDI), and unhealthy plant-based diet index (uPDI). Lipid profile, fasting blood sugar (FBS), blood pressure, and anthropometric indices were measured. Multivariable-adjusted logistic regression analysis was performed to determine the association between plant-based diets and CVDs risk factors. Higher adherence to the PDI was inversely associated with the level of FBS (odds ratio [OR] = 0.42; 95% confidence interval [CI]: 0.33-0.53; p < .001). A significant decrease was observed for total cholesterol in those with higher adherence to hPDI (OR = 0.80; 95% CI: 0.65-0.98; p = .035). Additionally, the score of uPDI was positively related to FBS (OR = 1.23; 95% CI: 1.00-1.53; p = .01), total cholesterol (OR = 1.23; 95% CI: 1.01-1.49; p = .061), and low-density lipoprotein (OR = 1.39; 95% CI: 1.13-1.71; p = .009). It was concluded that adherence to PDI and hPDI was related to a lower level of FBS and total cholesterol, respectively. Moreover, the findings suggested that regular intake of the uPDI was correlated with some risk factors for CVDs in adults with chronic diseases.

Acute or Short-term Effects of Whey Protein Alone or Along with Carbohydrate on Inflammation: A Systematic Review of Clinical Trials:.

BACKGROUND: Excessive inflammatory response is associated with several diseases. Recently, there has been an increasing trend for investigation of the acute or short-term effects of whey protein alone or in combination with carbohydrates on inflammatory status, especially in athletes. This systematic review aimed to clarify these effects. MATERIALS AND METHODS: PubMed, Scopus, and Web of Science databases were searched from January 1990 to September 2021, without language restriction. Adult studies examining the effects of whey protein alone or together with carbohydrates on interleukin-6, tumor necrosis factor-α, and C-reactive protein levels with a maximum duration of 15 days and with at least one comparison group were included. The quality of studies was analyzed using the Cochrane risk of bias tool. RESULTS: Twenty-five studies met the inclusion criteria. Significant reductions in inflammatory markers was observed in seven out of 25 studies (28%). However, one out of 25 studies (4%) reported a significant increase in inflammatory status. Among those studies comparing the effects of whey protein alone with non-protein or protein-containing groups, 18.18% (two out of 11) and 10% (one out of ten) of the trials revealed a significant decrease in the markers, respectively. Moreover, of those studies comparing whey protein plus carbohydrate with non-protein or protein-containing groups, 33.33% (two out of six) and 40% (two out of five) of them showed a significant reduction in the inflammatory response, respectively. The quality of the majority of studies (84%) was poor. CONCLUSION: It seems that whey protein alone or the combination of it with carbohydrates may not affect the inflammatory markers in the short run (PROSPERO registration number: CRD42021273915).[GMJ.2023;12:e2441].

The effect of acorn muffin consumption on glycemic indices and lipid profile in type 2 diabetic patients: A randomized double-blind placebo-controlled clinical trial.

Acorn is a nutritious fruit with the reported potential of ameliorating diseases, including diabetes. This research aimed to assess the effects of acorn muffin consumption on glycemic, lipid indices, and appetite in patients with type 2 diabetes. Sixty-six subjects were dichotomized to receive either one muffin containing 10 grams of acorn flour or a placebo muffin containing white wheat flour (no bran), per day, for 8 weeks. Acorn muffin consumption improved glycated hemoglobin (p = .06, mean difference [MD] = -0.65), triglyceride (p = .06, MD = -36.38), and high-density lipoprotein (p = .05, MD = 1.30), albeit only marginally significantly. Among appetite parameters, hunger, desire to eat, and prospective to eat were significantly lower, and satiety and fullness were significantly higher, in the acorn muffin group. In conclusion, acorn muffins could be utilized as an adjuvant therapy to control appetite and ameliorate glycated hemoglobin in patients with type 2 diabetes. However, further investigations are required for a more comprehensive conclusion.

A healthy diet, physical activity, or either in relation to cardiovascular and all-cause mortality: A prospective cohort study.

