Locoregional therapy containing surgery in metastatic breast cancer: Systematic review and meta-analysis.

INTRODUCTION: The role of locoregional therapy (LRT) containing surgery and systematic therapy in metastatic breast cancer patients remains controversial. This study investigated the effect of LRT in patients who were initially diagnosed with metastatic breast cancer (MBC) on overall survival (OS), locoregional progression-free survival (PFS), and distant systemic PFS. METHODS: The related keywords were searched in MEDLINE/PubMed, SCOPUS, and Web of Science databases up to August 15th, 2022. Hazard ratios (HR) with 95% confidence intervals (CIs) were pooled by the random-effects model. RESULTS: Seven articles with 1626 participants compared LRT with only systemic therapy (ST) for patients with de novo MBC. LRT did not improve (p = 0.28) OS compared to ST (HR: 0.83, 95% CI: 0.60, 1.16). LRT significantly improved locoregional PFS outcomes compared to ST (HR: 0.31, 95% CI: 0.15, 0.60, p = 0.001). LRT significantly (p = 0.001) improved OS in patients with solitary bone metastases (HR: 0.48; 95% CI: 0.35-0.67). CONCLUSION: LRT improves locoregional PFS. Furthermore, LRT improves OS in patients with solitary bone metastases.

The effect of anamorelin (ONO-7643) on cachexia in cancer patients: Systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Cachexia is associated with increased morbidity and mortality rates in patients with cancer. This meta-analysis aims to explore the effect of anamorelin on cancer cachexia markers. METHODS: We searched MEDLINE/PubMed, SCOPUS, and WOS from their inception until 5 June 2022. A systematic search was conducted according to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guidelines. We included trials investigating the effect of anamorelin on body weight, lean body mass, fat mass, insulin-like growth factor 1 (IGF-1), handgrip, quality of life insulin-like growth factor-binding protein 3 (IGFBP-3), and in patients with cancer. A random-effects model was run to pooled results. RESULTS: Five articles providing 1331 participants were analyzed in this study. Pooled analysis revealed a significant increase in body weight (weighted mean difference (WMD): 1.56 kg, 95% confidence interval (CI): 1.20, 1.92; I2= 0%), lean body mass (WMD: 1.36 kg, 95% CI: 0.85, 1.86; I2= 53.1%), fat mass (WMD: 1.02 kg, 95% CI: 0.51, 1.53; I2= 60.7%), IGF-1 (WMD: 51.16 ng/mL, 95% CI: 41.42, 60.90, I2= 0%), and IGFBP-3 (WMD: 0.43 µg/mL, 95% CI: 0.17, 0.68, I2= 98.6%). Results showed no significant increase in appetite when analysis run on all studies without considering different doses 0.29 (95% CI: -0.30, 0.89, I2= 73.8%), however, there was a significant increase in appetite without heterogeneity and inconsistency 0.59 (95% CI: 0.32, 0.86; I2= 0%) in the 100 mg/day group compared to anamorelin non-user. CONCLUSIONS: Patients with cancer who receive anamorelin as a treatment for cachexia showed a significant increase in body weight, lean body mass, fat mass, IGF-1, and IGFBP-3.

Association between intake of sodium, potassium, sodium-to-potassium ratio, and blood pressure among US adults.

High dietary sodium and low potassium intake is associated with high blood pressure (BP). The current study aimed to determine if the sodium-to-potassium ratio is more strongly associated with low (130-139/80-89 mm Hg) and high (≥140/90 mm Hg) BP thresholds among US adults than either sodium or potassium alone. A total of 30,776 patients aged ≥20 years with complete blood pressure participated in the National Health and Nutrition Examination Survey (NHANES) from 2003 to 2018. Demographic information and health characteristics were compared between men and women using the chi-square test for categorical variables and independent samples t-test for continuous variables. Logistic regression was performed to investigate the association of the odds ratios (OR) of different levels of sodium, potassium, and sodium-to-potassium ratio. After multivariable adjustment (age, gender, Body mass index, Smoking, education, Race, Alcohol, total energy intake, and physical activity), no relationship has been observed between high versus low sodium-to-potassium ratio and BP threshold of 130-139/80-89 mm Hg (odds ratio [OR]: 1.02, 95% confidence interval [CI]: 0.92-1.12). Higher sodium-to-potassium ratio (OR=1.24; CI: 1.11-1.38) and dietary intake of potassium (OR=0.66; CI: 0.55-0.80) showed significant association in reducing the BP threshold of ≥140/90 mm Hg. In dose-response analysis, higher BP ≥140/90 mm Hg was inversely associated with higher potassium intake. Furthermore, the sodium-to-potassium ratio showed higher odds in predicting the BP of patients aged ≤60 years, underweight, nonsmokers, and non-alcohol users. The study confirms an inverse association between higher potassium intake and higher BP threshold. The Doses-response analyses showed sodium-to-potassium ratio is a better predictor of BP thresholds than sodium or potassium alone.

