The effects of chicory supplementation on liver enzymes and lipid profiles in patients with non-alcoholic fatty liver disease: A systematic review and meta-analysis of clinical evidence.

BACKGROUND & AIMS: The beneficial effects of Cichorium intybus L., chicory, in patients with non-alcoholic fatty liver disease (NAFLD) are controversial. This review aimed to systematically summarize the evidence on the effects of chicory on liver function and lipid profile in patients with NAFLD. METHODS: Online databases of Scopus, Web of Science, PubMed, EMBASE, Cochrane Library, and grey literature were searched for relevant randomized clinical trials. Weighted mean differences (WMD) with 95% confidence intervals (CIs) were used as effect sizes and a random-effects model was used to pool the data. Besides, sensitivity analyses and publication bias analysis were performed. RESULTS: In total, five articles containing 197 patients with NAFLD were included. The study showed that chicory significantly decreased the levels of both aspartate transaminase (WMD: -7.07 U/L, 95%CI: -13.82 to -0.32) and alanine transaminase (WMD: -17.53 U/L, 95%CI: -32.64 to -2.42). However, no significant effects on alkaline phosphatase and gamma-glutamyl transferase levels and the components of the lipid profile were observed with the use of chicory. CONCLUSIONS: This meta-analysis showed that chicory supplementation may exert potential hepatoprotective effects in patients with NAFLD. However, for widespread recommendations, more studies with a higher number of patients and longer periods of intervention are mandatory.

The study protocol for the randomized controlled trial of the effects of a theory-based intervention on resilience, social capital, psychological wellbeing, and health-promoting lifestyle in healthcare workers.

BACKGROUND: The workplace has been identified as a key determinant of health status. There is evidence of innumerable health problems among employees, particularly healthcare workers. Against this background, a holistic-systemic approach together with a good theoretical framework is required to reflect on this issue, and to support the design of effective interventions to promote the health and wellbeing of the given population. The present study aims to evaluate the effectiveness of an educational intervention in improving resilience, social capital, psychological wellbeing, and health-promoting lifestyle in healthcare workers, utilizing the Social Cognitive Theory integrated into the PRECEDE-PROCEED model. METHODS: This randomized controlled trial will be performed on a large sample of the employees working in two healthcare centers in the city of Shiraz, Iran. The study will proceed with the healthcare workers of one city being given the educational intervention and the healthcare workers of the other city serving as a control group. Using a census method, all healthcare workers in the two cities will be informed of the trial and its purpose, and then invitations to join the study will be issued. The minimum sample size required has been calculated as 66 individuals in each healthcare centers. Recruitment to the trial will by systematic random sampling of eligible employees who submit an expression of interest in joining the trial, and subsequently give informed consent. Data will be collected through a self-administered survey instrument at three stages: at baseline, and both immediately and three months after the intervention. The experimental group members should participate in at least eight of the ten weekly educational sessions of the intervention and complete the surveys in the three stages. There is no educational intervention for the control group, and they simply experience some routine programs, and complete the surveys at the same three timepoints. DISCUSSION: The findings will provide evidence for the possible effectiveness of a theory-based educational intervention to improve resilience, social capital, psychological wellbeing, and health-promoting lifestyle among healthcare workers. If the educational intervention is found to be effective, then its protocol will be exploited in other organizations to boost resilience. Trial registration IRCT20220509054790N1.

Effects of Melatonin on Cardiac Injury and Inflammatory Biomarkers in Patients Undergoing Coronary Artery Bypass Graft Surgery: a Meta-analysis.

