The effect of zinc supplementation on anthropometric measurements in healthy children over two years: a systematic review and meta-analysis.

BACKGROUND: Zinc deficiency is one of the most important micronutrient deficiencies in children that can affect the children's growth pattern. In this regard, different studies were conducted to assess the effect of zinc supplementation on growth patterns in healthy children. To the best of our knowledge, no systematic review has summarized the results of these studies. So, in the present study, we systematically reviewed the result of the studies that assessed the effect of zinc supplementation on anthropometric parameters in healthy, over 2-year-old children. METHODS: A systematic search was carried out in PubMed, Scopus, and Web of Science from inception to November 2021. Data were pooled using the random-effects method and were expressed as weighted mean difference (WMD) and 95% confidence intervals (CI). RESULTS: The pooled results of eight studies, including 1586 participants, showed that zinc supplementation significantly increases height [(WMD): 0.9, 95% CI: (0.27, 1.52), p < 0.001], weight [(WMD): 0.51, 95% CI: (0.06, 0.97), p < 0.001], height for age (HAZ) [(WMD): 0.07, 95% CI: (0.03, 0.10), p < 0.001]. Also, meta-regression analysis did not reveal any significant association between dose and duration of intervention and anthropometric parameters. CONCLUSION: The present study demonstrates the beneficial effects of zinc supplementation on weight, height, and HAZ.

Systematic review and meta-analysis of the effect of garlic in patients with non-alcoholic fatty liver disease.

BACKGROUND: We aimed to conduct a systematic review and meta-analyses to examine the therapeutic effect of garlic on non-alcoholic fatty liver disease (NAFLD). METHODS: We searched PubMed, Scopus, Web of Science, and Embase databases for retrieving articles investigating the impact of garlic on NAFLD patients. The comprehensive meta-analysis software version 2.0 was used for statistical analysis. The standardized mean difference with a 95% confidence interval (CI) was reported and the effect size was calculated. RESULTS: A preliminary search yielded a total of 293 articles. After screening articles based on inclusion criteria, four articles were included in the final analyses. This systematic review included 186 patients with NAFLD. The result of the meta-analysis showed significant differences between the garlic and placebo groups regarding changes in alanine aminotransferase, aspartate aminotransferase, total cholesterol, low-density lipoprotein-cholesterol, triglyceride, and fasting blood sugar. Moreover, the probability of a decrease in hepatic steatosis was 2.75 times lower in the garlic group compared with the placebo group (RR [95% CI]: 2.75 [1.79, 4.23], p-value<0.001). CONCLUSION: This meta-analysis demonstrates that garlic supplementation had a positive effect on hepatic steatosis, liver enzyme levels, and metabolic profile of patients with NAFLD. However, considering the potential limitation of the included studies, more high-quality clinical trials are needed.

Effect of vitamin A supplementation on the outcome severity of COVID-19 in hospitalized patients: A pilot randomized clinical trial.

INTRODUCTION: Vitamin A is one of the vitamins that is suggested as adjuvant therapy in viral infections due to its immune enhancing role. In the present clinical trial, we intended to assess the effect of vitamin A supplementation on Coronavirus disease-2019 (COVID-19) in hospitalized patients. METHODS: The present pilot randomized controlled clinical trial was conducted on 30 hospitalized patients with COVID-19. Patients in the intervention group received 50000 IU/day intramuscular vitamin A for a maximum of two weeks. Patients in the control group continued their common treatment protocols. All participants were followed up until discharge from the hospital or death. The primary outcome of the study was time to achieve clinical response based on the six classes of an ordinal scale. Time to clinical response was calculated based on the days needed to improve two scores on the scale or patient's discharge. RESULTS: The time to clinical response was not significantly different between the two groups (7.23 ± 2.14 vs. 6.75 ± 1.85 days, respectively, p = 0.48). There was no significant difference between the groups regarding clinical response (hazard ratio: 1.76 [95% CI: 0.73, 4.26]). There were no significant differences between groups regarding the need for mechanical ventilation, duration of hospitalization, or death in the hospital. CONCLUSION: The results of this pilot clinical trial showed no benefit of vitamin A compared with the common treatment on outcome severity in hospitalized patients with COVID-19. Although the results are negative, there is still a great need for future clinical studies to provide a higher level of evidence.

Effect of cranberry supplementation on liver enzymes and cardiometabolic risk factors in patients with NAFLD: a randomized clinical trial.

