Is there a link between the inflammatory potential of a diet and mental health among patients with migraine? Findings from a cross-sectional survey.

AIMS: In this study, we aimed to evaluate the relationship between the dietary inflammatory index (DII) and mental health outcomes among patients with migraine headaches. METHODS: In this cross-sectional study, 262 subjects were included. The dietary intakes were collected using a validated 168-item semi-quantitative food frequency questionnaire. Items were scored according to their inflammatory potential, so a higher DII indicated a more pro-inflammatory diet. The association between DII and the mental health of participants was investigated using multinomial logistic regression and odds ratio (OR) with a corresponding 95% confidence interval (CI) was reported. RESULTS: Overall, 224 women and 38 men, with a mean (standard error) DII of -2.96 (0.06), age of 36.1 (0.53) years, and BMI of 25.55 (0.21) kg/m2, comprised our study population. DII was positively associated with a higher risk of depression in patients with the highest adherence to a pro-inflammatory diet compared to those with the lowest adherence (OR = 1.76; 95%CI: 1.04, 3.00; Ptrend = 0.035). Adjustments for age, sex, marital status, smoking status, migraine headache index score, number of family members, mean arterial pressure, medication, physical activity, and BMI intensified the association in a way that the risk of depression was 2.03 times higher in patients with the highest adherence to a pro-inflammatory diet compared to those with the lowest adherence to a pro-inflammatory diet (OR = 2.03; 95%CI: 1.18, 3.49; Ptrend = 0.011). CONCLUSION: Our findings suggest that depression was positively associated with adherence to a pro-inflammatory diet. However, no significant association was observed between anxiety and stress with DII.

Propolis as an adjunctive therapy for treatment of uncomplicated cystitis in women: A randomized double-blind placebo-controlled trial.

The current research is designed to investigate the effect of propolis supplementation on the clinical manifestations in women suffering from uncomplicated cystitis. In this randomized double-blind, placebo-controlled trial, 120 women with uncomplicated cystitis were selected and randomly assigned into two groups to receive two 500 mg capsules of propolis or placebo daily for 7 days along with ciprofloxacin (250 mg). Clinical symptoms including hematuria, urinary frequency, dysuria, suprapubic pain, and urgency, as well as bacteriuria, were assessed before and after the intervention. After supplementation, participants in the intervention group had significantly fewer days of urinary frequency (p < 0.001), dysuria (p = 0.005), and urgency (p = 0.03). However, there was no significant difference between the two groups regarding hematuria and suprapubic pain (p > 0.05). Furthermore, the severity of bacteriuria decreased significantly in both groups. In conclusion, it seems that propolis supplementation in women with uncomplicated cystitis could improve urinary frequency, dysuria, and urgency. However, further clinical trials should be conducted to fully understand the effects of propolis in women suffering from uncomplicated cystitis.

Consumption of pistachio nuts positively affects lipid profiles: A systematic review and meta-analysis of randomized controlled trials.

We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the effects of consuming pistachio nuts on lipid profiles (total cholesterol [TC], low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], and triglyceride [TG]). Databases of PubMed, Scopus, ISI Web of Science, and Cochrane Library were searched from inception to June 2019 to identify RCTs documenting the effects of consuming pistachio nuts on blood lipid profiles in adults. Effect sizes were reported as weighted mean difference (WMD) and 95% confidence interval (CI) using the random-effects models (DerSimonian-Laird method). Twelve eligible RCTs were included. Consumption of pistachio nuts decreased TC (WMD: -7.48 mg/dL; 95% CI, -12.62 to -2.34), LDL-C (WMD: -3.82 mg/dL; 95% CI, -5.49 to -2.16) and TG (WMD: -11.19 mg/dL; 95% CI, -14.21 to -8.17) levels. However, HDL-cholesterol levels (WMD: 2.45 mg/dL; 95% CI, -2.44 to 7.33) did not change following pistachio consumption. Consuming pistachio nuts may improve lipid profiles (TC, LDL-C, TG) in adults and may be protective against cardiometabolic diseases. However, further studies with larger sample sizes are required to confirm these results.