INTRODUCTION: The antiinflammatory and antioxidative effects of melatonin have been established in recent years. Several studies indicate that oxidative stress and inflammation are key drivers of post-coronary artery bypass graft (CABG) surgery complications. In the present study, we aimed to investigate the effects of melatonin on cardiac injury and inflammatory biomarkers in CABG candidates. METHODS: Embase, Medline/PubMed, Web of Science, Scopus, and the Cochrane library were searched up to 5 June 2022. All randomized controlled trials examining cardiac injury and inflammatory biomarkers of CABG patients who received melatonin were included. The random-effects model was utilized to perform the analysis. RESULTS: A total of 947 citations were retrieved through database searches. Finally, five articles (six trials with 342 patients) were included after the screening. Melatonin supplementation led to a significant reduction in cardiac troponin I (CTnI) [weighted mean difference(WMD): -2.28 ng/ml; 95% CI -2.87, -1.69; P < 0.01; I2: 91.25%] and high sensitivity-C reactive protein (hs-CRP) levels (WMD: -0.62 mg/L; 95% CI -0.73, -0.5; P < 0.01; I2: 99.98%) in patients undergoing CABG surgery. We found a nonsignificant decrease in creatine kinase isoenzyme muscle/brain (CK-MB) levels (WMD: -2.87 ng/ml; 95% CI -5.97, 0.23; P = 0.07; I2: 99.98%) after melatonin supplementation. No publication bias was found according to Egger's test. CONCLUSION: Melatonin supplementation may be useful in reducing cardiac injury and inflammatory biomarkers in CABG candidates. Future studies should investigate the clinical significance of these findings.

The effect of green cardamom on blood pressure and inflammatory markers among patients with metabolic syndrome and related disorders: A systematic review and meta-analysis of randomized clinical trials.

Research shows that herbal spices, including seeds of Elettaria cardamomum, may exert beneficial effects on unhealthy metabolic status. This study is a systematic review of the effect of green cardamom in patients with metabolic syndrome and its related disorders. PubMed/Medline, Scopus, EMBASE, Web of Science, and Cochrane Library were searched to identify the relevant randomized clinical trials. The data were pooled using the random-effects model, and weighted mean difference (WMD) was considered as summary effect size. Of 625 clinical trials, eight reports with 595 patients (299 in intervention group and 296 in control group) were included. The findings indicated that green cardamom significantly decreased diastolic blood pressure (WMD: -0.91 mmHg, 95%CI; -1.19, -0.62), high-sensitivity C-reactive protein (WMD: -1.21 mg/L, 95%CI; -2.18, -0.24), interleukin 6 levels (WMD: -2.41 ng/L, 95%CI; -4.35, -0.47). However, cardamom supplementation did not significantly affect systolic blood pressure. This meta-analysis demonstrated that green cardamom could improve blood pressure control and exert antiinflammatory effects which could help patients with unhealthy metabolic profile better manage their health. Importantly, there were few eligible randomized trials with quite a low number of participants. Further prospective studies on larger sample sizes and longer duration of supplementation are warranted for its widespread use.

The Effects of Probiotic Supplementation on Clinical Symptom, Weight Loss, Glycemic Control, Lipid and Hormonal Profiles, Biomarkers of Inflammation, and Oxidative Stress in Women with Polycystic Ovary Syndrome: a Systematic Review and Meta-analysis of Randomized Controlled Trials.

The purpose of this systematic review and meta-analysis of randomized controlled trials (RCTs) is to determine the effectiveness of probiotic supplementation on clinical symptoms, weight loss, glycemic control, lipid and hormonal profiles, and biomarkers of inflammation and oxidative stress in women with polycystic ovary syndrome (PCOS). Eligible studies were systematically searched from Cochrane Library, Embase, Medline, and Web of Science databases until January 2019. Cochran (Q) and I-square statistics were used to measure heterogeneity among included studies. Data were pooled by using random-effect model and expressed as standardized mean difference (SMD) with 95% confidence interval (CI). Eleven articles were included in this meta-analysis. Probiotic supplementation significantly decreased weight (SMD - 0.30; 95% CI, - 0.53, - 0.07; P = 0.01), body mass index (BMI) (SMD - 0.29; 95% CI, - 0.54, - 0.03; P = 0.02), fasting plasma glucose (FPG) (SMD - 0.26; 95% CI, - 0.45, - 0.07; P < 0.001), insulin (SMD - 0.52; 95% CI, - 0.81, - 0.24; P < 0.001), homeostatic model assessment for insulin resistance (HOMA-IR) (SMD - 0.53; 95% CI, - 0.79, - 0.26; P < 0.001), triglycerides (SMD - 0.69; 95% CI, - 0.99, - 0.39; P < 0.001), VLDL-cholesterol (SMD - 0.69; 95% CI, - 0.99, - 0.39; P < 0.001), C-reactive protein (CRP) (SMD - 1.26; 95% CI, - 2.14, - 0.37; P < 0.001), malondialdehyde (MDA) (SMD - 0.90; 95% CI, - 1.16, - 0.63; P < 0.001), hirsutism (SMD - 0.58; 95% CI, - 1.01, - 0.16; P < 0.001), and total testosterone levels (SMD - 0.58; 95% CI, - 0.82, - 0.34; P < 0.001), and also increased the quantitative insulin sensitivity check index (QUICKI) (SMD 0.41; 95% CI, 0.11, 0.70; P < 0.01), nitric oxide (NO) (SMD 0.33; 95% CI 0.08, 0.59; P = 0.01), total antioxidant capacity (TAC) (SMD 0.64; 95% CI, 0.38, 0.90; P < 0.001), glutathione (GSH) (SMD 0.26; 95% CI, 0.01, 0.52; P = 0.04), and sex hormone binding globulin (SHBG) levels (SMD 0.46; 95% CI, 0.08, 0.85; P = 0.01). Probiotic supplementation may result in an improvement in weight, BMI, FPG, insulin, HOMA-IR, triglycerides, VLDL-cholesterol, CRP, MDA, hirsutism, total testosterone, QUICKI, NO, TAC, GSH, and SHBG but did not affect dehydroepiandrosterone sulfate levels, and total, LDL, and HDL cholesterol levels in patients with PCOS.

