Effects of Nigella sativa supplementation on blood concentration and mRNA expression of TNF-α, PPAR-γ and adiponectin, as major adipogenesis-related markers, in obese and overweight women: a crossover, randomised-controlled trial.

Adipocyte expansion through adipogenesis can offset the adverse metabolic effects of obesity. Nigella sativa (NS) (black seed) oil is shown to have therapeutic features in the management of obesity. NS oil might have beneficial changes in obese populations through mediating serum levels of adipogenesis-related parameters and relative transcriptional gene-diet interactions (nutrigenomics), though no previous studies assessed this mechanism in overweight/obese participants. This study assessed the effects of NS oil supplements on blood concentration and mRNA expression levels of TNF-α, PPAR-γ and serum adiponectin and expression of AdipoR1, as major adipogenesis and obesity-related parameters, in overweight/obese women using a cross-over design. Eligible women were randomised to receive either NS oil supplements (2000 mg/d) or placebo. Two periods of interventions (8 weeks in each) were cross-changed by a 4-week washout period. An individualised diet plan without calorie deficits was given to participants to match their energy/macronutrient intakes. The Pkcross procedure and intention-to-treat analysis were performed using Stata. Cohen's d(d) was estimated to measure the magnitude of the effects. Forty-six participants were included. NS oil capsules reduced transcription levels ((d = -2·31), P < 0·001) and blood concentrations of TNF-α ((d = -0·29), P < 0·001). AdipoR1 expression (d = 2·24, P < 0·001) and serum adiponectin (d = 0·88, P < 0·001) showed a significant augmentation with a medium-high effect size, as did gene expression (d = 0·69, P < 0·001) and serum levels of PPAR-γ (d = 0·97, P < 0·001). There was a moderate but significant decrease in body weight (d = 0·6, P < 0·001). The present beneficial findings would provide strong information for future nutrigenomics/clinical trial studies assessing the role of NS in the management of obesity and other comorbidities.

The effect of Nigella sativa supplementation on cardiovascular risk factors in obese and overweight women: a crossover, double-blind, placebo-controlled randomized clinical trial.

PURPOSE: To assess the effect of Nigella sativa (N.S) oil supplements on CVD risk factors in a crossover design for the first time. METHODS: Obese and overweight healthy women were randomized to receive N.S oil (2000 mg/day) and placebo. This intervention period lasted for 8 weeks and separated by a 4-week washout period. An iso-caloric diet was given to every individual throughout the study. Blood pressure, lipid profile, atherogenic indices and liver enzymes were measured. Pkcross procedure was performed for statistical analyses using Stata software. Cohen's d was estimated as effect size for all outcomes to measure the magnitude of the effects. RESULTS: Thirty-nine participants completed the study. Capsules of N.S increased serum high-density lipoprotein cholesterol (Cohen's d = 0.47, P = 0.009), reduced low-density lipoprotein cholesterol (Cohen's d = - 0.33, P = 0.031), reduced TC/HDL-C ratio (as an atherogenic index, Cohen's d = - 0.9, P < 0.001), reduced serum glutamic-oxaloacetic transaminase (Cohen's d = 0- 0.5, P = 0.038) and reduced systolic blood pressure (Cohen's d = - 0.4, P < 0.001). There was no effect on diastolic blood pressure measures (P = 0.96). CONCLUSION: The overall improvements in cardiovascular disease (CVD) risk factors showed beneficial effects of N.S supplements among adults with obesity to prevent possible cardiovascular diseases. More studies with different designs and in other populations are suggested to clarify the exact effects of N.S as a complementary therapy for modulating CVD risk factors in individuals with overweight and obesity. TRIAL REGISTRATION: Iranian Registry of Clinical Trials, IRCT20180528039884N1, Registered on February 15th, 2019.

The effect of Nigella sativa on the measures of liver and kidney parameters: A systematic review and meta-analysis of randomized-controlled trials.

