Vitamin D and biomarkers of inflammation and oxidative stress among pregnant women: a systematic review of observational studies.

OBJECTIVE: This systematic review aimed to map the evidence evaluated the relationship between vitamin D and redox and inflammatory status during gestation. METHODS: Three databases (PubMed/MEDLINE, Scopus, and Web of Science (WoS)) and reference list of included documents were searched for related observational studies published until 2nd October 2023. To determine the quality of the selected observational studies, the Newcastle-Ottawa Scale (NOS) was used. RESULTS: After a primary search of three databases, 19492records were appeared. When duplicates and irrelevant documents were removed, 14 articles were found to have eligible criteria. The design of the identified studies was cross-sectional, case-control and cohort. Evidence showed an adverse association between 25(OH)D and the biomarkers of inflammation, such as high-sensitivity C-reactive protein (hs-CRP), Interleukin-1beta (IL-1ß), Interleukin-6 (IL-6), and tumor necrosis factor- alfa (TNF-α) during pregnancy. On the contrary, some studies represented that 25(OH)D positively correlated with hs-CRP in the cord blood. One study suggested a direct association between serum concentrations of 25(OH)D and Interleukin-8 (IL-8), macrophage inflammatory protein (MIP), and TNF-α levels in mothers with gestational diabetes mellitus (GDM). A case-control study showed that lower serum concentration of 25(OH)D positively correlated with total antioxidant capacity (TAC) levels in participants. CONCLUSIONS: Evidence confirmed the supposition of the direct relationship between vitamin D levels and biomarkers with anti-inflammatory and anti-oxidative properties. However, the Existence of inconsistent evidence confirms the need for further studies in mothers with GDM and hypertensive disorders. PROSPERO REGISTRATION CODE: CRD42020202600.

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

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

The effect of concentrated pomegranate juice on biomarkers of inflammation, oxidative stress, and sex hormones in overweight and obese women with polycystic ovary syndrome: A randomized controlled trial.

Polycystic ovary syndrome (PCOS) is a common gynecological endocrine disorder. Pomegranate juice (PJ) has been known to play anti-inflammatory and antioxidant roles. However, the effects of PJ on inflammation, oxidative stress, and sex hormones in PCOS patients are very little studied, and thus more studies are needed. This randomized controlled trial enrolled 44 women diagnosed with PCOS according to the Rotterdam criteria, body mass index (BMI) ≥ 25 kg/m2 , and aged 18-40 years old. Participants were randomly assigned to take 45 ml/day of concentrated PJ or a control group without intervention. Some biomarkers of sex hormones, inflammation, and oxidative stress were quantified at baseline and after the 8-week intervention. Compared with the controls, serum testosterone levels were significantly decreased in overweight and obese women with PCOS who supplemented with concentrated PJ (-0.004 ± 0.013 vs. 0.039 ± 0.013, p = .039). However, we did not observe significant differences in luteinizing hormone (LH) and sex hormone-binding globulin (SHBG) levels and inflammation and oxidative stress factors between the two groups after adjustment for confounding variables. An 8-week supplementation with concentrated PJ could effectively improve testosterone levels in overweight and obese women with PCOS. This study was registered at www.irct.ir (IRCT20191109045383N1).

Effect of bread fortification with pomegranate peel powder on glycemic indicators, antioxidant status, inflammation and mood in patients with type 2 diabetes: study protocol for a randomized, triple-blind, and placebo-controlled trial.

Background: The oxidative stress caused by the creation and breakdown of reactive oxygen species affects glucose tolerance, B-cell function, insulin resistance, and metabolites containing free fatty acids. Functioning foods are therefore becoming increasingly popular because they provide health benefits and prevent oxidative stress. This research aims to assess strategies to alleviate oxidative stress and inflammation in patients with type 2 diabetes (T2DM). In the present study, the metabolic effect wheat bread fortified with pomegranate peel powder(PPP) will be assessed in participants with type 2 diabetes. Methods: A randomized, triple-blind, placebo-controlled, and parallel arms clinical trial will be conducted on 90 patients with T2DM. Run-in courses will last for two weeks. The intervention and control groups will receive wheat bread with and without PPP, respectively. Anthropometric data, fasting plasma glucose, hemoglobin A1C, lipid profile, insulin level, high-sensitivity C-reactive protein (hs-CRP), malondialdehyde (MDA), Total antioxidant capacity(TAC), and mood state, will be measured at the baseline and three months post-intervention. Beta-cell function (HOMA-B) and insulin resistance (HOMA-IR) will also be assessed. Discussion: This trial will provide novel data on the impact of fortified bread with PPP on metabolic profile and mood state of patients with type 2 diabetes. The results will demonstrate the potential of such intervention in glycemic indices, antioxidant status, inflammation and mood in these patients. Trial Registration: Trial is registered in the Iranian Registry of Clinical Trials (ID: IRCT20191209045672N1). Date of registration 21/09/2020. https://en.irct.ir/trial/48132.

