The effect of psyllium on fasting blood sugar, HbA1c, HOMA IR, and insulin control: a GRADE-assessed systematic review and meta-analysis of randomized controlled trials.

There is equivocal evidence that psyllium can prevent or attenuate increases in fasting blood sugar. Therefore, this systematic review and meta-analysis sought to investigate the influence of psyllium on hemoglobin A1C (HbA1c), fasting blood sugar (FBS), insulin, and Homeostatic Model Assessment of Insulin Resistance (HOMA IR). We searched PubMed, ISI Web of Science (WOS), and Scopus for eligible publications, up to 15 July 2022, including randomized controlled trials (RCT) assessing the effect of psyllium on HbA1c, FBS, insulin, and HOMA IR levels in adults. Using a random effects model, we report the weighted mean differences (WMD) with 95% confidence intervals (CI). In this article, 19 RCT studies, consisting of 962 participants, were included. Psyllium significantly decreased FBS, HbA1c, and HOMA IR levels, but not insulin levels, as compared to placebo (FBS: WMD): -6.89; 95% CI: -10.62, -3.16; p < .001), HbA1c: (WMD: -0.75; 95% CI: -1.21, -0.29; p < .001), HOMA IR: (WMD: -1.17; 95% CI: -2.11, -0.23; p < .05), and insulin: (WMD: -2.08; 95% CI: -4.21, -0.035; p > .05)). Subgroup analyses illustrated differences in the effects of psyllium on FBS: dosages less than and more than 10 g/d showed significant differences (p value < 0.05). However, it was not significant in intervention durations less than 50 days (p value > 0.05). For HbA1c: psyllium consumption less than 10 g/d (p value > 0.05) was non-significant. For HOMA IR and insulin: no significant changes were noted with psyllium consumption less than vs. more than 10 g/d. In conclusion, we found that psyllium could significantly decrease FBS, HbA1c, and HOMA IR levels, but not insulin levels, as compared to placebo.

Effects of anti-Inflammatory-antioxidant-rich diet and co-supplemented synbiotics intervention in patients with progressive forms of multiple sclerosis: a single-center, single-blind randomized clinical trial.

BACKGROUND: Current evidence has demonstrated that patients with Multiple Sclerosis (MS) have dysbiotic gut microbiomes, and anti-inflammatory nutritional interventions can normalize this status. Therefore, we aimed to investigate the effects of dietary intervention in patients with progressive forms of MS. METHODS: Seventy patients with three forms of progressive MS (primary-progressive, secondary-progressive, and progressive-relapsing) were randomly assigned into intervention (daily synbiotics capsule plus anti-inflammatory-antioxidant rich diet) or control (placebo capsule plus dietary recommendations) groups for four months. Faecal calprotectin level, Impact of Vision Impairment (IVI), Gastrointestinal Symptom Rating Scale (GSRS), and anthropometric measurements were evaluated at baseline and trial cessation. Analysis of covariance was conducted and adjusted for age, gender, education level, family history & duration of MS, type of progressive MS, type of main drug, and physical activity. RESULTS: Sixty-nine participants were included in the final analysis (n of intervention = 34; n of control = 35). Synbiotics and dietary intervention significantly reduced Faecal calprotectin level after six months (110.5 ± 75.9-44.7 ± 49.3 É¥g/g, P < 0.001), and mean changes were statistically significant in comparison with control group. However, intervention did not elicit any change in the anthropometric measurements. CONCLUSION: Synbiotics supplementation and adherence to an anti-inflammatory-antioxidant-rich diet reduced intestinal inflammation and improved clinical manifestations in progressive forms of MS.Trial registration: Iranian Registry of Clinical Trials identifier: IRCT20141108019853N7..

The effects of Mediterranean diet on severity of disease and serum Total Antioxidant Capacity (TAC) in patients with Parkinson's disease: a single center, randomized controlled trial.

