The improvement effect of apple cider vinegar as a functional food on anthropometric indices, blood glucose and lipid profile in diabetic patients: a randomized controlled clinical trial.

Background: Numerous medical costs are spent each year on treating and preventing the progression of diabetes. The positive effect of apple cider vinegar (ACV) has been shown on post-prandial hyperglycemia. This study aimed to evaluate the effects of prolonged consumption of ACV on blood glucose indices and lipid profile in patients with type 2 diabetes. Methods: This study was a randomized clinical trial and the participants were adults with type 2 diabetes. Participants were divided into two groups: ACV and control. The ACV group was treated with 30 ml of ACV per day. Both the intervention and control groups received the same recommendation for a healthy diet. Before and after eight weeks, fasting blood glucose, insulin, hemoglobin A1C, insulin resistance, total cholesterol (Chol), low-density lipoprotein (LDL), high-density lipoprotein (HDL) and triglyceride were measured. Results: Fasting blood glucose decreased after intervention in both groups, which was only significant in the ACV group (p = 0.01). There was a significant difference in hemoglobin A1C levels between the two groups (p < 0.001) after eight weeks. LDL was decreased in the ACV group (p < 0.001). Total Chol, LDL/HDL and Chol/HDL ratio decreased after the intervention period in the ACV group compared to the control group (p = 0.003, p = 0.001 and p = 0.001, respectively). Conclusion: Daily consumption of ACV may have beneficial effects in controlling blood glucose indices and lipid profile in patients with type 2 diabetes. Clinical trial registration: http://www.irct.ir, identifier IRCT20140107016123N13.

Effect of Physical Activity Program on the Quality of Life of Children with Cystic Fibrosis at School Age: A Randomized Clinical Trail.

Background: Cystic fibrosis (CF) is a hereditary disease with a high mortality rate. The present study aimed to determine the effect of a physical activity program (PAP) on the life quality of children with CF at school age. Materials and Methods: This study conducted on 70 children with CF, the samples were randomly divided into intervention and control groups. A demographic information questionnaire and the Pediatric Quality of Life Inventory were used for data collection. This study was conducted in three stages and 2 months after the last intervention. Finally, the data were analyzed in SPSS software version 22 using the Chi-square test, independent t-test, and paired t-test at a p-value of less than 0.05. Results: The results indicated that the two groups had no significant difference in terms of demographic variables before the intervention. Moreover, it was observed that the mean scores of life quality in the physical, emotional, social, and academic performance of children in both groups before the intervention in child and parent evaluations did not show significant differences. After the intervention in the experimental group, the mean scores of life quality in all aspects significantly increased, compared to those of the control group (P<0.001). Moreover, there were no significant differences between the mean scores of life quality in the control group before and after the intervention. Conclusion: Given the effectiveness of the intervention to enhance life quality, PAP is feasible and possible in the field of CF. It has to be noted that this method is an effective way to improve life quality.

Comparing the effects of face-to-face versus phone counseling based on cognitive-behavioral therapy for vasomotor symptoms in postmenopausal women: a randomized controlled trial.

Purpose: Menopause is associated with complications that may affect quality of life, such as hot flashes, night sweats, and mood swings. This study aimed to compare the effects of phone versus face-to-face counseling based on cognitive-behavioral therapy (CBT) for vasomotor symptoms in postmenopausal women. Methods: In this study, 40 eligible postmenopausal women were randomly assigned to face-to-face (n = 20) and phone counseling methods (n = 20). Six counseling sessions were held weekly for each person, and the women were requested to record their hot flashes (HF) and night sweats (NS) in a diary. HF and NS were measured at baseline, and 6 and 8 weeks after the completion of intervention. Data were analyzed using χ2, repeated measures ANCOVA, and independent t-test. Results: Means of weekly hot flashes and night sweats decreased after intervention in both groups (face-to-face group: HF frequency from 31.92 ± 7.98 to 18.83 ± 7.35, HF severity from 2.24 ± 0.28 to 1.21 ± 0.23, HF duration from 4.22 ± 1.17 min to 2.79 ± 0.91 min, NS frequency from 2.34 ± 0.31 to 1.21 ± 0.24 and NS severity from 1.70 ± 0.34 to 1.03 ± 0.29; and also in the phone counseling group: HF frequency from 33.32 ± 7.77 to 19.53 ± 7.7, HF severity from 2.23 ± 0.24 to 1.20 ± 0.18, HF duration from 4.29 ± 1.23 min to 2.68 ± 0.95 min, NS frequency from 2.33 ± 0.31 to 1.14 ± 0.16 and NS severity from 1.59 ± 0.34 to 1.01 ± 0.30). Although the differences within each group were significant (p < 0.001), there was no significant difference between the groups after the intervention in terms of HF frequency, severity, and duration, as well as NS frequency and severity (p > 0.05). Conclusions: Face-to-face and phone counseling methods based on CBT had a similar effect on reducing hot flashes and night sweats. Both methods can be used for women with postmenopausal complications such as hot flashes and night sweats.