The aim of this systematic review and dose-response meta-analysis was to determine the effect of Nigella sativa (N.S) supplementation on liver and kidney parameters. We searched PubMed, Scopus, ISI Web of Science, Cochrane central register for controlled trials and Google Scholar from database inception to April 2019 for relevant controlled trials. Mean differences and standard deviations for each outcome were pooled using a random-effects model and a dose-response analysis was performed using a fractional polynomial model. Quality of evidence was evaluated using Cochrane Collaboration Risk of Bias tool and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. Nineteen trials (n = 1295 participants) were included in the meta-analysis. We observed that N.S supplements had significant reducing effects on alkaline-phosphatase (ALP) [9 trials, n = 710 participants, weighted mean difference (WMD)= -10.825; 95 %CI: -19.658, -1.992 U/L; P = 0.016; I2 = 75.7 %; P-heterogeneity = 0.000) and blood urea nitrogen (BUN) (12 trials, n = 821 participants, WMD= -1.016; 95 % CI: -1.760, -0.273 U/L; P = 0.007; I2 = 87.7 %; P-heterogeneity = 0.000) concentrations. Subgroup analysis showed that, an intervention of more than 12 weeks was found to have a reducing effect on aspartate- aminotransferase (AST) measures (2 trials, n = 201 participants, WMD= -11.317; 95 % CI: -15.007, -7.626; P = 0.000; I2 = 0.0 %; P-heterogeneity = 0.977). Creatinine levels increased significantly in studies that considered adjusted analysis based on covariates (3 trials, n = 152 participants, WMD = 0.070; 95 % CI: 0.027, 0.112 U/L; P = 0.001; I2 = 0.0 %; P-heterogeneity = 0.788). A daily dose of 1100-1500 mg of N.S supplements was observed to have a substantial reducing effect on ALP levels (5 trials, n = 340 participants, WMD= -11.323; 95 % CI: -21.418, -1.229 U/L; P = 0.028; I2 = 0.00 %; P-heterogeneity = 0.686), while a dosage of more than 2000 mg per day led to a significant increase in BUN concentrations (2 trials, n = 101 participants, WMD= -1.016; 95 % CI: -1.760, -0.273 U/L; P = 0.007; I2 = 87.7 %; P-heterogeneity = 0.000). Our data suggested that N.S supplementation had significant impacts on liver and kidney parameters leading to a decrease in ALP and BUN levels. Longer duration of intervention and normal daily dosages of N.S supplements led to significant reductions in ALP and AST concentrations, respectively, while higher daily dosages increased BUN levels. Hence, in spite of favorable impacts of N.S supplements on liver and kidney parameters, due to the herbal nature of N.S, more studies with high-quality, large-scale, long-term intervention and precise baseline characteristics are needed to assess the exact effective dose, duration and efficacy of N.S supplementation on kidney and liver parameters.

A crossover randomized controlled trial examining the effects of black seed (Nigella sativa) supplementation on IL-1ß, IL-6 and leptin, and insulin parameters in overweight and obese women.

BACKGROUND: Nigella sativa (NS) oil has been found to have advantageous benefits in the management of inflammation and obesity. This study investigated the effect of NS supplementation on blood mRNA expressions and serum levels of IL-1ß, IL-6, leptin, and insulin concentrations in overweight/obese women. METHODS: In a crossover design, participants were randomized to receive either NS supplements(2000 mg/day) or placebo for 2 durations(8 weeks). With between-subject and within-subject components and interactions, a repeated-measure ANOVA model was used considering the treatment, time, and the carryover effects. Cohen's d(d) was used to measure the magnitude of the effects. RESULTS: Forty-six eligible participants were included. NS supplementation significantly reduced the mRNA expressions(d=-0.68, P = 0.03) and serum levels of IL-1ß with medium-high effect sizes(d=-1.6, P < 0.001). Significant reductions with large effect sizes were observed in the gene expression and serum levels of IL-6(d=-1.8, d=-0.78, respectively; P < 0.01) and Leptin(d=-1.9, d=-0.89, respectively; P < 0.01, serum leptin P carryover < 0.001). Despite the meaningful carryover effect for serum leptin, results remained significant following the first intervention period analysis(P < 0.001). A significant but low effect size decrease in serum insulin was observed(d=-0.3, P = 0.02). CONCLUSIONS: The clinical significance of present findings regarding improvements in obesity-related pro-inflammatory markers must be interpreted with caution due to some observed medium-low effect sizes. TRIAL REGISTRATION: IRCT20180430039475N1 (Date:25/6/2018).

