The association between plant and animal protein intake with depression, anxiety, and stress.

BACKGROUND: Recent evidence suggests that diet composition is a key biological factor related to the development of depressive disorders. The present study was conducted to investigate the animal and plant protein intake and their replacement in association with depression, anxiety, and stress in Iranian adults. METHOD: In this cross-sectional study, the dietary intake of 7169 subjects were assessed using a validated food frequency questionnaire. The depression, anxiety, and stress Scale - 21 (DASS-21) questionnaire was used to psychological disorders. Logistic regression was used to obtain odds ratios for depression, anxiety, and stress across quintiles of animal and plant protein. RESULTS: The participants' age range was 20-69 years. Individuals with the highest animal protein consumption had a lower chance for developing depression compared to those with the lowest intakes (OR = 0.73, 95%CI: 0.59-0.90; Ptrend < 0.01). Results also showed a significant association between animal protein intake and anxiety, such that subjects in the highest quintile of animal protein intake had 24% lower odds for anxiety compared to those in the lowest quintile (p < 0.05). We found a significant association between highest quintiles of animal protein intake and a 40% lower risk for stress among female individuals (Ptrend = 0.05). The multivariable-adjusted non-linear analyses also revealed that the replacement of plant protein with animal protein was significantly associated with the likelihood of depression and anxiety (P < 0.05). CONCLUSION: Animal protein intake might lower the odds of depression and anxiety particularly. Future prospective investigations are proposed to confirm these findings.

Medicinal herbs consumption in relation to cardiometabolic indices and coronary artery stenosis in participants undergoing coronary angiography: A cross-sectional study.

Few studies have investigated the association between herbal medicine consumption and coronary artery disease severity. This cross-sectional study aimed to investigate the association between the frequency of medicinal herbs consumption and coronary artery stenosis (CAS), lipid profile, fasting blood sugar (FBS), and blood pressure level in participants undergoing coronary angiography. This study was conducted on 662 participants aged 35-75 years. Serum cardiometabolic markers were measured using standard kits. The extent and severity of CAS were evaluated using the Gensini score (GS) and syntax score (SS). Higher consumption of Thymus vulgaris and Sumac was associated with decreased odds of artery-clogging according to the GS. A higher intake of Thymus vulgaris and Mentha was associated with lower levels of serum cholesterol and triglyceride. Monthly intake of Thymus vulgaris, and weekly/daily intake of Mentha, Nigella Sativa, and Cuminum Cyminum were associated with lower low-density lipoprotein. Weekly/daily intake of Turmeric and Thymus vulgaris were associated with lower high-density lipoprotein levels and monthly intake of Mentha was related to lower serum FBS levels. Higher consumption of Mentha, Mentha pulegium L, Lavandula angustifolia, and Nigella Sativa was associated with lower levels of systolic blood pressure. According to the results of the present study, herbs consumption might be related to a reduction in CAS risk factors.

First Iranian guidelines for the diagnosis, management, and treatment of hyperlipidemia in adults.

This guideline is the first Iranian guideline developed for the diagnosis, management, and treatment of hyperlipidemia in adults. The members of the guideline developing group (GDG) selected 9 relevant clinical questions and provided recommendations or suggestions to answer them based on the latest scientific evidence. Recommendations include the low-density lipoprotein cholesterol (LDL-C) threshold for starting drug treatment in adults lacking comorbidities was determined to be over 190 mg/dL and the triglyceride (TG) threshold had to be >500 mg/dl. In addition to perform fasting lipid profile tests at the beginning and continuation of treatment, while it was suggested to perform cardiovascular diseases (CVDs) risk assessment using valid Iranian models. Some recommendations were also provided on lifestyle modification as the first therapeutic intervention. Statins were recommended as the first line of drug treatment to reduce LDL-C, and if its level was high despite the maximum allowed or maximum tolerated drug treatment, combined treatment with ezetimibe, proprotein convertase subtilisin/kexin type 9 inhibitors, or bile acid sequestrants was suggested. In adults with hypertriglyceridemia, pharmacotherapy with statin or fibrate was recommended. The target of drug therapy in adults with increased LDL-C without comorbidities and risk factors was considered an LDL-C level of <130 mg/dl, and in adults with increased TG without comorbidities and risk factors, TG levels of <200 mg/dl. In this guideline, specific recommendations and suggestions were provided for the subgroups of the general population, such as those with CVD, stroke, diabetes, chronic kidney disease, elderly, and women.

