The effect of synbiotics on liver enzymes, obesity indices, blood pressure, lipid profile, and inflammation in patients with non-alcoholic fatty liver: A systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Patients with non-alcoholic fatty liver disease (NAFLD) benefit from using synbiotics. However, findings from existing trials remain contentious. Therefore, this meta-analysis evaluated the effects of synbiotics on liver enzymes, blood pressure, inflammation, and lipid profiles in patients with NAFLD. METHODS: We searched PubMed, Embase, Cochrane, Scopus, and Web of Science for randomized controlled trials (RCTs) regarding synbiotics supplementation in patients with NAFLD. RESULTS: The meta-analysis revealed that synbiotics supplementation significantly improved liver enzymes (AST, WMD: -9.12 IU/L; 95 % CI: -13.19 to -5.05; ALT, WMD: -8.53 IU/L; 95 % CI: -15.07 to -1.99; GGT, WMD: -10.42 IU/L; 95 % CI: -15.19 to -5.65), lipid profile (TC, WMD: -7.74 mg/dL; 95 % CI: -12.56 to -2.92), obesity indices (body weight, WMD: -1.95 kg; 95 % CI: -3.69 to -0.22; WC, WMD: -1.40 cm; 95 % CI: -2.71 to -0.10), systolic blood pressure (SBP, WMD: -6.00 mmHg; 95 % CI: -11.52 to -0.49), and inflammatory markers (CRP, WMD: -0.69 mg/L; 95 % CI: -1.17 to -0.21; TNF-α, WMD: -14.01 pg/mL; 95 % CI: -21.81 to -6.20). CONCLUSION: Overall, supplementation with synbiotics positively improved liver enzymes, obesity indices, and inflammatory cytokines in patients with NAFLD.

Effects of flaxseed supplementation on inflammatory biomarkers: A GRADE-assessed systematic review and meta-analysis of randomized controlled trials.

Several studies reported the benefits of flaxseed on inflammatory biomarkers, while others reported conflicting findings. Thus, the aim of this meta-analysis was to assess the impacts of flaxseed on inflammatory biomarkers in adults. Databases including Embase, PubMed, Scopus, and Web of Sciences were searched till February 2024. The 54 RCTs were included in the final analysis, which involved 3000 individuals from 12 countries. Overall, the flaxseed supplementation had a significant reduction in C-reactive protein (CRP) (SMD = -0.46; 95 % CI: -0.70, -0.23, P < 0.001; I2 = 82.9 %, P < 0.001), and interleukin 6 (IL-6) (SMD = -0.64, 95 % CI: -1.13, -0.16, P = 0.010; I2 = 92.7, P < 0.001). Furthermore, flaxseed did not significantly change the concentration of tumor necrosis factor α (TNF-α) (SMD = -0.17; 95 % CI: -0.63, 0.29, P = 0.467; I2 = 92, P < 0.001). Flaxseed supplementation significantly decreased serum concentrations of CRP and IL-6, but not TNF-a. Thus, this meta-analysis suggests that the current evidence supports the potential benefits of flaxseed in managing inflammatory conditions.

The effects of flaxseed (Linum usitatissimum) supplementation on anthropometric indices: An updated systematic review and meta-analysis of randomized clinical trials.