Antioxidants and clinical outcomes of patients with coronavirus disease 2019: A systematic review of observational and interventional studies.

Coronavirus disease 2019 (COVID-19) is a newly emerging viral infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Oxidative stress appears to be a prominent contributor to the pathogenicity of SARS-CoV-2. Therefore, we carried out a systematic review of human observational and interventional studies to investigate the role of some antioxidants such as vitamins A, E, D, and C, selenium, zinc, and α-lipoic acid in the main clinical outcomes of subjects with COVID-19. Google Scholar, Cochrane Library, Web of Science, Scopus, and Medline were searched using Medical Subject Headings (MeSH) and non-MeSH terms without restrictions. Finally, 36 studies for vitamins C and D, selenium, and zinc were included in this systematic review; however, no eligible studies were found for vitamins A and E as well as α-lipoic acid. The results showed the promising role of vitamin C in inflammation, Horowitz index, and mortality; vitamin D in disease manifestations and severity, inflammatory markers, lung involvement, ventilation requirement, hospitalization, intensive care unit (ICU) admission, and mortality; selenium in cure rate and mortality; and zinc in ventilation requirement, hospitalization, ICU admission, biomarkers of inflammation and bacterial infection, and disease complications. In conclusion, it seems that antioxidants, especially vitamins C and D, selenium, and zinc, can improve multiple COVID-19 clinical outcomes. Nevertheless, more studies are necessary to affirm these results.

Validation of an instrument for perceived factors affecting fruit and vegetable intake based on Pender's health promotion model.

Increasing fruit and vegetable (F&V) intake has a protective role against chronic conditions such as cardiovascular disease, cancer and diabetes. The present study aimed to validate an instrument for measuring the perception of effective factors on consumption behaviour of F&V based on Pender's health promotion model (HPM).This cross-sectional validation survey has consisted of five steps: literature review in order to plan and develop an instrument, face validity assessment, content validity assessment, reliability assessment and construct validity assessment with the cooperation of experts in health education, nutritionists and the target group (government employees). In the present study, reliability and validity of constructs were determined through Cronbach's alpha and exploratory factor analysis, respectively, in SPSS 22. The mean impact score was acceptable for 96·42 % of items in face validity. The mean scores of content validity ratio (CVR), content validity index (CVI) and reliability were 0·92, 0·97 and 0·96, respectively. According to the principal component analysis with varimax rotation, 104 items were identified in 15 factors contributing to 61·17 % of the model cumulative variance. Given the favourable scores of the research instrument in face validity, content validity and reliability as well as its ability to predict the extracted factors from the model, it can be used as a suitable instrument in future studies.

The effect of vitamin D and calcium supplementation on inflammatory biomarkers, estradiol levels and severity of symptoms in women with postpartum depression: a randomized double-blind clinical trial.

Objectives: Postpartum depression (PPD) is a major depressive disorder. Vitamin D deficiency may play a role in PPD pathogenesis. This study was designed to determine the effect of vitamin D and calcium supplementation on the severity of symptoms and some related inflammatory biomarkers in women with PPD.Materials and Methods: Eighty-one women with a PPD score >12 participated in this study. A total of 27 patients were randomly assigned into three groups (1:1:1 ratio) to receive either 50,000 IU vitamin D3 fortnightly + 500 mg calcium carbonate daily; or 50,000 IU vitamin D3 fortnightly + placebo of calcium carbonate daily, or placebo of vitamin D3 fortnightly + placebo of calcium carbonate daily (placebo group) for 8 weeks. At the baseline and end of the study, the severity score of PPD, levels of 25-hydroxy vitamin D, calcium, tumor necrosis factor-alpha (TNFα), interleukin 6 (IL6) and estradiol were measured.Results: The PPD score had more reduction in the vitamin D + calcium and vitamin D + calcium placebo groups than that of the placebo group (-1.7 ± 3.44, -4.16 ± 5.90 and 0.25 ± 2.81, respectively; p = 0.008). The effect of vitamin D on the PPD score was larger when vitamin D was given alone than given together with calcium (p = 0.042 and p = 0.004, respectively). No significant differences in estradiol, IL6 and TNFα were observed between the three groups.Discussion: Vitamin D may be effective in improving the clinical symptoms of PPD; however, the mechanism of the effect might not entirely operate through inflammatory and/or hormonal changes.