Background: Parkinson's disease (PD) as one of the most common neurodegenerative disorders may be affected by healthy dietary pattern. The aim of this study was to investigate the effects of the Mediterranean Diet (MeD) on serum Total Antioxidant Capacity (TAC) and disease severity in PD patients.Materials & Methods: In this single-center randomized clinical trial, patients with idiopathic PD (n = 80) were selected randomly allocated to either MeD or control group (Iranian traditional diet); an individualized dietary plan based on the MeD was designed. Serum TAC and the motor & non-motor disease aspects using the Unified Parkinson's Disease Rating Scale (UPDRS) were evaluated in two groups. Statistical Analysis of data was performed using SPSS 24.Results: 70 PD patients with a mean age of 58.96 ± 8.7 and UDPRS of 41.66 ± 20.19 were analyzed in this study. MeD significantly increased serum TAC (P < 0.001). UPDRS score was also lowered in MeD group (P < 0.05).Conclusions: Mediterranean diet seems to have some benefits in PD. as well, TAC levels can also be affected by MeD. Anyway, further studies are needed to confirm the mentioned outcomes.Trial registration: Iranian Registry of Clinical Trials identifier: IRCT20141108019853N4.

The effects of olive oil and cholesterol enriched diets on aortic fatty streak development and lipid peroxidation in rabbits.

BACKGROUND AND AIM: High plasma cholesterol levels, mainly low-density lipoprotein-cholesterol (LDL) is a widely recognized major risk factor for coronary heart disease (CHD). According to epidemiologic studies' findings, people from the Mediterranean countries have lower CHD rates than other countries; in these countries the usual diet is high in olive oil. The present study compares the effects of a cholesterol-enriched diet with or without adding olive oil on serum lipoproteins, lipid peroxidation, and atherosclerosis development. METHODS: Twenty Dutch male rabbits were categorized into four groups (one group as control, and others as experimental). They received one of control (CON), olive oil-rich (OIL), cholesterol-rich (CHOL), and cholesterol + olive oil (COIL) diet for 12 weeks. Fasting blood samples from the heart were collected at the beginning and the end of the experimental period. RESULTS: Means of serum lipids were not significantly different at the beginning of the experimental period. After the intervention, significant differences were shown in total cholesterol (TC) (CON: 27.75 ± 4.83, OIL: 19.75 ± 2.62, CHOL: 1757.20 ± 149.62, COIL: 2906.40 ± 421.01; P < 0.001), high-density lipoprotein-cholesterol (HDL-C) (CON: 16 ± 1.47, OIL: 10.25 ± 1.70, CHOL: 22.2 ± 3.83, COIL: 28.60 ± 6.27; P = 0.04), triglyceride (CON: 65 ± 12.21, OIL: 71.75 ± 6.23, CHOL: 244.2 ± 44.45, COIL: 775.6 ± 105.07; P < 0.001), and MDA between groups (CON: 0.57 ± 0.10, OIL: 0.63 ± 0.15, CHOL: 5.62 ± 0.18, COIL: 2.06 ± 0.64; P < 0.001). The comparison of CHOL and the COIL groups showed a higher mean of malondialdehyde (MDA) in group CHOL (4.47 ± 0.28 vs 1.1 ± 0.6; P < 0.001). Aortic lesion was not observed in CON and OIL groups. Aortic lesion degree was significantly lower in the COIL group compared to the CHOL (2.4 ± 0.6 vs 3.66 ± 0.33; P = 0.02). CONCLUSIONS: These findings showed the preventive effect of olive oil on atherosclerosis development. However, it is independent of the plasma lipoprotein effect, and olive oil probably acts on arteries directly.

The effect of soy products on circulating adiponectin and leptin concentration in adults: A systematic review and meta-analysis of randomised controlled trials.