OBJECTIVE: Flaxseed (Linum usitatissimum) supplementation has shown promise as an anti-obesity agent in various clinical trials, although results have been inconsistent. To provide a more accurate assessment of the impact of flaxseed supplementation on anthropometric indices, a systematic review and meta-analysis was performed. METHODS: We searched several international databases until August 2023, including Scopus, PubMed, Web of Science, Embase, and Cochrane Library. Weighted mean differences (WMDs) were analyzed using a random-effects model. RESULTS: Sixty-four trials comprising 72 treatment arms were included. All studies reported the intervention types (Lignans, Whole flaxseed, and Flaxseed oil) and dosage. However, three studies did testing for purity, and 40 studies reported potency. Also, the risk of contamination with heavy metals was not mentioned in studies. Another limitation was the lack of blind evaluation in the studies. According to three trials included in the systematic review, flaxseed did not affect anthropometric indices. Our meta-analysis revealed significant reductions in body weight (WMD = -0.63 kg; 95 % CI: -1.00, -0.27, P < 0.001; I2 = 76.7 %, P < 0.001), body mass index (BMI) (WMD: -0.24 kg/m2, 95 % CI: -0.36, -0.11, P < 0.001; I2 = 78.5 %, P < 0.001) and waist circumference (WC) (WMD: -1.43 cm, 95 % CI: -2.06, -0.80, P < 0.001; I2 = 81.1 %, P < 0.001) following flaxseed supplementation. Subgroup analyses indicated that interventions lasting 10-20 weeks, and studies involving subjects with higher BMI (>30 kg/m2) showed more significant anti-obesity effects. Based on the GRADE evaluation, body weight, BMI, and WC results were considered as moderate-certainty evidence. CONCLUSION: Our systematic review and meta-analysis suggests that supplementation with flaxseed (Linum usitatissimum) leads to meaningful improvements in body weight, BMI, and WC. Therefore, flaxseed can be considered as an adjunctive therapeutic approach in improving obesity.

The effects of curcumin supplementation on biomarkers of inflammation, oxidative stress, and endothelial function: A meta-analysis of meta-analyses.

Numerous interventional studies have revealed the beneficial impact of curcumin supplementation on inflammation, oxidative stress, and endothelial function biomarkers, but the findings are still inconsistent. Thus, this study was conducted to investigate the effects of curcumin supplementation on inflammation, oxidative stress, and endothelial function biomarkers. A meta-analyses of randomized clinical trials was performed by searching PubMed, Embase, Scopus, and Web of Science up to March 31, 2024. Pooled estimates of 21 meta-analyses revealed that curcumin significantly reduced CRP (weighted mean difference (WMD) = -0.87; 95 % CI: - 1.14, - 0.59, P< 0.001), tumor-necrosis factor-alpha (TNF-α) (WMD = -2.72; 95 % CI: -4.05, -1.38; P< 0.001), interleukin-6 (IL-6) (WMD = -0.97, 95 % CI: -1.40, -0.54; P< 0.001), malondialdehyde (MDA) (Effect size (ES) = -0.81; 95 % CI: -1.39, -0.23, P = 0.006) and pulse wave velocity (PWV) (WMD = -45.60; 95 % CI: -88.16, -3.04, P = 0.036), and increased flow-mediated dilation (FMD) (WMD = 1.64, 95 % CI: 1.06, 2.22, P < 0.001), catalase (CAT) (WMD = 10.26; 95 % CI: 0.92, 19.61, P= 0.03), glutathione peroxidase (GPx) (WMD = 8.90; 95 % CI: 6.62, 11.19, P <0.001), and superoxide dismutase (SOD) levels (WMD = 20.51; 95 % CI: 7.35, 33.67, P= 0.002 and SMD = 0.82; 95 % CI: 0.27, 1.38, P= 0.004). However, curcumin did not significantly change total antioxidant capacity (TAC) (ES = 0.29; 95 % CI: -0.09, 0.66, P= 0.059). These results suggest that curcumin has a beneficial effect on CRP, IL-6, TNF-α, SOD, GPx, CAT, MDA, PWV, and FMD levels and may be an effective adjunctive therapy for improving inflammation, oxidative stress, and endothelial function. Registration number: PROSPERO, CRD42024539018.

Effects of Nigella sativa supplementation on lipid profiles in adults: An updated systematic review and meta-analysis of randomized controlled trials.