The addition of exercise to a weight loss diet on inflammatory markers: a systematic review and Meta-analysis of controlled clinical trials.

This systematic review and meta-analysis of controlled clinical trials was performed to evaluate the effects of weight-loss diets plus exercise compared with weight-loss diets alone on inflammatory biomarkers in adults. PubMed, Scopus, EMBASE, Web of Science (ISI), and Google Scholar were searched up to April 2021. Overall effects were derived using a random effects model. The overall quality of evidence was assessed using Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Twenty-nine trials were included in this systematic review and meta-analysis. The meta-analysis showed no significant difference in serum high sensitivity C-reactive protein (hs-CRP) [weighted mean difference (WMD) = -0.004 mg/l, 95% CI: -0.140, 0.132, P = 0.954], interleukin-6 (IL-6) (WMD = -0.039 pg/ml, 95% CI: -0.233 to 0.156, P = 0.696), and tumor necrosis factor-α (TNF-α) (WMD = 0.405 ng/ml, 95% CI: -1.036 to 0.226, P = 0.209) after adding exercise to a weight-loss diet compared with a weight-loss diet alone. Subgroup analysis revealed that exercise plus a weight-loss diet significantly reduced TNF-α in studies greater than 16 weeks in duration (WMD = -0.742 ng/ml, 95% CI: -1.384 to -0.1, P = 0.024). This systematic review and meta-analysis indicate that exercise in addition to a weight-loss diet does not have a significant effect on further reducing inflammatory markers compared to a weight loss diet alone.

The cluster of differentiation 36 (CD36) rs1761667 polymorphism interacts with dietary patterns to affect cardiometabolic risk factors and metabolic syndrome risk in apparently healthy individuals.

Several studies have examined the association between CD36 rs1761667 polymorphism with cardiometabolic risk factors and metabolic syndrome (MetS). This study aimed to investigate the interactions between rs1761667 polymorphism and dietary patterns on the cardiometabolic risk factors and the risk of MetS in apparently healthy individuals aged 20-70 years. Food consumption data were acquired using a validated semi-quantitative FFQ. Dietary patterns were identified by factor analysis. CD36 rs1761667 was genotyped by PCR-restriction fragment length polymorphism. The gene-diet interaction was detected by the general linear model or logistic regression. Significant or marginally significant interactions were observed between healthy dietary pattern (HDP) and CD36 rs1761667 on weight (P = 0·006), BMI (P = 0·009), waist circumference (P = 0·005), hip circumference (P = 0·06), body muscle percentage (P = 0·02), body fat percentage (P = 0·09), TAG-glucose index (P = 0·057), atherogenic index of plasma (P = 0·07), the risk of MetS (P = 0·02), risk of abdominal obesity (P = 0·02) and elevated blood pressure (P = 0·07). Besides, a gene-diet interaction was detected between the traditional dietary pattern and rs1761667 variants on odds of hypertriglyceridaemia (P = 0·02). The adherence to HDP was associated with a lower weight, BMI and higher odds of HDL-cholesterol only in A-allele carriers. In conclusion, adherence to HDP (a diet with high fibre, fish and dairy products) can be more effective on some cardiometabolic risk factors and risk of MetS components in the A-allele carrier than the GG genotype of rs1761667 polymorphism. However, future studies are required to shed light on this issue.

Dietary trans fatty acids and risk of colorectal cancer: a systematic review and meta-analysis of observational studies.

