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 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.

Antihypertensive effects of Nigella sativa supplementation: An updated systematic review and meta-analysis of randomized controlled trials.

Clinical studies have suggested that Nigella Sativa (N. sativa) supplementation may effectively reduce blood pressure, but the findings are controversial. Therefore, this study aimed to examine the effects of N. sativa on blood pressure in adults. PubMed, Cochrane Library, Web of Science, Scopus, Embase databases, and Google Scholar were searched till August 2022. To analyze weighted mean differences (WMDs), a random-effects model was utilized. Nonlinear dose-response analysis and a meta-regression were conducted. N. sativa supplementation was effective in reducing both systolic (WMD: -3.06 mmHg; 95% CI: -3.89 to -2.22, p < 0.001; I2 = 84.7%, p < 0.001) and diastolic blood pressure (WMD = -2.69 mmHg; 95% CI: -3.72, -1.66, p < 0.001; I2 = 97.3%, p < 0.001). The current meta-analysis suggests that N. sativa supplementation can improve blood pressure and claims that N. sativa could be used as an effective approach to blood pressure management.

The influence of arginine supplementation on IGF-1: A systematic review and meta-analysis.

BACKGROUND: Insulin-like growth factor-1 (IGF-1) secretion is thought to be induced by a semi-essential amino acid called arginine (Arg). Existing research on the effect of Arg on IGF-1 levels has provided conflicting results. This systematic review and meta-analysis investigated the efficacy of acute and chronic Arg supplementation on IGF-1 levels. METHODS: PubMed, Web of Science, and Scopus were systematically searched until November 2022. The meta-analysis was performed using random- and fixed-effects models. Sensitivity and subgroup analyses were also carried out. Publication bias was assessed using Begg's test. RESULTS: Nine studies were included in this meta-analysis. Chronic Arg supplementation did not significantly change IGF-1 levels (SMD = 0.13 ng/ml; %95 CI: -0.21, 0.46; p = 0.457). Furthermore, the IGF-1 level was not significantly affected by acute Arg supplementation (SMD = 0.10 ng/mL; CI: -0.42, 0.62; p = 0.713). The meta-analysis results did not change following subgroup analyses based on the duration, dosage, age, placebo, and study population. CONCLUSION: In conclusion, there was no significant effect of Arg supplementation on IGF-1 concentration. The meta-analyses revealed no acute or chronic Arg supplementation impact on IGF-1 levels.

Effect of vitamin D supplementation on type 2 diabetes biomarkers: an umbrella of interventional meta-analyses.

BACKGROUND: Vitamin D supplementation exerts several supporting effects on improving glycemic status, however, results are inconclusive. Thus, in the present study, we aimed to conduct an umbrella of meta-analysis regarding the impact of vitamin D on type 2 diabetes (T2DM) biomarkers. METHODS: The Scopus, PubMed, Web of Science, Embase, and Google Scholar online databases were searched up to March 2022. All meta-analyses evaluating the impact of vitamin D supplementation on T2DM biomarkers were considered eligible. Overall, 37 meta-analyses were included in this umbrella meta-analysis. RESULTS: Our findings indicated that vitamin D supplementation significantly decreased fasting blood sugar (FBS) (WMD = - 3.08; 95% CI: - 3.97, - 2.19, p < 0.001, and SMD = - 0.26; 95% CI: - 0.38, - 0.14, p < 0.001), hemoglobin A1c (HbA1c) (WMD = - 0.05; 95% CI: - 0.10, - 0.01, p = 0.016, and SMD = - 0.16; 95% CI: - 0.27, - 0.05, p = 0.004), insulin concentrations (WMD = - 2.62; 95% CI: - 4.11, - 1.13; p < 0.001, and SMD = - 0.33; 95% CI: - 0.56, - 0.11, p = 0.004), and homeostatic model assessment for insulin resistance (HOMA-IR) (WMD = - 0.67; 95% CI: - 1.01, - 0.32, p < 0.001, and SMD = - 0.31; 95% CI: - 0.46, - 0.16, p < 0.001). CONCLUSION: This umbrella meta-analysis proposed that vitamin D supplementation may improve T2DM biomarkers.

Effect of date seed (Phoenix dactylifera) supplementation as functional food on cardiometabolic risk factors, metabolic endotoxaemia and mental health in patients with type 2 diabetes mellitus: a blinded randomised controlled trial protocol.