The effect of grape seed extract supplementation on oxidative stress and inflammation: A systematic review and meta-analysis of controlled trials.

BACKGROUND: Grape seed extract (GSE) seems to have antioxidant and anti-inflammatory properties due to its high polyphenolic content. Nevertheless, the scientific literature in this field is controversial and inconclusive. Therefore, we aimed to conduct a systematic review and meta-analysis of controlled trials to evaluate the effect of supplementation with GSE on biomarkers of oxidative stress and inflammation. METHODS: Medline, Scopus, Cochrane Library, Google Scholar and Web of Science databases were searched up to 10 September 2020 using appropriate keywords without restrictions. In the systematic review phase, all biomarkers of oxidative stress and inflammation were considered as outcomes. In the meta-analysis phase, six biomarkers were selected as outcomes, and weighted mean difference (WMD) or standardised mean difference (SMD) with 95% confidence interval (CI) was calculated for them using a random-effects model. RESULTS: Twenty-three studies were included in the systematic review, and 19 studies were included in the meta-analysis. GSE supplementation caused a significant decrease in malondialdehyde (SMD: -1.04, 95% CI: -1.65, -0.42), oxidised low-density lipoprotein (SMD: -0.44, 95% CI: -0.75, -0.13) and high-sensitivity C-reactive protein (WMD: -0.48 mg/L, 95% CI: -0.94, -0.03) and a marginally significant increase in total antioxidant capacity (SMD: 0.49, 95% CI: -0.05, 1.04) but did not significantly influence C-reactive protein (WMD: -0.36 mg/L, 95% CI: -1.02, 0.30) and white blood cell count (WMD: 0.12 × 109 /L, 95% CI: -0.25, 0.48). CONCLUSION: It appears that GSE supplementation can remarkably modulate the body's redox system, particularly through the inhibition of lipid peroxidation, but has neutral or mildly beneficial effects on inflammatory responses.

The effects of canola and olive oils consumption compared to sunflower oil, on lipid profile and hepatic steatosis in women with polycystic ovarian syndrome: a randomized controlled trial.

BACKGROUND: Polycystic Ovarian Syndrome (PCOS) is one of the most common endocrinopathies and metabolic disorders in women during their reproductive years. It is often associated with dyslipidemia and other risk factors of cardiovascular diseases (CVD). This study was aimed to evaluate dietary intervention effects with canola and olive oils compared to sunflower oil on lipid profile and fatty liver severity among women with PCOS. METHOD: This study was a 10-week intervention including 72 women with PCOS. Patients were randomly assigned to three groups for receiving 25 g/day canola, olive, or sunflower oils for 10 weeks. The primary and secondary outcomes were to assess changes in lipid profile and in fatty liver severity, respectively. RESULT: At the end of the study, 72 patients with a mean age of 29.31 were analysed. Canola oil consumption resulted in a significant reduction in serum levels of TG (P = 0.002) and TC/HDL (P = 0.021), LDL/HDL (P = 0.047), and TG/HDL (P = 0.001) ratios, however, there was no significant reduction in lipid profile following olive oil consumption. Canola (P < 0.001) and olive oils (P = 0.005) could significantly reduce the fatty liver grade. Moreover, HOMA-IR in both canola (P < 0.001) and olive (P = 0.004) groups was significantly decreased. CONCLUSION: In total, compared to olive and sunflower oils, significant improvements in lipid profile, liver function, and HOMA-IR were observed following canola oil consumption in women with PCOS. TRIAL REGISTRATION: IR.MUI. RESEARCH: REC.1397.315. Registered 30 JUNE 2019 - Retrospectively registered, https://www.irct.ir/trial/38684.