The effect of mobile health educational intervention on body image and fatigue in breast cancer survivors: a randomized controlled trial.

BACKGROUND: Cancer-related fatigue, physical changes, and pain are among the most troublesome symptoms caused by breast cancer treatment and influence the patients' quality of life. The aim of the present study was to examine the effect of mobile health educational intervention on body image and fatigue in breast cancer survivors. METHODS: The present clinical trial study conducted on 38 women with breast cancer referred to Golestan and Shahid Baghaei 2 hospitals, Ahvaz, south west Iran in 2018-2019. Patients were randomly assigned into two intervention group, and control groups on 1:1 basis. Data collection tool included three parts: cancer fatigue scale, body image concern inventory, and demographic information. Text messages sent to intervention group via WhatsApp messenger for 7 weeks on a daily schedule. The control group did not receive any messages. Data were analyzed using SPSS Version 23.0. RESULTS: The mean age of participants was 46.34 ± 9.96. The mean score of cancer fatigue scale after the intervention in the intervention group was decreased significantly (p = 0.005), but no statistically significant difference was observed in the control group. There was a significant difference in the mean score of body image concern inventory in the intervention group (p = 0.002) after the intervention compared with the control group. CONCLUSION: Mobile health educational intervention improved cancer-related fatigue and body image among women breast cancer survivors. The integration of education for the management of fatigue and body image disturbance as part of routine care among breast cancer survivors is recommended.

The effect of combined education on the knowledge and care and supportive performance of parents with children with cleft lip and palate: A clinical trial study.

Cleft lip and palate is a major problem that disrupts the child's family life. The present study aimed to investigate the effect of combined education on the knowledge and care and supportive performance of parents with children with cleft lip and palate. This is a clinical trial study was conducted on 40 parents referring to hospitals. The data were collected using the demographic information questionnaire, the questionnaire of parental knowledge and care supportive performance questionnaire and analyzed using descriptive and analytical tests. After education the intervention group, the mean score of parents' care and supportive knowledge significantly increased in the intervention group as compared to the control group. There was also a significant difference in the mean score of parents' care-supportive performance between the two groups (P < 0.001). It is recommended to use the combined education as an effective method to increase knowledge and performance in parents of children with cleft lip and palate.

The Effect of Synbiotic and Probiotic Supplementation on Mental Health Parameters in Patients Undergoing Hemodialysis: A Double-blind, Randomized, Placebo-controlled Trial.