PURPOSE: Although trans fatty acid has been associated with diabetes and cardiovascular disorders, studies gave conflicting results when examined their impact on colorectal cancer (CRC). The present systematic review and meta-analysis aimed to summarize the current evidence regarding the association between dietary and tissue trans fatty acids and the risk of CRC. METHODS: We searched PubMed/MEDLINE, EMBASE, Scopus, Web of Science (ISI), and Google Scholar without date and language limitation up to May 2022 and included the eligible studies. The quality of included studies was assessed using the Newcastle-Ottawa scale. The overall odds ratios (ORs) were derived using a random-effects model. RESULTS: In assessment of dietary trans fatty acids 18 studies, including eight cohort, 10 case-control, and observational data from one randomized control trial were included. Although Dietary trans fats were associated with higher risk of CRC (OR = 1.093, 95% CI 1.017, 1.176, P = 0.016; I2 = 61.3%), Subgroup analysis by study design yielded an insignificant effect for case-control (OR = 1.152, 95% CI 1.000, 1.328, P = 0.050; I2 = 77.2%) and cohort (OR = 1.027, 95% CI 0.976, 1.081, P = 0.299; I2 = 0%) studies. Although there was no significant association of trans fatty acids with rectal cancer (OR = 1.093, 95% CI 0.984 to 1.215, P = 0.098; I2 = 0%), there was for colon cancer (OR = 1.91, 95% CI 1.062 to 1.335, P = 0.003; I2 = 37.6%).The analysis of four studies that evaluated the relation between tissue trans fat and CRC revealed meaningful result (OR = 0.745, 95% CI 0.619, 0.896, P = 0.002; I2 = 42.6%). While subgroup assessments for colon cancer (OR = 0.804, 95% CI 0.583, 1.109, P = 0.183; I2 = 0%) and plasma trans fatty acids OR = 0.853, 95% CI 0.633, 1.150, P = 0.298; I2 = 0%) were insignificant. CONCLUSION: Dietary trans fatty acids increased the risk of CRC, whereas tissue trans fatty acids had a protective effect on CRC. Nonetheless, neither type of trans fatty acid increased the risk of colon or rectal cancer; thus, more prospective studies are needed to determine the validity of these associations.

The relationship between dietary lipophilic index and load with depression, anxiety, and stress symptoms.

BACKGROUND: Dietary fatty acids can affect brain health by modifying neuronal membrane fluidity. Dietary lipophilic index (LI) and load (LL) may be related to cell membrane fluidity. This study aimed to determine the relationship between dietary LI and LL with symptoms of depression, anxiety and stress. METHODS: In this cross-sectional study, taken from the YaHS (Yazd Health Study) population-based cohort, the data of 2,982 individuals was extracted. Several questionnaires- a 178-item Food Frequency Questionnaire (FFQ), Depression, Anxiety and Stress Scale 21 (DASS 21), and International Physical Activity Questionnaire (IPAQ)- were used to obtain information on dietary intake, mental status, and physical activity, respectively. LI and LL were calculated using dietary intake and the melting point of each fatty acid. RESULTS: The analysis was performed on 2982 individuals. The odds ratio of depression in the second tertile of dietary LI compared to the first tertile was 0.815 (95% CI 0.66-1.00, P = 0.051, Ptrend = 0.017) and after adjusting confounders was 0.793 (95% CI 0.63-0.99, P = 0.043, Ptrend = 0.011). Also, LL was related inversely with anxiety (0.771, 95% CI 0.63-0.93, P = 0.003) that after multiple regression, OR of anxiety was 0.762 (95% CI 0.53-1.07, P = 0.045). The odds of stress in the third tertile of LL was 1.064 but not statistically significant (95% CI 0.88-1.28, P = 0.729). CONCLUSION: This study showed an inverse association between dietary LI and depression symptoms. Anxiety and stress did not show a significant relationship with LI or LL.

Interaction between CETP Taq1B polymorphism and dietary patterns on lipid profile and severity of coronary arteries stenosis in patients under coronary angiography: a cross-sectional study.