Effects of Nigella sativa Extract on Chronic Rhinosinusitis: A Randomized Double Blind Study.

Chronic rhinosinusitis (CRS) causes long-term discomfort for patients, and due to the frequent relapses and dissatisfaction with current treatments, CRS patients pay more attention to herbal-traditional remedies nowadays. Nigella sativa seed has a special place in Traditional Persian medicine because of its therapeutic and clinical applications. Therefore, we decided to evaluate the effect of N. sativa seed extract on clinical symptoms of CRS patients. In a double-blind controlled clinical trial on CRS patients referred to otolaryngology clinics of Firoozgar and Amiralmomenin hospitals, all the patients used nasal drops of the N. sativa (drug) or sesame oil extract (placebo), and standard SNOT-22 questionnaire completed on days 0 and 28th of study. Data collected and statistical analysis performed by SPSS software. Level of significance was considered as P < 0.05. Out of 53 subjects (33 male and 20 female), 27 were assigned in the drug group and 26 in the placebo group. The mean SNOT-22 score on the 28th day was 19.08 ± 13.21 in the drug group, and in the placebo group, the mean was 37.15 ± 21.47 (P = 0.001). N. sativa extract was particularly effective in improving the feeling of pain, pressure or fullness, numbness and congestion in the nose, and reduction of bad breath. The results of our study indicated that the N. sativa seed nasal drop significantly improved the symptoms of CRS-especially, four major and one minor symptoms- and improved the quality of life of the patients.

Quercetin and cancer: new insights into its therapeutic effects on ovarian cancer cells.

Ovarian cancer is known as a serious malignancy that affects women's reproductive tract and can considerably threat their health. A wide range of molecular mechanisms and genetic modifications have been involved in ovarian cancer pathogenesis making it difficult to develop effective therapeutic platforms. Hence, discovery and developing new therapeutic approaches are required. Medicinal plants, as a new source of drugs, could potentially be used alone or in combination with other medicines in the treatment of various cancers such as ovarian cancer. Among various natural compounds, quercetin has shown great anti-cancer and anti-inflammatory properties. In vitro and in vivo experiments have revealed that quercetin possesses a cytotoxic impact on ovarian cancer cells. Despite obtaining good results both in vitro and in vivo, few clinical studies have assessed the anti-cancer effects of quercetin particularly in the ovarian cancer. Therefore, it seems that further clinical studies may introduce quercetin as therapeutic agent alone or in combination with other chemotherapy drugs to the clinical setting. Here, we not only summarize the anti-cancer effects of quercetin but also highlight the therapeutic effects of quercetin in the ovarian cancer.

The effects of quercetin supplementation on lipid profiles and inflammatory markers among patients with metabolic syndrome and related disorders: A systematic review and meta-analysis of randomized controlled trials.