The effect of concentrated pomegranate juice consumption on risk factors of cardiovascular diseases in women with polycystic ovary syndrome: A randomized controlled trial.

Polycystic ovary syndrome (PCOS) is associated with insulin resistance and dyslipidemia. Pomegranate juice is a rich source of polyphenols that may improve blood pressure, lipid profile, and other risk factors of cardiovascular diseases (CVDs). No study has examined the effects of pomegranate juice consumption on the clinical outcomes of PCOS. This study aimed to examine the effects of concentrated pomegranate juice (CPJ) consumption on risk factors of CVDs in women with PCOS. In this randomized clinical trial, 44 PCOS women with an age range of 18-40 years and body mass index (BMI) of ≥25 kg/m2 were recruited. They were randomly allocated to the CPJ (n = 22) and control (n = 22) groups, and followed for 8 weeks. Anthropometric measures, blood pressure, and biochemical parameters were measured at baseline and at the end of the trial. Compared with the control group, CPJ consumption significantly reduced systolic (-9.77 ± 1.46 vs. -1.18 ± 1.46 mmHg, p < .001) and diastolic (-3.87 ± 1.36 vs. 0.30 ± 1.36 mmHg, p = .05) blood pressure, serum triglyceride (TG) levels (-7.82 ± 6.32 vs. 16.63 ± 6.32 mg/dl, p = .01), TG/high-density lipoprotein-cholesterol (HDL-C) ratio (-0.39 ± 0.24 vs. 0.66 ± 0.24, p = .007), and increased serum concentrations of low-density lipoprotein-cholesterol (LDL-C) (6.03 ± 2.47 vs. -1.98 ± 2.47 mg/dl, p = .04) and HDL-C (1.93 ± 1.10 vs. -1.78 ± 1.10 mg/dl, p = .03). These findings were obtained after taking baseline measurements and potential confounders into account. No adverse event or complication was reported due to CPJ consumption throughout the study. We found that CPJ consumption has a beneficial effect on blood pressure, serum concentrations of TG and HDL-C, and TG/HDL-C ratio in women with PCOS. However, this juice could increase serum LDL-C levels in these patients. This trial was registered at www.irct.ir as IRCT20191109045383N1.

Geraniol attenuates oxidative stress, bioaccumulation, serological and histopathological changes during aluminum chloride-hepatopancreatic toxicity in male Wistar rats.

Aluminum chloride (AlCl3) has different industrial applications including manufacturing paint and water treatment. The present study was designed to evaluate the alleviating effect of geraniol against AlCl3-induced hepatopancreatic toxicity. To this end, forty male Wistar rats were divided into control (0.9% NaCl, IP), geraniol (100 mg/kg orally), AlCl3 (70 mg/kg, IP), and AlCl3 (70 mg/kg, IP) plus geraniol (100 mg/kg orally) groups and then were treated daily for 28 days. Based on the results, serum cholesterol, triglyceride, as well as liver and pancreas enzymes increased significantly (P < 0.05) while the level of insulin significantly decreased in AlCl3-treated rats compared to the control group (P < 0.05). The presence of geraniol relieved the toxic effects of AlCl3 as well. On the other hand, the level of malondialdehyde (MDA) increased in the AlCl3-treated group while the activities of glutathione peroxidase and the total antioxidant activity demonstrated a reduction. However, the MDA level decreased while the antioxidant enzymes increased in co-treated with geraniol group. Histopathological examination revealed that simultaneous treatment with geraniol in AlCl3 intoxicated rats ameliorate the liver lesions such as necrosis, inflammatory cell infiltration, vacuolar degeneration, along with hyperemia and the cell density of the Langerhans islands. Finally, the results indicated that geraniol attenuated the side effect of AlCl3-induced hepatopancreatic toxicity.

A priority oriented nutrition education program to improve nutritional and cardiometabolic status in the workplace: a randomized field trial.