Effects of pistachios on glycaemic control: a systematic review and meta-analysis of randomised controlled trials.

To evaluate the effects of pistachio consumption on the glucoregulatory status in individuals with a high risk of CVD, a systematic review and meta-analysis of randomised controlled trials (RCT) were conducted. Online databases including PubMed, Scopus, Web of Science and Cochrane Library were searched from inception until June 2019. Human trials that reported data for fasting blood sugar (FBS), fasting insulin and homeostasis model assessment of insulin resistance (HOMA-IR) were included. Data were pooled using the random effect models and expressed as weighted mean difference (WMD) with 95 % CI. Eight RCTs were included in the analyses. Pistachio consumption, exchanged isocalorically for other foods, decreased FBS (WMD: -5·32 mg/dl, 95 % CI (-7·80, -2·64), P < 0·001) and insulin (WMD: -1·86 µIU/ml, 95 % CI (-3·13, -0·59), P < 0·01) concentrations in individuals with a high risk of CVD. However, no changes were observed in the levels of HOMA-IR between the groups (WMD: -0·66, 95 % CI (-1·89, 0·58), P = 0·30). Pistachio consumption may improve glucoregulatory status in individuals at risk for CVD, as evidenced by reduced FBS and insulin concentrations. However, due to the limited availability of studies with diabetic cases and relatively small sample sizes of available studies, well-designed trials with adequate sample sizes aimed at diabetic populations are recommended.

Associations between adherence to Mediterranean dietary pattern and frequency, duration, and severity of migraine headache: A cross-sectional study.

BACKGROUND: The present study was conducted to explore the association between adherence to Mediterranean dietary pattern and migraine headache features including frequency, duration, and severity, as well as patients' migraine-related disabilities among the Iranian population diagnosed with migraine. METHODS: In the present cross-sectional study on 262 migraine patients aged 20-50 years old, a validated 168-item, food frequency questionnaire was used to assess the dietary intakes of participants. The Mediterranean diet score was calculated for each subject using nine pre-defined dietary components and ranged from 0-9. The headache severity, duration, frequency, migraine headache index score (MHIS), and headache impact test-6 (HIT-6) were measured using related questionnaires. RESULTS: After controlling for potential confounders, Mediterranean diet tended to be associated with lower headache frequency (ß = -1.74, 95% CI: -3.53,0.03) and duration (ß = -0.28, 95% CI: -0.59, -0.02) and was significantly associated with lower MHIS (ß = -29.32, 95% CI: -51.22, -7.42), and HIT-6 score (ß = -2.86, 95% CI: -5.40, -0.32) for those in the highest category of Mediterranean diet scores compared to the lowest category. A subgroup analysis of women also revealed a negative association between Mediterranean diet and headaches frequency (ß = -2.30, 95% CI: -4.27, -0.32), duration (ß = -0.42, 95% CI: -0.78, -0.07), scores of MHIS (ß = -47.44, 95% CI: -71.90, -22.99), and HIT-6 (ß = -3.45, 95% CI: -6.29, -0.61), after controlling for potential confounders. CONCLUSIONS: The present study suggests that adherence to the Mediterranean dietary pattern is associated with lower headache frequency, duration, MHIS, and HIT-6 score.

Associations between diet quality and migraine headaches: a cross-sectional study.

