The roles of quercetin in diabetes mellitus and related metabolic disorders; special focus on the modulation of gut microbiota: A comprehensive review.

Quercetin is a dietary flavonoid that can affect the balance between anti-oxidant defense system and oxidative stress. A number of studies showed the positive effects of quercetin on diabetes mellitus and related metabolic disorders through different pathways such as gut flora. However, findings are conflicting. In addition, it seems no studies have summarized all potential mechanisms of quercetin in diabetes mellitus, so far. Therefore, the aims of the present comprehensive review were to provide an overview on biological and biochemical characteristics of quercetin and investigate the effect of quercetin on diabetes mellitus and related metabolic disorders by focusing on its effects on the modulation of gut microbiota. For this purpose, findings of In vitro, animal studies, clinical trials, and review studies with the English language published until January 2021 were summarized. They were identified through electronic databases (PubMed, Scopus, and Cochrane Library) and Google Scholar. Findings showed that quercetin can be an effective component for improving glycemic status and other metabolic disorders related to diabetes mellitus based on In vitro and animal studies. However, environmental factors, food processing and using nanoformulations can affect its efficacy in human studies. Several potential mechanisms, including the modulation of gut flora are proposed for its actions. However, due to limited clinical trials and contradictory findings, more high-quality clinical trials are needed to make a decision on the efficacy of supplementation with quercetin as a complementary therapy for the management of diabetes mellitus, metabolic disorders, and modulating gut flora.

Does infant formula containing synbiotics support adequate growth in infants? A meta-analysis and systematic review of randomized controlled trials.

In recent years, several studies have shown that formulas that contain synbiotics, i.e. composed prebiotics and probiotics have been proposed to have a beneficial effect on anthropometric indices. However, the results are inconsistent thus this meta-analysis was performed to assess this effect. PubMed/MEDLINE, Web of Science, SCOPUS, and Embase were systematically searched up to May-2020. Weight gain, length gain, head circumstance gain, weight-for-age z scores, and length-for-age z scores were considered as the outcomes. Weighted mean differences (WMD) with the 95% CI were applied for estimating the combined effect size. Subgroup analysis was performed to specify the source of heterogeneity among studies. Consumption of formulas containing synbiotics did not affect growth significantly in healthy infants (weight gain (WMD = 2.06, 95% CI: - 4.08 to 8.21; p = 0.51), length gain (WMD = - 0.05, 95% CI: - 0.70 to 0.60; p = 0.88), head circumstance (WMD = - 0.28, 95% CI: - 0.66 to 0.11; p = 0.15), on weight-for-age z-scores (WMD = - 0.05, 95% CI: - 0.23 to 0.13; p = 0.57) and length-for-age z-scores (WMD = - 0.16, 95% CI: - 0.50 to 0.19; p = 0.37)). The main results indicate a non-significant increase in infant's growth following synbiotics supplementation of infant formula. Further large-scale studies are warranted to confirm present findings.

Effect of omega-3 fatty acids supplementation on cardio-metabolic and oxidative stress parameters in patients with chronic kidney disease: a systematic review and meta-analysis.

