The effect of whole grape products on blood pressure and vascular function: A systematic review and meta-analysis of randomized controlled trials.

BACKGROUND AND AIMS: Grape consumption-associated improvements in cardiovascular health have received significant attention over the last few years; however, major gaps have remained in the meta-evidence related to this topic. This systematic review and meta-analysis of randomized controlled trials (RCTs) was performed to explore the effect of whole grapes and its products on blood pressure, endothelial function, heart rate, and pulse rate. METHODS AND RESULTS: Four database (PubMed, Scopus, Web of Sciences, and the Cochrane Library) were searched until the 14th of January 2022. The pooled effect size of interested outcomes was calculated using the random-effects model. Thirty eligible RCTs were identified. Pooled results indicated that compared to the control group, consumption of grape products significantly decreased systolic blood pressure (SBP) (WMD = -3.17 mmHg; 95% CI: -5.36, -0.99 mmHg; P = 0.004; I2 = 64%; P-heterogeneity<0.001); while, vascular cell adhesion molecule-1 (VCAM-1) increased (WMD = 34.11 ng/ml; 95% CI: 0.98, 67.25 ng/ml; P = 0.04; I2 = 2%; P-heterogeneity = 0.4). Although, the certainty of evidence was low and very low, respectively. No significant effect was observed on diastolic blood pressure, endothelial function, heart rate, pulse rate, and soluble intercellular adhesion molecule-1 (sICAM-1). In a subgroup analysis, consumption of whole grape products (raisin and grape powder) induced a significant decrease in SBP (WMD = -2.69 mmHg; 95% CI: -4.81, -0.57; P = 0.01; I2 = 18.1%; P-heterogeneity < 0.001), while grape juice did not. CONCLUSION: The low certainty of evidence from RCTs revealed that consumption of grape products, especially in whole forms, resulted in a small reduction of SBP but did not influence other markers of cardiovascular health. PROSPERO REGISTRATION CODE: CRD42022379231.

The effects of sesame, canola, and sesame-canola oils on cardiometabolic markers in patients with type 2 diabetes: a triple-blind three-way randomized crossover clinical trial.

AIMS: To compare the effects of replacing regular dietary oils intake with sesame (SO), canola (CO), and sesame-canola (SCO) oils (a novel blend), on cardiometabolic markers in adults with type 2 diabetes mellitus (T2DM), in a triple-blind, three-way, randomized, crossover clinical trial. METHODS: Participants were assigned to receive SO, CO, and SCO in three 9-week phases (4 weeks apart). Cardiometabolic makers (serum lipids, Apolipoprotein, cardiovascular risk scores, kidney markers, and blood pressure) were considered at the beginning and the end of intervention phases. RESULTS: Ninety-two, ninety-five, and ninety-five participants completed the SO, SCO, and CO periods, respectively. After CO consumption, serum Apo A-1 concentrations were significantly higher compared with the SCO period in the whole population (p < 0.05). A considerable reduction in visceral adiposity index values was seen in the CO compared with the SO period in males (p < 0.05). Serum high-density lipoprotein concentration was also significantly higher after the SO intake compared with SCO in females (p < 0.05). The between-period analysis showed a substantial reduction in diastolic blood pressure in the SCO period compared with the CO and SO periods and lower systolic blood pressure after SCO versus CO intake in males (p < 0.05). CONCLUSIONS: Canola oil might protect CVD through improving Apo A-1 levels in patients with T2DM (particularly in females) and visceral adiposity index in male patients. However, the blend oil might beneficially affect blood pressure in men. Future sex-specific studies might warrant the current findings. REGISTRY OF CLINICAL TRIALS: This trial was registered in the Iranian Registry of Clinical Trials (IRCT, registration ID: IRCT2016091312571N6).

The effect of sesame, canola, and sesame-canola oils on cardiometabolic risk factors in overweight adults: a three-way randomized triple-blind crossover clinical trial.

Limited data exist on the cardiometabolic effects of sesame oil compared with canola oil. In the present study, 77 overweight adults were randomized to replace their regularly consumed oils with canola (CO), sesame (SO), and sesame-canola oils (SCO, 40% SO, and 60% CO) in three 9-week phases. Blood pressure, visceral adiposity index, serum apo-proteins (APOs) and lipid profile, glycemic control markers, kidney markers, liver enzymes, and cardiovascular disease risk scores were assessed at baseline and endline. After adjustment for confounders, SO significantly reduced serum alkaline aminotransferase (ALT) compared to CO (p ≤ 0.05) in all participants, increased serum urea compared to SCO in males, and decreased serum alkaline phosphatase compared to other oils in males, and improved serum high-density lipoprotein cholesterol (HDL-C) and triglycerides (TG) compared to SCO, and eGFR compared with CO in females (p ≤ 0.05). Canola oil significantly improved serum Apo A1 and APO B/A ratio compared with SO, in males (p ≤ 0.05). Sesame-canola oil significantly reduced serum urea compared to other oils in all participants (p ≤ 0.05). Sesame oil and SCO might beneficially affect serum ALT and urea, respectively. Intervention oils might have different cardiometabolic effects in each gender. Further studies are needed to confirm our results (Trial registration code: IRCT2016091312571N6).