BACKGROUND AND AIM: Several experiments have suggested that Nigella sativa (N. sativa) supplementation may have a beneficial effect on the lipid profile. However, the results from these trials have been inconclusive. Therefore, this study aimed to explore the impact of N. sativa supplementation on the lipid profile of adult participants. METHODS: We searched Scopus, Web of Science, PubMed, Cochrane, and Web of Science databases until December 2022. Random effects models were used, and pooled data were determined as standardized mean differences with a 95% confidence interval. RESULTS: The findings of 34 studies with 2278 participants revealed that N. sativa supplementation significantly reduced total cholesterol (TC) (SMD: -1.78; 95% CI: -2.20, -1.37, p < 0.001), triglycerides (TG) (SMD: -1.2725; 95% CI: -1.67, -0.83, p < 0.001), and low-density lipoprotein cholesterol (LDL-C) (SMD: -2.45; 95% CI: -3.06, -1.85; p < 0.001) compared to control groups. However, a significant increase was found in high-density lipoprotein cholesterol (HDL-C) (SMD: 0.79; 95% CI: 0.38, 1.20, p < 0.001). CONCLUSION: N. sativa has improved effects on TG, LDL-C, TC, and HDL-C levels. Overall, N. sativa may be suggested as an adjuvant anti-hyperlipidemic agent.

The role of vitamin D in outcomes of critical care in COVID-19 patients: evidence from an umbrella meta-analysis of interventional and observational studies.

OBJECTIVES: Several meta-analyses have suggested the beneficial effect of vitamin D on patients infected with severe acute respiratory syndrome coronavirus-2. This umbrella meta-analysis aims to evaluate influence of vitamin D supplementation on clinical outcomes and the mortality rate of COVID-19 patients. DESIGN: Present study was designed as an umbrella meta-analysis. The following international databases were systematically searched till March 2023: Web of Science, PubMed, Scopus, and Embase. SETTINGS: Random-effects model was employed to perform meta-analysis. Using AMSTAR critical evaluation tools, the methodological quality of the included meta-analyses was evaluated. PARTICIPANTS: Adult patients suffering from COVID-19 were studied. RESULTS: Overall, 13 meta-analyses summarising data from 4 randomised controlled trial and 9 observational studies were identified in this umbrella review. Our findings revealed that vitamin D supplementation and status significantly reduced mortality of COVID-19 [Interventional studies: (ES = 0·42; 95 % CI: 0·10, 0·75, P < 0·001; I2 = 20·4 %, P = 0·285) and observational studies (ES = 1·99; 95 % CI: 1·37, 2·62, P < 0·001; I2 = 00·0 %, P = 0·944). Also, vitamin D deficiency increased the risk of infection and disease severity among patients. CONCLUSION: Overall, vitamin D status is a critical factor influencing the mortality rate, disease severity, admission to intensive care unit and being detached from mechanical ventilation. It is vital to monitor the vitamin D status in all patients with critical conditions including COVID patients.

Corrigendum: Remarkable impacts of probiotics supplementation in enhancing of the antioxidant status: results of an umbrella meta-analysis.

[This corrects the article DOI: 10.3389/fnut.2023.1117387.].

The effect of cinnamon supplementation on glycemic control in patients with type 2 diabetes mellitus: An updated systematic review and dose-response meta-analysis of randomized controlled trials.

Although many randomized controlled trials (RCTs) have revealed the benefits of cinnamon on type 2 diabetes mellitus (T2DM), the effects of cinnamon supplementation on glycemic control in patients with T2DM are inconclusive. Therefore, the aim of this meta-analysis of RCTs was to assess the effects of cinnamon supplementation in managing glycemic control in patients with T2DM. Scientific international databases including Scopus, Web of Sciences, PubMed, Embase, and the Cochrane Library were searched till December 2022. For net changes in glycemic control, standard mean differences (SMDs) were calculated using random-effects models. Findings from 24 RCTs revealed that cinnamon supplementation had a statistically significant reduction in fasting blood sugar (SMD: -1.32; 95% CI: -1.77, -0.87, p < 0.001), Homeostatic Model Assessment for Insulin Resistance (SMD: -1.32; 95% CI: -1.77, -0.87, p < 0.001), and hemoglobin A1C (SMD: -0.67; 95% CI: -1.18, -0.15, p = 0.011) compared with the control group in patients with T2DM. Additionally, cinnamon did not change the serum levels of insulin (SMD: -0.17; 95% CI: -0.34, 0.01, p = 0.058) significantly. Our analysis indicated that glycemic control indicators are significantly decreased by cinnamon supplementation. Together, these findings support the notion that cinnamon supplementation might have clinical potential as an adjunct therapy for managing T2DM.