AIMS: We evaluated associations between diet quality and migraine outcomes. METHODS: The current work represented a cross-sectional study on 262 patients with migraine (20-50 y). Diet quality was assessed using the standard healthy eating index 2015 (HEI-2015) and alternative healthy eating index 2010 (AHEI-2010). A validated 168-item food frequency questionnaire was used to assess dietary intake. Migraine outcomes included clinical factors (severity, duration, frequency, and disability related to migraine) and serum nitric oxide (NO). Associations between diet quality indices and migraine outcomes were evaluated using linear regressions, and ß and 95% corresponding confidence interval (CI) were reported. RESULTS: HEI-2015 was inversely associated with migraine frequency (ß = -4.75, 95% CI: -6.73, -2.76) in patients with the highest HEI scores (third tertile) vs. those with the lowest scores (first tertile) after adjusting for relevant confounders. AHEI-2010 was inversely associated with migraine frequency (ß = -3.67, 95% CI: -5.65, -1.69) and migraine-related disability (ß = -2.74, 95% CI: -4.79, -0.68) in adjusted models. Also, AHEI-2010 was inversely associated with migraine severity in patients in the second vs. first tertile (ß = -0.56; 95% CI: -1.08, -0.05). We detected no associations between diet quality and NO levels (All P > 0.14). CONCLUSIONS: Improved diet quality may be associated with favorable migraine outcomes (lower headache frequency, severity, and migraine-related disability). Future studies are required to confirm and delineate the causal mechanisms of our observations.

The effect of saffron (Crocus sativus L.) on glycemia, lipid profile, and antioxidant status in patients with type-2 diabetes mellitus: A randomized placebo-controlled trial.

In the current study, we aimed to investigate the effect of saffron supplementation on glycemic status, lipid profile, atherogenic indices, and oxidative status in patients with type-2 diabetes (T2DM). In a randomized, double-blind controlled trial, 70 patients were randomly allocated into two groups (n = 35, each) and received 100 mg/day of saffron or placebo for eight weeks. Dietary intake, weight, body mass index (BMI), waist and hip circumferences (WC and HC), waist to hip ratio (WHR), fasting blood sugar (FBS), hemoglobin A1c (HbA1c), insulin, and Homeostatic model assessment for insulin resistance (HOMA-IR), lipid profile, atherogenic indices, oxidative status, and liver enzymes were determined before and after the intervention. At the end of the eighth week, saffron intervention could significantly reduce FBS (7.57%), lipid profile (except high-density lipoprotein cholesterol [HDL-C]), atherogenic indices, and liver enzymes (p < .05). Moreover, saffron could improve oxidative status (nitric oxide [NO] and malondialdehyde [MDA] reduced by 26.29% and 16.35%, respectively). Catalase (CAT) concentration remained unchanged. Saffron supplementation may alleviate T2DM by improving glycemic status, lipid profile, liver enzymes, and oxidative status. Further investigation is necessary to assess possible side effects and confirm the positive effect of saffron as a complementary therapy in clinical recommendations for T2DM.

Efficacy of synbiotic interventions on blood pressure: a systematic review and meta-analysis of clinical trials.

PURPOSE: The present systematic review and meta-analysis aimed to evaluate the effect of synbiotic interventions on blood pressure levels in adults. METHODS: A systematic literature search was conducted in the databases of MEDLINE, Scopus, Web of Science, and Cochrane through March 2020 to identify all randomized control trials (RCTs) investigating the effects of synbiotic interventions on blood pressure parameter, including systolic (SBP) and diastolic blood pressure (DBP). Grading of Recommendations Assessment, Development and Evaluation (GRADE) scale was used to assess the certainty of evaluated outcomes and determine the strength of recommendations. RESULTS: Eleven RCTs were included in the meta-analysis. Synbiotic interventions significantly reduced SBP (-3.02 mmHg; 95% CI: -4.84, -1.21; I2 = 55%) without changing DBP levels (-0.57 mmHg; 95% CI: -1.78, 0.64; I2 = 50%). Subgroup analyses revealed that the SBP-lowering effects of synbiotic interventions were more pronounced wherein trials were longer (≥12 weeks), synbiotic interventions were administrated as a supplement, and participants were younger (<50 years old). Also, a significant improvement in both SBP and DBP levels was evident in subgroups with a lower (<30 kg/m2) body mass index. CONCLUSIONS: Synbiotic interventions may significantly improve SBP levels in adults.

The effect of nigella supplementation on blood pressure: A systematic review and dose-response meta-analysis.