INTRODUCTION: Recently, the improvement of chronic hyperglycaemia-related damage of type 2 diabetes mellitus (T2DM) through functional food consumption has attracted the attention of many clinicians. This study aims to determine the effectiveness of date seed powder (DSP) as a functional food (prebiotic) on the cardiometabolic risk factors, oxidative stress, anti-/inflammatory biomarkers, metabolic endotoxaemia (gut microbiota), adipokines, hypothalamic-pituitary-adrenal axis biomarkers, immune system, anthropometric indices and mental health in patients with T2DM. METHODS: This study protocol will be conducted as randomised, triple-blind, placebo-controlled trial with the inclusion of 48 patients with T2DM. The participants will be randomly assigned into two equal groups of intervention (n=24) and placebo (n=24) and receive 5 g/day of DSP or placebo for 8 weeks, respectively. At baseline and post-intervention, fasting blood samples will be collected to assess the serum levels of lipid profile, glycaemic indices, antioxidant and oxidative stress, anti-/inflammatory biomarkers, lipopolysaccharide, 8-hydroxy-guanine, adipokines, hypothalamic-pituitary-adrenal axis biomarkers, immune system and mental health. Data will be analysed using the SPSS software (V.16.0). To compare the quantitative variables, paired and unpaired Student's t-tests and covariance analyses will be used. DISCUSSION: In this study, the potential effects of DSP on patients with T2DM will be evaluated for the first time. It is hoped that the results would increase the body of scientific knowledge about DSP supplementation on the cardiometabolic risk factors, oxidative stress, anti-/inflammatory biomarkers, metabolic endotoxaemia, adipokines, hypothalamic-pituitary-adrenal axis biomarkers, immune system, anthropometric indices and mental health in patients with T2DM. ETHICS AND DISSEMINATION: The study protocol was approved by the Ethical Committee of the Tabriz University of Medical Sciences, Tabriz, Iran (code: IR.TBZMED.REC.1400.752). TRIAL REGISTRATION NUMBER: Iranian Registry of Clinical Trials (www.irct.ir/IRCT20150205020965N10).

Effectiveness of supplementation with date seed (Phoenix dactylifera) as a functional food on inflammatory markers, muscle damage, and BDNF following high-intensity interval training: a randomized, double-blind, placebo-controlled trial.

PURPOSE: High-intensity interval training (HIIT) is one of the most effective protocols, even though acute HIIT causes inflammatory and oxidative damage. The aim of this study was to examine the effect of date seeds powder (DSP) during HIIT sessions on inflammation markers, oxidants and antioxidants, brain-derived neurotrophic factor (BDNF), exercise-induced muscle damage, and body composition. MATERIAL AND METHODS: Thirty-six recreational runners (men and women), aged 18-35 years, were randomly assigned to consume 26 g/day of DSP or wheat bran powder during HIIT workouts for a period of 14 days. At baseline, at the end of the intervention, and 24 h after the intervention, blood samples were obtained to determine inflammatory, oxidant/antioxidant, and muscle damage markers, as well as BDNF. RESULTS: DSP supplementation resulted in a significant downward trend in high-sensitivity C-reactive protein (Psupplement × time = 0.036), tumor necrosis factor alpha (Psupplement × time = 0.010), interleukin-6 (Psupplement × time = 0.047), malondialdehyde (Psupplement × time = 0.046), creatine kinase (Psupplement × time = 0.045), and lactate dehydrogenase (Psupplement × time = 0.040) after the intervention, as well as a significant increase in total antioxidant capacity (Psupplement × time ≤ 0.001). However, interleukin-10 (Psupplement × time = 0.523), interleukin-6/interleukin-10 (Psupplement × time = 0.061), BDNF (Psupplement × time = 0.160), and myoglobin (Psupplement × time = 0.095) levels did not change significantly in comparison to the placebo group. Moreover, analysis demonstrated that DSP supplementation over 2 weeks had no significant effect on body composition. CONCLUSION: During the 2 weeks of the HIIT protocol, the consumption of date seed powder by participants who had engaged in moderate or high physical activity alleviated inflammation and muscle damage. ETHICS AND DISSEMINATION: This study was approved by the Medical Ethics Committee of TBZMED (No.IR.TBZMED.REC.1399.1011). TRIAL REGISTRATION: Iranian Registry of Clinical Trials website ( www.IRCt.ir/ , IRCT20150205020965N9).