Menstrual health and hygiene among young Palestinian female university students in the West Bank: a cross-sectional study.

OBJECTIVE: We investigated some aspects of menstrual health and hygiene among young female students at Birzeit University in the West Bank of the occupied Palestinian territory. DESIGN: Cross-sectional study in a large central university. PARTICIPANTS: Out of a total of 8473 eligible female students, a calculated sample size of 400 students aged between 16 and 27 years was obtained.SettingLarge central university, West Bank, occupied Palestinian territory (oPt). MEASURES: An anonymous structured international research instrument consisting of 39 questions based on the Menstrual Health Questionnaire, in addition to few questions relevant to the context, was administered. RESULTS: 30.5% of participants were not informed about menstruation before menarche, and 65.3% reported that they were not ready when they got their first period. The highest reported source of information regarding menstruation was family (74.1%), followed by school (69.3%). About 66% of respondents reported that they need more information on various topics of menstruation. The most common type of menstrual hygiene products used were single-use pads (86%), followed by toilet paper (13%), nappies (10%) and reusable cloths (6%). Of the total 400 students, 14.5% reported that menstrual hygiene products are expensive, and 15.3% reported that they always/sometimes had to use menstrual products that they do not like because they are cheaper. Most (71.9%) of the respondents reported that they used menstrual products for longer time than recommended due to inadequate washing facilities at the university campus. CONCLUSIONS: The findings provide useful evidence on the lack and the need for menstrual-related information for female university students, inadequate infrastructure to help them manage their menstruation with dignity and pointed to some menstrual poverty in accessing menstrual products. A national intervention programme is needed to increase awareness regarding menstrual health and hygiene among women in local communities and female teachers in schools and universities to enable them to disseminate information to and meet the practical needs of girls at home, at school and at the university.

The effect of Nigella sativa on TAC and MDA in obese and overweight women: secondary analysis of a crossover, double blind, randomized clinical trial.

Purpose: Since obesity is a risk factor for various diseases and is associated with increased oxidative stress conditions, some herbs are considered to be effective in reducing obesity and its complications. Methods: This secondary analysis investigates the effect of Nigella sativa (N.S) oil supplement on total antioxidant capacity (TAC) and malondialdehyde (MDA) levels in obese/overweight women. Obese and overweight healthy women were randomized to receive 2,000 mg/d of N.S supplement and placebo. The intervention periods lasted 8 weeks and were separated by a 4-week washout period. Also, each participant was given an iso-calorie diet. Baseline characteristics and TAC and MDA levels were measured. Pkcross analysis was performed for statistical analysis using Stata software. Also, Cohen's d was estimated as effect size for all results to assess the magnitude of the effects. Results: 39 women completed the study. N.S oil supplementation at a dose of 2000 mg/d significantly increased serum TAC (P effect = 0.017, Cohen's d = 1.81) and reduced serum MDA (P effect < 0/001, Cohen's d = - 0.32). Conclusion: Based on our findings taking N.S supplementation for 8 weeks can improve antioxidant conditions in obese and overweight adults. However, more studies with a larger population and the presence of both genders need to be done to confirm the results.Registration number: IRCT20180430039475N1.

The effect of Nigella sativa on appetite, anthropometric and body composition indices among overweight and obese women: A crossover, double-blind, placebo-controlled, randomized clinical trial.