This study was performed to assess the effect of nigella supplementation on blood pressure levels among the adult population. A comprehensive search was carried out through PubMed, Scopus, Web of Science, and Cochrane Library by using relevant keywords to find out the randomized clinical trials evaluating the effect of nigella administration on systolic blood pressure (SBP) and diastolic blood pressure (DBP). A random-effect model was applied to achieve the overall effect size. Subgroup analysis and meta-regression were used to explore the source of heterogeneity and the effects of the possible moderators. Of the twenty-two trials that were eligible for the present study, seventeen studies consisting of 1048 participants were included in the meta-analysis. The results indicated that nigella administration could significantly reduce both SBP (-4.58 mmHg; 95%CI: -6.22, -2.94) and DBP (-3.08 mmHg; 95%CI: -4.62, -1.55). Subgroup analysis did not show any superiority between subgroups of variables. Dose-response analysis detected a nonlinear association between dose and duration of administration and change in blood pressure outcomes, highlighting that maximum SBP and DBP reduction was experienced at 2000 mg/day and 8 weeks of nigella administration, respectively. The present study suggests that nigella supplementation can be beneficial for managing blood pressure.

The Effect of Saffron (Crocus sativus L.) Supplementation on Renal Function: A Systematic Review and Meta-Analysis of Randomized Controlled Clinical Trials.

Background: The present systematic review and meta-analysis of randomized controlled trials (RCTs) aimed at determining the effect of saffron supplementation on renal function. Methods: Electronic databases were searched up to February 2021. The risk of bias in individual studies was assessed using the Cochrane Collaboration tool. The overall weighted mean difference (WMD) and their 95% confidence intervals (CIs) were calculated using random-effect models. P < 0.05 was considered statistically significant. Results: A total of 11 trials were included in this study. Saffron had beneficial effect on BUN (WMD = -0.69 mg/dl; 95% CI, -1.36 to -0.01; P=0.046) compared to placebo, with significant heterogeneity (I 2 = 49.6%, P=0.037). However, it had no significant effect on serum Cr (WMD = 0.04 mg/dl; 95% CI: -0.01 to 0.09; P=0.127). Conclusion: It seems that saffron supplementation had no significant effect on Cr as a renal function factor. However, BUN reduction was significant in the saffron group compared to placebo.

A novel inflammatory signaling pathway in patients with slow coronary flow: NF-κB/IL-1ß/nitric oxide.

PURPOSE: The slow coronary flow (SCF) was identified as delayed opacification of epicardial coronary arteries in the absence of stenotic lesion. Metabolic syndrome (MetS), oxidative stress, and inflammation may be possible known insulting factors for the pathogenesis of SCF. This investigation aimed to assess the relationship between some inflammatory markers, oxidative stress parameters and MetS components with SCF phenomenon. METHODS: A total of 35 patients with SCF and 35 subjects with normal coronary flow (NCF) were included in the study. We assessed some inflammatory markers (IL-1ß, IL-18, TNF-α, and NF-κB mRNA expression in peripheral blood mononuclear cells (PBMCs)). Moreover, blood samples of the participants were tested for total antioxidant capacity (TAC), glutathione peroxidase (GPX) and nitric oxide (NO) levels using enzyme-linked immunosorbent assay (ELISA). Diagnosis of MetS was based on the National Cholesterol Education Program's Adult Treatment Panel III report (ATPIII) criteria, 2005. Diagnostic criteria for coronary flow rates of all subjects were documented by thrombolysis in myocardial infarction (TIMI) frame count method. RESULTS: SCF patients had significantly higher prevalence of MetS (46%, p = 0.048).We found that the level of TAC was significantly higher in the NCF group (p = 0.006). Furthermore, the NO concentration was significantly lower in SCF groups (p = 0.001). A significant incremental difference was detected in IL-1ß (fold change 2.82 ± 0.31, p < 0.05) and NF-κB (fold change 4.62 ± 0.32, p < 0.05) mRNA expression in the SCF group when compared with its level in the NCF group. Furthermore, according to logistic regression analysis, there were significant associations between IL-1ß, NF-κB expression levels and the incidence of SCF (p < 0.05). CONCLUSION: Based on the findings of this study, the pathogenesis of the SCF phenomenon may be closely associated with metabolic syndrome and inflammation. The NF-κB/IL-1ß/nitric oxide & MetS signaling pathway might be considered as potential therapeutic targets in the management of SCF patients but further researches is required to guarantee these findings.