BACKGROUND: Workplace nutrition has been identified as a priority setting that can significantly reduce cardiovascular diseases (CVD) risk factors. This study was conducted as a part of the workplace education program to improve nutritional practices and cardiometabolic status in industrial personnel. METHODS: The present research was a randomized controlled field trial conducted on employees of a regional petrochemical company. The health-related priorities of the program were defined and addressed in the study in which 104 employees with dyslipidemia were randomly divided into two groups of education and control. Data were collected pre- and post-intervention, using valid and reliable multi-session questionnaires on demographic data, nutritional knowledge, and nutritional intake. Anthropometric measures, serum FBS, HbA1C, hs-CRP and homocysteine (Hcy) were assessed in both groups. In the education group, the nutrition program included five educational workshops about healthy nutrition and regular exercise along with educational messages over a 3-month period. The controls did not receive any education during the study. RESULTS: There were no statistically significant differences between the two groups regarding the baseline variables. The education group significantly improved their nutritional knowledge (p < 0.001), dietary intakes (p < 0.005), serum FBS (p < 0.001) and Hcy levels (p < 0.001) and anthropometric indices. CONCLUSION: Workplace nutrition education programs can improve knowledge and reduce important CVD risk factors.

The effects of curcumin supplementation on glycemic status, lipid profile and hs-CRP levels in overweight/obese women with polycystic ovary syndrome: A randomized, double-blind, placebo-controlled clinical trial.

OBJECTIVE: The aim of the current study was to assess the effects of curcumin supplementation on glycemic status, lipid profile and high sensitivity C-reactive protein (hs-CRP) serum levels in women with polycystic ovary syndrome (PCOS). DESIGN: This randomized double-blind placebo-controlled clinical trial was conducted on 60 women who were randomly assigned to the intervention or control groups using block randomization. SETTING: Infertility referral center. INTERVENTIONS: Curcumin (500 mg/d) or placebo twice daily for 6 weeks. MAIN OUTCOME MEASURES: Serum evaluation of lipid profile (triglycerides (TG), low-density lipoprotein (LDL)-cholesterol, high-density lipoprotein (HDL)-cholesterol concentrations, LDL/HDL-C and TG/HDL-C ratios), glycemic index (fasting blood sugar (FBS), insulin concentrations, homeostasis model of assessment insulin resistance (HOMA-IR) and quantitative insulin sensitivity check index (QUICKI)) and hs-CRP levels. RESULTS: Glycemic index, lipid profile and hs-CRP serum levels were measured at first and at the end of trial. Serum insulin (p = 0.020) and Quantitative Insulin Sensitivity Check Index (QUICKI) (p = 0.003) were improved significantly, while Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) (p = 0.067) improved marginally in curcumin treated group (within group analysis). CONCLUSIONS: Curcumin supplementation might be beneficial for improving serum insulin and QUICKI, however, future investigations are suggested in order to draw a firm link between curcumin and glycemia control.

Vitamin D Supplementation for Premenstrual Syndrome-Related inflammation and antioxidant markers in students with vitamin D deficient: a randomized clinical trial.

Premenstrual syndrome (PMS) is a common disorder in the reproductive age that negatively significant impacts on women's quality of life. This randomized clinical trial study was undertaken to investigate the effect of vitamin D supplementation on inflammatory and antioxidant markers in 44 vitamin D deficient (25(OH)D < 20 ng/mL) students with PMS. Participants received either 50,000 IU vitamin D3 or a placebo pearl fortnightly for 4 months. At the baseline and in the last 2 months of intervention, participants were asked to complete the PMS Daily Symptoms Rating form along with taking the pearls and their blood samples were collected to assess serum levels of 25(OH)D3, Interleukin10 and 12 (IL-10, IL-12) and total antioxidant capacity (TAC). In vitamin D group, serum levels of IL-10 and IL-12 significantly decreased while TAC significantly increased post-intervention. There were significant differences regarding serum IL-12 and TAC levels between the two groups. Mean score of the total PMS symptoms showed significant improvement in 25(OH)D. Vitamin D supplementation seems to be an effective strategy to improve inflammation and antioxidant markers in vitamin D deficient women with PMS. This clinical trial was registered at Iranian Registry of Clinical Trials on 20/06/2018 (IRCT20180525039822N1).

Effects of saffron on homocysteine, and antioxidant and inflammatory biomarkers levels in patients with type 2 diabetes mellitus: a randomized double-blind clinical trial.