BACKGROUND: Human clinical trials that have investigated the effect of soy product consumption on adipokines have reported inconsistent results. Our objective was to elucidate the role of soy product consumption on adiponectin and leptin in adults through a systematic review and meta-analysis of available randomised placebo-controlled trials (RCTs). METHODS: The systematic search included PubMed, Scopus, Web of Science, EmBase, Google Scholar and Cochrane database from inception to July 2020. Human clinical trials that reported the effect of soy product consumption on leptin and adiponectin were included. The pooled weighted mean difference (WMD) was calculated by the random-effects model. Heterogeneity, sensitivity analysis, and publication bias were reported using standard methods. Quality assessment was performed using Cochrane risk of bias assessment tool. RESULTS: Overall, 13 RCTs with 824 participants were included in this meta-analysis. Our analysis showed that soy product consumption did not significantly affect leptin (WMD: 0.01 ng/mL; 95% CI, -0.16, 0.18; P = .88) and adiponectin (WMD: -0.09 ng/mL; 95% CI, -0.29, 0.12; P = .39) concentration in comparison with control. Furthermore, subgroup analysis indicated that the effect remained non-significant when analysed by study design, participant demographics and intervention characteristics. Based on the Cochrane Collaboration Risk of Bias tool, seven studies were considered good quality and six studies were fair. CONCLUSION: The present systematic review and meta-analysis suggest that soy product consumption had no significant effect on leptin and adiponectin levels in adults. However, future larger and well-designed trials are still needed to further explore this research area and to address the heterogeneous study design used in the existing literature.

Dietary total antioxidant capacity and severity of stenosis in patients with coronary artery disease.

Aim: Coronary artery disease (CAD) is a major cause of mortality worldwide. Many studies suggest that dietary antioxidant can offer significant protection against stroke, heart failure, and coronary heart disease. However, there is no study that assessed the association between dietary TAC and severity of stenosis in patients with CVD. The aim of this study was to investigate the association of dietary TAC and severity of stenosis in patients with coronary artery disease. Methods: Dietary and medical History of 160 patients with CAD were assessed. The extent of Stenosis was determined using the Gensini score. Dietary history was investigated by food frequency questionnaire (FFQ), and Dietary TAC was calculated by multiplying the average frequency of intake of each food by oxygen radical absorbance capacity (ORAC) content. Results: Across the Gensini score quartiles the dietary TAC, dietary hydrophilic TAC, dietary lipophilic TAC, and dietary phenolic TAC values were significantly increased in the highest quartile compared with the lowest quartile (dietary TAC (mmolTE/100 g):17.5 ± 1.82 vs. 11.2 ± 1.90; dietary hydrophilic TAC (mmolTE/100 g): 16.56 ± 1.29 vs. 10.74 ± 1.81; dietary lipophilic TAC (mmolTE/100 g): 0.55 ± 0.12 vs. 0.23 ± 0.09; dietary phenolic TAC (mmolTE/100 g):1.84 ± 0.31 vs. 0.98 ± 0.21; (P < 0.001 for all)). However, a non-significant association between the plasma TAC and Gensini quartiles was observed (P = 0.789). Multivariate regression analysis showed that dietary TAC (Beta = -0.53; P < 0.001) was statistically significant independent predictors that associated with the Gensini score values. Conclusions: There was a significant association between dietary TAC and severity of stenosis in patients with coronary artery disease.

Association of dietary patterns with systemic inflammation, quality of life, disease severity, relapse rate, severity of fatigue and anthropometric measurements in MS patients.

Background: Multiple sclerosis (MS) is associated with changes in quality of life, disability, fatigue and anthropometric measurements. The important relationship of dietary patterns with such clinical manifestations was not completely investigated. Aims: The goal of this study was to define the dietary patterns and their association with systemic inflammation, Health-Related Quality Of Life, disease severity, Relapse Rate, severity of fatigue and anthropometric measurements in MS subjects. Methods: This cross-sectional study was conducted in 261 MS patients (mean age 38.9 ± 8.3). Dietary patterns were explored by a Food Frequency Questionnaire. Serum hs-CRP, Multiple Sclerosis Quality Of Life-54 item questionnaire, Extended Disability Status Scale, Fatigue Severity Scale and Visual Analog Fatigue Scale, Relapse Rate, Height, Weight and Deurenberg Equation were also used as tools. Data were analyzed by SPSS24, and using ANOVA, Tukey, Chi-square and ANCOVA tests. Results: Fruits, Vegetables, Low fat dairy-based pattern and Mediterranean-Like pattern were associated with lower serum hs-CRP (F = 6.037, P adjusted < 0.01), higher Physical and Mental Health Composite Scores (P adjusted < 0.001), lower attacks (F = 4.475, P adjusted < 0.05), lower acute and chronic fatigue (F = 5.353 and F = 7.011, respectively, P adjusted < 0.01), lower BMI (F = 7.528, P adjusted < 0.01) and Percent Body Fat (F = 6.135, P adjusted < 0.01); but no difference was observed about EDSS across the patterns. Conclusions: Adherence to healthy dietary patterns may reduce systemic inflammation, severity of fatigue, MS attacks, improved quality of life and balance weight especially body fat in MS patients.