AIM: Evidence indicates there are still conflicts regarding CETP Taq1B polymorphism and coronary artery disease risk factors. Current findings about whether dietary patterns can change the relationship of the Taq1B on lipid profile and the severity of coronary arteries stenosis appears to be limited. The present research made an attempt to investigate this possible relationship. METHODS: This cross-sectional study involved 453 male and female participants with a mean age of 57 years. A validated 178-item food frequency questionnaire (FFQ) was used to assess dietary usual intake. Dietary patterns were extracted through principal component analysis (PCA). Taq1B variant was genotyped by the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Two-way ANOVA was used to test the interaction between Taq1B polymorphism and dietary patterns. RESULTS: Two dietary patterns were detected: the western dietary pattern (WDP) and the traditional dietary pattern (TDP). The frequency of Taq1B genotypes turned out to be 10.4, 72.4, and 17.2% for B1B1, B1B2, and B2B2, respectively. A significant difference was observed in TG and TG/HDL-C levels among TaqIB genotypes in higher adherence to TDP (P = 0.01 and P = 0.03, respectively). Taq1B showed a significant interaction with TDP for modulating TG levels and TG/HDL-C ratio (P = 0.02 and P = 0.04, respectively). Greater compliance to WDP demonstrated a significant difference in TG and TG/HDL-C levels across rs708272 genotypes (P = 0.03) after adjusting for confounding factors. Other lipid components and coronary arteries stenosis scores failed to show any relationship or significant difference across Taq1B genotypes or dietary patterns. CONCLUSION: Adherence to TDP may adjust the association between the Taq1B variant and TG and TG/HDL-C levels in patients undergoing coronary angiography. To better understand the relationships, we suggest prospective studies in different race groups with multivariate approaches.

Maternal circulating leptin, tumor necrosis factor-alpha, and interleukine-6 in association with gestational diabetes mellitus: a systematic review and meta-analysis.

Background: Over the last decade, an emerging role of novel cytokines in the pathogenesis of gestational diabetes mellitus (GDM) has been proposed. The present study was implemented to provide a more accurate estimate of the effect size of the association between leptin, tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) and the risk of GDM.Methods: Online databases were looked up to January 2023 using the search string: (leptin OR TNF-α OR IL-6) AND "gestational diabetes." Observational studies investigating the association of selected cytokines and GDM risk were included. Odds ratios and their 95% confidence intervals (CIs) were extracted and random-effects models were used to estimate the pooled effect.Results: Twenty-four studies were included in the meta-analysis. A significant association was found between higher circulating leptin and the risk of GDM and the pooled estimate was 1.16 (95%CI: 1.07, 1.27). Higher circulating levels of IL-6 and TNF-α were associated with increased risk of GDM, and the pooled estimates were 1.35 (95%CI: 1.05, 1.73) and 1.28 (95%CI: 1.01, 1.62), respectively.Conclusions: The studied cytokines could be implicated in the GDM pathogenesis and used as potential biomarkers for assessing the GDM risk. Additional longitudinal studies with large sample sizes are needed for a further evaluation of these findings.

Dietary approaches to stop hypertension (DASH)-style diet in association with gastroesophageal reflux disease in adolescents.

BACKGROUND: Dietary patterns and food items have been associated with gastroesophageal reflux disease (GERD) risk and they have led to conflicting findings. The aim of this study was to determine the association between a dietary approach to stop hypertension (DASH)-style diet with the risk of GERD and its symptoms in adolescents. STUDY DESIGN: Cross-sectional. METHODS: This study was performed on 5,141 adolescents aged between 13 and 14 years. Dietary intake was evaluated using a food frequency method. The diagnosis of GERD was done by using a six-item GERD questionnaire that asked about GERD symptoms. A binary logistic regression was used to assess the association between the DASH-style diet score and GERD and its symptoms in crude and multivariable-adjusted models. RESULTS: Our findings revealed that after adjustment for all confounding variables, the adolescents with the highest adherence to the DASH-style diet had a lower chance of developing GERD [odds ratio (OR) = 0.50; 95%CI 0.33-0.75, Ptrend< 0.001)], reflux (OR = 0.42; 95%CI 0.25-0.71, Ptrend=0.001), nausea (OR = 0.59; 95% CI:0.32-1.08, Ptrend=0.05) and stomach pain (OR = 0.69; 95%CI 0.49-0.98, P trend=0.03) compared to those with the lowest adherence. Similar results were found for odds of GERD among boys, and the total population (OR = 0.37; 95%CI: 0.18-0.73, Ptrend=0.002, OR = 0.51; 95%CI: 0.34-0.77, P trend<0.0, respectively). CONCLUSION: The current study revealed that adherence to a DASH-style diet might protect against GERD and its symptoms including, reflux, nausea, and stomach pain in adolescents. Further prospective research is needed to confirm these findings.

Dietary fats and their sources in association with the risk of bladder cancer: A pooled analysis of 11 prospective cohort studies.