INTRODUCTION: The purpose of this double-blind clinical trial, was to examine the effect of supplementation with the synbiotic and probiotic on the mental health, quality of life, and anemia in HD patients. METHODS: Seventy-five HD patients were randomly assigned to receive the synbiotic (n = 23) as 15 g of prebiotics, 5 g of probiotic powder containing Lactobacillus acidophilus, Bifidobacterium bifidum, Bifidobacterium lactis, and Bifidobacterium longum (2.7 × 107 CFU/g each); probiotics (n = 23) as 5 g probiotics similar to the synbiotic group with 15 g of maltodextrin as placebo; and placebo (n = 19) as 20 g of maltodextrin. Serum hemoglobin (Hb) and albumin (Alb) were measured. Beck depression and anxiety index (BDI/BAI) was used to assess symptoms of depression and anxiety. The health-related quality of life (HRQoL) was assessed using the questionnaire SF-36. RESULTS: From baseline to 12 weeks, synbiotic and probiotic supplementation resulted in a significant decrease in BDI and BAI score in comparison to the placebo (P < 0.05). Between and intergroup comparison showed no significant changes between the groups in terms of HRQoL. However, the serum Hb level increased significantly in the synbiotic and probiotic group compared to the placebo group (P < 0.001). CONCLUSION: Overall, 12 weeks of synbiotic and probiotic supplementation resulted in an improvement in mental health and anemia compared with the placebo, whereas they failed to enhance the quality of life in HD patients.

The effect of group cognitive behavioural therapy for insomnia in postmenopausal women.

The menopausal period is associated with several complications in women. One of these complications is sleep disorders including insomnia disorder that can affect all aspects of personal life. The present study aimed to evaluate the effectiveness of cognitive behavioural therapy for insomnia (CBT-I) on insomnia severity and sleep quality among postmenopausal women. This was a randomised clinical trial in which 46 women were recruited and randomly allocated into two groups, one receiving CBT-I and a control group. The CBT-I group received six sessions of training, while the control group received only usual care. A demographic questionnaire, Insomnia Severity Index (ISI), and Pittsburgh Sleep Quality Index (PSQI), were used to collect the data. The ISI and PSQI were measured at baseline, 3 and 6 weeks after intervention, and in a 4-week follow-up. The Independent t test, the chi-square test, generalised estimating equation models, and Bonferroni correction were applied to analyse the data. According to our results, in the CBT-I group compared to the control group, the mean ISI, PSQI, sleep onset latency, sleep time, and sleep quality score reduced continuously from baseline to week 3 and from week 3 to week 6, and remained constant from week 6 to week 10. The mean sleep efficiency score improved significantly from baseline to week 3 in the CBT-I group and remained unchanged until the end of the study. CBT-I could significantly improve insomnia severity and sleep quality in postmenopausal women. Therefore, using this method is recommended for menopausal women with insomnia.

Association of Hematological Parameters with Obesity- Induced Inflammation Among Young Females in Ahvaz, South-West of Iran.

BACKGROUND: Iron deficiency is prevalent in overweight and obese individuals and may be induced by adiposity-related inflammation that affect iron metabolism. OBJECTIVE: The objective of this study was to investigate the relationship between hematological parameters and obesity-induced inflammation among young females. METHODS: A total of 170 young women (aged between 18-35 years) participated in this cross-sectional study. Obesity was assessed by BMI (body mass index), WHR (waist to hip ratio), and body fat percentage. Inflammatory and hematological parameters including hs-CRP (high-sensitivity C-reactive protein), serum Fe, hemoglobin, ferritin, transferrin, TIBC (total iron binding capacity) were measured. Dietary intakes of some nutrients (total iron, proteins, calcium, and vitamin C) were assessed according to BMI, WHR and fat mass categories. RESULTS: Serum iron were negatively correlated with BMI (P = 0.045, r = -0.154) and hs-CRP (P = 0.032, r = -0.165). Hemoglobin were also negatively correlated with BMI (P = 0.043, r = -0.155). A significant correlation was also shown between WHR with transferrin (P = 0.034, r = 0.163) and TIBC levels (P = 0.035, r = 0.162), hs-CRP was positively correlated with BMI (P = 0.014, r = 0.183), WHR (P = 0.009, r = 0.202) and body fat percentage (P = 0.037, r = 0.353). Dietary intakes did not differ significantly among BMI, WHR and fat mass categories (P > 0.05). CONCLUSIONS: Obesity-induced inflammation, regardless of dietary intake of iron, can lead to iron deficiency. Therefore, weight control, especially in obese subjects is necessary to prevent iron deficiency and anemia.

Comparing between the effect of energy-restricted diet and yoga on the resting metabolic rate, anthropometric indices, and serum adipokine levels in overweight and obese staff women.