Aims: This systematic review and meta-analysis of randomized controlled trials (RCTs) was performed to determine the effect of quercetin administration on lipid profiles and inflammatory markers among patients with metabolic syndrome (MetS) and related disorders.Methods: We searched systematically online databases including Cochrane Library, EMBASE, MEDLINE, and Web of Science to identify the relevant RCTs until November 2018. Q-test and I2 statistics were applied to assess heterogeneity among included studies. Data were combined using fixed- or random-effects model and presented as standardized mean difference (SMD) with 95% confidence interval (CI).Results: Out of 591 citations, 16 RCTs were included in the meta-analysis. The pooled findings showed that quercetin consumption significantly decreased total-cholesterol (SMD = -0.98; 95% CI, -1.48, -0.49; p < 0.001; I2: 94.0), LDL-cholesterol (SMD = -0.88; 95% CI, -1.35, -0.41; p < 0.001; I2: 92.7) and C-reactive protein (CRP) levels (-0.64; 95% CI, -1.03, -0.25; p = 0.001; I2: 90.2). While, quercetin supplementation did not significantly affect triglycerides (TG) (SMD = -0.32; 95% CI, -0.68, 0.04; p = 0.08; I2: 84.8), HDL-cholesterol (SMD = 0.20; 95% CI, -0.20, 0.24; p = 0.84; I2: 70.6), interleukin 6 (IL-6) (SMD = -0.69; 95% CI, -1.69, 0.31; p = 0.17; I2: 94.5) and tumor necrosis factor-alpha (TNF-α) levels (SMD = -0.06; 95% CI, -0.25, 0.14; p = 0.58; I2: 35.6)Conclusions: In summary, the current meta-analysis demonstrated that quercetin supplementation significantly reduced total-cholesterol, LDL-cholesterol, and CRP levels, yet did not affect triglycerides, HDL-cholesterol, IL-6 and TNF-α among patients with MetS and related disorders.

The effects of resveratrol intake on weight loss: a systematic review and meta-analysis of randomized controlled trials.

This systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to summarize the effect of resveratrol intake on weight loss. We searched the following databases until July 2018: MEDLINE, EMBASE, Web of Science and Cochrane Central Register of Controlled Trials. Data were pooled using the inverse variance method and expressed as standardized mean difference (SMD) with 95% confidence intervals (95% CI). Out of 831 reports, 36 RCTs were eligible for including to our meta-analysis. The pooled results, using random-effects model showed that resveratrol supplementation significantly decreased body weight (SMD = -0.17; 95% CI, -0.33, -0.01; P = 0.03; I2: 62.6), body mass index (BMI) (SMD = -0.20; 95% CI, -0.35, -0.05; P = 0.01; I2: 60.6), fat mass (SMD = -0.32; 95% CI, -0.62, -0.03; P = 0.03; I2: 77.9) and waist circumference (WC) (SMD = -0.42; 95% CI, -0.68, -0.16; P = 0.001; I2: 75.2), and significantly increased lean mass (SMD = 1.21; 95% CI, 0.75, 1.67; P < 0.001; I2: 87.6). We found no significant effect of resveratrol administration on leptin (SMD = -0.20; 95% CI, -0.68, 0.27; P = 0.40; I2: 85.3) and adiponectin levels (SMD = 0.08; 95% CI, -0.39, 0.55; P = 0.74; I2: 91.0). Resveratrol supplementation significantly decreased body weight in obese patients (SMD -0.43; 95% CI, -0.60, -0.26) compared with other diseases (SMD 0.02; 95% CI, -0.29, 0.33), and type 2 diabetes mellitus (SMD -0.17; 95% CI, -0.37, 0.02). Overall, the current meta-analysis demonstrated that resveratrol intake significantly reduced weight, BMI, WC and fat mass, and significantly increased lean mass, but did not affect leptin and adiponectin levels.

Correction: The effects of melatonin supplementation on blood pressure in patients with metabolic disorders: a systematic review and meta-analysis of randomized controlled trials.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

The effects of vitamin D supplementation on muscle function among postmenopausal women: a systematic review and meta-analysis of randomized controlled trials.