The effects of fat intake from different dietary sources on bladder cancer (BC) risk remains unidentified. Therefore, the present study aimed to investigate the association between fat intakes and BC risk by merging world data on this topic. Data from 11 cohort studies in the BLadder cancer Epidemiology and Nutritional Determinants (BLEND) study, provided sufficient information on fat intake for a total of 2731 BC cases and 544 452 noncases, which yielded 5 400 168 person-years of follow-up. Hazard ratios (HRs), with corresponding 95% confidence intervals (CIs), were estimated using Cox-regression models stratified on cohort. Analyses were adjusted for total energy intake in kilocalories, gender, smoking status (model-1) and additionally for sugar and sugar products, beers, wine, dressing and plant-based and fruits intakes (model-2). Among women, an inverse association was observed between mono-unsaturated fatty acids (MUFAs) and BC risk (HR comparing the highest with the lowest tertile: 0.73, 95% CI: 0.58-0.93, P-trend = .01). Overall, this preventative effect of MUFAs on BC risk was only observed for the nonmuscle invasive bladder cancer (NMIBC) subtype (HR: 0.69, 95% CI: 0.53-0.91, P-trend = .004). Among men, a higher intake of total cholesterol was associated with an increased BC risk (HR: 1.37, 95% CI: 1.16-1.61, P-trend = .01). No other significant associations were observed. This large prospective study adds new insights into the role of fat and oils in BC carcinogenesis, showing an inverse association between consumption of MUFAs and the development of BC among women and a direct association between higher intakes of dietary cholesterol and BC risk among men.

Does exercise affect bone mineral density and content when added to a calorie-restricted diet? A systematic review and meta-analysis of controlled clinical trials.

The effects of exercise in conjunction with weight-loss diets on bone health are mixed. Our objective was to systematically review and meta-analyze controlled clinical trials in adults investigating the addition of exercise to a weight-loss diet compared with a calorie-matched weight-loss diet without exercise on bone measures. Online databases including PubMed/MEDLINE, EMBASE, ISI (Web of Science), Scopus, and Google Scholar were searched up to April 2021 with no restriction. A random effects model was used to calculate the overall estimates. Quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. Fourteen eligible controlled clinical trials were included in the systematic review. The meta-analysis revealed that, compared to weight-loss diets alone, the addition of exercise did not improve total body bone mineral density (BMD) [weighted mean difference (WMD) = 0.002 g/cm2, P = 0.62, n = 8], lumbar BMD (WMD = 0.007 g/cm2, P = 0.44, n = 9), total hip BMD (WMD = 0.015 g/cm2, P = 0.14, n = 4) and total bone mineral content (BMC) (WMD = - 11.97 g, P = 0.29, n = 7). Subgroup analysis revealed that resistance exercise in conjunction with hypocaloric diets positively affects total BMD compared to an energy restrictive diet alone (WMD = 0.01 g/cm2, P = 0.003, n = 3). Overall, it appears that only resistance exercise beneficially affects total BMD during a calorie-restricted diet in adults. Further well-controlled and long-term clinical trials are still needed to confirm these results. PROSPERO registration number: CRD42020173434.

Dietary Inflammatory Index and Breast Cancer: report from a Large-Scale Case-Control Study.

OBJECTIVE: The relationship between diet, including its inflammatory potential, and breast cancer has led to inconsistent results. We investigated the association between a dietary inflammatory index (DII) and the odds of breast cancer in a large case-control study among women. METHODS: This case-control study was carried out on 412 women with pathologically confirmed breast cancer and 456 apparently healthy controls. DII scores were calculated from dietary intake data. Multi-variable adjusted logistic regression was used to obtain odds ratios for breast cancer across quartiles of DII. RESULTS: A total participants aged 45 ± 10.8 years were included in the present study. After adjustment for potential confounders, individuals in the highest quartile of DII scores had 1.5 times higher odds of breast cancer than those with the lowest (OR= 1.56; 95%CI: 1.04-2.35, Ptrend=0.02). Premenopausal women with the greatest DII had higher odds for breast cancer, compared with those with the lowest DII (OR= 1.92; 95% CI: 1.14-3.25, Ptrend=0.01). No significant association was seen between DII and odds of breast cancer in postmenopausal women. CONCLUSION: Dietary inflammatory index might be directly associated with odds of breast cancer particularly in premenopausal women. Prospective cohort studies are needed to confirm these findings.