BACKGROUND: Weight management is an important strategy to prevent the consequences of obesity. The aim of the study was to compare the effect of yoga practice and energy-restricted diet on resting metabolic rate (RMR), anthropometric indices, and serum adiponectin and leptin in overweight and obese women. MATERIALS AND METHODS: Obese or overweight women were divided into two groups: yoga practicing and energy-restricted diet. Exercise trials consisted of 60-min Hatha yoga equal to 200 kilocalories (kcal) combined with 300 kcal restriction per day, and an energy-restricted diet consisted of 500 kcal restriction per day. The intervention period for both the groups was 8 weeks. RMR, anthropometric indices, and serum adiponectin, leptin, and lipid profiles were measured at baseline and at the end of the study. RESULTS: RMR was increased in yoga but not in the diet group (P = 0.001). The level of adiponectin was increased in the yoga group compared with the diet (P = 0.035). The concentration of high-density lipoprotein-cholesterol was decreased in the diet group significantly but not in yoga (P = 0.006). The level of leptin was decreased in both the groups (P = 0.001), and there were no significant differences between the two groups. CONCLUSION: The findings of the study demonstrated the effect of yoga practicing on RMR, and serum adiponectin, in overweight and obese women. It seems yoga practice with less energy restriction compared with a common energy restriction diet and is more effective in weight management for those who are in weight loss programs.

Effects of Synbiotics and Probiotics Supplementation on Serum Levels of Endotoxin, Heat Shock Protein 70 Antibodies and Inflammatory Markers in Hemodialysis Patients: a Randomized Double-Blinded Controlled Trial.

The aim of this study was to investigate the effects of probiotic and synbiotic supplementation on serum inflammatory markers, endotoxin, and anti-HSP70 in hemodialysis (HD) patients. This study was a randomized, double-blind, placebo-controlled trial. Seventy-five hemodialysis patients who met the inclusion and exclusion criteria were randomly assigned for 12 weeks to one of the three arms: synbiotics [n = 23; 15 g of prebiotics, 5 g of probiotic powder containing Lactobacillus acidophilus T16, Bifidobacterium bifidum BIA-6, Bifidobacterium lactis BIA-6, and Bifidobacterium longum LAF-5 (2.7 × 107 CFU/g each)], probiotics [n = 23; 5 g probiotics as in synbiotic group with 15 g of maltodextrin in the sachet as placebo], and placebo [n = 19; 20 g of maltodextrin in the sachet]. Blood and feces were collected at baseline and after intervention. Serum high sensitive C-reactive protein (hs-CRP), interleukin-6, endotoxin, and anti-heat shock protein 70 antibodies (anti-HSP70) were measured. The number of fecal colonies was determined using the plate-counting method. The mean serum level of hs-CRP, anti-HSP70, and endotoxin decreased significantly between groups (p = 0.007, p = 0.037, and p = 0.036, respectively). For the synbiotic group, the mean changes in hs-CRP and IL-6 were significantly lower than for the placebo (p < 0.001 and p < 0.001, respectively) and probiotic group (p = 0.011 and p = 0.008, respectively). Anti-HSP70 mean changes in the synbiotic and probiotic groups differed from the placebo group (p = 0.002 and p = 0.013, respectively). Administration of synbiotics was more effective than probiotics for improvement of inflammatory markers, endotoxin and anti-HSP70 serum levels. Trial registration number: IRCT2017041233393N1.

Investigating the effect of sildenafil on improving lung function and quality of life in the patients with severe asthma.