A randomized, double-blind, placebo-controlled clinical trial, evaluating the garlic supplement effects on some serum biomarkers of oxidative stress, and quality of life in women with rheumatoid arthritis.

AIM: Rheumatoid arthritis (RA), is a prevalent immune-inflammatory disease, which is associated with disabling pain. Oxidative stress might play a role in RA pathogenesis and outcomes. According to the antioxidant properties of garlic, the current study was performed to evaluate the garlic supplement effects on some serum levels of oxidative stress biomarkers, and quality of life in patients with rheumatoid arthritis. METHODS: Seventy women with RA participated in this randomized, double-blind, placebo-controlled, parallel-design trial. The patients were randomly divided into two groups, receiving two tablets of either 500 mg garlic or placebo daily for 8 weeks. Serum levels of total antioxidant capacity (TAC) and malondialdehyde (MDA) and quality of life were determined at baseline and end of week 8. A health assessment questionnaire (HAQ) was used to evaluate the quality of life related to health. RESULTS: Of 70 patients enrolled in the trial, 62 subjects were included in the final analysis. At the end of the study, there was a significant increase in serum levels of TAC in the garlic group as compared with the placebo group (26.58 ± 77.30 nmol of Trolox equivalent/ml vs 16.11 ± 0.92 nmol of Trolox equivalent/mL; P = .026). In addition, MDA levels were significantly decreased in the intervention group compared with the control group (-0.82 ± 1.99 nmol/mL vs 0.36 ± 2.57 nmol/mL; P = .032). Pain after activity and HAQ scores decreased in the garlic group compared with the placebo (-11.96 ± 13.43 mm vs -0.06 ± 13.41 mm; P < .001, 0.17 ± 20 vs 0.05 ± 0.15; P < .001, respectively). CONCLUSIONS: The findings suggest that garlic supplementation for 8 weeks resulted in significant improvements in oxidative stress, HAQ in women with RA.

The effects of garlic (Allium sativum) supplementation on inflammatory biomarkers, fatigue, and clinical symptoms in patients with active rheumatoid arthritis: A randomized, double-blind, placebo-controlled trial.

Based on the antiinflammatory properties of garlic, current study was conducted to evaluate the garlic supplement effects on serum levels of some inflammatory biomarkers, clinical symptoms, and fatigue in women with active rheumatoid arthritis. In this randomized, double-blind, placebo-controlled trial study, 70 women with RA were randomly divided into two groups: The intervention group was supplemented with 1,000 mg of garlic, and the control group received placebo for 8 weeks. At baseline and at the end of the study, clinical symptoms, fatigue, serum level of C-reactive protein (CRP), tumor necrosis factor-a (TNF-a), and erythrocyte sedimentation rate (ESR) were determined. After intervention, serum levels of CRP (p = .018) and TNF-a (p < .001) decreased significantly in the garlic group as compared with the placebo group. Also, pain intensity, tender joint count, disease activity score (DAS-28), and fatigue were significantly decreased in the intervention group compared with the control group (p < .001; for all). Swollen joint count was significantly decreased in the garlic group (p < .001), but not in the placebo group (p = .123). No significant changes were observed for ESR. Garlic supplementation by improving inflammatory mediators and clinical symptoms can be considered as a potential adjunct treatment in patients with RA. However, further studies with larger duration are needed.