The effect of bitter almond (Amygdalus communis L. var. Amara) gum as a functional food on metabolic profile, inflammatory markers, and mental health in type 2 diabetes women: a blinded randomized controlled trial protocol.

BACKGROUND: Using functional foods in the prevention and treatment of type 2 diabetes mellitus (T2DM) has increased across the world owing to their availability, cultural acceptability, and lower side effects. The present study will aim to examine the impact of bitter almond (Amygdalus communis L. var. Amara) gum as a functional food on metabolic profile, inflammatory markers, and mental health in women with T2DM. METHODS: We will conduct a randomized, triple-blind, placebo-controlled trial. A total of 44 women with T2DM will be randomly allocated into two groups: an intervention group (n = 20) and a placebo group (n = 20). Patients will receive either 5 g/d of bitter melon gum or a placebo for 8 weeks. Clinical and biochemical outcome parameters which include glycemic indices, lipid profile, inflammatory markers, oxidative stress indices, tryptophan (Trp), kynurenine (KYN), cortisol, glucagon-like peptide 1 (GLP-1), leptin, adiponectin, ghrelin, peroxisome proliferator-activated receptor (PPAR) gene expression, brain-derived neurotrophic factor (BDNF), endothelial cell adhesion molecules, plasminogen, cluster deference 4 (CD4), cluster deference 8 (CD8), anthropometric indices, blood pressure, dietary intake, and mental health will be measured at the baseline and end of the study. Statistical analysis will be conducted using the SPSS software (version 24), and P value less than 0.05 will be considered statistically significant. DISCUSSION: The present randomized controlled trial will aim to investigate any beneficial effects of bitter almond gum supplementation on the cardio-metabolic, immune-inflammatory, and oxidative stress biomarkers, as well as mental health in women with T2DM. ETHICS AND DISSEMINATION: The study protocol was approved by the Ethical Committee of the Tabriz University of Medical Sciences (IR.TBZMED.REC.1399.726). TRIAL REGISTRATION: Iranian Registry of Clinical Trials ( www.irct.ir/IRCT20150205020965N7 ).

Omega-3 polyunsaturated fatty acids in the treatment of non-alcoholic fatty liver disease: An umbrella systematic review and meta-analysis.

There has been conflicting evidence from meta-analyses on the effect of polyunsaturated fatty acids (PUFA) on non-alcoholic fatty liver disease (NAFLD). Therefore, in this umbrella meta-analysis, we are evaluating whether omega-3 PUFA supplementation has any benefit in treating NAFLD. Electronic databases such as PubMed, Web of Science, Scopus, Embase and Google Scholar were assessed to October 2022. This meta-analysis included all meta-analyses that examined the effect of PUFAs on liver fat and liver function tests [aspartate aminotransferase (AST), alanine aminotransferase (ALT), and gamma-glutamyl transferase (GGT)]. Meta-analysis was conducted using a random effects model. Subgroup analyses and sensitivity analyses were also performed. In total, eight articles involving 6,561 participants met the eligibility criteria. Advantageous impacts PUFA supplementation were observed on ALT (ESWMD  = -6.72 IU/L; 95% CI: -8.61, -4.84; p < 0.001, and ESSMD  = -0.52 IU/L; 95% CI: -0.84, -0.20, p < 0.001), AST (ESWMD  = -3.73 IU/L, 95% CI: -5.93, -1.53, p < 0.001, and ESSMD  = -0.65 IU/L; 95% CI: -1.08, -0.22, p = 0.003), GGT levels (ESWMD  = -4.20 IU/L, 95% CI: -6.85, -1.55, p = 0.002), and liver fat (ESWMD  = -5.16; 95% CI: -8.49, -1.82, p < 0.001). Intervention with omega-3 PUFAs improves ALT, AST, GGT, and liver fat in patients with NAFLD. Thus, omega-3 PUFAs could be considered as a therapeutic option in the treatment of NAFLD.

Efficacy of vitamin D supplementation as an adjunct therapy for improving inflammatory and oxidative stress biomarkers: An umbrella meta-analysis.