The loss of muscle mass and its strength is one of the most critical changes in aging which is associated with an increased risk of falls, osteoporotic fractures and mobility disability. Vitamin D, with its extra-skeletal benefits, might improve muscle function in elderly. The current systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to summarize available relevant data and determine the effect of vitamin D supplementation on muscle function among postmenopausal women. We reached databases including; Cochrane library, Embase, PubMed, and Web of Science database until the end of May 2018 to identify relevant published RCTs. Heterogeneity among included studies was assessed using Q-test and I2 statistics. Random-effect model was applied to pool data and weighted mean difference (WMD) was calculated representing summary effect size. Outcomes of interest included the effects of vitamin D supplementation on hand grip strength (HGS), back muscle strength (BMS), and Timed Up and Go (TUG). Twelve RCTs out of 1739 potential reports were included in our meta-analysis. The pooled findings showed that vitamin D supplementation had no significant effect on HGS (WMD -0.03 kilogram (Kg); 95 % CI, -0.26, 0.20; P=0.78), BMS (WMD 7.21 newton (N); 95 % CI, -5.98, 20.40; P=0.28), and TUG (WMD 0.01 second (S); 95 % CI, -0.17, 0.18; P=0.93) in postmenopausal women. Overall, the current meta-analysis showed that taking vitamin D supplementation by postmenopausal women did not affect markers of muscle function. Further studies are required to confirm the effect of vitamin D supplementation on markers of muscle function.

The Effects of Resveratrol Supplementation on Endothelial Function and Blood Pressures Among Patients with Metabolic Syndrome and Related Disorders: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

INTRODUCTION: There are current trials investigating the effect of resveratrol supplementation on endothelial function and blood pressures among patients with metabolic syndrome (MetS); however, the findings are controversial. AIM: This systematic review and meta-analysis of randomized controlled trials (RCTs) were carried out to summarize the effects of resveratrol supplementation on endothelial activation and blood pressures among patients with MetS and related disorders. METHODS: We searched systematically online databases including: PubMed-Medline, Embase, ISI Web of Science and Cochrane Central Register of Controlled Trials until October, 2018. Two independent authors extracted data and assessed the quality of included articles. Data were pooled using the fixed- or random-effects model and considered as standardized mean difference (SMD) with 95% confidence intervals (95% CI). RESULTS: Out of 831 electronic citations, 28 RCTs (with 33 findings reported) were included in the meta-analyses. The findings showed that resveratrol intervention significantly increased flow-mediated dilatation (FMD) levels (SMD 1.77; 95% CI 0.25, 3.29; P = 0.02; I2: 96.5). However, resveratrol supplements did not affect systolic blood pressure (SBP) (SMD - 0.27; 95% CI - 0.57, 0.03; P = 0.07; I2: 88.9) and diastolic blood pressure (DBP) (SMD - 0.21; 95% CI - 0.52, 0.11; P = 0.19; I2: 89.8). CONCLUSIONS: Resveratrol supplementation significantly increased FMD among patients with MetS and related disorders, but did not affect SBP and DBP. Additional prospective studies are needed to investigate the effect of resveratrol supplementation on endothelial function and blood pressures, using higher-dose of resveratrol with longer durations.

The effects of mobile health interventions on lipid profiles among patients with metabolic syndrome and related disorders: A systematic review and meta-analysis of randomized controlled trials.

OBJECTIVE: The current systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to summarize the effect of mobile health (m-health) interventions on lipid profiles among patients with metabolic syndrome and related disorders. METHODS: Cochrane Library, EMBASE, PubMed, and Web of Science databases were searched to indentify the relevant randomized clinical trials published up April 30th, 2018. Two reviewers examined study eligibility, extracted data, and assessed risk of bias of included clinical trials, individually. Heterogeneity was measured using I-square (I2) statistic and Cochran's Q test. Data were pooled the standardized mean difference (SMD) effect size by the random-effect model. RESULTS: 18 trials of 1681 citations were identified to be appropriate for the current meta-analysis. Findings random-effects model indicated that m-health interventions significantly decreased total- (SMD -0.54; 95% CI, -1.05, -0.03) and LDL-cholesterol levels (SMD -0.66; 95% CI, -1.18, -0.15). M-health interventions had no significant effect on triglycerides (SMD -0.14; 95% CI, -0.56, 0.28) and HDL-cholesterol levels (SMD -0.35; 95% CI, -0.81, 0.11). CONCLUSION: Overall, the current meta-analysis demonstrated that m-health interventions resulted in an improvement in total- and LDL-cholesterol, but did not affect triglycerides and HDL-cholesterol levels.