The Effect of Ketogenic Diet on Weight Loss in Adult Patients with Cancer: A Systematic Review and Meta-Analysis of Controlled Clinical Trials.

Recently, Ketogenic diets have been investigated as an adjunct cancer treatment. This study aimed to summarize the effect of a ketogenic diet on weight in adults with cancer. Literature search was performed in PubMed/MEDLINE, Web of Science (ISI), Scopus, and Google Scholar up to August 2020. The overall estimates were calculated through a random-effects model. A total of eight trials were eligible to be included in the current study. Meta-analysis revealed that a ketogenic diet significantly reduces body weight in cancer patients [weighted mean difference (WMD) = -3.992 kg, 95% confidence interval (CI): -7.417 to 0.566, P = 0.022, n = 7]. The subgroup analysis revealed that the decreasing effect remained significant in trials done in patients with breast cancer (WMD = -3.332 kg, 95%CI: -4.169 to -2.495, P < 0.001, n = 3) and in studies with >10 (WMD = -2.795, 95%CI: -4.053 to -1.537, P < 0.001, n = 3) and ≤10 weeks of duration (WMD = -7.257, 95%CI: -13.034 to -1.481, P = 0.014, n = 4). However, our findings did not support significant effect of ketogenic diets on body mass index (BMI) (WMD = -1.808 kg/m2, 95%CI: -3.945 to 0.33, P = 0.097, n = 4). In conclusion, ketogenic diets might result to a weight loss in adults with cancer. Future well-designed randomized controlled clinical trials might warrant current findings.

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.

Substitution of dietary macronutrients and their sources in association with breast cancer: results from a large-scale case-control study.

PURPOSE: To evaluate the association between dietary replacement of carbohydrates, proteins, fats, and their sources and odds of developing breast cancer (BC). METHODS: This hospital-based large-scale case-control study recruited 464 women with confirmed BC within the past year and 500 apparently healthy controls matched in terms of age and residential place. Dietary data as well as other variables were collected by trained interviewers. RESULTS: After adjustment for all possible confounders, substituting every 50 kcal of energy from dietary carbohydrates for the same amount of energy from total fats was associated with lower odds for developing BC among all participants [odds ratio (OR) 0.97, 95% confidence interval (CI) 0.95-0.99] as well as premenopausal women (OR 0.96, 95% CI 0.94-0.99). Replacing protein intake with fat was associated with a higher likelihood of BC among postmenopausal women (OR 1.11, 95% CI 1.03-1.20). Replacement of carbohydrates with MUFAs might be associated with a decreased odds of BC and replacement of dietary carbohydrates with PUFAs might be associated with an increased odds of BC in all participants as well as postmenopausal women (P < 0.05). The same association was shown for protein only in postmenopausal women. Substituting MUFAs for saturated (SFAs) and PUFAs was associated with a significant decreased odds of BC in the whole population (P < 0.05). The same association was observed for replacing MUFAs for PUFAs in postmenopausal women. CONCLUSION: Substitution of dietary carbohydrates for total fats and PUFAs might reduce the odds of breast cancer. Also, substituting MUFAs for carbohydrates, SFAs and PUFAs might lower the disease risk. Future prospective investigations are highly recommended.

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 association between dairy products and psychological disorders in a large sample of Iranian adults.

BACKGROUND: Dairy products contain certain nutrients that are useful in mental disorders. This study aimed to assess the associations between dairy products and psychological disorders in a large sample of Iran, a Middle Eastern country. METHODS: This cross-sectional study was undertaken on 7387 adults. Data on dietary intakes were obtained using a validated Food Frequency Questionnaire. Psychological health was assessed by the Iranian validated version of depression, anxiety, and stress scale 21. Multivariable logistic regression analysis was performed to analyze the association between dairy intake and psychological disorders. RESULTS: After adjustment for potential confounders, total milk consumption (OR for the highest vs. lowest tertile: 0.73, 0.58-0.92) and total yogurt consumption (0.78, 0.62-0.97) were associated with decreased odds of depression. An inverse relationship was found between total dairy (0.73, 95% CI 0.590.91), total milk (0.72; 0.58-0.88), kashk (0.79, 0.65-0.96), and yogurt drink (0.80, 95% CI 0.65-0.98) consumption and anxiety symptoms. Higher intake of cheese was related to greater odds of stress (1.52, 1.02-2.26). No association was found between the consumption of high-fat dairy, low-fat dairy, low-fat milk, low-fat yogurt, high-fat yogurt, cheese, kashk, yogurt drink, and depression. Also, there is no association between dairy products and stress symptoms. This association was significant among men and women and high-fat and low-fat products in the total adjusted stratified analysis models. CONCLUSIONS: Findings of this study revealed that both high-fat and low-fat dairy products are associated with a reduced prevalence of psychological disorders. Still, more prospective studies are required to confirm these associations.