BACKGROUND: Vitamin D supplementation has attracted a lot of attention as a potential modulator of inflammation and oxidative stress, while some studies have reported controversial findings. In this regard, the purpose of this study was to summarize existing systematic reviews and meta-analyses of clinical trials that determined the effects of supplementation with vitamin D on inflammatory and oxidative biomarkers. METHODS: The following international databases were systematically searched till March 20th, 2022: PubMed, Scopus, Embase, Web of Science, and Google Scholar. A random-effects model was applied to evaluate the effects of vitamin D on inflammatory and oxidative stress biomarkers. RESULTS: Overall, 23 meta-analyses were qualified in this umbrella meta-analysis. Our findings revealed that the vitamin D supplementation significantly reduced serum C-reactive protein (CRP) (ES = -0.42; 95% CI: -0.55, -0.29, p < 0.001), tumor necrosis factor-α (TNF-α) (ES = -0.27; 95% CI: -0.42, -0.12; p < 0.001), and malondialdehyde (MDA) concentrations (ES = -0.37; 95% CI: -0.48, -0.25, p < 0.001). However, no significant changes were illustrated regarding interleukin-6 (IL-6) (ES = -0.35, 95% CI: -0.80, 0.10; p = 0.125), total antioxidant capacity (TAC) (ES = 0.68; 95% CI: -0.31, 1.66, p = 0.179), and glutathione (GSH) activity (ES = 0.08; 95% CI: -0.44, 0.60, p = 0.757). CONCLUSION: The present umbrella meta-analysis indicated that supplementation of vitamin D in adults can improve CRP, TNF-α, and MDA levels under various health conditions. Vitamin D could be considered an adjuvant therapy for relieving inflammation and oxidative stress.

The beneficial effects of omega-3 polyunsaturated fatty acids on controlling blood pressure: An umbrella meta-analysis.

Several meta-analyses have revealed that n-3 PUFAs can lower blood pressure, but the findings are conflicting. In this regard, the present umbrella meta-analysis aimed was performed to clarify whether n-3 PUFAs have effects on blood pressure. PubMed, Scopus, Embase, Web of Science, and Google Scholar were used as international databases from inception to May 2022. To examine the effects of n-3 PUFA supplementation on blood pressure, a random-effects model was applied. The leave-one-out method was performed for the sensitivity analysis. The pooled estimate of 10 meta-analyses with 20 effect sizes revealed significant reductions in both systolic (ES = -1.19 mmHg; 95% CI: -1.76, -0.62, p < 0.001) and diastolic blood pressure (ES = -0.91 mmHg, 95% CI: -1.35, -0.47; p < 0.001) following n-3 PUFAs supplementation. In studies with a sample size of ≤ 400 participants and a mean age over 45, SBP and DBP were found to be substantially reduced. Overall, this umbrella meta-analysis indicates that n-3 PUFAs supplementation might play a role in improving DBP and SBP.

The effect of Tribulus terrestris supplementation on inflammation, oxidative stress, and performance of recreational runners: study protocol for a randomized placebo-controlled trial.

BACKGROUND: High intensity and endurance exercises lead to exercise-induced oxidative stress (EIOS), exercise-induced muscle damage (EIMD), and inflammation, which are the influencing factors on muscle soreness, localized swelling, and sports performance decrease. Therefore, the purpose of this study is to determine the effectiveness of Tribulus terrestris (TT) as an herbal supplement with antioxidant and anti-inflammatory properties on the nutritional, oxidative, inflammatory, and anti-inflammatory status, as well as the sports performance of recreational runners. METHODS/DESIGN: This study is a double-blind, randomized, placebo-controlled trial, which will be conducted among recreational runners of Tabriz stadiums, Iran. Thirty-four recreational runners will be selected, and participants will be assigned randomly to two groups: to receive 500 mg TT supplement or placebo capsules twice daily for 2 weeks. Both groups will do high-intensity interval training (HIIT) workouts during the study. Baseline and post-intervention body composition, muscle pain, and aerobic and anaerobic performance will be assessed. In addition, assessment of malondialdehyde (MDA), total antioxidant capacity (TAC), total oxidant status (TOS), superoxide dismutase (SOD), glutathione peroxidase (GPx), uric acid (UA), 8-iso-prostaglandin F2α (8-iso-PGF2α), protein carbonyl (PC), catalase (CAT), glutathione (GSH), nitric oxide (NO), high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), interleukin-10 (IL-10), tumor necrosis factor-alpha (TNF-α), creatine kinase (CK), myoglobin (MYO), lactate dehydrogenase (LDH), insulin-like growth factor-1 (IGF-1) irisin, cortisol, and brain-derived neurotrophic factor (BDNF) will be done during three blood samplings. Changes in oxidative stress, anti/inflammatory biomarkers, and sports performance will be assessed as primary outcomes. DISCUSSION: This study will be the first to assess the potential effects of TT on recreational runners. Our results will contribute to the growing body of knowledge regarding TT supplementation on the nutritional, oxidative, inflammatory, and anti-inflammatory status and sports performance in recreational runners. TRIAL REGISTRATION: Iranian Registry of Clinical Trials ( www.irct.ir ) (ID: IRCT20150205020965N8 ). Registration date: 13 February 2021.