The effect of curcumin supplementation on circulating adiponectin and leptin concentration in adults: a GRADE-assessed systematic review and meta-analysis of randomised controlled trials.

Curcumin is a phytocompound found in the root of turmeric, a common herbal ingredient in many Asian cuisines. The compound contains anti-inflammatory activity, which is mediated through an upregulation of adiponectin and reduction of leptin. Results of randomised controlled trials (RCT) have shown that the effects of curcumin on adipokines are conflicting. Therefore, the current systematic review and meta-analysis of RCT were conducted with the aim of elucidating the role of curcumin supplementation on serum adiponectin and leptin. The search included PubMed, Embase, Cochrane Library, Scopus, Web of Science and Google Scholar from inception to August 2023. For net changes in adipokines, standardised mean differences (SMD) were calculated using random effects models. Thirteen RCT with fourteen treatment arms were eligible for inclusion in this meta-analysis. Curcumin supplementation was effective in increasing serum adiponectin (SMD = 0·86, 95 % CI (0·33, 1·39), P < 0·001; I2 = 93·1 %, P < 0·001) and reducing serum leptin (SMD = -1·42, 95 % CI (-2·29, -0·54), P < 0·001; I2 = 94·7 %, P < 0·001). In conclusion, curcumin supplementation significantly increased circulating adiponectin and decreased leptin levels in adults.

The effect of flaxseed supplementation on sex hormone profile in adults: a systematic review and meta-analysis.

Inconsistent data suggest that flaxseed supplementation may have a role in sex hormones. We aimed to carry out a systematic review and meta-analysis of randomized controlled trials (RCTs) investigating effects of flaxseed supplementation on sex hormone profile. PubMed, Scopus, Embase, Cochrane Library, Web of Science databases, and Google Scholar were searched up to March 2023. Standardized mean difference (SMD) was pooled using a random-effects model. Sensitivity analysis, heterogeneity, and publication bias were reported using standard methods. The quality of each study was evaluated with the revised Cochrane risk-of-bias tool for randomized trials, known as RoB 2. Finding from ten RCTs revealed that flaxseed supplementation had no significant alteration in follicle-stimulating hormone (FSH) (SMD: -0.11; 95% CI: -0.87, 0.66: p = 0.783), sex hormone-binding globulin (SHBG) (SMD: 0.35; 95% CI: -0.02, 0.72; p = 0.063), total testosterone (TT) levels (SMD: 0.17; 95% CI: -0.07, 0.41; p = 0.165), free androgen index (FAI) (SMD = 0.11, 95% CI: -0.61, 0.83; p = 0.759), and dehydroepiandrosterone sulfate (DHEAS) (SMD: 0.08, 95%CI: -0.55, 0.72, p = 0.794). Flaxseed supplementation had no significant effect on sex hormones in adults. Nevertheless, due to the limited included trials, this topic is still open and needs further studies in future RCTs.

The effects of purslane (Portulaca oleracea) on glycemic indices: A GRADE-assessed systematic review and meta-analysis of randomized controlled trials.