Effects of curcumin supplementation on markers of inflammation and oxidative stress among healthy overweight and obese girl adolescents: A randomized placebo-controlled clinical trial.

INTRODUCTION: It is well known that there is a strong linkage between obesity, systemic low-grade inflammation, and oxidative stress in the pediatric population. Possible strategies that might control obesity and its relevant problems in this crucial group are of utmost importance. Therefore, the aim of this study was to evaluate the effects of curcumin supplements on inflammation, oxidative stress, and chemerin levels in adolescent girls. METHODS: Totally, 60 overweight and obese adolescent girls were randomly assigned to either placebo or intervention group in a randomized placebo-controlled parallel trial design. Adolescents consumed one 500-mg curcumin or placebo per day along with a slight weight loss diet for 10 weeks. High-sensitive C-reactive protein (hs-CRP), interleukin 6 (IL-6), total antioxidant capacity (TAC), malondialdehyde (MDA), chemerin levels, and anthropometric measurements were assessed at the beginning and end of the trial. RESULTS: Curcumin supplementation had a significant effect on IL-6 levels and oxidative stress markers including TAC and MDA in crude model. After controlling the effects of confounders, curcumin supplementation had a substantial effect on inflammation (hs-CRP and IL-6) and oxidative stress (TAC) marker of adolescents. DISCUSSION: Ten weeks of curcumin supplementation had beneficial effects on inflammation and oxidative stress markers among postpubescent overweight and obese girl adolescents.

The relationship between different diet quality indices and severity of airflow obstruction among COPD patients.

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a major public health problem worldwide. Smoking is the number one cause of COPD; however, genetic, environmental and dietary factors contribute to the etiology of this disease. In this study, we assessed the association between three diet quality indices -the Healthy Eating Index-2005 (HEI-2005), the Healthy Eating Index-2010 (HEI-2010), and Mediterranean Diet Score (MED)- and the severity of disease in COPD patients. METHODS: This cross-sectional study was performed at Rasul-e-Akram Hospital in Tehran on 121 COPD patients with the mean age of (SD) of 66.1(10.9) years. A pulmonary specialist diagnosed all participants based on a spirometry test. They were categorized into four groups (1, 2, 3, 4 stages of disease). Three diet quality indices, spirometry test and determination of disease severity were performed for all the participants. ANCOVA and Kruskal-Wallis test were used to assess the relationship between dietary quality indices and severity of the disease. The relationship between HEI-2010, HEI-2005, MED score, their components and lung function was assessed using a multiple linear regression analysis. All analyses were done using SPSS 18. RESULTS: Reduction of the Healthy Eating Index-2010 and MED score were observed along with the increase in disease severity, but they were not significant. The relationship between the three diet quality indices and lung function showed a significant association between MED score and Forced expiratory volume in one second (FEV1), The Forced Vital Capacity (FVC) (ß=2.9, 95% CI (1.1, 4.8), p=0.002), (ß=2.8, 95% CI (0.9, 4.8), p=0.007), respectively. CONCLUSION: Mediterranean dietary pattern and obtaining a better score on HEI-2010 diet were associated with a better lung function test.

Lifestyle interventions for hypertension treatment among Iranian women in primary health-care settings: Results of a randomized controlled trial.

BACKGROUND: Lifestyle factors such as weight, salt intake, and physical activity have shown to be important in treating hypertension. The object of this study was to describe feasibility and to assess the effectiveness of a multicomponent lifestyle intervention on high blood pressure (BP) of Iranian women. MATERIALS AND METHODS: This randomized controlled trial was conducted in four health centers by recruiting 161 women aged 35-65 years with high BP and randomizing them to a 4-week lifestyle modification (n = 80) or control group (n = 81). BP level and other health behavioral factors were assessed before and after the 4-week intervention and also after 6 months. RESULTS: The mean systolic BP changed from 158.8 (±8.1) mmHg to 153.2 (±6.4) mmHg during 4-week and to 145.5 (±4.6)) mmHg after 6 months in the intervention group (P < 0.001). There was a significant difference between two groups of study after 4-week mean = 5.6 (confidence interval [CI] = 5.1-6.6) and 6 months follow mean (CI = 12.3-14.6).(P < 0.001) A significant correlation was detected between systolic BP (SBP) and diastolic BP (DBP) with weight, body mass index, waist circumference, salt intake, and physical activity level (P < 0.001). Stepwise regression analyses indicated that the weight, dietary salt intake, and physical activity level were significant predictors of SBP and DBP. CONCLUSION: The results of this study suggest that lifestyle modification program is associated with improvements in BP level in Iranian women.