The effect of magnesium supplementation on anthropometric indices: a systematic review and dose-response meta-analysis of clinical trials.

The aim of this study was to determine the effects of Mg supplementation on anthropometric indices consisting of body weight, waist circumference (WC), BMI and body fat percentage. In this systematic review and dose­response meta-analysis, we searched PubMed, Cochrane Library, Scopus, Web of Science and Google Scholar from databases inception up to February 2020 for relevant randomised controlled trials. Quality of evidence was evaluated using the Cochrane Collaboration Tool. All the outcomes of this meta-analysis were pooled using the random effect model. Analysis of dose­response for Mg dosage was carried out using a fractional polynomial model. The systematic review and meta-analysis include twenty-eight randomised clinical trials, comprising 2013 participants. There were no significant changes in anthropometric indices after Mg supplementation in the overall analysis. However, subgroup analysis revealed that Mg supplementation decreases WC in subjects with BMI > 30 kg/m2 (obese) (twelve trials, n 997 participants; weighted mean difference = ­2·09 cm, 95 % CI ­4·12, ­0·07, P = 0·040; I2 = 0 %). Dose­response analysis revealed a non-significant non-linear effect of supplementation dosage on anthropometric indices. The results suggest that Mg supplementation is associated with lower WC only in obese subjects. However, more high-quality studies are needed to clarify the nature of this association.

Effects of pistachios on anthropometric indices, inflammatory markers, endothelial function and blood pressure in adults: a systematic review and meta-analysis of randomised controlled trials.

Evidence suggests that eating nuts may reduce the risk of CVD. This study was intended to pool the data of all randomised controlled trials (RCT) available to determine if pistachios confer a beneficial effect on anthropometric indices, inflammatory markers, endothelial dysfunction and blood pressure. Without language restriction, PubMed, Scopus, Cochrane Library and Web of Science were searched for articles published from the earliest records to June 2019 investigating the effect of pistachio consumption on inflammation, endothelial dysfunction and hypertension. Mean difference (MD) was pooled using a random effects model. The Cochrane risk of bias tool was used to evaluate the quality of the studies. The meta-analysis of thirteen RCT with 563 participants indicated that pistachio consumption significantly decreased systolic blood pressure (SBP) (MD: -2·12 mmHg, 95 % CI -3·65, -0·59, P = 0·007), whereas changes in flow-mediated dilation (MD: 0·94 %, 95 % CI -0·99, 2·86, P = 0·813), diastolic blood pressure (MD: 0·32 mmHg, 95 % CI -1·37, 2·02, P = 0·707), C-reactive protein (MD: 0·00 mg/l, 95 % CI -0·21, 0·23, P = 0·942), TNF-α (MD: -0·09 pg/ml, 95 % CI -0·38, 0·20, P = 0·541), body weight (MD: 0·09 kg, 95 % CI -0·38, 0·69, P = 0·697), BMI (MD: 0·07 kg/m2, 95 % CI -0·16, 0·31, P = 0·553) and waist circumference (MD: 0·77 cm, 95 % CI -0·09, 1·64, P = 0·140) were not statistically significant. This systematic review and meta-analysis suggested the efficacy of pistachio consumption to reduce SBP levels. However, further large-scale studies are needed to confirm these results.

Dietary patterns and risk of non-alcoholic fatty liver disease.