The effects of coenzyme Q10 supplementation on biomarkers of inflammation and oxidative stress in among coronary artery disease: a systematic review and meta-analysis of randomized controlled trials.

OBJECTIVE: Systemic inflammation and oxidative stress significantly contribute in developing coronary artery disease (CAD). This systematic review and meta-analysis was aimed to determine the effects of coenzyme Q10 (CoQ10) supplementation on biomarkers of inflammation and oxidative stress among patients with CAD. METHODS: The electronic databases including MEDLINE, EMBASE, Scopus, Web of Science, and Cochrane Library databases were systematically searched until Oct 2018. The quality assessment and heterogeneity of the selected randomized clinical Trials (RCTs) were examined using the Cochrane Collaboration risk of bias tool, and Q and I2 tests, respectively. Given the presence of heterogeneity, random-effects model or fixed-effect model were used to pool standardized mean differences (SMDs) as summary effect sizes. RESULTS: A total of 13 clinical RCTs of 912 potential citations were found to be eligible for the current meta-analysis. The pooled findings for biomarkers of inflammation and oxidative stress demonstrated that CoQ10 supplementation significantly increased superoxide dismutase (SOD) (SMD 2.63; 95% CI, 1.17, 4.09, P < 0.001; I2 = 94.5%) and catalase (CAT) levels (SMD 1.00; 95% CI, 0.57, 1.43, P < 0.001; I2 = 24.5%), and significantly reduced malondialdehyde (MDA) (SMD - 4.29; 95% CI - 6.72, - 1.86, P = 0.001; I2 = 97.6%) and diene levels (SMD - 2.40; 95% CI - 3.11, - 1.68, P < 0.001; I2 = 72.6%). We did not observe any significant effect of CoQ10 supplementation on C-reactive protein (CRP) (SMD - 0.62; 95% CI - 1.31, 0.08, P = 0.08; I2 = 87.9%), tumor necrosis factor alpha (TNF-α) (SMD 0.22; 95% CI - 1.07, 1.51, P = 0.73; I2 = 89.7%), interleukin-6 (IL-6) (SMD - 1.63; 95% CI - 3.43, 0.17, P = 0.07; I2 = 95.2%), and glutathione peroxidase (GPx) levels (SMD 0.14; 95% CI - 0.77, 1.04, P = 0.76; I2 = 78.7%). CONCLUSIONS: Overall, this meta-analysis demonstrated CoQ10 supplementation increased SOD and CAT, and decreased MDA and diene levels, but did not affect CRP, TNF-α, IL-6, and GPx levels among patients with CAD.

The effects of melatonin supplementation on blood pressure in patients with metabolic disorders: a systematic review and meta-analysis of randomized controlled trials.

The current systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to evaluate the potential effect of melatonin supplementation on blood pressure in patients with metabolic disorders. The following databases were searched until June 2018: PubMed, MEDLINE, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials. Two reviewers independently assessed the eligibility of retrieved studies, extracted data from included trials, and evaluated the risk of bias of included studies. Statistical heterogeneity was tested using Cochran's Q test and I-square (I2) statistic. Data were pooled using random-effect models and standardized mean difference (SMD) was considered as the effect size. Eight RCTs, out of 743 potential citations, were eligible to be included in the current meta-analysis. The pooled findings indicated a significant reduction in systolic (SBP) (SMD = -0.87; 95% CI, -1.36, -0.38; P = 0.001; I2: 84.3) and diastolic blood pressure (DBP) (SMD = -0.85; 95% CI, -1.20, -0.51; P = 0.001; I2: 68.7) following melatonin supplementation in individuals with metabolic disorders. In summary, the current meta-analysis demonstrated that melatonin supplementation significantly decreased SBP and DBP in patients with metabolic disorders. Additional prospective studies are recommended using higher supplementation doses and longer intervention periods to confirm our findings.

The effects of ginger intake on weight loss and metabolic profiles among overweight and obese subjects: A systematic review and meta-analysis of randomized controlled trials.