Although several studies have revealed the benefits of purslane on glycemic indices, the results of some studies reject such effect. Therefore, aim of this meta-analysis of randomized controlled trials (RCTs) was to assess the effects of purslane supplementation on glycemic indices. Scientific international databases as Scopus, Web of Sciences, PubMed, Embase, and the Cochrane library were searched up to December 2022. For net changes in glycemic indices, weighted mean differences (WMDs) were calculated using random-effects models. Purslane supplementation had a statistically significant reduction in fasting blood glucose [FBG, WMD: -6.37; 95% CI: -9.34, -3.40, p < 0.001]. In addition, purslane did not significant effect on serum levels of insulin [WMD: -0.74; 95% CI: -2.58, 1.10; p = 0.430], homeostasis model assessment for insulin resistance [HOMA-IR, WMD: -0.25; 95% CI: -0.88, 0.37, p = 0.429], and QUICKI [WMD: -0.01; 95% CI: -0.01, 0.03, p = 0.317] compared with the control group. The results of our meta-analysis revealed a beneficial effect of purslane supplementation as a tool to decrease FBG levels, but not to HOMA-IR, insulin, and QUICKI levels. However, future high-quality, long-term clinical trials are needed to confirm our results.

The effect of L-carnitine supplementation on lipid profile in adults: an umbrella meta-analysis on interventional meta-analyses.

Introduction: Previous meta-analyses investigating the therapeutic effects of L-carnitine on lipid profiles have demonstrated inconsistent results. The present umbrella meta-analysis aimed to investigate the impact of efficacy of L-carnitine on lipid profiles in adults. Methods: Databases including PubMed, Scopus, and Embase, Web of Science, and Google Scholar were searched up to June 2023. Meta-analysis was performed using a random-effects model. Results: Our results from thirteen meta-analyses indicated that L-carnitine supplementation significantly total cholesterol (TC) (ES = -1.05 mg/dL, 95% CI: -1.71, -0.39; p = 0.002), triglycerides (TG) (ES = -2.51 mg/dL; 95% CI: -3.62, -1.39, p < 0.001), and low-density lipoprotein-cholesterol (LDL-C) (ES = -4.81 mg/dL; 95% CI: -6.04, -3.59; p < 0.001). It also increased high-density lipoprotein-cholesterol (HDL-C) (ES: 0.66 mg/dL, 95% CI: 0.20, 1.12, p = 0.005) levels. Conclusion: The present umbrella meta-analysis suggests supplementation with L-carnitine in a dosage of more than 2 g/day can improve lipid profile. Thus, L-carnitine supplementation can be recommended as an adjuvant anti-hyperlipidemic agent.

The role of probiotic supplementation in inflammatory biomarkers in adults: an umbrella meta-analysis of randomized controlled trials.

OBJECTIVE: Despite the increasing evidence for probiotics' anti-inflammatory effects, the results of meta-analyses remain inconsistent. The present umbrella meta-analysis aimed to investigate the effects of probiotic supplementation on inflammatory biomarkers. METHODS: We performed a wide-ranging systematic search in several databases, including PubMed, Web of Science, Scopus, EMBASE, and Google Scholar up to April 2023. The overall effect sizes were calculated using effect size (ES) values and their corresponding confidence intervals (CI). RESULTS: Out of a total of 580 related articles, 39 studies were qualified for inclusion in the analysis. The results of the analysis revealed a significant reduction of C-reactive protein (CRP) (ES = -1.02; 95% CI: -1.23, -0.80, p < 0.001; I2: 94.1%, p < 0.001), TNF-α (ES = -0.35; 95% CI: -0.50, -0.20, p < 0.001; I2: 75.6%, p < 0.001), and interleukin-6 (IL-6) levels (ES = -0.36; 95% CI: -0.59, -0.13, p = 0.002; I2: 85.6%, p < 0.001), following probiotic supplementation. CONCLUSION: Probiotic supplementation significantly reduced serum concentrations of TNF-a, CRP, and IL-6. Thus, probiotic supplementation can be considered adjuvant therapy to alleviate inflammation in various inflammatory conditions.

Can flaxseed supplementation affect circulating adipokines in adults? An updated systematic review and meta-analysis of randomized controlled trials.