Probiotic therapy, a novel and efficient adjuvant approach to improve glycemic status: An umbrella meta-analysis.

BACKGROUND: Probiotics exert several promoting effects on the glycemic status, however, the results of meta-analyses are inconsistent. we conducted an umbrella meta-analysis, across existing systematic reviews and meta-analyses of clinical trials to determine the definite effects of supplementation with probiotics on glycemic indices. METHODS: A comprehensive systematic search of PubMed/Medline, Scopus, EMBASE, and Web of Science was carried out till August 2021. The random-effects model was employed to conduct meta-analysis. Meta-analysis studies of randomized clinical trials examining the impacts of probiotics supplementation on glycemic indices were qualified in the current umbrella meta-analysis. RESULTS: 48 articles out of 693 in the literature search qualified for inclusion in the umbrella meta-analysis. Pooled effects of probiotics on fasting plasma glucose (FPG), hemoglobin A1C (HbA1c), homeostatic model assessment for insulin resistance (HOMA-IR), and insulin levels were reported in articles 45, 21, 35, and 33, respectively. The analysis indicated a significant decrease of FPG (ES= -0.51 mg/dL; 95% CI: -0.63, -0.38, p < 0.001), HbA1c (ES = -0.32 mg/dL; 95% CI: -0.44, -0.20, p < 0.001), HOMA-IR (ES= -0.56; 95% CI: -0.66, -0.47, p < 0.001), and insulin levels (ES= -1.09 IU/mL; 95% CI: -1.37, -0.81, p = 0.006) by probiotics supplementation. CONCLUSION: Probiotics have amending effects on FPG, HbA1c, HOMA-IR, and insulin levels. A < 8-week period of probiotic supplementation in the moderate dosages (108 or 109 CFU) is an efficacious approach in improving glycemic parameters. Overall, probiotics could be recommended as an adjuvant anti-hyperglycemic agent.

Efficacy of the omega-3 fatty acids supplementation on inflammatory biomarkers: An umbrella meta-analysis.

BACKGROUND: Existing meta-analyses on omega-3 polyunsaturated fatty acids and their anti-inflammatory effects have reported uncertain findings. The current umbrella meta-analysis aimed to assess the findings of multiple meta-analyses on the efficacy of n-3 PUFAs on inflammatory biomarkers in adults with different health conditions. METHODS: Using suitable keywords, articles published until December 2021 were searched in PubMed/Medline, Web of Science, Scopus, EMBASE, and Google Scholar. Meta-analyses investigating the impact of supplementation of n-3 PUFAs on inflammatory biomarkers in adults were included. We performed this meta-analysis using a random-effects model. RESULTS: Overall, 32 meta-analyses were qualified in this umbrella meta-analysis. Our findings demonstrated that the n-3 PUFA supplementation significantly reduced serum C-reactive protein (CRP) (ES = -0.40; 95 % CI: -0.56, -0.24, p < 0.001; I2 = 89.5 %, p < 0.001), Tumour necrosis factor α (TNFα) (ES = -0.23; 95 % CI: -0.37, -0.08, p = 0.002; I2 = 60.1 %, p < 0.001), and interleukin 6 (IL-6) concentrations (ES = -0.22; 95 % CI: -0.39, -0.05, p = 0.010; I2 = 66.2 %, p < 0.001). CONCLUSION: The current umbrella meta-analysis found that supplementation of n-3 PUFAs in adults can improve CRP, TNF-α, and IL-6 concentrations under various health conditions. n-3 PUFAs can be recommended as adjuvant anti-inflammatory agents.

Efficacy of omega-3-rich Camelina sativa on the metabolic and clinical markers in nonalcoholic fatty liver disease: a randomized, controlled trial.