BACKGROUND: We aimed to evaluate the effect of cranberry supplementation on serum liver enzymes, hepatic steatosis, and cardiometabolic risk factors in patients with non-alcoholic fatty liver (NAFLD). METHODS: In the present parallel-designed randomized controlled clinical trial, 110 patients with NAFLD were enrolled. The patients were randomized to receive 144 mg cranberry capsule or placebo for 6 months. The primary efficacy of the treatment was lipid profile, glycemic measurements, and liver enzyme levels. RESULTS: The data were reported for 46 in the supplementation group and 48 in the placebo group. The patient's mean (SD) age was 43.16 (11.08) years. No significant differences between groups were observed regarding the post-intervention level of liver enzyme. The mean after-intervention levels of total cholesterol (p < 0.001) and triglyceride (p = 0.01) were significantly lower in the intervention group compared with the placebo group. At the end of the study, the mean insulin and HOMA-IR levels were significantly lower in the cranberry group compared with the placebo group. Significantly more patients in the cranberry group experienced a decrease in steatosis level compared with the control group. CONCLUSION: The results of the present study showed that cranberry supplementation had a positive effect on some lipid profiles, insulin resistance, and hepatic steatosis in patients with NAFLD. TRIAL REGISTRATION: IRCT20200725048200N1 ; first registration date: 11.8.2020.

The interaction effect of aerobic exercise and vitamin D supplementation on inflammatory factors, anti-inflammatory proteins, and lung function in male smokers: a randomized controlled trial.

BACKGROUND: This study aimed to investigate the interaction effect of aerobic exercise and vitamin D supplementation on inflammation (TNF-α, IL-6, CC16, SP-D, and CC16/SP-D ratio) and lung function (FEV1, FVC, and FEV1/FVC ratio) in male smokers. METHODS: After applying inclusion criteria, a total of 40 healthy male smokers were recruited in this study. The participants were randomly divided into four groups as follows: Aerobic Exercise + vitamin D Supplementation (AE + VitD, n = 10), Aerobic Exercise (AE, n = 10), vitamin D Supplementation (VitD, n = 10), and Control (C, n = 10). The participants in the AE + VitD and AE groups performed aerobic exercise training (running) up to 50% of the maximum heart rate, three times a week for four weeks. Participants in AE + VitD and VitD groups received 6000 IU/w vitamin D3 for four weeks. The participants in control group did not receive any intervention. Serum tumor necrosis factor (TNF)-α, interleukin (IL)-6, Clara cell protein (CC16), surfactant protein (SP)-D, CC16/SP-D ratio, and lung function (FEV1, FVC, and FEV1/FVC ratio) were measured before and after four weeks of intervention. RESULTS: Serum levels of TNF-α, IL-6, and CC16 decreased significantly in AE + VitD, VitD, and AE groups after four weeks (P < 0.05). Serum SP-D level decreased significantly only in the AE + VitD group (P = 0.011). In addition, FEV1 and FVC increased significantly (P < 0.05) in AE + VitD and AE groups after four weeks of intervention. However, the interventions did not have a significant effect on CC16/SP-D ratio and FEV1/FVC ratio (P > 0.05). Furthermore, serum levels of 1,25-dihydroxyvitamin D increased significantly in AE + VitD and VitD groups (P < 0.05) after four weeks of intervention. However, except for TNF-α, between-group comparisons showed no significant differences in levels of IL-6, CC16, SP-D, CC16/SP-D ratio, FEV1, FVC, FEV1/FVC, and 1,25-dihydroxyvitamin D (P > 0.05). CONCLUSIONS: The results of present study were that aerobic exercise combined with vitamin D supplementation can reduce serum inflammatory factors and anti-inflammatory proteins and improve lung function after four weeks of intervention. Further trials with larger sample size and longer duration are suggested to confirm these results. Trial registration Retrospectively registered. IRCT20180513039637N4. Registration date: 2020/10/20. URL: https://www.irct.ir/search/result?query=IRCT20180513039637N4.

Effect of N-acetylcysteine on remission maintenance in patients with ulcerative colitis: A randomized, double-blind controlled clinical trial.