BACKGROUND: Omega-3 fatty acids (FAs) have been suggested as a beneficial supplement in chronic kidney disease (CKD) patients, but the results of randomized clinical trials (RCTs) are controversial. We conducted a systematic review and meta-analysis to evaluate all the RCTs about the impact of omega-3 FAs supplementation on cardiometabolic outcomes and oxidative stress parameters in patients with CKD. METHODS: We performed a systematic database search in PubMed/MEDLINE, EMBASE, Scopus, Web of Science, and Cochrane Central, up to May 2020. We included all placebo-controlled randomized trials that assessed the effect of omega-3 FAs supplementation on any cardiometabolic outcomes: blood pressure, total cholesterol (TC), low-density lipoprotein (LDL) and high-density lipoprotein (HDL) or triglycerides (TG) and oxidative stress parameters. Data were pooled using DerSimonian-Laird's random-effects model. RESULTS: Finally, thirteen articles met the inclusion criteria for this review omega-3 FAs supplementation significantly decrease TC (SMD: -0.26; 95% CI: - 0.51, - 0.02; I2 = 52.7%), TG (SMD: -0.22; 95% CI: - 0.43, - 0.02; I2 = 36.0%) and Malondialdehyde (MDA) levels (SMD: -0.91; 95% CI: - 1.29, - 0.54; I2 = 00.0%) and also significantly increase superoxide dismutase (SOD) (SMD: 0.58; 95% CI: 0.27, 0.90; I2 = 00.0%) and Glutathione peroxidase (GPx) (SMD: 0.50; 95% CI: 0.14, 0.86; I2 = 00.0%) activities. However our results show that omega-3 FAs supplementation have no significant effects on HDL, LDL and blood pressure. Conclusion This systematic review and meta-analysis supports current evidence for the clinical benefit of omega-3 FAs intake to improve cardiometabolic parameters in CKD patients. However, well-designed RCTs still needed to provide a conclusive picture in this field.

Effect of ginger (Zingiber officinale) on inflammatory markers: A systematic review and meta-analysis of randomized controlled trials.

The aim of this systematic review and meta-analysis was to investigate the efficacy of ginger supplementation on circulating levels of C-reactive protein (CRP), high sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-alpha (TNF-α), soluble intercellular adhesion molecule (sICAM), and interleukin-6 (IL-6) concentrations in randomized controlled trials (RCTs). The search included PubMed-Medline, EMBASE, Scopus, Web of Science and Cochrane Library databases to identify randomized clinical trials on the effect of ginger supplementation on circulation levels of CRP, hs-CRP, IL-6, sICAM, and TNF-α published up until February 1st, 2020. We did not restrict articles based on language of publication. Standard mean differences and 95% confidence intervals were calculated for net changes in inflammatory mediators using a random-effects model. Sixteen RCTs comprising 1010 participants were found to be eligible for this meta-analysis. There was a significant reduction of circulating CRP (SMD: -5.11, 95% CI: -7.91, -2.30, I2 = 98.1%), hs-CRP (SMD: -0.88, 95% CI: -1.63, -0.12, I2 = 90.8%) and TNF-α levels (SMD: -0.85, 95% CI: -1.48, -0.21, I2 = 89.4%) following ginger supplementation. However, meta-analysis results did not show any significant impact of ginger supplementation on IL-6 (SMD: -0.45, 95% CI: -1.29, 0.38, I2 = 89.2%), and sICAM levels (SMD: -0.05, 95% CI: -0.36, 0.26, I2 = 00.0%). This systematic review and meta-analysis of RCTs demonstrates a significant impact of ginger in lowering circulating CRP, hs-CRP and TNF-α levels. Large-scale RCTs are still needed to draw concrete conclusions about the effect of ginger on other inflammatory mediators.

Effect of melatonin supplementation on oxidative stress parameters: A systematic review and meta-analysis.