Canola oil compared with sesame and sesame-canola oil on glycaemic control and liver function in patients with type 2 diabetes: A three-way randomized triple-blind cross-over trial.

BACKGROUND: This study aimed to compare the effects of sesame (SO), canola (CO), and sesame-canola (SCO: a blend) oils on glycaemic control markers and liver function enzymes in adults with type 2 diabetes. METHODS: In this randomized, triple-blind, three-way, cross-over clinical trial, participants replaced their usual oil with the intervention oils for 9 weeks. Serum fasting blood sugar, fasting serum insulin (FSI), insulin resistance (HOMA2-IR), beta-cell function (HOMA2-%B), insulin sensitivity (HOMA2-%S), quantitative insulin sensitivity check index (QUICKI), as well as serum liver function enzymes were measured at baseline and end of intervention periods. RESULTS: Ninety-two participants completed all treatment periods. After adjusting for confounders, all treatment oils resulted in significant improvements in FSI and HOMA2-%S (p < 0.05). SO and SCO led to favourable changes in HOMA2-IR and QUICKI (p < 0.05). Following CO and SCO, there was a significant decrease in HOMA2-%B (p < 0.05). The sex-stratified analysis revealed that FSI and HOMA2-IR were decreased after SO compared to CO in males (p = 0.024). Serum gamma-glutamyltransferase (GGT) was significantly lower following SO compared to CO in females (p = 0.02), however, the difference in change values was not significant (p = 0.058). CONCLUSIONS: SO consumption appears to improve glycaemic control markers in males and serum GGT in females compared with CO in patients with type 2 diabetes (registration code: IRCT2016091312571N6).

The effect of dietary approaches to stop hypertension (DASH) diet on attention-deficit hyperactivity disorder (ADHD) symptoms: a randomized controlled clinical trial.

BACKGROUND: The dietary approaches to stop hypertension (DASH) diet have several components like high amounts of fruits, vegetables, low-fat dairy products, and vitamin C and low amounts of simple sugars that might improve attention-deficit hyperactivity disorder (ADHD) symptoms. We aimed to investigate the effect of a DASH diet on children (aged 6-12 years) with ADHD, for the first time. METHODS: Participants were randomized to receive a DASH or a control diet for 12 weeks. The severity of ADHD symptoms [determined by abbreviated 10-item Conner's scale (ACS), 18-item Swanson, Nolan and Pelham (SNAP-IV) scale and strengths and difficulties questionnaire (SDQ)] were assessed every four weeks. RESULTS: Eighty children completed the study. After adjustment for confounders, parent (- 4.71 for the DASH group vs. - 3 for the control group) and teacher-reported (- 5.35 vs. - 1.87) ACS scores, parent-, teacher-, child-reported hyperactivity (- 1.40 vs. - 0.66, - 1.95 vs. -0.63, - 1.60 vs. - 0.43, respectively), emotional symptoms (- 1.50 vs. - 0.45, - 1.42 vs. - 0.63, and - 1.09 vs. - 0.61, respectively), and total SDQ scores (- 3.81 vs. - 1.65, - 4.11 vs. - 1.23, - 4.44 vs. - 1.26, respectively), teacher-reported of conduct problems (- 1.42 vs. - 0.63), peer relationship problems (- 0.87 vs. - 0.07), and prosocial behaviors (1.36 vs. 0.08) assessed by the SDQ were significantly improved in the DASH group compared with the control group (P < 0.05). CONCLUSION: Adherence to a DASH-style diet might improve ADHD symptoms. Further RCTs which include participants from both sexes and with longer follow-up periods are needed to warrant current findings (The trial registration code: IRCT20130223012571N6; http://irct.ir/trial/12623 ). Trial registration Trial registration number: The trial was registered in the Iranian registry of clinical trials (registration code: IRCT20130223012571N6), URL: http://irct.ir/trial/12623 .

The effect of canola, sesame and sesame-canola oils on body fat and composition in adults: a triple-blind, three-way randomised cross-over clinical trial.