BACKGROUND: Nutrition is a modifiable risk factor that plays an important role in the prevention or delaying of the onset of non-alcoholic fatty liver disease (NAFLD). Previous studies have focused on NAFLD and individual nutrients, which does not take into account combinations of food that are consumed. Therefore, we aimed to investigate the relationship between major dietary patterns and NAFLD. METHODS: This case-control study was conducted on 225 newly diagnosed NAFLD patients and 450 healthy controls. Usual dietary intake over the preceding year was assessed using a validated 168-item semi-quantitative food frequency questionnaire. Major dietary patterns were determined by exploratory factor analysis. RESULTS: Three dietary patterns, including "western dietary pattern", "healthy dietary pattern", and "traditional dietary pattern" were identified. Subjects in the highest tertile of healthy dietary pattern scores had a lower odds ratio for NAFLD than those in the lowest tertile. Compared with those in the lowest tertile, people in the highest tertile of "western dietary pattern" scores had greater odds for NAFLD. After adjusting for potential confounding factors, "western dietary pattern" had a positive significant effect on NAFLD occurrence. In contrast, "healthy dietary pattern" was associated with a decreased risk of NAFLD. Furthermore, Higher consumption of the "traditional dietary pattern" was significantly associated with NAFLD, albeit in the crude model only. CONCLUSION: This study indicated that healthy and western dietary patterns may be associated with the risk of NAFLD. The results can be used for developing interventions in order to promote healthy eating for the prevention of NAFLD.

Vitamin D and thyroid disorders: a systematic review and Meta-analysis of observational studies.

BACKGROUND: The contribution of vitamin D to thyroid disorders has received paramount attention; however, results are mixed. Hence, we designed a systematic review and meta-analysis to obtain a definitive conclusion. METHODS: The search included PubMed, ISI Web of Science, Scopus, and Google Scholar databases up to March 2021 to collect available papers reporting the relationship between serum levels of vitamin D and thyroid disorders. The pooled effect was reported as weighted mean difference (WMD) and 95% confidence interval (CI). RESULTS: Out of 6123 datasets, 42 were eligible to get into this systematic review and meta-analysis. Serum vitamin D was markedly lower in autoimmune thyroid diseases (AITD) (WMD - 3.1 ng/dl; 95% CI, - 5.57 to - 0.66; P = 0.013; I2 = 99.9%), Hashimoto's thyroiditis (HT) (WMD - 6.05 ng/dl; 95% CI, - 8.35 to - 3.75; P < 0.001; I2 = 91.0%) and hypothyroidism patients (WMD - 13.43 ng/dl; 95% CI, - 26.04 to - 0.81; P = 0.03; I2 = 99.5%), but not in subjects with Graves' disease (GD) (WMD - 4.14 ng/dl; 95% CI, - 8.46 to 0.17; P = 0.06; I2 = 97.5%). CONCLUSIONS: Our findings suggested lower vitamin D levels in patients with hypothyroidism, AITD, and HT compared to healthy subjects. However, the link between serum vitamin D and GD was only significant among subjects ≥40 years old.

Effects of resveratrol supplementation on liver enzymes: A systematic review and meta-analysis of randomised controlled trials.

BACKGROUND: The available evidence regarding the possible effects of resveratrol on liver function is inconsistent. Therefore, the present meta-analysis was performed to investigate the overall effects of resveratrol supplementation on liver enzymes in adults. METHODS: A systematic and comprehensive search of the online medical databases including PubMed, Scupos, Web of Science and Cochran Library was performed up to February 2020. All RCTs using resveratrol supplements in adults were included in this systematic review and meta-analysis. The overall effect was presented as weighted mean difference (WMD) and 95% confidence interval (CI) in a random-effects meta-analysis model. RESULTS: Finally, 15 randomised trials including 714 participants were selected for the present meta-analysis. Pooled analysis did not show any significant changes in alanine aminotransferase (ALT) (WMD: 0 IU/L, 95% CI: -3.17 to 3.17, P = .99; I2 = 74.2%), aspartate aminotransferase (AST) (WMD: -2.40 IU/L, 95% CI: -5.45 to 0.65, P = .11; I2 = 82.9%), gamma-glutamyl transferase (GGT) (WMD: -1.26 IU/L, 95% CI: -4.64 to 2.13, P = .64; I2 = 23.7%), alkaline phosphatase (ALP) (WMD: 3.80 IU/L, 95% CI: -4.65 to 12.25, P = .37; I2 = 29.9%) and bilirubin (WMD: 0.13 IU/L, 95% CI: -0.43 to 0.17, P = .39; I2 = 8.9%) after supplementation with resveratrol. CONCLUSION: Overall, in our study, resveratrol does not affect liver enzyme levels significantly, but subgroup analysis indicates that these results may be influenced by resveratrol dose, duration of the study and population status, so future high-quality studies are necessary to get definitive results.