BACKGROUND: Oxidative stress, defined as an imbalance between pro-oxidants and neutralizing antioxidants within the body, is a growing public health concern. Oxidative stress is involved in the progression of nearly all chronic diseases. Melatonin has been suggested to reduce oxidative stress by its potential radical scavenging properties. OBJECTIVE: To determine the efficacy and safety of melatonin as a therapy for the improvement of oxidative stress parameters in randomized controlled trials. METHODS: A systematic database search using Scopus, PubMed/Medline, EMBASE, Web of Science, the Cochrane Controlled Register of Trials and clinicaltrials.gov (https://clinicaltrials.gov) for studies published up to July 2020 was conducted. We included studies which investigated the effect of supplemental melatonin compared to placebo on oxidative stress parameters in unhealthy patients. Quantitative data synthesis was conducted using a random-effects model with standard mean difference (SMD) and 95 % confidence intervals (CI). Cochrane's Q and I2 values were used to evaluate heterogeneity. RESULTS: A total of 12 randomized controlled trials (RCTs) were eligible. The meta-analysis indicated an association between melatonin intake and a significant increase in total antioxidant capacity (TAC) (SMD: 0.76; 95 % CI: 0.30, 1.21; I2 = 80.1 %), glutathione (GSH) levels (SMD: 0.57; 95 % CI: 0.32, 0.83; I2 = 15.1 %), superoxide dismutase (SOD) (SMD: 1.38; 95 % CI: 0.13, 2.62; I2 = 86.9 %), glutathione peroxidase (GPx) (SMD: 1.36; 95 % CI: 0.46, 2.30; I2 = 89.3 %), glutathione reductase (GR) (SMD: 1.21; 95 % CI: 0.65, 1.77; I2 = 00.0 %) activities, and a significant reduction in malondialdehyde (MDA) levels (SMD: -0.79; 95 % CI: -1.19, -0.39; I2 = 73.1 %). Melatonin intake was not shown to significantly affect nitric oxide (NO) levels (SMD: -0.24; 95 % CI: -0.61, 0.14; I2 = 00.0 %) or catalase (CAT) activity (SMD: -1.38; 95 % CI: -1.42, 4.18; I2 = 96.6 %). CONCLUSION: Melatonin intake was shown to have a significant impact on improving Oxidative stress parameters. However, future research through large, well-designed randomized controlled trials are required to determine the effect of melatonin on oxidative stress parameters in different age groups and different disease types.

Coenzyme Q10 supplementation and oxidative stress parameters: a systematic review and meta-analysis of clinical trials.

PURPOSE: Oxidative stress (OS) is associated with several chronic complications and diseases. The use of coenzyme Q10 (CoQ10) as an adjuvant treatment with routine clinical therapy against metabolic diseases has shown to be beneficial. However, the impact of CoQ10 as a preventive agent against OS has not been systematically investigated. METHODS: A systematic literature search was performed using the PubMed, SCOPUS, EMBASE, and Cochrane Library databases to identify randomized clinical trials evaluating the efficacy of CoQ10 supplementation on OS parameters. Standard mean differences and 95% confidence intervals were calculated for net changes in OS parameters using a random-effects model. RESULTS: Seventeen randomized clinical trials met the eligibility criteria to be included in the meta-analysis. Overall, CoQ10 supplementation was associated with a statistically significant decrease in malondialdehyde (MDA) (SMD - 0.94; 95% CI - 1.46, - 0.41; I2 = 87.7%) and a significant increase in total antioxidant capacity (TAC) (SMD 0.67; 95% CI 0.28, 1.07; I2 = 74.9%) and superoxide dismutase (SOD) activity (SMD 0.40; 95% CI 1.12, 0.67; I2 = 9.6%). The meta-analysis found no statistically significant impact of CoQ10 supplementation on nitric oxide (NO) (SMD - 1.40; 95% CI - 0.12, 1.93; I2 = 92.6%), glutathione (GSH) levels (SMD 0.41; 95% CI - 0.09, 0.91; I2 = 70.0%), catalase (CAT) activity (SMD 0.36; 95% CI - 0.46, 1.18; I2 = 90.0%), or glutathione peroxidase (GPx) activities (SMD - 1.40; 95% CI: - 0.12, 1.93; I2 = 92.6%). CONCLUSION: CoQ10 supplementation, in the tested range of doses, was shown to reduce MDA concentrations, and increase TAC and antioxidant defense system enzymes. However, there were no significant effects of CoQ10 on NO, GSH concentrations, or CAT activity.

Effects of Melissa officinalis (Lemon Balm) on cardio-metabolic outcomes: A systematic review and meta-analysis.