This systematic review and meta-analysis of randomized controlled trials (RCTs) was performed to summarize the effect of ginger intake on weight loss, glycemic control and lipid profiles among overweight and obese subjects. We searched the following databases through November 2017: MEDLINE, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials. The relevant data were extracted and assessed for quality of the studies according to the Cochrane risk of bias tool. Data were pooled using the inverse variance method and expressed as Standardized Mean Difference (SMD) with 95% Confidence Intervals (95% CI). Heterogeneity between studies was assessed by the Cochran Q statistic and I-squared tests (I2). Overall, 14 studies were included in the meta-analyses. Fourteen RCTs with 473 subjects were included in our meta-analysis. The results indicated that the supplementation with ginger significantly decreased body weight (BW) (SMD -0.66; 95% CI, -1.31, -0.01; P = 0.04), waist-to-hip ratio (WHR) (SMD -0.49; 95% CI, -0.82, -0.17; P = 0.003), hip ratio (HR) (SMD -0.42; 95% CI, -0.77, -0.08; P = 0.01), fasting glucose (SMD -0.68; 95% CI, -1.23, -0.05; P = 0.03) and insulin resistance index (HOMA-IR) (SMD -1.67; 95% CI, -2.86, -0.48; P = 0.006), and significantly increased HDL-cholesterol levels (SMD 0.40; 95% CI, 0.10, 0.70; P = 0.009). We found no detrimental effect of ginger on body mass index (BMI) (SMD -0.65; 95% CI, -1.36, 0.06; P = 0.074), insulin (SMD -0.54; 95% CI, -1.43, 0.35; P = 0.23), triglycerides (SMD -0.27; 95% CI, -0.71, 0.18; P = 0.24), total- (SMD -0.20; 95% CI, -0.58, 0.18; P = 0.30) and LDL-cholesterol (SMD -0.13; 95% CI, -0.51, 0.24; P = 0.48). Overall, the current meta-analysis demonstrated that ginger intake reduced BW, WHR, HR, fasting glucose and HOMA-IR, and increased HDL-cholesterol, but did not affect insulin, BMI, triglycerides, total- and LDL-cholesterol levels.

The effects of alpha-lipoic acid supplementation on fasting glucose and lipid profiles among patients with stroke: a systematic review and meta-analysis of randomized controlled trials.

BACKGROUND AND OBJECTIVE: Stroke is a devastating condition with long-term comorbidities including metabolic abnormalities. Alpha lipoic acid (ALA), with its antioxidant properties, might improve metabolic status of patients, though current evidence is still inclusive. This systematic review of randomized controlled trials (RCTs) was conducted to summarize the existing evidence regarding the effects of ALA supplementation on fasting glucose and lipid profiles among patients with stroke. METHODS: We searched Cochrane Library, EMBASE, MEDLINE, and Web of Science from 1990 until April 5th, 2018. The relevant randomized-controlled articles, based on defined key words, were included in the analyses. Two independent researchers investigated study eligibility, extracted data, and assessed the risk of bias for included studies. Heterogeneity among included studies was tested using Q-test and I2 statistics. Random-effects models were applied to pool the data and standardized mean differences (WMD) were considered as summary effect size. RESULTS: A total of five studies (140 patients in each intervention group) were included in our meta-analysis. The findings showed that ALA supplementation significantly decreased fasting glucose levels (WMD -36.93 mg/dL; 95% CI, -65.58, -8.28; P = 0.01; I2 = 85.0%) in patients with stroke. We found no significant effect of ALA supplementation on triglycerides (WMD -7.45 mg/dL; 95% CI, -51.35, 36.45; P = 0.739; I2 = 83.9%), total cholesterol (WMD -23.23 mg/dL; 95% CI, -48.07, 1.62; P = 0.067; I2 = 80.5%), LDL-cholesterol (WMD -10.46 mg/dL; 95% CI, -21.01, 0.09; P = 0.052; I2 = 47.4%) and HDL-cholesterol levels (WMD -3.02 mg/dL; 95% CI, -20.18, 14.14; P = 0.730; I2 = 85.8%). CONCLUSIONS: This meta-analysis suggested the beneficial impacts of ALA supplementation in improving fasting glucose of patients diagnosed with stroke.

The effects of curcumin-containing supplements on biomarkers of inflammation and oxidative stress: A systematic review and meta-analysis of randomized controlled trials.