BACKGROUND: The use of antioxidant agents is suggested as a complementary therapy in UC patients for the prevention of flares. Considering the potent antioxidant activity of N-acetylcysteine (NAC), in the present study we aimed to assess the effect of this supplement on remission maintenance in patients with ulcerative colitis (UC). METHODS: In the present double-blind randomized controlled clinical trial, 168 volunteer UC patients who were on high dose corticosteroid and Mesalamine for flare-up management, were recruited. The patients received 800 mg NAC or placebo for 16 weeks. Simultaneously, the prednisolone dose was tapered. The patients were followed up six more weeks post-intervention. The primary efficacy of the treatment was remaining in remission. The secondary outcomes were the endoscopic relapse, serum level of hs-CRP, hemoglobin, and fecal calprotectin level. RESULTS: During 22 weeks follow up, 25 patients experienced relapses, six of them were in the NAC group and 19 of them were in the placebo group. There was a significant difference between the NAC and placebo groups regarding the relapse-free period (P = 0.007). Compared with the NAC group, significantly more patients in the placebo group had an endoscopic relapse (p < 0.001). At the end of the intervention period (16 weeks) and 6 weeks post-intervention, the mean fecal calprotectin, serum erythrocyte sedimentation rate, and hs-CRP levels were significantly lower in the NAC group compared with the placebo group (p < 0.05). CONCLUSION: The findings indicated that NAC had a significantly more positive effect on the maintenance of remission compared with placebo in UC patients that were in the steroid-tapering phase of therapy.

Synbiotic supplementation is not effective on breast milk selenium concentrations and growth of exclusively breast fed infants: a pilot study.

In this randomized, double-blind, placebo-controlled trial, 57 lactating mothers were randomly allocated into two groups to receive a daily supplement of synbiotic (n = 30) which contained different probiotic strains (2.0 × 108 CFU) and fructooligosaccharide (394 mg) or a placebo (n = 27) for 30 days. Dietary intake was collected from lactating women by 24-hour recall method. Breast milk selenium contents were determined by atomic absorption spectrometry with graphite furnace. Weight for age Z-score (WAZ) and Height for age Z-score (HAZ) were evaluated for infants. Data analyses were assessed using nutritionist IV, Epi Info and SPSS software and presented as mean ± sd or SEM. The total mean breast milk selenium levels were 50.1 ± 16.1 mcg L-1. At the baseline, the mean breast milk selenium concentrations in the synbiotic and placebo groups were 51.7 ± 20.2 and 48.5 ± 12.1 mcg L-1. The mean breast milk selenium levels increased and decreased in the symbiotic and placebo groups respectively, which were not significant (p > 0.05). Also, comparison of the changes in breast milk selenium concentration showed no significant difference between the two study groups after the intervention. At the baseline, the mean WAZ and HAZ of infants whose mothers' milk selenium was more than 60 mcg/l was significantly (P < 0.05) higher than for others. In this pilot study, no significant effect was observed by synbiotic supplementation, however, for concise conclusion, more human studies with higher doses of supplements and longer duration of supplementation are needed to determine the effects of synbiotic supplementation on breast milk selenium contents and infants' growth.

Vitamin A supplementation decreases disease activity index in patients with ulcerative colitis: A randomized controlled clinical trial.

INTRODUCTION: Considering the link between vitamin A deficiency and disease activity in ulcerative colitis (UC) and also the association between dietary intake of vitamin A and gastrointestinal symptoms in these patients, this study aimed to investigate the effect of vitamin A supplementation on disease activity in patients with UC. METHOD: In the present double-blind randomized controlled clinical trial, one hundred and fifty patients with Mayo score of 6-12 were randomly assigned to receive 25,000 IU/day vitamin A supplements or placebo for two months. The disease activity was calculated by the Mayo clinic score. Within groups and between groups comparisons were performed using paired sample t-test and one-way ANCOVA respectively. For measuring the treatment effect, the response ratio and number needed to treat (NNT) was calculated for the rate of clinical response and mucosal healing. RESULTS: One hundred and forty three patients completed the study. After two months of supplementation, significant decreases in Mayo clinic score (p < 0.001) and subscores (p < 0.001) was observed in the intervention group. There were significant differences between the two groups regarding Mayo clinic score and subscores after adjusting for age, sex, BMI, disease duration and baseline values (P < 0.05). Moreover, there were significant differences between two groups regarding clinical response ratio (P < 0.001) and mucosal healing ratio (P < 0.001). The NNT [95%CI] values for the clinical response was 3 [2-40] and for the mucosal healing was 5 [2.90-10.4]. CONCLUSION: Although according to the results, daily dose of 25,000 IU vitamin A had positive clinical and endoscopic effects, considering the limitations, further studies with longer duration and larger sample size and considering dietary intake are needed to confirm these preliminary results.

Does Maternal Synbiotic Supplementation Affect Conjugated Linoleic Acid Level in Breast Milk? A Randomized Placebo-Controlled Clinical Trial.