Recent evidence indicates a beneficial effect of Melissa officinalis (MO) intake on several chronic diseases. However, the effects of MO intake have not yet been systematically reviewed. Therefore, we conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the effect of MO intake and focused on several cardiometabolic outcomes. MEDLINE, Scopus, EMBASE, Web of Science and the Cochrane Central Register of Controlled Trials were searched for MO-RCTs evaluating cardiometabolic outcomes. Random-effects meta-analyses estimated the pooled standardized mean differences (SMD) between intervention and control groups. Risk of bias was assessed with the Cochrane Collaboration's tool for assessing the risk of bias in RCTs. Seven RCTs were finally deemed eligible. MO intake was associated with a reduced total cholesterol (TC) (SMD: -0.26; 95% CI: -0.52, -0.01; I2 = 13.7%; k = 6) and a reduced systolic blood pressure (SBP) (SMD: -0.56; 95% CI: -0.85, -0.27; I2 = 00.0%; k = 3). MO intake was not associated with statistically significant changes in triglycerides, low-density lipoprotein, diastolic blood pressure, high sensitivity c-reactive protein levels, fasting blood sugar, HbA1c, insulin or high-density lipoprotein levels. No serious adverse events were reported. The risk of bias was high in a considerable amount of studies. Our study suggests that MO is a safe supplement with beneficial effects on TC and SBP. However, the findings of our study must be seen in the light of major limitations such as a low number of included studies and a serious risk of bias. High-quality RCTs are needed for firm conclusions concerning the effects of MO on cardiometabolic outcomes.

Adherence to the vegetarian diet may increase the risk of depression: a systematic review and meta-analysis of observational studies.

CONTEXT: Several epidemiological studies have investigated the association between a vegetarian diet and risk of depression, but because of inconsistency between studies, the exact association remains unclear. OBJECTIVE: In this systematic review and meta-analysis, the relationship between vegetarian diets and risk of depression in observational studies was evaluated. DATA SOURCES: The Medline, Embase, Scopus, ISI Web of Science, and Cochrane Library databases were searched from inception through September 1, 2020. STUDY SELECTION: Observational studies were included that examined mean levels of depression and risk for depression in vegetarians compared with nonvegetarians. DATA EXTRACTION: Pooled effect sizes were estimated using the random-effects model and were reported as standardized mean differences or odds ratios (ORs) with their corresponding 95%CIs. Heterogeneity was tested using the I2 statistic. RESULTS: Combining 9 effect sizes in this meta-analysis illustrated that adherence to a vegetarian diet was associated with a 53% greater risk of depression compared with that of omnivores (95%CI, 1.14-2.07; I2 = 69.1%). Subgroup analysis of depression risk suggested that results depended on the type of vegetarian diet and country where the study was conducted. For studies that assessed a semivegetarian diet (OR, 1.86; 95%CI, 1.42-2.44; I2 = 35.7%) and those conducted in Europe and the United States (OR, 1.45; 95%CI, 1.06-1.98; I2 = 73.2%), there was a positive association between a vegetarian diet and depression, but in lacto-ovo vegetarians and Asian countries, a null association was found. Comparing mean depression scores showed no evidence of difference between vegetarians and nonvegetarians (n = 16; standardized mean difference, 0.10; 95%CI, -0.01 to 0.21; I2 = 79.1%). CONCLUSION: Vegetarian diet significantly increased depression risk; however, the findings were not robust, and more studies are required to investigate the vegetarian diet and depression association.

The effect of chromium intake on oxidative stress parameters: A systematic review and meta-analysis.

BACKGROUND: Trivalent chromium is a trace element thought to have a beneficial effect on oxidative stress (OS) parameters and inflammation. This review aimed to investigate the dose-response of chromium and summarize the effects of chromium supplementation on OS parameters in the literature. METHODS: MEDLINE, Scopus, Web of Science and Cochrane CENTRAL databases were searched for RCTs published from inception to January 2021 evaluating the effect of chromium supplementation on OS parameters, namely MDA, TBARS, SOD, TAS, CAT, GPx, and GSH. A random-effects model was used to pool data and calculated standard mean difference and 95 % confidence intervals. Quantified heterogeneity among studies was assessed through Cochrane's I2 values. RESULTS: Nine studies enrolling 550 participants met the inclusion criteria. The obtained results indicate that chromium supplementation significantly increases TAC (SMD: 0.46; 95 % CI: 0.08, 0.84; I2 = 00.0 % n = 2) and significantly decreases MDA levels (SMD: -0.46; 95 % CI: -0.86, -0.07; I2 = 52.4 % n = 5). Supplementation did not significantly change CAT, GPx, GSH, SOD, TAS, and TBARS. CONCLUSION: Chromium supplementation may improve OS parameters, however, due to high heterogeneity observed in the included studies, these findings should be interpreted with caution. Large RCTs on various patient groups evaluating the impact of chromium supplementation are needed to allow an adequate generalization of the benefits of chromium on human health.