Introduction: The findings of randomized controlled trials (RCTs) regarding the effect of flaxseed on adipokine concentrations are conflicting. Therefore, the present meta-analysis was conducted to provide definite and conclusive results. Methods: Systematically, Scopus, Embase, PubMed, Web of Science databases, and Google Scholar were searched for relevant literature published up to December 2022. Based on random-effect models, standard mean differences (SMDs) were calculated for net changes in adipokine concentrations. Results: Overall, 13 RCTs (15 arms) were eligible to be included. The results indicated that leptin was significantly reduced after the intervention with flaxseed supplement (SMD = -0.69, 95% CI: -1.37, -0.01; p = 0.048; I2 = 92.0%, p < 0.001). In addition, flaxseed supplements had no considerable effect on plasma adiponectin (SMD = 0.52, 95% CI: -0.20, 1.25, p = 0.159; I2 = 92.0%, p < 0.001). Discussion: Flaxseed significantly improves leptin but does not affect adiponectin concentrations. Additional future well-designed trials are required to further assess the potential benefits of flaxseed on adipokines in humans.

Remarkable impacts of probiotics supplementation in enhancing of the antioxidant status: results of an umbrella meta-analysis.

Introduction: Numerous meta-analyses have demonstrated the beneficial effects of probiotics on oxidative stress biomarkers, although some studies have contradictory results. Therefore, the current research was conducted to obtain a precise and definite understanding on the impact of probiotics on oxidative stress biomarkers in adults. Methods: We conducted a comprehensive systematic search of results on Scopus, PubMed, Embase, Web of Science, and Google Scholar dating up to March 2022. Fifteen meta-analyses were included in this umbrella meta-analysis. The random-effects model was employed to obtain the overall effect size. Subgroup analyses were carried out based on supplementation dosage and duration, mean age, and study population. Results: Our results indicated that probiotics supplementation meaningfully decreased serum malondialdehyde (MDA) (ESWMD = -0.56, 95% CI: -0.72, -0.39; p < 0.001, and ESSMD = -0.50, 95% CI: -0.66, -0.34; p < 0.001). Moreover, the findings showed that probiotics resulted in a significant increase in total antioxidant capacity (TAC) (ESWMD = 29.18, 95% CI: 16.31, 42.04; p < 0.001, and ESSMD = 0.25, 95% CI: 0.02, 0.47; p = 0.032), total glutathione (GSH) (ESWMD: 30.65; 95% CI: 16.94, 44.35, p < 0.001), and nitric oxide (NO) (ESWMD: 1.48; 95% CI: 0.31, 2.65, p = 0.013; I2 = 51.7%, p = 0.043). Discussion: Probiotics could be considered a strong agent in the reinforcement of antioxidant status and preventing the incidence of chronic diseases.

Alleviating effects of coenzyme Q10 supplements on biomarkers of inflammation and oxidative stress: results from an umbrella meta-analysis.

Introduction: Although several meta-analyses support the positive effect of coenzyme Q10 (CoQ10) on biomarkers of oxidative stress and inflammation, the results of some other studies reject such effects. Methods: Therefore, in this umbrella meta-analysis, we performed a comprehensive systematic search in such databases as Web of Science, PubMed, Scopus, Embase, and Google Scholar up to January 2023. Results: Based on standardized mean difference analysis, CoQ10 supplementation significantly decreased serum C-reactive protein (CRP) (ESSMD = -0.39; 95% CI: 0.77, -0.01, p = 0.042) and malondialdehyde (MDA) (ESSMD = -1.17; 95% CI: 1.55, -0.79, p < 0.001), while it increased the total antioxidant capacity (TAC) (ESSMD = 1.21; 95% CI: 0.61, 1.81, p < 0.001) and serum superoxide dismutase (SOD) activity (ESSMD = 1.08; 95% CI: 0.37, 1.79, p = 0.003). However, CoQ10 supplementation had no significant reducing effect on tumor-necrosis factor-alpha (TNF- α) (ESSMD = -0.70; 95% CI: 2.09, 0.68, p = 0.320) and interleukin-6 (IL-6) levels (ESSMD = -0.85; 95% CI: 1.71, 0.01, p = 0.053). Based on weighted mean difference analysis, CoQ10 supplementation considerably decreased TNF-α (ESWMD = -0.46, 95% CI: 0.65, -0.27; p < 0.001), IL-6 (ESWMD = -0.92, 95% CI: 1.40, -0.45; p < 0.001), and CRP levels (effect sizes WMD = -0.28, 95% CI: 0.47, -0.09; p < 0.001). Discussion: The results of our meta-analysis supported the alleviating effects of CoQ10 on markers of inflammation cautiously. However, CoQ10 had antioxidant effects regarding the improvement of all the studied antioxidant and oxidative stress biomarkers. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=323861, identifier CRD42022323861.