The present study aimed to examine the effect of replacing edible oils with sesame oil (SO), canola oil (CO) and sesame-canola oil (SCO) on body weight and composition in adults. Adults without any chronic diseases (n = 77) were entered a 4-week run-in period and then were randomised to receive SO, CO and SCO for their household use in 9-week intervention periods (separated by 4-week washout intervals). Anthropometric measurements, as well as body composition markers, were assessed at baseline, middle and after each intervention period. In total, 73 participants completed the study. Although significant time effects were seen for waist and hip circumference, waist-to-hip ratio, central obesity index, body adiposity index, muscle mass and body fat percent (ptime<.05), the treatment and treatment × time effects were not significant (p>.05). The present clinical trial revealed that CO, SO and SCO might not differently affect body fat and composition. Trial registration code: IRCT2016091312571N6 (http://en.irct.ir/trial/12622).

Effects of sesame, canola and sesame-canola oils on body weight and composition in adults with type 2 diabetes mellitus: a randomized, triple-blind, cross-over clinical trial.

BACKGROUND: Recent investigations have proposed that sesame and canola oils might affect body fat distribution. The present study aimed to examine the effects of sesame, canola and sesame-canola (a blend of sesame and canola oils) oils on body weight and composition in adults with type 2 diabetes mellitus in the context of a randomized, triple-blind, three-way, cross-over clinical trial. RESULTS: Eligible participants were randomized to replace their regular dietary oil with sesame oil (SO), canola oil (CO) and sesame-canola oil (SCO) (with 40% SO and 60% CO). Treatment periods lasted 9 weeks and were separated by 4-week wash-out periods. Body weight and composition were measured at the beginning, in the middle and at the end of each intervention phase. In total, 93 participants completed the study. After adjustment for confounders, within-period changes were observed following SO and CO intake for body weight (0.34 ± 0.16 kg and 0.33 ± 0.17 kg) and visceral fat (0.13 ± 0.06% and 0.13 ± 0.05%, P < 0.05), respectively. Body mass index was increased within SO intake (0.13 ± 0.05 kg m-2 , P = 0.031). All of the treatment oils resulted in reduced waist circumference and index of central obesity (P < 0.05). A significant difference in change values was observed for visceral fat between SCO (-0.14 ± 0.07%) and SO (0.12 ± 0.08%) treatment periods in females (P = 0.02). CONCLUSION: Sesame and canola oils might lead to a modest favorable body fat redistribution by reducing central adiposity, particularly in females; however, the changes were of little clinical importance. © 2021 Society of Chemical Industry.

Validity and Reproducibility of a Semiquantitative Multiple-Choice Food Frequency Questionnaire in Iranian Adults.

Previous multiple-choice food-based food frequency questionnaires (FFQs) were not validated against weighed dietary records (WDRs) in Iran. This study investigated the validity and reproducibility of a multiple-choice semi-quantitative food frequency questionnaire (SQ-FFQ) in adults living in central Iran. Patients with diabetes and their spouses were asked to complete 3 SQ-FFQs by interview, and nine 3-day WDRs, over 9 months. They provided 2 blood samples to assess serum calcium, magnesium, zinc, and vitamin C levels. The Pearson and intraclass correlation coefficients were calculated to assess reproducibility and validity. The degree of misclassification was explored using a contingency table of quartiles which compare the information between third FFQ and WDRs. The method of triads was incorporated to assess validity coefficients between estimated intakes using third FFQ, WDRs, and biochemical markers and assumed true intakes. A total of 180 participants aged 48.9 ± 8.4 years completed the study. Compared to WDRs, FFQs overestimated all nutrient intakes except for iron. The median intraclass correlation between FFQs was 0.56. The median de-attenuated, age, sex, and education adjusted partial correlation coefficients for validity were 0.17 and 0.26 for FFQ1-WDRs and FFQ3-WDRs, respectively. The FFQ3 validity coefficients for vitamin C, calcium, magnesium, and zinc were 0.13, 0.62, 0.89, and 0.66, respectively, using the triads method. The median exact agreement and complete disagreement between FFQ3 and WDRs were 33% and 6%, respectively. The SQ-FFQ seems to be an acceptable tool to assess the long-term dietary intake for future large-scale studies in this population.

The combined effects of cholesteryl ester transfer protein (CETP) TaqIB gene polymorphism and canola, sesame and sesame-canola oils consumption on metabolic response in patients with diabetes and healthy people.