OBJECTIVE: Type 2 diabetes mellitus (T2DM) is one of the most common health problems worldwide. Studies have shown that saffron and its derivatives may have therapeutic potentials in T2DM through reducing plasma glucose. The present study aimed to evaluate the effects of saffron extract on serum anti-inflammatory and antioxidant variables in T2DM patients. MATERIALS AND METHODS: This was a double-blind randomized clinical trial conducted on 64 T2DM patients. Participants received either 15 mg of saffron or placebo capsules (two pills per day) for 3 months. Anthropometric indices, homocysteine, serum anti-inflammatory and antioxidant variables and dietary intake were assessed pre- and post-intervention. RESULTS: After 3 months of treatment, interleukin-6 (IL-6), and tumor necrosis factor (TNF-α) increased significantly in both group (p<0.05). No significant differences were observed for total antioxidant capacity (TAC), malondialdehyde (MDA), high sensitivity C-reactive protein (hs-CRP) and interleukin 10(IL-10) after the treatment period (p>0.05). Homocysteine decteased significantly in control group (p<0.05). CONCLUSION: Our results showed no improvement in homocystein levels, antioxidant status and inflammatory biomarkers in T2DM patients after treatment with saffron.

Subchronic effects of different doses of Zinc oxide nanoparticle on reproductive organs of female rats: An experimental study.

BACKGROUND: Zinc performs many biochemical and physiological functions; however, toxicological studies demonstrate that Nano-zinc oxide has harmful effects on human health and environmental species in high concentrations. OBJECTIVE: The aim of this study was to investigate the toxicity of zinc oxide nanoparticles on reproductive tissues of female rat. MATERIALS AND METHODS: Eighty female Wistar adult rats weighing 180-200 gr, divided into eight groups (n= 10 in each group) including control, sham (treated with saline), and six groups injected with different doses of zinc oxide nanoparticle with 10-30 nanometer size (4, 8, 25, 50, 100, and 200 mg/kg) twice a week for four weeks. At the end of the study, the rats were bled and slaughtered; the Ovary and Uterus were taken for histopathology studies and blood samples were transferred to the laboratory for biochemical analysis. RESULTS: Microscopic diagnoses in ovary tissue were included; increase in the corpus luteum, follicular cysts, inflammatory cells infiltration and fibrosis. Histopathological changes in ovary in a dose-dependent manner. In uterus tissue the lesions consisted; epithelial destruction, hyperplasia of endometrial glands. The Estrogen and Progesterone level in the serum of rats increased in low doses and reduced in a dose-dependent manner at high doses. CONCLUSION: The results of the current study proved the toxicity of zinc oxide nanoparticles on the ovary and uterus organs at high concentrations, so further investigation is needed to reduce these effects.

Sugary beverages are associated with cardiovascular risk factors in diabetic patients.

PURPOSE: Sugar-sweetened beverages (SSBs) containing high amount of added sugars have increased over the last decades. Due to increased risk of cardiovascular events in type 2 diabetes mellitus (T2DM) patients, we designed a study to assess the association between SSBs and metabolic syndrome, a collection of cardiovascular risk factors, in these patients. METHODS: A cross-sectional study was performed on T2DM adults (N = 157). Participants had no serious disease or insulin treatment. SSBs records were obtained from a validated food frequency questionnaire. Metabolic syndrome status was extracted from biochemical and anthropometric measurements. Subjects risk factors were compared based on their usual SSBs consumption. RESULTS: About half of participants consumed at least one serving of SSBs (Mean intake: 145.6 mL/d) on a weekly basis. Men and women had a similar SSBs pattern. Demographic and anthropometric characteristics were identical in both groups. Higher SSBs intake (≥ 0.5 vs <0.5 serving/ week) was positively associated with hypertension (OR: 3.48, 95% CI: 1.31, 9.26) and obesity (OR: 4.61, 95% CI: 1.31, 16.25). After adjustment for confounders, a higher risk of the metabolic syndrome was observed in those with higher SSBs intake (OR: 4.23, 95% CI: 1.42, 12.62). CONCLUSION: Drinking SSBs, even in low amounts, could potentially elevate the risk of cardiovascular risk factors in diabetic patients. Reduction of sugary drinks would be an urgent recommendation.

Genetic Variations in VDR could Modulate the Efficacy of Vitamin D3 Supplementation on Inflammatory Markers and Total Antioxidant Capacity among Breast Cancer Women: A Randomized Double Blind Controlled Trial.