A randomized field trial for the primary prevention of osteoporosis among adolescent females: Comparison of two methods, mother centered and daughter centered.

BACKGROUND: Osteoporosis is a serious public health. Since the majority of bone mass occurs during adolescence, primary prevention is important. Probably mother's participation in health education interventions leads to promote health behaviors in children. AIMS: To assess a lifestyle modification intervention focused on mothers and students has an impact on osteoporosis preventive behaviors in adolescent girls. MATERIALS AND METHODS: It is a randomized field trial in female high schools. 210 girls aged between 11 and 15 were randomly selected. Students in groups A and C and mothers in group B were selected Through the sampling frame. Our lifestyle modification was based on group based education in the public girls' high schools. Subjects in the intervention groups participated in three educational sessions. Students' osteoporosis preventive behaviors were measured by using a lifestyle questionnaire consisting of items assessing nutrition, physical activity and sun exposure. Repeated measure ANOVA at baseline, 4 week, 2 months and 6 months and were used to analyze the data. RESULTS: After 1 month, diet and sun exposure scores increased significantly (P < 0.001) but it was higher in group B compared with group A. (About diet P < 0.001 and sun exposure = 0. 001). After 6 months, diet and sun exposure status in the group A approximately decreased to baseline, while in group B, diet components were significantly different compared to baseline (P < 0.001). There was no change in physical activity. CONCLUSION: Osteoporosis prevention intervention of adolescent can be effective when parents or girls participate in training sessions, but education is associated with better outcomes when focused on mothers.

Effects of multicomponent lifestyle modification on blood pressure control in health centers: Design of the study.

BACKGROUND: Designing an intervention based on healthcare settings resources and patient acceptability is potentially important in the prevention of high blood pressure(BP) and other risk factors of cardiovascular disease. To explain a multicenter randomized controlled trial that is designed to examine the effects of the multicomponent lifestyle modification program on BP. MATERIALS AND METHODS: The effectiveness of the lifestyle modification program versus usual care in health-care centers is evaluated in a randomized controlled trial. Patients aged 30years or older having a systolic blood pressure(SBP) of 140-179mmHg or a diastolic blood pressure(DBP) of 90-109 mm Hg or patients taking antihypertensive medications are eligible for the study. -The primary outcomes measured are SBP and DBP levels. Mediator outcomes include physical activity level, stress scale, dietary composition, and weight measurements. All measurements will be conducted after the 4weeks of intervention and also at 6months. CONCLUSION: Outcomes of the study will present the effects of implementing multicomponent lifestyle intervention programs to control BP in health-care centers settings.

Anti-inflammatory-antioxidant modifications and synbiotics improved health-related conditions in patients with progressive forms of multiple sclerosis: A single-center, randomized clinical trial.