INTRODUCTION: Phosphodiesterase inhibitors (PDEs) increase intracellular cyclic adenosine monophosphate, which results in a wide range of anti-inflammatory effects and pathologically leads to improve asthma disease. Because no human study has surveyed the effect of PDEs on pulmonary function, except some case reports and animal researches, we decided to perform a pilot study for evaluating the effect of sildenafil (PDE5) on pulmonary function in patients with severe asthma. METHODS: This randomized controlled trials study was conducted on 20 patients with severe asthma in 2019 in Iran. For case group, was prescribed sildenafil (50 mg) daily and the control group received the placebo. In the beginning of the study and one month later, volume parameters, 6-minute walk distance (6MWD), and the quality-of-life questionnaire were measured and compared in the two groups. RESULTS: Twenty patients were entered into this study. 8 patients (40%) were male and 12 (60%) were female. The results showed that mean forced vital capacity 1 in the sildenafil group turned from 1259 ± 170 to 1603 ± 527, while in the placebo group it changed from 1135 ± 125 to 1365 ± 251 (P-value = 0.215). There is no statistically significant difference between two groups. In addition, in comparison with placebo, sildenafil did not show any significant improvement in the volume parameters, the quality-of-life questionnaire scale, and 6MWD at the end of the study. CONCLUSION: According to present result can be concluded that sildenafil does not improve the severity of asthma and the quality of life in patients with severe asthma.

The association between dietary intakes and stone formation in patients with urinary stones in Shiraz.

Background: Kidney stone is a common and costly disease, but it may be improved by a healthy diet. The aim of this study was to evaluate the association between dietary intake and stone formation in patients with urinary stones in Shiraz. Methods: In this cross sectional study, 110 patients with kidney stone were selected from Faghihi hospital, Shiraz. Demographic information was collected, and anthropometric indices, disease-related variables, physical activity (using IPAQ), and dietary intake (using food frequency questionnaire, analyzed by Nut 4 software, to estimate micro and macro nutrients) were evaluated. Independent sample t test and one-way ANOVA were used to compare the quantitative variables between the 2 groups and multi groups, respectively. Chi square test was also used to compare qualitative variables. The correlation between variables was determined using Pearson test. Results: Out of 110 participants in this study, 37 (33.6%) were female, with the mean BMI of 27.0 ± 4.68 kg/m2, and 73 (66.4%) were male, with the mean BMI of 24.21±2.96 kg/m2. The mean intake of calcium-containing foods (p=0.02) and high-fructose beverages (p=0.03) was significantly greater in patients with calcium stones compared to those with uric acid stones. The mean intake of high-purine foods was significantly higher in patients with uric acid stones than in those with calcium stones (p=0.007). The mean intake of vitamin A (p=0.02), beta-carotene (p=0.03), and fructose (p=0.03) was significantly higher in patients with calcium stones than in those with uric acid stones, while caffeine intake was significantly higher in patients with uric acid than in those with calcium stones (p=0.01). There was a significant correlation between consumption of high-oxalic beverages (p=0.005, correlation coefficient = 0.26) and high-fructose (p=0.048, correlation coefficient = 0.18) with spontaneous stone expulsion. Conclusion: There was a significant relationship between consuming vitamin A, beta-carotene, and foods containing calcium, purine, fructose, and oxalate and formation of kidney stones. Therefore, adopting a healthy diet and increasing physical activity may be effective in the treatment of kidney stones.

Dietary and Biochemical Characteristics Associated with Normal-Weight Obesity.

Background: Inflammation and oxidative stress have been reported to be higher in subjects with normal weight obesity (NWO) syndrome [normal body mass index (BMI) (<25 kg/m2) but excessive body fat (for women ≥ 30% and for men ≥ 20%) according to World Health Organization (WHO) definitions]; however, it is unclear whether this is due to inadequate dietary antioxidant intake or the pathophysiology of NWO. The aim of present study was to assess the association between dietary factors and body antioxidant status with NWO syndrome in male university students. Methods: This study was a case-control study carried out on ninety age-matched male university students [30 normal weights (NW), 30 NWO and 30 overweight-obese (OB)]. A validated food frequency questionnaire (98 items) and 3-day 24-h recalls were used for dietary assessment. Total antioxidant capacity (TAC) of diet and serum and high-sensitive C-reactive protein (hs-CRP) concentrations were also measured. Results: Dietary intake of fruits (frequency factor (FF) = 2.3 vs 2.9, p < 0.05), legumes (FF = 0.7 vs 1.3, p < 0.01), nuts and seeds (FF = 0.4 vs 0.8, p < 0.05), beta-cryptoxanthin (p < 0.05), lycopene (p < 0.05) and serum TAC levels (p < 0.01) were significantly lower in NWO compared to the NW group. No significant differences in these parameters were observed between NWO and OB group. A significant negative correlation was observed between serum TAC levels and BMI (r = -0.57, p < 0.001) and body fat percent (r = -0.52, p < 0.001). Conclusions: This study shows that NWO male subjects consume lower amounts of dietary antioxidants and share the same low body antioxidant status as obese individuals, although they appear lean.