Introduction: Cholesteryl ester transfer protein (CETP) is a key regulating enzyme in the lipid metabolism pathway, and its gene polymorphism may be a candidate for modulating the metabolic responses to dietary intervention. We thus examined whether the effects of the CETP TaqIB polymorphism on metabolic profiles were modified by dietary plant oils. Methods: This is a retrospective analysis of data collected during a randomized triple-blind cross over trial. A total of 95 patients with type 2 diabetes and 73 non-diabetes individuals completed a 9-weekof the intake of sesame, canola and sesame-canola oils. Blood samples were collected at the beginning and at the end of each intervention period for biochemical analysis. Genotyping was done using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Results: In diabetes patients, B1B1 homozygotes of the CETP TaqIB polymorphism compared with B2 carriers (B1B2 + B2B2) had significantly lower diastolic blood pressure, apoB and apoB: apoA-1,and higher Lp(a) after the intake of sesame-canola oil, as well as lower insulin and HOMA-IR after the intake of sesame oil. There was also a significant effect of genotype on adjusted changes of apoB, apoB: apoA-1, insulin, HOMA-IR and QUICKI. A significant genotype-dietary oils combined effects were observed for diastolic blood pressure, and LDL: HDL, TC: HDL and TG: HDL ratios in diabetes patients. No independent or combined effects of dietary oils and genotypes on outcomes were found in healthy people. Conclusion: There was a modulatory effect of the CETP TaqIB polymorphism on some metabolic traits in response to plant oils in patients with diabetes. Taken together, the intake of sesame-canola and canola oils showed more favorable effects in diabetes patients with B1B1 genotype. Future investigations are needed to confirm these results.

Association of rs670 variant of APOA-1 gene with cardiometabolic markers after consuming sesame, canola and sesame-canola oils in adults with and without type 2 diabetes mellitus.

BACKGROUND & AIMS: The inter-individual variations of the metabolic markers in response to dietary interventions may be mediated by genetic factors. We examined whether the type of dietary oils can modulate the effects of -75G/A polymorphism in APOA-1 gene on cardiometabolic markers. METHODS: This study was a randomized, triple-blind, cross-over clinical trial. Participants with and without type 2 diabetes were randomly assigned to replace their regular oil with sesame oil, canola oil and sesame-canola oil for 9 weeks. Genotyping was conducted using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. RESULTS: Ninety-five diabetes patients and 73 healthy individuals completed the study protocol. In patients with type 2 diabetes, the A allele carriers experienced greater decrease in systolic blood pressure compared with GG homozygotes following sesame-canola oil intake. Serum levels of HDL-C and TG: HDL ratio was increased and decreased following canola oil intake in patients carrying the A allele rather than non-A allele carriers, respectively. More reductions for risk of cardiovascular diseases and mortality, except risk of stroke were found in the A allele carriers compared with GG homozygotes after intakes of canola and sesame-canola oils, but not sesame oil. There was also a significant genotype effect as well as genotype-dietary oil interactions on cardiovascular risk scores. In healthy individuals, a considerable decrease in visceral fat was accompanied by a significant increase in HDL-C levels in the A allele carriers compared with non-A allele carriers after sesame oil intake. CONCLUSION: Patients with diabetes carrying the A allele might benefit from canola and sesame-canola oils intakes, and healthy A allele carriers from sesame and sesame-canola oils intakes as well. Future clinical trials are recommended to warrant current findings.

The effect of canola oil compared with sesame and sesame-canola oil on cardio-metabolic biomarkers in patients with type 2 diabetes: Design and research protocol of a randomized, triple-blind, three-way, crossover clinical trial.

BACKGROUND: Both canola and sesame oils consumption have been associated with favorable effects on cardio-metabolic biomarkers. However, to the best of our knowledge, no study has compared their effects on cardiovascular risk factors. The present study aimed to assess the effect of canola, sesame, and sesame-canola oils consumption on cardio-metabolic biomarkers in patients with type 2 diabetes mellitus (T2DM). METHODS: This study was a randomized, triple-blind, three-way, crossover clinical trial. The study participants included 102 individuals with T2DM. Their spouses were also included in the study. The participants were entered into a 4-week run-in period. After that, their regular dietary oil was replaced with canola, sesame, or sesame-canola oils (a blend of sesame and canola oils) in three 9-week phases, which were separated by two 4-week washout periods (sunflower oil was consumed during the run-in and the washout periods). Dietary, physical activity, blood pressure, and anthropometric measurements were assessed at the beginning, in the middle (week 4-5), and at the end of each treatment phase. Blood samples were taken at the beginning and at the end of each phase. Serum, plasma, buffy coat, and whole blood samples were extracted and kept at -80 ºC for further analysis. Serum fasting blood sugar (FBS), triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) were selected as the primary outcomes. RESULTS: 102 participants with T2DM were randomly assigned to one of the 6 rolling methods. Through them, 93 individuals (91.2%) completely participated in all phases. CONCLUSION: The present study will provide an exceptional opportunity to examine the effect of canola, sesame, and sesame-canola oil on cardio-metabolic markers in adults with and without T2DM. This trial will also provide a good medium for the investigation of gene-dietary oils interaction in the future.