BACKGROUND AND PURPOSE: There is growing evidence that dietary modification can improve clinical manifestations in multiple sclerosis (MS) patients. This study aimed to assess the impact of synbiotics and anti-inflammatory-antioxidant-rich diet on fatigue, pain, gut and bladder status, and sexual function in patients with progressive forms of MS. MATERIALS AND METHODS: In this single-center, single-blind, randomized, controlled clinical trial, seventy participants with three forms of progressive MS (primary-progressive, secondary-progressive, and progressive-relapsing) were randomly assigned to receive either synbiotics supplement and anti-inflammatory-antioxidant-rich diet or a placebo along with their usual diet for a duration of four months. Modified fatigue impact scale (MFIS), global pain scale (GPS), bladder control scale (BLCS), bowel control scale (BWCS), and sexual satisfaction scale (SSS) were assessed at baseline and at the end of the trial. RESULTS: Sixty-nine participants successfully completed the trial, resulting in a 98% adherence rate to the diet, and no reports of serious side effects. Significant mean changes were observed in fatigue (Δ for experimental group = -10.5 ± 10.8 vs. Δ for control group = -0.08 ± 4.1; P < 0.001), pain (-14.1 ± 19.0 vs. 0.9 ± 10.3; P < 0.001), bladder (-0.76 ± 2.1 vs. 0.3 ± 1.1; P = 0.013) and bowel (-6.6 ± 3.2 vs. -0.05 ± 2.3; P < 0.001) control, as well as sexual function (-1.0 ± 2.3 vs. 0.51 ± 0.21; P < 0.001). CONCLUSION: The anti-inflammatory-antioxidant-rich diet and synbiotics co-supplementation demonstrated improvements in fatigue, pain, sexual function, and bowel/bladder status among patients with progressive MS.

Does quercetin and vitamin C improve exercise performance, muscle damage, and body composition in male athletes?

BACKGROUND: Quercetin is a bioflavonoid occurs in many food items. Some previous studies on quercetin showed the inconsistent results on exercise performance and muscle damage in athletes. The aim of this study was to determine the effects of 8 weeks of quercetin supplementation on exercise performance and muscle damage indices in student athletes. METHODS: This placebo-controlled, double-blind clinical trial was conducted on 60 male students for 8 weeks. The subjects were randomly assigned to one of the four groups: a) quercetin (500 mg/day quercetin + 200 mg/day placebo), b) quercetin+ vitamin C (500 mg/day quercetin + 200 mg/day vitamin C), vitamin C (500 mg/day placebo + 200 mg/day vitamin C), and placebo (500 mg/day placebo + 200 mg/day placebo). Time to exhaustion (TTE) for measuring performance, aspartate transaminase (AST), and creatine kinase (CK) for measuring muscle damage and body fat percent (BFP) were measured before and after intervention. RESULTS: CK levels reduced in group 1 significantly (P=0.045) and BFP reduced in group 1, 3, and 4, significantly, too (P=0.018, P=0.013, and P=0.043, respectively). Whereas statistically significant changes between groups were not observed for TTE, AST, CK, and BFP after 8 weeks of intervention. CONCLUSIONS: Supplementation with quercetin and vitamin C for 8 weeks did not improve exercise performance but reduced muscle damage and body fat percent in healthy subjects.

Probiotics Against Viruses; COVID-19 is a Paper Tiger: A Systematic Review.

BACKGROUND: Probiotics can improve immune function leading to the prevention and management of viral infections like SARS-CoV-2 infection (COVID-19 disease). METHODS: We searched PubMed, EMBASE, Google Scholar, Science Direct, Scopus, and Web of Science up to May 2020 to identify interventional & observational studies documenting the effects of probiotics on incidence, severity, duration, and other clinical manifestations of viral infections, especially SARS-CoV-2-induced. RESULTS: From a total of 91 records, 24 studies were obtained and classified into three domains based on the efficacy of probiotics on 1) shortening the period and severity of infections (n=9), 2) incidence (n=6), and 3) other clinical complications that may be followed by viral disorders (n=9). Identified probiotics have positive effects on the mentioned domains. CONCLUSION: Based on the evidence, some probiotic strains may be useful in SARS-CoV-2 infection; randomized trials are needed to show the facts.

Effect of garlic powder supplementation on blood pressure and hs-C-reactive protein among nonalcoholic fatty liver disease patients: A randomized, double-blind, placebo-controlled trial.