The effect of Nigella sativa oil on serum levels of inflammatory markers, liver enzymes, lipid profile, insulin and fasting blood sugar in patients with non-alcoholic fatty liver.

BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is one of the metabolic disturbances associated with inflammation. Nigella sativa (NS) seed oil has different chemical compounds including Thymoquinone (TQ), unsaturated fatty acids, and flavonoids. NSs are used as anti-inflammatory and antioxidants in medical sciences. This study aimed to investigate the effect of NS oil on several parameters in serum levels of patients with NAFLD. METHODS: Forty-four patients diagnosed with NAFLD participated in a randomized, double-blind, placebo-controlled clinical trial. Patients were randomly assigned into two groups; one receiving NS oil and the other receiving placebo (paraffin oil), for 8 weeks. Blood samples were taken from the patients at the beginning and the end of the study. Afterwards, liver enzymes (ALT, AST, and GGT), inflammatory markers (Hs-CRP, TNF-α, and IL-6), insulin, lipid profiles (total cholesterol, triglyceride, VLDL, LDL-C, and HDL-C), FBS, and blood pressure were measured. RESULTS: Consumption of NS seed oil as supplement decreased the FBS level, lipid profiles (TG, TC, LDL, VLDL), liver enzymes (AST and ALT), hs-CRP inflammatory marker, IL-6, TNF-α, while it increased the HDL-C levels, compared to the placebo group (P < 0.05). Receiving NS oil had no significant effect on serum levels of insulin, blood pressure, and GGT in comparison with the beginning of the study (P < 0.05). CONCLUSION: NS seed oil supplements may decrease the liver enzymes and lipid profiles in the patients with NAFLD and play a protective role in the liver via reducing the inflammation in this group of patients.

Effect of Synbiotic and Probiotic Supplementation on Serum Levels of Endothelial Cell Adhesion Molecules in Hemodialysis Patients: a Randomized Control Study.

The aim of this study was to investigate the effect of synbiotic and probiotic supplementation on serum vascular dysfunction and necrosis markers in hemodialysis (HD) patients. In this randomized, double-blind, placebo-controlled trial, 75 HD patients were randomly assigned to either the synbiotic or probiotic or placebo group. The patients in the synbiotic group received 15 g of prebiotics and 5 g probiotic powder containing Lactobacillus acidophilus strain T16 (IBRC-M10785), Bifidobacterium bifidum strain BIA-6, Bifidobacterium lactis strain BIA-6, Bifidobacterium longum strain LAF-5 (2.7 × 107 CFU/g each) in sachets (n = 25), whereas the probiotic group received 5 g probiotics same to the first group with 15 g of maltodextrin powder in sachets (n = 25) and the placebo group received 20 g of maltodextrin powder in sachets (n = 25) for 12 weeks. At baseline and the end of the study, serum concentrations of soluble intercellular adhesion molecule type 1 (sICAM-1), soluble vascular cell adhesion molecule type 1 (sVCAM-1), cytokeratin 18 (CK-18) as the necrosis marker, uric acid, and phosphate levels were measured. Feces also were collected for microbiota colony counting. Serum ICAM-1 level reduced significantly in the synbiotic group after the intervention period (P = 0.02), and this reduction was significantly different in the synbiotic group in comparison to the placebo group (P = 0.03). Serum levels of VCAM-1 and CK-18 were not significantly different between the groups. However, the reduction in serum levels of VCAM-1 in the synbiotic group was significantly higher in comparison to the placebo group (P = 0.01). Multivariate linear regression analysis revealed that ∆ phosphate was the sole independent determinant of ∆ICAM-1 (P = 0 < 001). The study indicated that synbiotic supplementation reduced serum ICAM-1 level, which is a risk factor for cardiovascular diseases in HD patients, but has no effect on the necrosis marker. Trial registration: www.irct.ir (IRCT2017041233393N1).