Background: Low levels of vitamin D are found in a great part of breast cancer women. Study subjects using vitamin D3 supplement had lower rates of cancers and fewer markers of inflammation. Additionally, recent studies demonstrate the power of vitamin D supplementation to lower inflammation and oxidative stress biomarkers associate with VDR polymorphism to reduce inflammation. This study was aimed to assess the impact of vitamin D3 supplementation on the serum concentration of inflammatory markers and antioxidant capacity with regard to VDR polymorphism in the VDR gene in breast cancer women. Methods: A randomized, double-blind, placebo-controlled trial was conducted on 56 breast cancer women. Participants were assigned to 2 treatment arms: placebo and vitamin D3 for 2 months intervention. Supplementation group received 50,000 IU of vitamin weekly. Blood samples were collected at baseline and after the intervention to measure the 25(OH) D3, TNF-α, TGF- ß and TAC. Genotyping was performed for FokI, BsmI, ApaI, and TaqI polymorphism. Results: After eight weeks supplementation, the intervention group showed a significant increase in the serum concentration of 25(OH) D3 (28±2.6 to 39±3.5; p=0.004 and TAC (48.9±13.3 to 63.5±13.3; p= 0.017). Changes in TNF-α, TGF- ß1 were not significant. Serum TAC levels of participants with the TT/Tt, Ff genotypes were more responsive to supplementation. Conclusions: Supplementation with a vitamin D3 increased the TAC in breast cancer women, although it had no effect on inflammatory markers. Serum TAC in the TT/Tt, Ff were more responsive to vitamin D supplement compared with those with the FF/ff and tt genotypes.

Zinc status and polycystic ovarian syndrome: A systematic review and meta-analysis.

Several studies have investigated serum zinc levels in patients with polycystic ovarian syndrome (PCOS), but the results of these studies remain inconclusive. Therefore, to derive a more precise estimation, we conducted a meta-analysis to investigate serum zinc concentrations in women with PCOS in comparison with healthy subjects. Electronic search was performed in PubMed, Scopus, and Google scholar up to April; 4, 2018 without any restriction. Eligible studies that evaluated the levels of zinc status in subjects with PCOS were included. Weighted mean differences (WMDs) with corresponding 95% CIs in serum zinc levels were initially estimated using a random-effects model. Eight studies, measuring circulating zinc levels in 552 PCOS and 464 control subjects, were included. Pooled effect size suggested that serum zinc levels in women with PCOS were not statistically different than their controls (WMD = -4.43 mg/dL; 95% CI = [-10.30, 1.44]; P = 0.139). Exclusion of one study revealed that women with PCOS significantly have lower serum zinc levels compared to healthy controls (WMD: -6.60 mg/dL; 95% CI = [-12.43, -0.76], P = 0.027). Our study indicated that circulating zinc levels in women with PCOS were significantly lower than those in healthy controls when detailed analysis is conducted. Large scale studies are needed to elucidate clear relation between zinc status and etiology of PCOS.

The impact of self-efficacy education based on the health belief model in Iranian patients with type 2 diabetes: a randomised controlled intervention study.

BACKGROUND AND OBJECTIVES: Type 2 diabetes is a chronic illness which can be managed by patients' commitment to self-care and self-efficacy behaviors. METHODS AND STUDY DESIGN: A randomized controlled intervention study was carried out to determine the impact of self-efficacy education based on the Health Belief Model (HBM) in 240 patients with type 2 diabetes at the Golestan Hospital, Ahvaz, Iran between October 2014 and August 2015. The education duration was three months followed by a 24-week follow-up visit to determine the progress of the subjects. In this study, reliable and validated diabetes educational booklet and questionnaires based on knowledge, health beliefs and quality of life were used. The participants were randomly allocated to either the intervention group (n=120) or to the conventional dietary counseling group as controls (n=120), and assessed at the baseline, week 12 and week 36. The study was divided into primary outcome measurements consisting of glycated hemoglobin A1c (HbA1c), fasting blood glucose, lipid profile, and anthropometric levels. Secondary outcome measures were related to nutrition knowledge, health beliefs and quality of life. RESULTS: The results showed that subjects in the intervention group had significantly better metabolic and glycemic profiles compared with those in the control group. It also showed that knowledge, health belief and quality of life significantly increased in the intervention group. CONCLUSIONS: Findings indicate that through tailored self-efficacy education, the quality of life and metabolic profile of diabetes patients can be improved.