Effect of Alkaline Drinking Water on Bone Density of Postmenopausal Women with Osteoporosis.

OBJECTIVES: Postmenopausal women are predisposed to osteoporosis, and those on acidic diets are at a higher risk, because it has been demonstrated that such diets have adverse effects on bone health. In this study, the effect of alkaline drinking water on bone mineral density was evaluated in postmenopausal women with osteoporosis. METHODS: One hundred postmenopausal women with osteoporosis (T-score ≤ -2.5) were equally divided into an intervention group and a control group (n = 50 each). The intervention group received calcium D (daily), alkaline drinking water (1.5 L daily with pH 8.6 ± 0.3), and Osteofos tablet (70 mg weekly), whereas the control group received only calcium D and Osteofos tablet for 3 months. T-scores of the femur and spine bones were obtained using bone densitometry before and 3 months after the intervention. RESULTS: After the intervention, the mean T-scores of the femur and spine bones significantly increased in both the control and intervention groups (P < 0.05). However, the mean changes in the spine T-score were significantly higher in the intervention group (0.39 ± 0.07) than in the control group (0.08 ± 0.01) (P < 0.05). No significant differences were observed in the mean changes in the femur T-score between the two groups. CONCLUSION: Our findings demonstrate that drinking alkaline water improves spine T-scores in postmenopausal women with osteoporosis. Hence, alkaline water can be used to treat osteoporosis due to increased bone density in postmenopausal women. Long-term interventions are necessary to confirm the effects of alkaline water on femur density.

Association between dietary satisfaction and depression, anxiety and stress in obese and overweight patients during the coronavirus pandemic.

BACKGROUND & AIM: The coronavirus disease-2019 (COVID-19) pandemic is a global health threat. The aim of this study was to evaluate the association between D-Sat and depression, anxiety and stress in obese patients during the coronavirus pandemic. METHODS: A cross-sectional study in 228 obese and overweight women on a weight loss diet was conducted through the use of two questionnaires. General characteristics, anthropometric indices, D-Sat and mental status were assessed in these patients. RESULTS: The greatest weight loss (WL) and waist circumference (WC) change was associated with the highest tertile of the D-Sat score in the first four months of the coronavirus pandemic (P < 0.05). Participants with the highest tertile of all D-sat score compared to those with the lowest had an 84% decrease in odds of depression. The highest tertile was also associated with decreased odds of anxiety (OR: 0.32 95%CI: 0.14; 0.68) The adjusted odds of stress score were negatively associated to the highest tertile of the D-Sat score (OR: 0.09, 95%CI (0.03, 0.23). WL was inversely related to stress (P < 0.05). Participants with higher WL and WC reduction had fewer depressive symptoms (P < 0.05). Sleep time and family income were associated with obesity. CONCLUSIONS: D-Sat and positive personal and family dynamics can improve the mental status of obese and overweight patients during quarantine.

Effect of ginger (Zingiber officinale) supplementation on oxidative stress parameters: A systematic review and meta-analysis.