The effectiveness of treatment with probiotics in Helicobacter pylori eradication: results from an umbrella meta-analysis on meta-analyses of randomized controlled trials.

Background and aims: The purpose of this umbrella meta-analysis was to quantitatively summarize meta-analyses of randomized controlled trial (RCT) studies regarding the effects of probiotic supplementation on Helicobacter pylori (H. pylori) eradication. Methods: A thorough search of the electronic databases including PubMed, Web of Science, Embase, Scopus, and Google Scholar was carried out from the inception up to May 2022. For the evaluation of overall effect sizes, the pooled relative risk (RR) or odds ratio (OR) and their corresponding 95% confidence intervals (CI) were calculated. The random-effects model was used for the meta-analysis. Results: Overall, 18 eligible studies (47 278 participants in total) were included in the study. The findings revealed that probiotics have a beneficial impact on H. pylori eradication (pooled ESRR: 1.13; 95% CI: 1.11, 1.14, p < 0.01, and ESOR = 1.86, 95% CI: 1.70, 2.03, p < 0.01). Greater effects on H. pylori eradication were observed when higher doses (>10 × 1010 CFU) and mixed strains were supplemented. Conclusion: The present umbrella meta-analysis suggests that supplementation with probiotics may be considered as an efficient approach to ameliorate H. pylori complications, particularly probiotics with higher CFUs and mixed strains.

The effects of royal jelly supplementation on anthropometric indices: a GRADE-assessed systematic review and dose-response meta-analysis of randomized controlled trials.

Inconsistent data are available about the effect of royal jelly supplementation on anthropometric indices in humans. This systematic review and meta-analysis was done to summarize data from available randomized controlled trials (RCTs) on the effect of royal jelly supplementation on anthropometric indices such as body weight (BW), body mass index (BMI), and fat mass (FM) in adults. We systematically searched Embase, PubMed, Web of Science, and Scopus databases up to March 2023. All RCTs assessing the effect of royal jelly on anthropometric indices were included. Data were pooled using the random-effects method and were expressed as weighted mean difference (WMD) and 95% confidence intervals (CIs). Sensitivity and subgroup analyses were also performed. Out of 1,492 records, 10 studies that enrolled 512 participants were included. There was no significant effect on BW (WMD: -0.29 kg, 95% CI: -1.24, 0.65, p = 0.543), BMI (WMD: 0.11 kg/m2, 95% CI: -0.29, 0.52, p = 0.583), and FM (WMD: 0.02%, 95% CI: -0.41, 0.46, p = 0.84). However, we observed a reduction in BW and BMI following royal jelly intake in subgroup of royal jelly dosage <3,000 mg/day. Although the royal jelly supplementation significantly reduced BW and BMI at the dosages <3,000 mg/day, until additional trials have been conducted to assess the effects on obesity measures, it is best to prescribe royal jelly with caution.

The Impact of Vitamin D Supplementation on Improving Blood Pressure: Evidence Obtained From an Umbrella Meta-analysis.