Besides other benefits, curcumin is getting more recognized for its antioxidant and anti-inflammatory properties, highlighting the importance of curcumin application for chronic disease prevention. This systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to assess the influence of curcumin-containing supplements on biomarkers of inflammation and oxidative stress. MEDLINE, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials were searched till January 2018 for eligible studies. The selected studies were evaluated for their quality using the Cochrane risk of bias tool and relevant data were extracted from included studies. Data were pooled using the inverse variance method and expressed as standardized mean difference (SMD) with 95% confidence intervals (95% CI). Fifteen RCTs were included in the final analysis. The meta-analysis indicated that curcumin supplementation significantly decreased interleukin 6 (IL-6) (SMD -2.08; 95% CI [-3.90, -0.25]; p = 0.02), high-sensitivity C-reactive protein (hs-CRP) (SMD -0.65; 95% CI [-1.20, -0.10], p = 0.02), and malondialdehyde (MDA) concentrations (SMD -3.14; 95% CI [-4.76, -1.53], p < 0.001). Though, curcumin supplementation had no significant effect on tumor necrosis factor-alpha (SMD -1.62; 95% CI [-3.60, 0.36]; p = 0.10) and superoxide dismutase levels (SMD 0.34; 95% CI [-1.06, 1.74], p = 0.63). Overall, this meta-analysis suggests that taking curcumin-containing supplements may exert anti-inflammatory and antioxidant properties through a significant reduction in IL-6, hs-CRP, and MDA levels.

The effects of vitamin D supplementation on endothelial activation among patients with metabolic syndrome and related disorders: a systematic review and meta-analysis of randomized controlled trials.

BACKGROUND AND OBJECTIVE: The current systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to summarize the effect of vitamin D supplementation on endothelial activation among patients with metabolic syndrome and related disorders. METHODS: Cochrane library, Embase, PubMed, and Web of Science database were searched to identify related RCTs published before 30th April 2018. The heterogeneity among the included studies was assessed using Cochran's Q test and I-square (I2) statistic. Data were pooled by using the random-effect model and standardized mean difference (SMD) was considered as summary effect size. RESULTS: Fourteen clinical trials that contained a total of 1253 participants were included in the current meta-analysis. Vitamin D supplementation significantly decreased von willebrand factor (vWF) (SMD -0.27; 95% CI, - 0.46, - 0.08; P = 0.006; I2:40.5%). However, we found no significant impact of vitamin D supplementation on intercellular adhesion molecule 1(ICAM-1) (SMD -1.96; 95% CI, - 4.02, 0.09; P = 0.06; I2:97.4%), vascular celladhesion molecule 1 (VCAM-1) (SMD -0.50; 95% CI, - 1.19, 0.19; P = 0.15; I2:91.2%), on E-selectin (SMD -0.04; 95% CI, - 0.36, 0.28; P = 0.81; I2:78.8%) and endothelin (SMD -0.49; 95% CI, - 1.18, 0.19; P = 0.15; I2:90.5%). The pooled data from trials of vitamin D supplementation with dosage of ≤4000 IU/day (- 0.37, 95% CI: -0.65, - 0.10, I2: 73.5%) significantly reduced vWF concentrations, while there was no effect of vitamin D supplementation on vWF concentrations among trials with the dosage of intervention > 4000 IU/day (- 0.17, 95% CI: -0.43, 0.10, I2: 0.0%). VWF concentrations significantly reduced in pooled data from trials with duration study ≤8 weeks (- 0.37, 95% CI: -0.67, - 0.07, I2: 60.6%), but there was no effect of vitamin D supplementation on vWF concentrations among trials with > 8 weeks (- 0.20, 95% CI: -0.45, 0.05, I2: 0.0%). While there was no effect of vitamin D supplementation on vWF concentrations among trials with total sample size of ≤60 patients (- 0.03, 95% CI: -0.42, 0.36, I2: 0.0%), vWF concentrations in trials with more than 60 patients decreased significantly (- 0.34, 95% CI: -0.56, - 0.12, I2: 60.9%). CONCLUSIONS: Overall, the current meta-analysis demonstrated that vitamin D supplementation to patients with metabolic syndrome and related disorders resulted in an improvement in vWF, but did not affect ICAM-1, VCAM-1, E-selectin and endothelin levels.