Dark Chocolate Effect on Serum Adiponectin, Biochemical and Inflammatory Parameters in Diabetic Patients: A Randomized Clinical Trial.

BACKGROUND: An appropriate snack for patients with diabetes mellitus should be considered to help them in their treatment due to their hard administrative diet. This study was conducted to evaluate the effect of dark chocolate on inflammatory markers, serum adiponectin, and certain biochemical factors in patients with type 2 diabetes (T2D). METHODS: This study was a randomized parallel clinical trial. Thirty grams of 84% dark chocolate, along with therapeutic lifestyle changes (TLCs) guidelines, were administrated to patients with T2D. Control group received only TLC guidelines. The intervention period was 8 weeks. Twenty-one subjects in dark chocolate and 23 subjects in control group completed the study. Fasting blood samples were collected before and after the intervention period and inflammatory markers, biochemical factors, and adiponectin levels were assessed. RESULTS: Fasting blood sugar, hemoglobin A1C, low-density lipoprotein and triglyceride levels declined significantly in the dark chocolate group and this decrease was significant between the intervention and control groups. Tumor necrosis factor-alpha, interleukin-6, and high sensitive C-reactive protein were significantly decreased in the dark chocolate group. Adiponectin levels were not significantly different between the two groups. CONCLUSIONS: In this study subjects who received dark chocolate along with TLC guidelines had lower levels of inflammatory markers such as hs-CRP, TNF-α, and IL-6, compared with the subjects who were devoid of dark chocolate and followed only the TLC guidelines. Other studies should be conducted to evaluate the most effective and administrative dosage of dark chocolate as a snack along with the common treatment of diabetes.

Effects of Phytosterol Supplementation on Serum Levels of Lipid Profiles, Liver Enzymes, Inflammatory Markers, Adiponectin, and Leptin in Patients Affected by Nonalcoholic Fatty Liver Disease: A Double-Blind, Placebo-Controlled, Randomized Clinical Trial.

OBJECTIVE: Considering the high prevalence of nonalcoholic fatty liver disease and based on the evidence about the role of dietary cholesterol in liver inflammation, and also with regard to the effect of phytosterols on the metabolism of cholesterol, we aimed at exploring the therapeutic potential of phytosterol supplementation against nonalcoholic fatty liver disease. METHOD: Thirty-eight patients with nonalcoholic fatty liver disease were randomly divided into two groups: The phytosterol group (n = 19) received a 1.6-g phytosterol supplement daily and the control group (n = 19) received 1.6 g starch daily as placebo for an 8-week period. Blood samples of all patients were taken at baseline (week 0) and at the end of the study (week 8) for measurement of lipid profiles, liver enzymes, inflammatory markers, adiponectin, and leptin. RESULTS: Phytosterol supplementation significantly improved the levels of low-density lipoprotein cholesterol, aspartate aminotransferase, alanine aminotransferase, and tumor necrosis factor alpha compared to the placebo group. On the other hand, there were no significant differences between the two groups in total cholesterol, triglycerides, high-density lipoprotein cholesterol, very-low-density lipoprotein cholesterol, ratios of low-density lipoprotein cholesterol/high-density lipoprotein cholesterol and total cholesterol/high-density lipoprotein cholesterol, gamma-glutamyl transferase, interleukin 6, high-sensitivity C-reactive protein, adiponectin, and leptin. CONCLUSIONS: The present study suggested that daily consumption of 1.6 g phytosterols efficiently lowers low-density lipoprotein cholesterol, aspartate aminotransferase, alanine aminotransferase, and tumor necrosis factor alpha in patients with nonalcoholic fatty liver disease.

Astaxanthin improves glucose metabolism and reduces blood pressure in patients with type 2 diabetes mellitus.