OBJECTIVES: The aim of our study was to compare four lifestyles-healthy diet and low activity, unhealthy diet and high activity, unhealthy diet and low activity, and healthy diet and high activity-in relation to the risk of cardiovascular disease (CVD) and all-cause mortality. METHODS: A total of 6504 adults ages ≥35 y were recruited to participate in the Isfahan Cohort Study and followed for 13 y. Diet was assessed using a validated 48-item food frequency questionnaire, and the quality of diet was assessed using the Dietary Quality Index. Physical activity (PA) was evaluated using the International Physical Activity Questionnaire. The primary outcomes were CVD and all-cause mortality. Cox proportional hazards regression was used to calculate the hazard ratio (HR) and the 95% CIs. RESULTS: During 771 440 person-years of follow-up, 390 and 147 deaths occurred due to all causes and CVD, respectively. High PA, either with a healthy or unhealthy diet, was associated with a lower risk of death from CVD (HR = 0.43; 95% CI, 0.26-0.69, and HR = 0.32; 95% CI, 0.18-0.56, respectively) and also all-cause mortality(HR = 0.53, 95% CI, 0.39-0.71, and HR = 0.5, 95% CI, 0.36-0.68). Moreover, type of PA was important, such that when leisure time PA was considered, none of the lifestyles was associated with a lower risk of CVD and all-cause mortality. However, for occupational PA, the result was the same as the total PA. CONCLUSIONS: Having high PA (total or occupational), with or without adhering to a healthy diet, is associated with a lower risk of death from any cause and CVD; although leisure time PA, irrespective of adhering to a healthy diet, was not associated with a lower risk of all-cause and CVD mortality.

The effect of spirulina sauce on glycemic index, lipid profile, and oxidative stress in type 2 diabetic patients: A randomized double-blind clinical trial.

We aimed to evaluate the effect of spirulina sauce on glycemic indices, lipid profile, oxidative stress markers, and anthropometric measurement in type 2 diabetic patients. Forty patients were randomly assigned to receive 20 g/day spirulina sauce (containing 2 g of spirulina) or placebo for 2 months. Anthropometric and biochemical indices were measured at the beginning and end of the intervention. Fasting blood glucose (mean difference (MD): -15.3 mg/dL, 95% confidence (CI): -44.2 to 13.60, p = .26), HbA1c (MD: 0.13%, 95% CI: -0.83 to 0.57, p = .75), insulin (MD: -1.46 µIU/mL, 95% CI: -4.0 to 1.09, p = .28), and HOMA-IR (MD: -0.35, 95% CI: -2.0 to 1.32, p = .68) did not change significantly between groups. QUICKI increased significantly (MD: 0.025, 95% CI: 0.006 to 0.045, p = .03). Among the lipid profile, triglyceride (TG) (MD: -68.6 mg/dL, 95% CI: -107.21 to -29.98, p < .001), total cholesterol (MD: -29.55 mg/dL, 95% CI: -55.28 to -3.81, p = .02), and LDL (MD: -17.7 mg/dL, 95% CI: -33.24 to -2.15, p = .01) were significantly decreased in the spirulina group compared to the control; whereas, the change in HDL was non-significant. No significant change was observed in body composition and anthropometric measurements, except waist circumference, which was reduced (MD: -2.65 cm, 95% CI: -3.91 to -1.38, p = .001). Hunger index significantly decreased and fullness increased marginally significantly. Although malondialdehyde was significantly reduced, no change was observed in total antioxidant capacity (TAC). Spirulina sauce was not effective for glycemic control in type 2 diabetes; however, could be useful for controlling appetite and ameliorating lipid profile.

The effect of pro-/synbiotic supplementation on the brain-derived neurotrophic factor: a systematic review and meta-analysis of randomized controlled trials.

There is growing interest in supplementation with pro-/synbiotics for brain and mental health. Animal studies have reported that pro-/synbiotic administration can increase the brain-derived neurotrophic factor (BDNF), a key regulator of neuronal function. Nevertheless, the results obtained from human studies are inconsistent and conflicting. Therefore, we aimed to conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) to investigate the impact of pro-/synbiotic supplementation on BDNF levels. Scopus, Medline, Web of Science, Cochrane Library, and Google Scholar were searched up to July 10, 2022 to find eligible RCTs. The weighted mean difference (WMD) and 95% confidence interval (CI) were computed for BDNF using a random-effects model. In the present study, 10 RCTs with 12 treatment arms consisting of 652 participants were included. The meta-analysis revealed that supplementation with pro-/synbiotics significantly increased BDNF concentrations in comparison with the placebo (WMD: 0.20 ng mL-1, 95% CI: 0.06 to 0.34, I2 = 86.6%). Moreover, subgroup analysis showed that the target population, ethnicity and the mean age of participants, the number and type of probiotic strains, administration form, and the dose and duration of pro-/synbiotic supplementation were the potential sources of heterogeneity between RCTs. In conclusion, pro-/synbiotic administration can be considered as a BDNF enhancer and a possible brain booster.