Selective serotonin reuptake inhibitor use and the risk of hepatocellular carcinoma: a systematic review and dose-response analysis of cohort studies with one million participants.

PURPOSE: Recent studies have suggested a lower risk of hepatocellular carcinoma (HCC) in patients receiving selective serotonin reuptake inhibitors (SSRIs). The current study aimed to provide an updated and comprehensive assessment of the association between SSRI use and development of HCC. METHODS: This is a systematic review and meta-analysis of all observational studies published until June 2021. We comprehensively searched PubMed/Medline, Web of Science, and Embase to identify studies comparing SSRIs use with control in relation to the risk of HCC. We calculated pooled relative risks (RRs) and 95% confidence intervals (CIs) for the association between SSRI use and incident HCC risk using random-effects meta-analysis. A dose-response analysis was conducted to evaluate the HCC risk according to the defined daily dose (DDD) of SSRI use. RESULTS: Eight observational studies, comprising 1,051,096 participants and 22,316 incidences of HCC, examining the association between SSRIs use and HCC risk, were included in the systematic review (adjusted RR: 0.66; 95% CI: 0.56-0.79; P ≤ 0.001). In subgroup analysis, the magnitude of benefit associated with SSRIs was significantly higher in patients with hepatitis infection (RR: 0.70, 95% CI: 0.51-0.95) than the general population (Pheterogeneity = 0.700). The dose-response analysis indicated strong inverse association between cumulative DDD of SSRI and risk of HCC (coefficient: - 0.0030; P = 0.002; R2 = 0.78). CONCLUSIONS: The results of this review show that SSRI use was associated with a 34% lower risk of HCC, which tend to be dose dependent. Further prospective studies are warranted to confirm these observations across the spectrum of chronic liver disease and hepatitis infection.

Body mass index and risk of Parkinson, Alzheimer, Dementia, and Dementia mortality: a systematic review and dose-response meta-analysis of cohort studies among 5 million participants.

Objective: Inconsistent results regarding the association between the Body Mass Index (BMI) and brain disorders have been reported. We performed this study to investigate the association between BMI and risk of Parkinson, Alzheimer, Dementia and Dementia-mortality.Methods: A systematic search was conducted up to April 2019 in MEDLINE/PubMed, SCOPUS, and Cochrane Library. Results pooled with random-effects model.Results: Totally, 29 articles which were included in this study with4,978,621 participants. The pooled HR for Parkinson's in the underweight person was 1.20 (95%CI1.10-1.30). The pooled HR for dementia in underweight and overweight category was 1.23 (95%CI = 1.05-1.45) and 0.88 (95%CI = 0.83-0.94), respectively. There is not any significant relation between each categories of BMI and Alzheimer disease. The pooled HR for dementia in underweight and overweight category was 1.36 (95%CI = 1.14-1.63) and 0.81 (95%CI = 0.49-1.33), respectively. The non-linear association between BMI and risk of Dementia-mortality was significant (p = 0.001,Coeff = 0.003).Conclusion: This study highlights underweight related to increase incidence of Parkinson, Dementia, and Dementia mortality but no on Alzheimer disease.

Maternal polycystic ovary syndrome and the potential risk of attention-deficit/hyperactivity disorder and autism spectrum disorder in the offspring: a systematic review and meta-analysis.