A wide variety of antioxidant properties are attributed to ginger (Zingiber officinale) and several randomized controlled trials (RCTs) have investigated the effect of ginger intake on major oxidative stress (OS) parameters. We conducted a systematic review and meta-analysis to evaluate the effects of using ginger to improve OS levels. Medline, Scopus, ISI Web of Science, EMBASE, and the Cochrane Central Register of Controlled Trials were systematically searched up until March 2020 to gather RCTs that evaluated the impact of ginger intake on the levels and activity of OS parameters in adult subjects. Means and standard deviations for relevant OS variables were extracted and evaluated to assess the quality of the trials based on the Cochrane risk-of-bias tool for randomized trials. The gathered data were pooled and expressed as standardized mean difference (SMD) with 95% Confidence Intervals (95% CI). Twelve trials were included in this review. Ginger intake was shown to significantly increase glutathione peroxidase (GPx) activity (SMD: 1.64; 95% CI: 0.43, 2.85; I2  = 86.8%) and total antioxidant capacity (TAC) (SMD: 0.40; 95% CI: 0.06, 0.73; I2  = 42.8%) and significantly decrease malondialdehyde (MDA) levels (SMD: -0.69; 95% CI: -1.26, -0.12; I2  = 85.8%) compared to control groups. Ginger supplementation also non-significantly associated with an increase in CAT activity (SMD: 1.09; 95% CI: -0.07, 2.25; I2  = 87.6%). This systematic review and meta-analysis presents convincing evidence supporting the efficacy of ginger supplementation on improving OS levels. PRACTICAL IMPLICATIONS: In health sciences, OS, due to its pivotal role in the pathophysiology of several chronic diseases, is a subject with a long history. Recent research strives for a safe, ideal, and effective antioxidant. Ginger is herbal medicine, which has been widely used in traditional and complementary medicine. Proving the antioxidant effect and potential benefit of ginger has positive clinical implications for the application of this practical herb.

Prophylactic effects of secretion metabolites of dairy lactobacilli through downregulation of ErbB-2 and ErbB-3 genes on colon cancer cells.

Colon cancer is one of the most prevalent cancers, and intestinal microbial community plays a pivotal role in colorectal tumor genesis. Probiotics as live microorganisms may be able to exert an anticancer effect in colon cancer. The aim of this study was to isolate and identify Lactobacillus spp. from traditional dairy products with probiotic properties and to investigate their anticancer effects through ErbB-2 and ErbB-3 gene expression in colon cancer cells. The isolated lactobacilli from yogurt and cheese samples were molecularly identified by blasting of 16-23s rDNA region PCR sequenced products. The probiotic properties, including acid and bile tolerance, antimicrobial activity, and antibiotic susceptibility, were assayed. The proliferation inhibition effects of lactobacilli secretion metabolites with probiotic potential on colon cancer cell lines (HT-29 and caco-2) were analyzed using MTT assay. The real-time PCR was used for assessment of ErbB-2 and ErbB-3 gene expression after being treated with probiotics. Four species of bacteria with the most probiotic properties, including Lactobacillus casei, Lactobacillus paracasei, Lactobacillus rhamnosus, and Lactobacillus plantarum, were characterized and their effects on different human cell lines were taken into consideration. Total bacterial secretions significantly reduced the viability of HT-29 and caco-2 cancer cells compared with untreated controls. The metabolites secreted by bacteria downregulated the expression of ErbB-2 and ErbB-3 genes in colon cancer cells. The present study indicated that probiotic bacteria isolated from traditional dairy products exert anticancer effect on colon cancer cells through the downregulation of ErbB-2 and ErbB-3 gene expression.

Effect of Calcium and Vitamin D Co-supplementation on Blood Pressure: A Systematic Review and Meta-Analysis.

PURPOSE: Vitamin D and calcium insufficiency has been related to elevated blood pressure (BP) and cardiovascular complications. This systematic review and meta-analysis investigates the effect of calcium and vitamin D co-supplementation on BP. METHODS: A systematic search was conducted of electronic databases, including Web of Sciences, MEDLINE, Scopus, EMBASE, and the Cochrane Library, along with searches of gray literature and reference lists from included trials. There were no language restrictions, and the databases were searched from inception to October 2019. Randomized controlled trials, using calcium and vitamin D co-supplementation and reporting mean systolic BP and/or diastolic BP (DBP) with SDs, were included in the systematic review. Articles were evaluated independently by 2 researchers based on inclusion and exclusion criteria. A random effects model was conducted to synthesize the data. FINDINGS: Eight trials were included in the meta-analysis. Meta-analysis of these 8 trials indicated a nonsignificant reduction in systolic BP in the calcium and vitamin D co-supplementation group compared with control (standardized mean difference, -0.23; 95% CI, -0.52 to 0.06). Conversely, there was a statistically significant decrease in DBP (standardized mean difference, -0.29; 95% CI, -0.55 to -0.02). Subgroup analysis suggested that young adults achieve a greater reduction in DBP than other age groups. IMPLICATIONS: Calcium and vitamin D co-supplementation can modulate DBP and should be investigated more specifically in large, well-designed trials of hypertensive populations. (Clin Ther. 2020;42:XXX-XXX) © 2020 Elsevier HS Journals, Inc.