OBJECTIVES: Obesity is a global concern which is associated with several complications and disease. DESIGN: Present study is the first crossover, double-blind, placebo-controlled, randomized clinical trial aimed to evaluate the effect of Nigella Sativa (N. sativa) intervention on anthropometric and body composition parameters as well as dietary intake and appetite in a crossover design. METHOD: Forty-five healthy women with obesity or overweight were randomized into two groups of intervention and placebo, and the study conducted in two 8-week periods of intervention separated by a 4-week washout period. Anthropometric and body composition indices and dietary intake were measured. Also, appetite sensation was evaluated via a standard visual analog scale (VAS) questionnaire. Pkcross procedure was performed for statistical analysis using STATA. Cohen's d effect size was estimated for all outcomes to determine the magnitude of the effects. RESULTS: Supplementation with 2000 mg of N. sativa oil found to have a considerable increment in the measures of body mass index (P < 0.001, Cohen's d = 0.5), body weight (P < 0.001, Cohen's d = 0.6) and waist circumference (P = 0.020, Cohen's d = 0.4) with a medium effect size measure, and a significant decrease in body fat mass (P = 0.019, Cohen's d = 0.2), body fat percent (P < 0.001, Cohen's d = 0.2) and visceral fat area (P = 0.011, Cohen's d = 0.2) with a small effect size measure. CONCLUSION: The overall improvements in anthropometric and body composition parameters and a significant decrease in appetite represents the beneficial effects of N. sativa supplements in the treatment of obesity. More studies with different dosages, a larger number of participants, and longer intervention duration are recommended to illustrate the exact effects of N. sativa as a complementary therapy for obesity.

Effect of a low energy diet, containing a high protein, probiotic condensed yogurt, on biochemical and anthropometric measurements among women with overweight/obesity: A randomised controlled trial.

BACKGROUND & AIMS: The aim of this study was to determine the effect of low energy diet containing condensed processed yogurt (Kashk), as a high protein, calcium and probiotic enriched product, on glycemic control, lipid profile, anthropometric measurements and blood pressure among women with overweight/obesity. METHODS: 70 women with overweight/obesity were randomly assigned to receive either a low energy diet contained 50 g of Kashk (intervention group) or a low energy diet without Kashk (control group) for 8 weeks. Anthropometric, blood pressure and biochemical measurements were obtained before and after the intervention. RESULTS: Between-group comparisons showed that the intervention group significantly decreased triglycerides (P = 0.013) and low density lipoprotein cholesterol (P = 0.049) levels relative to the control group. Significantly greater reductions in body mass index (P = 0.018), fat percent (P = 0.037) and waist circumference (P = 0.047) were observed in the intervention group compared to control. Within-group comparisons revealed significant reductions in systolic blood pressure (P = 0.035) and weight (P = 0.005) in the intervention group. CONCLUSIONS: Long-term consumption of Kashk, as a high protein and calcium product enriched with probiotic that is accompanied by a low energy diet, might have beneficial effects on anthropometric and biochemical indices, though more cross-over and parallel blinded trials with placebo groups are needed to confirm these results. (The clinical trial registration number is IRCT2013042913163N1).

Effects of oral Nigella sativa oil on the expression levels and serum concentrations of adiponectin, PPAR-γ, and TNF-α in overweight and obese women: a study protocol for a crossover-designed, double-blind, placebo-controlled randomized clinical trial.