OBJECTIVE: Autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) are two increasing important problems among children. This study aims to explore the link between maternal polycystic ovary syndrome (PCOS) and the risk of ASD and ADHD in the offspring. METHOD: The MOOSE guidelines were followed in the conduct of this meta-analysis. A literature search was done in PubMed/MEDLINE, Scopus, and Web of Science from inception until January 2021. The DerSimonian and Laird random-effects model was used to estimate the combined risk ratios (RR) and 95% confidence intervals (CI). Sensitivity analysis was also used to investigate the effect of each study on the combined results. RESULTS: Seven studies, with 1,358,696 participants, comprising 7,334 ADHD cases and 3,920 ASD cases, were included in this study. Children born to mothers with maternal PCOS had higher risks of developing ASD (RR = 1.46, 95% CI: 1.26-1.69, I2 = 64%) and ADHD (RR = 1.43, 95% CI: 1.35-1.41, I2 = 0%) when compared with children born to mothers without maternal PCOS. CONCLUSION: This study showed that there might be a link between maternal PCOS and the risk of developing ASD and ADHD in the offspring. This important issue must be considered in PCOS women during and after pregnancy.

Serum Vitamin D Levels and Risk of Liver Cancer: A Systematic Review and Dose-Response Meta-Analysis of Cohort Studies.

Data regarding the relationship between serum vitamin D levels and the risk of liver cancer are conflicting. Therefore, we performed a systematic review and dose-response meta-analysis of all available data of cohort studies on the association of 25-OH-vitamin-D levels with the risk of hepatocellular carcinoma. We conducted a systematic search in PubMed-MEDLINE, Scopus, Cochrane and Web of Science databases for prospective observational studies conducted on the general population from inception to May 2019. Six studies provided data from 6357 participants. According to the pooled HR, the subjects with the highest serum concentrations of vitamin D had a 47% lower risk of liver cancer vs. the subjects with the lowest serum concentrations of vitamin D (pooled HR: 0.53, 95% CI: 0.41-0.68; P < 0.001). There was no significant heterogeneity among the studies (P = 0.431, I2 = 0.0). The pooled HR from the random-effects dose-response model indicated an indirect significant linear association between vitamin D and the risk of liver cancer (coef = -0.017, P < 0.001). However, there was no significant nonlinear dose-response association between serum vitamin D and the risk of liver cancer (coef = -0.0001, P = 0.342). The evidence from this meta-analysis suggests that there may be an inverse relationship between serum vitamin D levels and the risk of liver cancer.

The effect of Alpha-lipoic acid supplementation on endothelial function: A systematic review and meta-analysis.

There is evidence that alpha-lipoic acid (ALA) supplementation plays an important role in preventing cardiovascular diseases. However, its effect, specifically, on endothelial function (EF) is unclear. Therefore, this systematic review and meta-analysis aimed to evaluate the effects of ALA supplementation on EF. Databases including PubMed/Medline, Scopus, and ISI Web of Science were searched to identify eligible publications from inception up to April 2020. Randomized controlled trials assessing the effect of ALA supplementation on flow-mediated dilation (FMD) levels in adults were included. The pooled results were obtained using the random-effects model and are expressed as weighted mean differences (WMD) with 95% confidence intervals (CI). Five studies including six effect sizes and 300 participants were included. ALA supplementation significantly increased FMD levels by 2.36% (95% CI: 1.21-3.51; p < .001), compared with the control. Subgroup analyses suggested that the effects of ALA on FMD could be changed by age and health status of the participants. Dose-response analysis also showed that ALA dosage had a significant non-linear effect on FMD levels. The results showed that ALA supplementation appears to improve the EF. However, the role of ALA supplementation in improving other biomarkers of EF requires further research.

The effect of L-arginine supplementation on obesity-related indices: A systematic review and meta-analysis of randomized clinical trials.