Effect of Vitamin D Supplement on Mood Status and Inflammation in Vitamin D Deficient Type 2 Diabetic Women with Anxiety: A Randomized Clinical Trial.

BACKGROUND: Vitamin D plays an important role in nervous health and depression. Vitamin D deficiency and anxiety affect diabetic status. The purpose of this study was to determine the effect of vitamin D supplementation on anxiety, depression, and inflammation in diabetic women with anxiety. METHODS: In this randomized controlled trial, totally 51 women with type 2 diabetes (T2DM) and vitamin D deficiency were randomly allocated to receive one oral pearl of 50,000 IU vitamin D3 (26 women) or a placebo (25 women) fortnightly for 16 weeks. Anthropometric indices, sun exposure, dietary intake, depression, anxiety, and stress scores and biochemical biomarkers including high sensitivity C-reactive protein (hs-CRP) and interleukin-10 (IL-10) were measured at the baseline and after 16-week supplementation. RESULTS: Mean ± SD age of participant was 47.43 ± 9.57 years old. Baseline values were not different between the groups. Anxiety score changes were significantly lower in vitamin D group than the controls (P = 0.001). Within group comparison indicated that depression in supplement group with lower vitamin D levels was significantly reduced. Serum hs-CRP reduced (P = 0.01), while IL-10 concentrations increased (P = 0.04) in the intervention group. CONCLUSIONS: Vitamin D supplementation can improve mood status and anti-inflammatory biomarkers in female diabetics with anxiety and vitamin D deficiency.

Impact of Dietary Calcium Supplement on Circulating Lipoprotein Concentrations and Atherogenic Indices in Overweight and Obese Individuals: A Systematic Review.

Dyslipidemia is the main risk factor for developing cardiovascular disease. There are discrepancies in the effects of calcium supplementation on modulation of lipid status. Therefore, we aimed to summarize the effects of dietary calcium supplement on circulating lipoprotein concentrations and atherogenic indices in overweight and obese individuals. We conducted a systematic literature search from 2000 until July 2016. PubMed, Scopus, Cochran Library, and ISI Web of Science databases were searched for clinical trials written in English. Placebo controlled clinical trials on calcium or calcium with vitamin D supplement in overweight and obese indiciduals were considered. Finally, 11 clinical trials met the criteria and were included. Most studies (n = 9) evaluated Ca/D co-supplementation. Positive effects of calcium supplementation alone or with vitamin D were as follows: serum levels of total cholesterol (TC; n = 1), triglyceride (TG) concentrations (n = 1), serum levels of low-density lipoprotein cholesterol (LDL-C; n = 5) and high-density lipoprotein cholesterol (HDL-C; n = 3). Seven clinical trials reported atherogenic indices and three of them demonstrated beneficial effects of calcium supplementation on at least one atherogenic index. Calcium supplementation may not be helpful to reduce serum levels of TC and TG in overweight and obese individuals. However, it may modulate LDL-C and HDL-C concentration. More studies are warranted to clarify the effects of calcium supplementation on each atherogenic index.

Nutritional management in women with polycystic ovary syndrome: A review study.