Effect of exercise as adjuvant to energy-restricted diets on quality of life and depression outcomes: a meta-analysis of randomized controlled trials.

BACKGROUND AND AIM: Obesity and related co-morbidities lead to a decrease in health-related quality of life (HRQOL) and mood. Lifestyle strategies may improve these outcomes. However, the efficacy of exercise in conjunction with a weight-loss diet on HRQOL and mood is unclear. The aim of this systematic review and meta-analysis of randomized controlled trials (RCTs) was to examine whether the addition of exercise to energy-restricted dietary programs improves HRQOL and mood status when compared with energy-restricted diets alone in overweight and obese adults. METHODS: Eligible RCTs were identified by searching PubMed/MEDLINE, EMBASE, ISI (Web of sciences), Scopus, and Google Scholar up to April 2021. Summary effects were derived using a random-effects model. The quality of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. RESULTS: The meta-analysis revealed that an energy-restricted diet plus exercise compared with an energy-restricted diet alone had no significant effects on depression (n = 6, hedges'g = - 0.04, 95% CI: - 0.28,0.20), MOS 36-Item Short-Form Health Survey (SF-36)-physical component summary scores (n = 8, weighted mean difference (WMD) = 1.51, 95% CI: - 0.16, 3.18), SF36-mental component summary scores (n = 7, WMD = 0.64, 95% CI: - 1.00, 2.28), and HRQOL disease-specific questionnaire scores (n = 5, hedges'g = 0.16, 95% CI: - 0.09, 0.40). The GRADE revealed that the quality of evidence was low for disease-specific HRQOL scores, and depression status; and high for physical and mental health assessed by SF-36. CONCLUSION: In our sample of overweight and obese adults, no beneficial effect of adding exercise to an energy-restricted diet was found in terms of HRQOL and Depression.

The association between major dietary patterns and severe mental disorders symptoms among a large sample of adults living in central Iran: Baseline data of YaHS-TAMYZ cohort study.

BACKGROUND: The diet's role in developing psychological disorders has been considered by researchers in recent years. OBJECTIVE: To examine the association between major dietary patterns and severe mental disorders symptoms in a large sample of adults living in Yazd city, central Iran. METHODS: This cross-sectional study used the baseline data of a population-based cohort study (Yazd Health study: YaHS). Dietary intakes were assessed by a multiple-choice semi-quantitative food frequency questionnaire (FFQ, Yazd nutrition survey called TAMYZ). Psychological assessments were also done by using the depression, anxiety, and stress scale-21 (DASS-21) questionnaire. Major dietary patterns were identified using principal component analysis (PCA). Analysis of covariance (ANCOVA) and logistic regression analyses were used to evaluate the relationship between dietary patterns and mental disorders symptoms. RESULTS: A total of 7574 adults were included in the current analysis. Four major dietary patterns were identified: "Sugar and Fats", "Processed Meats and Fish", "Fruits" and "Vegetables and Red Meat". After adjustment for all confounding variables, participants in the fifth quintile of "Fruits" dietary pattern which was highly correlated with dried fruits, canned fruits, fruit juice, olive, hydrogenated fats and fruits intake, had a lower odds of severe depression (OR=0.61, 95% CI: 0.45-0.81, p for trend=0.057), anxiety (OR=0.64, 95% CI: 0.50-0.80, p for trend=0.007), and stress, (OR=0.45, 95% CI: 0.30-0.68, p for trend=0.081). CONCLUSIONS: The intake of a dietary pattern high in dried fruits, canned fruits, fruit juice, olive, hydrogenated fats, and fruits might be inversely associated with depression, anxiety, and stress symptoms. Future prospective studies are needed to warrant this finding.