OBJECTIVE: Recently, omega-3 fatty acids and antioxidants co-supplementation was considered as alternative treatment in the management of nonalcoholic fatty liver disease (NAFLD). This trial evaluated effects of Camelina sativa oil (CSO) as a rich source of omega-3 fatty acids and antioxidants on anthropometric indices, lipid profile, liver enzymes, and adiponectin in NAFLD patients. PARTICIPANTS AND METHODS: This triple-blind, placebo-controlled, randomized clinical trial was conducted on 46 NAFLD patients who were randomly assigned to either a CSO supplement or placebo for 12 weeks. Both groups received a loss weight diet. Levels of liver enzymes, adiponectin, lipid profile, atherogenic index, and anthropometric indices were assessed for all patients at baseline and post-intervention. RESULTS: CSO caused significant differences in weight, BMI, waist circumference, waist-to-hip ratio, triglyceride, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c), TC/HDL-c, LDL-c/HDL-c, atherogenic index, alanine aminotransferase, and adiponectin concentrations in the CSO group compared with the placebo group (P < 0.046 for all). No significant differences were found in hip circumference, neck circumference, HDL-c, and other liver enzymes in the CSO group compared with the placebo group (P = 0.790, P = 0.091, P = 0.149, P < 0.159 for liver enzymes, respectively). DISCUSSION AND CONCLUSION: This study showed that CSO supplementation for 12 weeks causes significant changes in all of anthropometric indices (except hip circumference and neck circumference), ALT, lipid profile (except HDL-c), atherogenic index, and adiponectin in NAFLD patients.

The effects of N-acetylcysteine on recovery biomarkers: A systematic review and meta-analysis of controlled trials.

N-acetylcysteine (NAC) is one of the antioxidant supplements which is thought to improve recovery. Existing studies regarding NAC and recovery presented conflicting results. This systematic review and meta-analysis evaluated the existing trials and determined the efficacy of acute and chronic NAC administration on recovery biomarkers. PubMed, Web of Science, and Scopus were searched up to July 2021. The random effects or fixed effects model was applied in the meta-analysis. Sensitivity and subgroup analyses were performed. In case of the presence of publication bias, standard methods were applied. The meta-analysis comprised 37 papers (1,388 participants). All included studies were in English language. Acute NAC administration indicated no significant effects on lactate, pH, VO2 , and CPK-MB ([SMD = -0.06 mmol/L; 95% CI: -0.40, 0.28; p = .714], [SMD = 0.17; 95% CI: -0.28, 0.62; p = .454], [SMD = -0.11 L/min; 95% CI: -0.63, 0.41; p = .686], and [SMD = -0.19 units/L; 95% CI: -0.62, 0.24; p = .395]). Additionally, no evidence of significant influence of chronic NAC administration on lactate, pH, VO2 , and CK was revealed ([SMD = 0.01 mmol/L; 95% CI: -0.25, 0.27; p = .950], [SMD = -0.51; 95% CI: -1.73, 0.70; p = .424], [SMD = -0.18 L/min; 95% CI: -0.56, 0.20; p = .361], and [SMD = -0.04 units/L; 95% CI: -0.36, 0.29; p = .821]). No considerable effect of NAC on recovery was found. PRACTICAL APPLICATIONS: Previous studies on the influence of NAC administration on recovery biomarkers have presented conflicting results. This systematic review and meta-analysis offers a broad range of detailed information on the influence of chronic and acute NAC supplementation outcomes regarding recovery biomarkers. Overall, the results support that NAC supplementation may not be effective in improving recovery biomarkers. However, subgroup analyses based on NAC dosage indicated the meaningful effect of NAC on CK-MB at the dosage of ≥100 mg/kg.

Omega 3-rich Camelina sativa oil in the context of a weight loss program improves glucose homeostasis, inflammation and oxidative stress in patients with NAFLD: A randomised placebo-controlled clinical trial.