Polycystic ovary syndrome (PCOS) is endocrine disorder in women of reproductive age, which leads to reproductive, hormonal and metabolic abnormalities. Due to the presence of insulin resistance, PCOS increases the risk of chronic diseases like type 2 diabetes, hypertension, lipid disorders, cardiovascular diseases and malignancies such as breast and endometrial cancer. The actual cause of this syndrome is unknown but environmental factors such as dietary habits play an important role in prevention and treatment and lifestyle modifications are the most important therapeutic strategies in these patients. The approach of the diet therapy in these patients must be to reach specific goals such as improving insulin resistance, metabolic and reproductive functions that will be possible through the design of low-calorie diet to achieve weight loss or maintaining a healthy weight, limit the intake of simple sugars and refined carbohydrates and intake foods with a low glycemic index, reduction of saturated and trans fatty acids and attention to possible deficiencies such as vitamin D, chromium and omega-3. Given the prevalence of overweight and obesity and insulin resistance, a relatively low reduction in weight, about 5%, can improve problems such as insulin resistance, high levels of androgens, reproductive system dysfunctions and fertility in these women.

Chromium supplementation and polycystic ovary syndrome: A systematic review and meta-analysis.

INTRODUCTION: polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women. Some vitamins and mineral can play role in improvement of PCOS. Chromium (Cr) is an essential element in glucose and insulin homeostasis. However, findings are not consistent regarding PCOS improvement. Therefore, the purpose of this paper was to assess the effect of Cr supplementation in PCOS that have not yet fully been elucidated. METHODS: We searched ISI Web of Science, MEDLINE (1966 to June 2016), Google Scholar databases and Proquest and identified eligible papers and extracted the following terms: total testosterone, DHEAS, insulin sensitivity, fasting glucose, fasting insulin, OGTT 1h glucose, OGTT 2h glucose (mg/dL), LH (mIU/mL), FSH, DHEAS, ferriman-Galwey score (FG score). We calculated overall effect size with random effects model, between-study heterogeneity with I square (I2) statistic. Publication bias was assessed using Begg's test regression. RESULT: Totally, 7 RCTs were selected. Results indicated that Cr supplementation had a beneficial effect on BMI with effect size: -2.37 (kg/m2), 95% CI: -2.99, -1.76, p=0.001 and free testosterone concentration with effect size=-0.52 (pg/mL), 95% CI: -0.83, -0.23, p=0.001. Cr reduced fasting insulin in subgroup of studies with >10 participants with effect size: -0.86mIU/ml, 95% CI: -0.67, -0.17; p=0.001. Cr supplementation had no beneficial effects on reducing total testosterone, FG score, DHEA, FSH and LH. CONCLUSION: This systematic review and meta-analysis shows that using Cr picolinate supplementation has beneficial effects on decreasing BMI, fasting insulin and free testosterone in PCOS patients.

Effects of L- Arginine Supplementation on Antioxidant Status and Body Composition in Obese Patients with Pre-diabetes: A Randomized Controlled Clinical Trial.

PURPOSE: The aim of present study was to determine effects of L-Arginine supplementation on antioxidant status and body composition in obese patients with prediabetes. METHODS: A double-blind randomized control trial was performed on 46 (24 men, 22 women) obese patients with prediabetes. They were divided randomly into two groups. Patients in intervention (n = 23) and control group (n=23) received 3 gr/day L-arginine and placebo, respectively for 8 weeks. Anthropometric indices, dietary intake and biochemical measurements ((serum total antioxidant capacity (TAC), Glutathione Peroxidase (GPx) and Superoxide Dismutase (SOD)) were performed at the baseline and after 8-week intervention. RESULTS: The mean age and BMI of participants were 44.29±8.65 years old and 28.14±1.35 kg/m(2), respectively. At the end of study, in both intervention and control group, percentage of carbohydrate decreased and %fat intake increased compared to the baseline (P<0.05). After adjusting for dietary intake, no significant difference was observed in Fat Mass (FM) and Fat Free Mass (FFM) between two groups (P>0.05). Among measured biochemical factors, only serum TAC level showed significant differences at the end of study in the intervention group compared to the control group (pv<0.01). CONCLUSION: 3gr/day L-Arginine supplementation increased TAC level in obese patients with prediabetes.