AIM: As conjugated linoleic acid (CLA)is a potential growth promotor in newborns, the present pilot study aimed at measuring the effect of synbiotic supplementation on breast milk CLA level. MATERIALS AND METHODS: Sixty lactating mothers were randomly allocated to take either synbiotic (n = 31) or placebo (n = 29) for 30 days. Maternal anthropometric indices were measured at the onset and end of the study by standard methods and body mass index was calculated. Information on food intake was collected by using a 24 hours 24-hour recall method for 2 days and food record questionnaire for 1 day. Breast milk lipids were extracted and CLA level was quantified by gas chromatography. RESULTS: No significant differences were observed in the baseline mean breast milk concentrations of Fatty acids (FAs) between the synbiotic and placebo groups (p > 0.05). The CLA content of breast milk increased significantly by 58% (from 0.19 ± 0.15 to 0.30 ± 0.22 mmol/L) in the supplemented group, whereas it decrease decreased slightly but not significantly by 14% (from 0.22 ± 0.14 to 0.19 ± 0.10 mmol/L) in the placebo group. After adjustment for covariates, the CLA content of breast milk was significantly higher in the supplemented group compared with placebo group after the intervention (p = 0.03). The ratio of total n - 6:3 increased significantly over time in both groups, but was not different among groups (p < 0.05). CONCLUSIONS: This pilot study showed that supplementation of lactating women with synbiotic, resulted in increased breast milk CLA composition. Further research using different species of probiotic bacteria and analysis of maternal and infant plasma FAs would be beneficial.

Does probiotic supplementation affect pulmonary exacerbation and intestinal inflammation in cystic fibrosis: a systematic review of randomized clinical trials.

BACKGROUND: Patients with cystic fibrosis (CF) usually have abnormal intestinal microbiota due to massive exposure to antibiotics. Probiotics could modify the gut microbiota and hence may affect CF management. So the aim of present systematic review was evaluation of the efficacy and safety of probiotic supplementation for the management of cystic fibrosis. DATA SOURCES: We searched PubMed, Science Direct, Google Scholar, Springer Cochrane Library Databases until January 2016 for randomized controlled trials (RCTs) performed in pediatric or adult populations related to the study aim. Key words were selected based on Mesh terms. Based on the Critical Appraisal Skills Programme checklist, eligibility of included articles was evaluated. RESULTS: Five studies included in this review represent 188 participants with a follow up period ranging from 1 month to 6 months. The results of the included studies supporting the use of probiotics in management of pulmonary exacerbation and intestinal calprotectin in patients with cystic fibrosis. However the level of evidence was limited. CONCLUSIONS: The lack of high quality RCTs makes it impossible to support a general recommendation about the use of probiotics in the treatment of CF pulmonary exacerbation and intestinal inflammation.

Effects of Elaeagnus angustifolia L. on Lipid Profile and Atherogenic Indices in Obese Females: A Randomized Controlled Clinical Trial.

In the present randomized double-blinded placebo-controlled study, the effect of Elaeagnus angustifolia L. (EA) whole fruit and medulla powders on anthropometric indices, serum lipid profile, and atherogenic indices in females with knee osteoarthritis (OA) was investigated. Ninety females with mild to moderate knee osteoarthritis were randomly assigned to one of three groups-medulla powder, whole fruit powder, or placebo. The subjects received 15 g/day of medulla powder of EA, whole fruit powder of EA, or placebo. Lipid profile, weight, and dietary intake were measured at baseline and at the end of the study. Body mass index and atherogenic indices were calculated. Statistical analysis was performed using SPSS version 13.0, and Paired t tests, analysis of variance (ANOVA), analysis of covariance (ANCOVA), and the Tukey post hoc test were used to compare within-group and between-group values. After 8 weeks of supplementations, compared with the baseline, significant reductions in total cholesterol (TC), low density lipoprotein/high density lipoprotein (LDL/HDL), and TC/HDL ratios were observed in the two supplemented groups; however, the reduction of these values was not statistically significant in the placebo group. There were significant differences between the patients who received medulla powder and placebo group in the case of changes in TC/HDL and LDL/HDL ratios (p < .001). However, no significant differences were found between the two supplemented groups in the case of changes in studied values (p > .05). Generally, whole fruit and medulla powders of Elaeagnus angustifolia L. had positive effects, especially in decreasing total cholesterol and atherogenic indices in females with knee OA.

Effects of Elaeagnus angustifolia L. supplementation on serum levels of inflammatory cytokines and matrix metalloproteinases in females with knee osteoarthritis.