PURPOSE: The results of meta-analyses regarding the effect of vitamin D on blood pressure are conflicting. The present umbrella meta-analysis was conducted to provide definite and conclusive results. METHODS: Systematically, Scopus, EMBASE, PubMed, and Web of Science databases and Google Scholar were searched for relevant literature published up to July 2022. All meta-analyses of clinical trials addressing the effect of vitamin D on blood pressure were included. Random effects analysis was performed to obtain the overall effect size based on the standardized mean differences (SMDs) and weighted mean differences (WMDs) separately. The quality of included meta-analyses was assessed by using the Measurement Tool for Assessing Multiple Systematic Reviews 2 questionnaire. FINDINGS: Overall, 21 meta-analyses were enrolled in the umbrella review. The results indicated that systolic blood pressure was significantly reduced after the intervention based on WMD effect size analysis (ESWMD = -0.69 mm Hg; 95% CI, -1.35 to -0.04 [P < 0.038]; I2 = 46.7%, P = 0.021); however, no considerable impact was observed based on analysis of SMD effect sizes (ESSMD = -0.05 mm Hg; 95% CI, -0.24 to 0.14; P = 0.615). Also, vitamin D supplementation indicated a significant improvement in diastolic blood pressure based on WMD effect sizes (ESWMD = -0.66 mm Hg; 95% CI, -1.05 to -0.27 [P < 0.001]; I2 = 56.4%, P = 0.004) but not SMD analysis (ESSMD = -0.04 mm Hg; 95% CI, -0.13 to 0.04 [P = 0.328]; I2 = 53.4%, P = 0.057). IMPLICATIONS: Based on obtained evidence, vitamin D could be considered an efficient adjuvant for improving blood pressure.

The effect of cinnamon consumption on lipid profile, oxidative stress, and inflammation biomarkers in adults: An umbrella meta-analysis of randomized controlled trials.

AIMS: Cinnamon is a polyphenol-rich spice that has beneficial effects on markers of cardio metabolic health such as lipid profile, oxidative stress, and inflammation. Despite the accumulating evidence from meta-analyses on the effects of cinnamon on these markers, their findings are controversial. Thus, this umbrella meta-analysis was performed to evaluate the present evidence and provide a conclusive clarification. DATA SYNTHESIS: We searched the following international databases from inception to January 2022: PubMed, Scopus, Web of Science and Embase, and Google Scholar. Our findings of eleven meta-analyses showed that cinnamon consumption can significantly improve total cholesterol (TC) (WMD = -1.01 mg/dL; 95% CI: -2.02, -0.00, p = 0.049), low-density lipoprotein-cholesterol (LDL-C) (WMD = -0.82 mg/dL; 95% CI: -1.57, -0.07, p = 0.032), and high-density lipoprotein-cholesterol (HDL-C) (WMD = 0.47 mg/dL; 95% CI: 0.17, 0.77, p = 0.002) levels but not triglyceride (TG) levels (WMD = -0.13 mg/dL; 95% CI: -0.58, 0.32, p = 0.570). Our results did not show any significant effect of cinnamon on malondialdehyde (MDA) levels (WMD = -0.47; 95% CI: -0.99, 0.05, p = 0.078) and C-reactive protein (CRP) levels (WMD = -1.33; 95% CI: -2.66, 0.00, p = 0.051) but there was enhanced total antioxidant capacity (TAC) in patients with type 2 diabetes (T2DM) and polycystic ovary syndrome (PCOS) (WMD = 0.34; 95% CI: 0.04, 0.64, p = 0.026) and increased levels of interleukin-6 (WMD = -1.48; 95% CI: -2.96, -0.01, p = 0.049). CONCLUSIONS: Our results support the usefulness of cinnamon intake in modulating an imbalanced lipid profile in some metabolic disorders, particularly PCOS, as well as in improving TAC and interleukin-6. The review protocol was registered on PROSPERO as CRD42022358827.