The clinical studies regarding the effect of L-arginine in human anthropometry have not been fully consistent, therefore, we carried out a systematic review and meta-analysis of randomized clinical trials in order to precisely evaluate and quantify the efficacy of L-arginine on weight, waist circumference, and BMI. We searched online databases including PubMed, SCOPUS, and Google Scholar for relevant articles up to September 2017. Eligible articles were reviewed by two independent investigators. Mean differences of the outcomes were used for calculation of weighted mean difference (WMD) derived from the random-effects model. Statistical heterogeneity between studies was examined using Cochran's Q-test and I2 index. Funnel plot and Egger's tests were performed to assess the publication bias. In our initial search, we found 1598 publications, of which 8 RCTs (9 treatment arms) were included. The results of the meta-analysis displayed a significant reduction in WC following L-arginine supplementation (WMD: -2.97 cm; 95% CI: -4.75 to -1.18, P = 0.001). However, L-arginine intervention had not elicited a significant effect on BMI (WMD: -0.51 kg/m2; 95% CI: -1.11 to .08, P = 0.09) and body weight (WMD: -0.57 kg; 95% CI: -1.77 to 0.61, P = 0.34). Subgroup analyses displayed that longer-term interventions (≥8 weeks) had a positive effect on body weight and using < 8 g/day L-arginine with longer duration (≥8 weeks) could significantly decrease BMI. In conclusion, this meta-analysis result suggested L-arginine supplementation could reduce waist circumference without any significant effect on body weight and body mass index.

The effects of garlic supplementation on weight loss: A systematic review and meta-analysis of randomized controlled trials.

Obesity is related to increase in the incidence of morbidity and mortality. Studies have suggested anti-obesity properties of garlic; however, results are inconsistent. This systematic review and meta-analysis is done to summarize the data obtained from available randomized clinical trials on the effect of garlic supplementation on body weight, Body Mass Index (BMI), and Waist Circumference (WC). The online databases of Scopus, PubMed, Google Scholar and Cochrane library were searched until March 2018 for related publications using relevant keywords. Effect sizes of eligible studies were pooled using random-effects models. Cochran's Q-test and I2 index were used for assessing heterogeneity. We found 1241 records in our initial search, of which 13 randomized clinical trials (RCTs) with 15 treatment arms were included. Pooled analysis showed that garlic administration might significantly decrease WC (Weighed Mean Difference (WMD): -1.10 cm, 95% CI: -2.13, -0.07, P = 0.03, I2 = 0%). However, garlic intervention had no significant effect on body weight (WMD): -0.17 kg, 95% CI: -0.75 to 0.39, P = 0.54, I2 = 0%) and BMI (WMD: -0.17 kg/m2, 95% CI: -0.52, 0.16, P = 0.30, I2 = 44.5%) as compared to controls. From Subgroup analysis, it was ascertained that the effect of garlic supplementation on BMI was significant in trials with duration < 12 weeks (WMD: -0.58 kg/m2, 95% CI: -1.08, -0.08, I2 = 19.8%, P = 0.02) compared to those with higher duration (>12 weeks). The current meta-analysis results suggest that garlic supplementation seems to reduce waist circumference unlike body weight and BMI.

Roxadustat (FG-4592) treatment for anemia in dialysis-dependent (DD) and not dialysis-dependent (NDD) chronic kidney disease patients: A systematic review and meta-analysis.

The effect of roxadustat (FG-4592) on individuals with chronic kidney diseases (CKD) patients receiving or not receiving the dialysis was unclear. The aim of this study was to evaluate the efficacy of roxadustat for the treatment of anemia in patients who are dialysis dependent (DD) or dialysis independent (NDD) CKD. We performed a systematic review of randomised controlled trials (RCTs) comparing treatment with roxadustat versus placebo or epoetin alfa up to November 2019. We investigated the efficacy of roxadustat in the levels of hemoglobin and other clinical parameters in renal anemia in patients with NDD and DD-CKD. We estimated weighted-mean difference (WMD) using random effect models. We included six RCTs comprising 1001 patients of whom 70.6 % were treated with roxadustat and 294 controls. The control group for studies of NDD-CKD patients was placebo whereas an active control of epoetin-alfa was used in studies of DD-CKD patients. Median follow-up time was 8 weeks. All trials were industry-sponsored. Overall, roxadustat increased hemoglobin levels by 1.20 g/dl (95 % CI:0.66, 1.75,P < 0.0001,I2 = 99.3 %). Hemoglobin levels increased by 1.99 g/dl in NDD-CKD patients versus placebo and 0.52 g/dl in DD-CKD patients versus epoetin-alfa. Roxadustat was associated with a decrease the levels of hepcidin by -49.3 ng/dl (-38.5 ng/dl in NDD patients versus placebo and -27.7 ng/dl in DD patients versus epoetin alfa), a decrease in ferritin of -49.7 µmol/l (-52.2 µmol/l in NDD patients versus placebo and -7.3 µmol/l in DD patients versus epoetin alfa), and increase in total iron-binding capacity of 32.2 µmol/l (14.1 µmol/l in NDD patients versus placebo and 13.6 µmol/l in DD patients versus epoetin alfa). The percentage change in the transferrin saturation levels was -2.07 % (-6%, NDD patients versus placebo, and +3.7 % in DD patients versus epoetin alfa) in anemia associated CKD patients. This review found roxadustast increases the levels of hemoglobin, serum transferrin, intestinal iron absorption, and reduces hepcidin in both NDD and DD-CKD patients. Safety data is still emerging.