OBJECTIVE: In an attempt to investigate new strategies aimed at reducing inflammation in osteoarthritis, the anti-inflammatory effect of Elaeagnus angustifolia L. as a complementary treatment was evaluated in females with knee osteoarthritis. METHOD: In this clinical trial, 90 females with mild to moderate osteoarthritis were assigned to two intervention and one placebo groups. In addition to the conventional therapy, the patients in intervention groups received 15g/day of E. angustifolia L. medulla and whole fruit powders respectively for 8 weeks. The levels of tumor necrosis factor-alpha (TNF-α), interleukine-1ß (IL-1ß), interleukine-10 (IL-10), matrix metalloproteinase-1 (MMP-1) and -13 (MMP-13) were measured with human ELISA kits. Paired t-test and ANOVA were used for statistical analysis. RESULTS: The statistically significant decrease was observed in the mean levels of serum TNF-α in the medulla (0.004) and whole fruit (0.001) groups after 8 weeks of supplementation. In contrast to the placebo group, there was a significant rise in the mean levels of serum IL-10 in medulla (p-value=0.01) and whole fruit groups (p-value=0.009) at the end of study. The interventions resulted in significant decrease in the mean levels of serum MMP-1 in the medulla (0.001) and whole fruit (0.002) groups. After the interventions, no significant changes were observed in the serum IL-1ß and MMP-13 levels. CONCLUSION: Daily supplementation with E. angustifolia L. in both forms of medulla and whole fruit powders appeared to be effective for decreasing inflammatory cytokines (TNF-α and MMP-1) and enhancing anti-inflammatory cytokines (IL-10).

Effect of different brewing times on soluble oxalate content of loose-packed black teas and tea bags.

Because of the postulated role of increased dietary oxalate intake in calcium oxalate stone formation, the effect of different brewing times on soluble oxalate contents of loose-packed black tea and tea bags was studied. The oxalate content of 25 different samples of loose-packed black teas after brewing at 5, 10, 15, 30, and 60 min and of ten brands of tea bags after infusion for 1, 2, 3, 4, and 5 min was measured by enzymatic assay. The oxalate concentration resulting from different brewing times ranged from 4.3 to 6.2 mg/240 ml for loose-packed black teas and from 2.7 to 4.8 mg/240 ml for tea bags. There was a stepwise increase in oxalate concentration associated with increased brewing times.

The effects of magnesium, L-carnitine, and concurrent magnesium-L-carnitine supplementation in migraine prophylaxis.

Given the conflicting results about the positive effects of magnesium and L-carnitine and as there is no report concerning concurrent supplementation of magnesium and L-carnitine on migraine prophylaxis, the effects of magnesium, L-carnitine, and concurrent magnesium-L-carnitine supplementation on migraine indicators were assessed. In this clinical trial, 133 migrainous patients were randomly assigned into three intervention groups: magnesium oxide (500 mg/day), L-carnitine (500 mg/day), and Mg-L-carnitine (500 mg/day magnesium and 500 mg/day L-carnitine), and a control group. After 12 weeks of supplementation, the checklist of migraine indicators including migraine attacks/month, migraine days/month, and headache severity was completed, and serum concentrations of magnesium and L-carnitine were measured by atomic absorption spectrophotometry and enzymatic UV test, respectively. The results showed a significant reduction in all migraine indicators in all studied groups (p < 0.05). The ANOVA results showed a significant reduction in migraine frequency across various supplemented and control groups (p = 0.008). By separating the effects of magnesium supplementation from other confounding factors such as routine treatments using the repeated measures and nested model, it was clarified that magnesium supplementation had a significant effect on all migraine indicators. Oral supplementation with magnesium oxide and L-carnitine and concurrent supplementation of Mg-L-carnitine besides routine treatments could be effective in migraine prophylaxis; however, larger trials are needed to confirm these preliminary findings.

Effects of an oral supplementation of germinated barley foodstuff on serum tumour necrosis factor-alpha, interleukin-6 and -8 in patients with ulcerative colitis.

BACKGROUND: The efficacy of germinated barley foodstuff (GBF) on tumour necrosis factor-alpha (TNF-α), interleukin-6 (IL-6) and -8 (IL-8) in patients with ulcerative colitis (UC) has not yet been examined. The aim of the present study was to determine the effect of administration of GBF on serum TNF-α, IL-6 and -8 levels in UC patients in remission. METHODS: Forty-one patients with UC were divided into two groups, namely control and GBF group. Twenty-one patients in the control group received standard treatment while 20 patients in the GBF group received 30 g of GBF daily by oral administration during two months of the study along with standard drug therapy. RESULTS: Levels of TNF-α, IL-6 and -8 all decreased in the GBF group compared with baseline during the two-month study, while in the control group all values rose. For IL-6 and -8 this effect was significant, P = 0.034 and 0.013, respectively. CONCLUSIONS: The results of the present study showed that the consumption of GBF may reduce the level of serum TNF-α, IL-6 and -8 in patients with UC. This investigation was designed as a pilot study and the results may provide a basis for more future clinical trials.