BACKGROUND AND OBJECTIVES: This randomized, placebo-controlled trial was performed for 8 weeks to investigate the potential effects of astaxanthin (AST) supplementation on the adiponectin concentration, lipid peroxidation, glycemic control, insulin sensitivity, and anthropometric indices in participants with type 2 diabetes mellitus. METHODS AND STUDY DESIGN: We enrolled 44 participants with type 2 diabetes who met our inclusion criteria. Eight milligrams of AST supplementation or a placebo were randomly administered once daily for 8 weeks to these participants. RESULTS: The 8-week administration of AST supplementation increased the serum adiponectin concentration and reduced visceral body fat mass (p<0.01), serum triglyceride and very-low-density lipoprotein cholesterol concentrations, and systolic blood pressure (p<0.05). Furthermore, AST significantly reduced the fructosamine concentration (p<0.05) and marginally reduced the plasma glucose concentration (p=0.057). CONCLUSIONS: We demonstrated that because participants with type 2 diabetes often have hypertriglycemia and uncontrolled glucose metabolism; our findings of dual beneficial effects are clinically valuable. Our results may provide a novel complementary treatment with potential impacts on diabetic complications without adverse effects.

The effect of hydro-alcohol extract of Tribulus terrestris on sexual satisfaction in postmenopause women: A double-blind randomized placebo-controlled trial.

INTRODUCTION: Increasing life expectancy in women and having menstrual problems and hormone-associated complications have led people to use complementary and alternative medicine. In menopause, the reduction in estrogen and androgen physiologically leads to a decrease in blood flow in the volvuleous and vaginal zone, resulting in a reduction in sexual desire and arousal. Sexual satisfaction plays an important role in mental health. The aim of this study was to investigate the effect of Tribulus terrestris on sexual satisfaction in postmenopausal women. METHODS: This double-blind clinical trial was conducted in 2017 with the aim of investigating the effect of hydro-alcohol extract of T. terrestris on sexual satisfaction of postmenopausal women on 60 women referred to health center number 1 in eastern Ahvaz. A total of 60 postmenopausal women were randomly assigned into two groups of 30 to receive a syrup containing T. terrestris extract at a concentration of 0.9 mg and placebo for 8 weeks. Sexual satisfaction was calculated based on Larsson questionnaire. Data were analyzed by SPSS software (version 22) and t-test was used for comparing two groups in quantitative variables and Chi-square test was used for qualitative variables. P value less than 0.05 was considered significant. FINDINGS: After intervention, the mean of sexual satisfaction in the intervention group was significantly higher than in the preintervention group (P < 0.005), and a significant increase in sexual satisfaction was observed in the tetanus syrup group. RESULTS: Taking T. terrestris syrup increased sexual satisfaction in postmenopausal women.

The effect of educational program based on the precede-proceed model on improving self-care behaviors in a semi-urban population with type 2 diabetes referred to health centers of Bavi, Iran.

AIMS: Self-care in patients with diabetes reduces the number of hospital admissions, costs and improves their quality of life so that just by training self-care to them can reduce 80 percent of diabetic complications. Therefore, this study aimed to investigate the effect of educational program based on precede-proceed model on improving self-care behaviors in patients with type 2 diabetes referred to health centers in city Bavi in 2016-2017. MATERIALS AND METHODS: This quasi-experimental study, conducted on 110 patient women with type 2 diabetes referred to health centers in Bavi city in 2016-2017. The training program was designed based on Precede-Proceed Model. Data collection tools included the Precede researcher-made questionnaire and the Glasgow questionnaire. The duration of the training course was three months. After one month, the effect of this program, and the amount of improvement of the patients' self-care behavior were evaluated. Independent t-test, paired t-test, Chi-square and Fisher's exact tests were carried was used for data analysis. RESULTS: After the intervention, the average score of predisposing factors (knowledge, attitude and self-efficacy), reinforcing factors, enabling factors and self-care behaviors, in the intervention group compared to the control group, significantly increased (P<0.05). After the training, the fasting blood sugar (FBS) and body mass index (BMI) decreased in the experimental group, but this reduction was not statistically significant (P>0.05). CONCLUSION: The findings of this research showed that Precede-Proceed Model would be an appropriate framework to educate patients with type 2 diabetes as well as promote self-care behaviors.