Based on the anti-inflammatory and antihypertensive properties of garlic, the current study was designed to evaluate the garlic powder effects on blood pressure and high-sensitivity C-reactive protein (hs-CRP) among Nonalcoholic Fatty Liver Disease patients (NAFLD). This randomized, double-blind, placebo-controlled trial study was conducted on 110 patients with NAFLD. The patients were randomly divided into 2 groups, receiving two tablets of either 400 mg garlic or placebo daily for 15 weeks. At baseline and the end of the study, blood pressure and hs-CRP were determined. Of 110 patients enrolled in the trial, 98 subjects were included in the final analysis. After the intervention, systolic blood pressures (SBP) (mean: -7.89; 95%CI:‒11.39 to -4.39 mm Hg), diastolic blood pressure (DBP) (mean: -5.38; 95%CI: -7.77 to -3 mm Hg), and Mean Arterial Pressure (MAP) (mean: -6:95%CI: -8.4 to -3.6 mm Hg) decreased significantly in the garlic group as compared to the placebo group. Also, the percentage of reduced hs-CRP was significantly higher in the intervention group compared with the control group (mean: -16.1; 95%CI: -32.7 to -0.53; p = .035). Moreover, a positive correlation was observed between the percentage change in hs-CRP and percentage changes in SBP (r = 0.221; p = .029), DBP (r = 0.166; p = .012), and MAP (r = 0.210; p = .038). Garlic supplementation can be a safe and potentially adjunct treatment to reduce blood pressure and the risk of cardiovascular disorders in patients with NAFLD.

Therapeutic Effects of Garlic on Hepatic Steatosis in Nonalcoholic Fatty Liver Disease Patients: A Randomized Clinical Trial.

BACKGROUND AND AIMS: Emerging evidence suggests that garlic (Allium sativum L.) and its bioactive components can mitigate hepatic steatosis by the modulation of hepatic lipid metabolism. We aimed to assess the efficacy of the garlic administration on hepatic steatosis in patients with NAFLD. PATIENTS AND METHODS: This clinical trial was conducted on adult patients with ultrasound-diagnosed NAFLD. Eligible participants were randomly assigned, with the use of the stratified blocked procedure, to receive 800 mg garlic or placebo for 15 weeks. The primary outcome was the improvement in the hepatic steatosis diagnosed by ultrasound technique after 15 weeks of intervention. RESULTS: A total of 110 patients underwent randomization, and 98 patients completed the trial. Twenty-four (51.1%) patients in the garlic group achieved improvement in the hepatic steatosis compared to eight (15.7%) patients in the placebo group with the relative risk of 5.6 (95% CI: 2.17 to 14.5; P=0.001), which remained significant after adjusting for baseline value of hepatic steatosis. There were significant reductions in weight and serum ALT, AST, FBS, Hb A1C, total cholesterol, LDL-cholesterol, and TG concentration with the garlic intake compared to placebo (P<0.05). The results were also significant after adjusting for weight change, energy intake, and physical activity. No serious adverse effects were observed with the garlic intake. CONCLUSION: The intake of garlic powder was accompanied by a significant improvement in the hepatic steatosis and comorbidity related to this condition among subjects with NAFLD.

The effect of a Mediterranean diet on metabolic parameters in patients with non-alcoholic fatty liver disease: A systematic review of randomized controlled trials.

BACKGROUND: Dietary habit can play a key role in the prevention and treatment of fatty liver disease (NAFLD). Although many studies have investigated the effect of Mediterranean diet on NAFLD, findings are inconsistent and there is no systematic review on this topic. Therefore, the aim of this systematic review is to summarize the effect of Mediterranean diet on serum metabolic indices and anthropometric measures among NAFLD patients. METHODS: We searched titles, abstracts, and keywords of articles indexed in Science Direct, MEDLINE, and Google Scholar databases up to October 2018 to identify eligible RCT studies. Randomized clinical trials assessing the effects of MD on NAFLD were included. RESULTS: The present study included 10 randomized controlled trials, which involved a total of 856 adults with NAFLD. According to the result, MD may improve anthropometric measures, lipid profile, glycemic indices, liver enzyme, and NAFLD severity indices among patients with NAFLD. CONCLUSION: We found that MD could alleviate NAFLD severity parameters but differences between studies should be taken into account. Finally, in order to draw a firm link between MD and NAFLD, more clinical trials with adequate sample size and better methodology should be done.