Saffron improves life and sleep quality, glycaemic status, lipid profile and liver function in diabetic patients: A double-blind, placebo-controlled, randomised clinical trial.

BACKGROUND: Type 2 diabetes (T2D) is a metabolic disorder that is related to hyperglycaemia, hyperlipidaemia and liver dysfunction and has detrimental effects on a patient's mental health. Hence, the current study investigated the effects of saffron supplementation on dietary intake, anthropometric measures, mood, sleep quality and metabolic biomarkers in overweight/obese patients with T2D. METHODS: In a double-blind, randomised controlled trial, 70 overweight/obese patients with T2D were randomly allocated to two groups and received 100 mg/day saffron or placebo for 8 weeks. Participants completed the Beck depression inventory-II (BDI-II), Hurlbert index of sexual desire (HISD), Pittsburgh Sleep Quality Index (PSQI) and Diabetes-specific Quality-of-Life Brief Clinical Inventory questionnaires (DQOL-BCI). Dietary intake, anthropometric measures, fasting plasma glucose (FPG), haemoglobin A1C (HbA1C), insulin, lipid profile and liver enzymes were determined at baseline and the end of the study. RESULTS: At the end of the eighth week, saffron supplementation significantly decreased FPG, triglyceride (TG), insulin, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) (P < .001). Moreover, significant improvements in BDI-II scores and total quality of life were observed in the intervention group (P < .001). The saffron group showed more significant improvements in PSQI scores than the placebo group, such that at the post-intervention analysis, only the saffron group achieved a "good" sleep band. At this relatively high dose, saffron supplementation improved glycaemic status, lipid profile and liver enzyme measures in patients with T2D while also improving sleep and overall quality of life. CONCLUSION: Our results indicate that saffron notably reduced hyperglycaemia and hyperlipidaemia and improved liver function in patients with T2D in an 8-week randomised clinical trial. Saffron also significantly improved depression, sleep quality and overall quality of life in diabetic patients. However, further investigation is necessary to confirm whether saffron is an effective complementary therapy for T2D.

The interplay between fasting, gut microbiota, and lipid profile.

BACKGROUND: This study aimed to investigate the consequence of Ramadan fasting on gut bacterium (Bacteroides and Firmicutes), serum concentration for butyrate, and lipid profile. METHODS: Thirty healthy subjects were enlisted and investigated two times (before and at the end of Ramadan). Fasting blood samples were obtained for measuring fasting blood sugar (FBS) and lipid profile and serum butyrate concentration. Anthropometrics variables were measured before and after Ramadan for all 30 subjects. Quantitative reverse transcription polymerase chain reaction (RT-PCR) analysis, targeting the genome of Bacteroides and Firmicutes was performed to determine its presence in the stool samples. Food intake was assessed by a 3-day food record before and after Ramadan. Statistical analysis was performed by SPSS ver.13 and Minitab ver.17. P < 0.05 considered the level of significance. RESULTS: The study results showed that serum levels of butyrate significantly increase during the month from 0.23 ± 0.02 mM to 0.46 ± 0.03 mM (P < 0.05). The gut Bacteroides and Firmicutes increased by 21 and 13 percent after Ramadan compared to before (P < 0.05). The increment in Bacteroides occurred in both sexes, but Firmicutes significantly increased only in women. Food intake was decreased during Ramadan. Ramadan fasting caused significant reduction in BMI from 25.72 ± 0.58 kg/m2to 25.25 ± 0.55 kg/m2 (P < 0.05). Serum levels of LDL, HDL, LDL/HDL ratio, and total cholesterol significantly decreased during Ramadan (P < 0.05). However, the decrease in FBS and TG level were not statistically significant (P > 0.05). CONCLUSION: It can be stated that the promotion of Bacteroides and Firmicutes in the gut might play a crucial role in health promotion. However, more research is needed to achieve a definite conclusion.