BACKGROUND: Obesity is a major public health problem in recent decades. The accumulation of excessive fat promotes inflammatory status. Meanwhile, herbal products are marketed for their weight-loss properties, such as Nigella sativa (N. Sativa) which has been used for centuries to treat rheumatoid arthritis, diabetes, and asthma; recently, the anti-obesity characteristics of N. sativa have also been indicated. However, the exact mechanisms and cellular-related pathways are still unclear. Thus, we will aim to assess the effects of oral N. sativa on the gene expression of inflammatory and adipogenesis-related factors, including TNF-α, PPAR-γ, and adiponectin as well as assessing their serum concentrations among obese and overweight individuals. METHODS: Obese and overweight women aged 25-55 years with a body mass index (BMI) of 25-35 kg/m2 will be recruited from the Obesity Clinic in Shahid Sadoughi University of Medical Sciences and will be assessed for eligibility against inclusion criteria. They will be randomly assigned into two groups to receive either two capsules of N. sativa or two capsules of placebo per day for eight weeks (each capsule contains 1000 mg of N. sativa or placebo). There will be a four-week wash-out period and then participants will receive the reverse supplements for another eight weeks. Biochemical assessments and gene expressions (using real-time polymerase chain reaction) will be conducted at the beginning and at the end of every intervention period. DISCUSSION: The present study will investigate the probable cellular pathways for the anti-obesity effects of N. sativa in overweight/obese women. TRIAL REGISTRATION: Iranian Registry of Clinical Trials, IRCT20180528039884N1 . Registered on 2nd of July, 2018.

Sample Type and Storage Conditions Affect Calprotectin Measurements in Blood.

BACKGROUND: Calprotectin, a complex of calcium-binding proteins, is abundant in granulocytes. Increased levels of plasma calprotectin have been found in patients with inflammatory and autoimmune diseases. However, a number of preanalytical factors may affect calprotectin measurement in blood samples. METHODS: Twelve blood samples [4 tubes, 1 each of lithium-heparin (Li-heparin), EDTA, and serum] were drawn from each of 14 healthy individuals. To evaluate the effect of temperature and storage time in the lag time between collection and centrifugation, samples were kept for 2 h at 4 °C, 20 °C, or 37 °C, before centrifugation. Leukocyte, neutrophil, and monocyte counts were measured in EDTA samples on a Sysmex XN-10 hematology analyzer to investigate the relationship between calprotectin concentrations and the granulocyte count. RESULTS: Calprotectin measurements in EDTA samples were not influenced by temperature or time lag between collection and analysis. Compared to EDTA plasma, significantly higher calprotectin concentrations were found in serum and Li-heparin plasma samples. Furthermore, calprotectin concentrations increased in serum and Li-heparin samples when stored at higher temperatures. There was a linear relationship between the serum calprotectin concentration and neutrophil count in EDTA whole blood. CONCLUSIONS: EDTA is the most suitable anticoagulant for determination of calprotectin in plasma, as this sample matrix does not seem to be affected by temperature or time between sample collection and analysis. Of particular note, neutrophil activation by either clotting or centrifugation should be avoided during the preanalytical process.

The Effect of Green Tea Extract Supplementation on Liver Enzymes in Patients with Nonalcoholic Fatty Liver Disease.

BACKGROUND: Green tea is one of the most popular beverages in the world. It is believed to have beneficial effects in the prevention and treatment of many diseases, one of which is nonalcoholic fatty liver disease (NAFLD). The present study investigated the effects of consumption of green tea in NAFLD patients. METHODS: This study was a double-blind, placebo-controlled, randomized clinical trial. Ultrasonography was used to diagnose fatty liver in patients with alanine aminotransferase (ALT) >31 mg/dl and 41 mg/dl and aspartate aminotransferase (AST) >31 mg/dl and 47 g/dl in women and men, respectively and without other hepatic diseases. A total of 80 participants (20-50 years) with NAFLD were randomly allocated into two groups to receive either green tea extract (GTE) supplement (500 mg GTE tablet per day) or placebo for 90 days. At baseline and at the end of the intervention weight, serum ALT, AST, and alkaline phosphatase (ALP) were measured in fasting state, and dietary data were collected at baseline and end of the study. RESULTS: Green tea group showed significant reductions in ALT and AST levels after 12 weeks period (P < 0.001). The placebo group showed a reduction in ALT and AST levels at the end of the study, but it was no significant. ALP levels showed significant reductions in both groups after 12 weeks period (P < 0.001). CONCLUSIONS: According to the findings of this study, GTE supplementation decrease liver enzymes in patients with NAFLD. It can be claimed that GTE prescribed can be considered as a treatment to improve serum levels of liver enzymes in NAFLD patients.