BACKGROUND: Over the past few years, the benefits of omega-3 fatty acids have been reported in the management of non-alcoholic fatty liver disease (NAFLD) complications.This study evaluated the effects of Camelina sativa oil (CSO) supplementation as one of the richest dietary sources of omega-3 fatty acids on glucose homeostasis,inflammation, metabolic endotoxemia, and oxidative stress in NAFLD patients. METHODS: A total of 46 patients with NAFLD were allocated to either an intervention (20 g/d CSO) or placebo (20 g/d sunflower oil) group receiving a calorie-restricted diet for 12 weeks. Fasting plasma levels of glycemic indices, hs-CRP, lipopolysaccharide (LPS), antioxidant enzymes activity, total antioxidant capacity (TAC), malondialdehyde (MDA), 8-iso-prostaglandin F2α (8-iso-PGF2α), and uric acid were measured at baseline and post-intervention. RESULTS: The CSO supplementation led to significant differences in insulin concentration, homeostasis model assessment of insulin resistance (HOMA-IR), hs-CRP, LPS, TAC, superoxide dismutase (SOD) activity, MDA and 8-iso-PGF2α between the two groups at end of the study (ANCOVA, P < .05). Hs-CRP decreased significantly in both groups (pair-t-test, P < .05). Insulin concentration, quantitative insulin sensitivity check index, LPS, TAC, SOD, glutathione peroxidase activity, MDA and 8-iso-PGF2α changed significantly only in CSO group (P < .05). CONCLUSION: These findings indicate that CSO may improve glycemia, inflammation, metabolic endotoxemia, and oxidative stress status in patients with NAFLD.

Co-supplementation of camelina oil and a prebiotic is more effective for in improving cardiometabolic risk factors and mental health in patients with NAFLD: a randomized clinical trial.

This trial evaluated the effects of co-supplementing Camelina sativa oil (CSO) and a prebiotic as modulators of the gut microbiota on cardiometabolic risk factors and mental health in NAFLD patients. In all, 44 subjects with NAFLD were allocated to either an intervention (20 g d-1 CSO + resistant dextrin) or a placebo (20 g d-1 CSO + maltodextrin) group and received a calorie-restricted diet (-500 kcal d-1) for 12 weeks. Fasting plasma levels of gucose, insulin, hs-CRP, endotoxin, antioxidant enzyme activity, total antioxidant capacity (TAC), malondialdehyde (MDA), 8-iso-prostaglandin F2α, and uric acid were measured at the baseline and post-intervention. The depression, anxiety and stress scale (DASS) and the general health questionnaire (GHQ) were used to assess mental health. Co-supplementing CSO and resistant dextrin significantly decreased the level of insulin concentration (-0.84 µU ml-1, p = 0.011), HOMA-IR (-0.27, p = 0.021), hs-CRP (-1.25 pg ml-1, p = 0.023), endotoxin (-3.70 EU mL-1, p = 0.001), cortisol (-2.43, p = 0.033), GHQ (-5.03, p = 0.035), DASS (-9.01, p = 0.024), and MDA (-0.54 nmol mL-1, p = 0.021) and increased the levels of TAC (0.16 mmol L-1, p = 0.032) and superoxide dismutase (106.32 U g-1 Hb, p = 0.45) in the intervention group compared with the placebo group. No significant changes were observed in the levels of other biomarkers. Co-supplementing CSO and resistant dextrin in combination with a low-calorie diet may improve metabolic risk factors and mental health in NAFLD patients.

The effects of Melissa officinalis (lemon balm) in chronic stable angina on serum biomarkers of oxidative stress, inflammation and lipid profile.

BACKGROUND AND OBJECTIVES: Coronary artery disease (CAD) is a major cause of death worldwide. Chronic stable angina (CSA) is the primary sign of CAD. Oxidative stress and inflammation play a substantial role in pathogenesis and progression of CAD. The aim of this study was to investigate the effects of oral administration of powdered Melissa officinalis (MO) on biomarkers of oxidative stress, inflammation, and lipid profile in patients with CSA. METHODS AND STUDY DESIGN: A randomized, double-blind, placebo-controlled clinical trial was performed in 80 patients with CSA. The subjects were randomly assigned to obtaineither oral MO 3 g/d (n=40) or placebo (n=40) for eight weeks. Anthropometric indices, biomarkers of oxidative stress, inflammation, and lipid profile were evaluated at baseline and post-intervention. RESULTS: The mean serum concentrations of triglycerides, total-cholesterol, LDL-cholesterol, and malondialdehyde (MDA), and high sensitive C-Reactive Protein (hs-CRP) were lower in the intervention group compared with placebo (p<0.01) post intervention. Moreover, the mean serum concentration of paraxonase 1 (PNO1) and HDL-c were higher (p<0.001) in the intervention group compared with the control group. CONCLUSION: Oral MO supplementation improves the lipid profile, MDA, hs-CRP, and PNO1 in patients with CSA.