Postmenopausal hormone therapy and Alzheimer's disease, dementia, and Parkinson's disease: A systematic review and time-response meta-analysis.

Hormone therapy continues to be a favourable option in the management of menopausal symptomatology, but the associated risk-benefit ratios with respect to neurodegenerative diseases remain controversial. The study aim was to determine the relation between menopausal hormone therapy and Alzheimer's disease, dementia, and Parkinson's disease in human subjects. A literature search was performed in PubMed/Medline, Cochrane collaboration, and Scopus databases from onset of the database to September 2019. Random-effects model was used to estimate pooled odd ratio (OR) and 95 % confidence intervals (CI). Subgroup analysis was performed based on the type and formulation of hormone. In addition, the time-response effect of this relationship was also assessed based on duration of hormone therapy. Associations between hormone therapy and Alzheimer's disease, dementia, and Parkinson's disease in menopausal women were reported in 28 studies. Pooled results with random effect model showed a significant association between hormone therapy and Alzheimer's disease (OR 1.08, 95 % CI 1.03-1.14, I2: 69 %). This relationship was more pronounced in patients receiving the combined estrogen-progestogen formulation. Moreover, a significant non-linear time-response association between hormone therapy and Alzheimer's disease was also identified (Coef1 = 0.0477, p1<0.001; Coef2 = -0.0932, p2<0.001). Similarly, pooled analysis revealed a significant association between hormone therapy and all-cause dementia (OR 1.16, 95 % CI 1.02-1.31, I2: 19 %). Interestingly, no comparable relationship was uncovered between hormone therapy as a whole and Parkinson's disease (OR 1.14, 95 % CI 0.95-1.38, I2: 65 %); however, sub-group analysis revealed a significant relationship between the disease and progestogen (OR 3.41, 95 % CI 1.23-9.46) or combined estrogen-progestogen formulation use (OR 1.49, 95 % CI 1.34-1.65). Indeed, this association was also found to be driven by duration of exposure (Coef1 = 0.0626, p1 = 0.04). This study reveals a significant direct relationship between the use of certain hormonal therapies and Alzheimer's disease, all-cause dementia, and Parkinson's disease in menopausal women. However, the association appears to shift in direct after five years in the context of Alzheimer's disease, adding further weight to the critical window or timing hypothesis of neurodegeneration and neuroprotection.

The influence of metformin on IGF-1 levels in humans: A systematic review and meta-analysis.