The Effect of Green Coffee Bean Extract on Cardiovascular Risk Factors: A Systematic Review and Meta-analysis.

BACKGROUND AND AIM: Cardiovascular disease remains the primary cause of noncommunicable disease- related death. The present systematic review and meta-analysis was performed to assess the possible benefit of the green coffee bean extract on cardio-metabolic markers. METHODS: PubMed, Scopus, Web of Science, and Cochrane Library were systematically searched to identify clinical trials that examined the effect of green coffee bean extract on cardio-metabolic risk factors including serum lipid profiles, glycemic status-related markers, blood pressure, and anthropometric indices. Since the included RCTs were carried out in different settings, random effect models were used to conduct all meta-analyses. RESULTS: Fifteen studies (19 arms) consisting of 637 participants were included. The results indicated that green coffee bean extract significantly reduced levels of total cholesterol (-5.93 mg/dl; 95% CI: -9.21, -2.65; I2: 0%), fasting plasma glucose (-2.21 mg/dl; 95% CI: -3.94, -0.48; I2: 32%), systolic blood pressure (-3.08 mmHg; 95% CI: -4.41, -1.75; I2: 26%), diastolic blood pressure (-2.27 mmHg; 95% CI: -3.82, -0.72; I2: 61%), body weight (-1.24 kg; 95% CI: -1.82, -0.66; I2: 15%), and BMI (-0.55 kg/m2; 95% CI: -0.88, -0.22; I2: 73%). Although the pooled effect size of LDL-C, fasting insulin, and waist circumstance were significant, the results were significantly influenced by individual studies. No significant effect was detected for triglycerides, HDL-C, HbA1C, and HOMA-IR. However, the nonsignificant pooled effect size for triglyceride levels was influenced by one individual study. CONCLUSION: The present study suggests that green coffee been extract consumption can improve total cholesterol, triglycerides, body weight, blood pressure, and fasting plasma glucose.

The effect of cocoa/dark chocolate consumption on lipid profile, glycemia, and blood pressure in diabetic patients: A meta-analysis of observational studies.

Due to the increasing rate of cardiovascular disease and related risk factors in the worldin recent decades, the present meta-analysis was performed to investigate the effects ofcocoa/chocolate consumption on lipid profile, glycemia, and blood pressure control in diabetic patients. A systematic search of the databases PubMed, Scopus, Web of Science, and Cochran Library was performed up to July 2020. All randomized controlled trials (RCTs) using cocoa/dark chocolate in diabetic patients were included in the study. The search results were limited to English-language publications. Eight RCTs, including 433 participants, were selected for this meta-analysis. Pooled analysis indicated a significant reduction in low-density lipoprotein cholesterol LDL-c levels (WMD: -15.49 mg/dl; 95% CI: -24.56, -6.42, p = .001) and fasting blood sugar (FBS) concentrations (WMD: -6.88 mg/dl; 95% CI: -13.28, -0.48, p = .03) following cocoa/dark chocolate consumption. The analysis of papers included in current study indicates that the consumption of cocoa/dark chocolate reduced the serum fasting blood glucose (FBS) and LDL cholesterol concentrations. However, further high quality trials are essential for confirming the clinical efficacy of cocoa/dark chocolate consumption on complete metabolic profile.