BACKGROUND: A meta-analysis is needed to comprehensively consolidate findings from the influence of metformin on IGF-1 levels. The present study was conducted with the objective to accurately evaluate the influence of metformin intake on IGF-1 levels via a meta-analysis of randomized controlled trials. METHODS: A comprehensive systematic search was carried out in PubMed/MEDLINE, Web of Science, SCOPUS and Embase from inception until June 2019. Weighted mean difference (WMD) with the 95 % CI were applied for estimating the effects of metformin on serum IGF-1 levels. RESULTS: 11 studies involving a total of 569 individuals reported changes in IGF-1 plasma concentrations as an outcome measure. Pooled results demonstrated an overall non-significant decline in IGF-1 following metformin intake (WMD: -8.292 ng/ml, 95 % CI: -20.248, 3.664, p = 0.174) with heterogeneity among (p = 0.000,I2 = 87.1 %). The subgroup analyses displayed that intervention duration <12 weeks on children (WMD:-55.402 ng/ml, 95 % CI: -79.845, -30.960, I2 = 0.0 %) significantly reduced IGF-1. Moreover, in age 18 < years older metformin intake (WMD: 15.125 ng/ml, 95 % CI: 5.522, 24.729, I2 = 92.5 %) significantly increased IGF-1 than 18 ≤ years older (WMD:-1.038 ng/ml, 95 % CI: -3.578,1.502,I2 = 78.0 %). Following dose-response evaluation, metformin intake reduced IGF-1 (coefficient for dose-response analysis= -13.14, P = 0.041 and coefficient for liner analysis= -0.066, P = 0.038) significantly based on treatment duration. CONCLUSION: We found in children, intervention duration <12 weeks yielded significant reductions in IGF-1, whilst paradoxically, in participants >18 years old, metformin intake significantly increased IGF-1. We suggest that caution be taken when interpreting the findings of this review, particularly given the discordant supplementation practices between children and adults.

Association of aspirin therapy with risk of hepatocellular carcinoma: A systematic review and dose-response analysis of cohort studies with 2.5 million participants.

Although aspirin is commonly used for the prevention of cardiovascular disease, evidence from research has shown that these beneficial effects might extend to hepatocellular carcinoma (HCC). This dose-response analysis was performed to investigate the association between aspirin use and risk of HCC. A systematic search was conducted in MEDLINE/PubMed, SCOPUS, Cochrane, and Web of Science databases from inception up to 29th October 2019. DerSimonian and Laird Random-effects model was used to estimate pooled hazard ratios (HRs) from included studies. Overall, eight studies containing 2,604,319 participants evaluating the association between aspirin use and risk of HCC were uncovered and included in the present meta-analysis. Pooled results of included studies showed a significant reduction in risk of HCC in participants who used aspirin (HR 0.59, 95 % CI 0.47-0.75, Pheterogeneity = 0.001, I2 = 90 %). In total, 13,636 cases of HCC detected during the follow-up period of these studies. Furthermore, linear dose-response model showed an significant inverse association between aspirin dose and risk of HCC (exp (b) = 0.994, p < 0.001), while non-linear dose-response analysis revealed an even more robust association (Coef1=-0.008, p1 = 0.04, Coef2 = 0.033, p2 = 0.13). This systematic review and dose-response analysis identified significant inverse relation between aspirin and risk of HCC using both linear and non-linear models.

The effects of green coffee bean extract supplementation on lipid profile in humans: A systematic review and meta-analysis of randomized controlled trials.

BACKGROUND AND AIM: This systematic review and meta-analysis aimed to assess the effects of green coffee bean extract (GCBE) supplementation on lipid profile in adults. METHODS AND RESULTS: The PubMed/Medline, Scopus, Web of sciences, and Google Scholar were systematically searched for randomized controlled trials available in English and published before February 2019. The meta-analysis was conducted using fixed effects models, and between-study heterogeneity was assessed by Cochran's Q test and I2. A total of 17 effect sizes were included in the meta-analysis. Combined effect sizes on serum total cholesterol concentrations revealed significant effects of GCBE supplementation on serum total cholesterol [weighted mean difference (WMD): -4.51 mg/dL, 95% confidence interval (CI): -6.89, -2.12, p < 0.001], low density lipoprotein-cholesterol (LDL-C) (WMD: -4.38 mg/dL, 95% CI: -6.44, -2.31, p < 0.001), and high density lipoprotein-cholesterol (HDL-C) (WMD: 2.63 mg/dL, 95% CI: 2.20, 3.07, p < 0.001) compared to controls. Nevertheless, no significant changes were observed in serum triglycerides levels (WMD: -4.34 mg/dL, 95% CI: -9.00, 0.32, p = 0.068). CONCLUSION: The evidence from available studies suggests that the GCBE supplementation leads to significant reductions in total cholesterol, HDL-C, and LDL-C levels, and has modest, but, non-significant effects on triglycerides levels.

Effect of tomato consumption on fasting blood glucose and lipid profiles: A systematic review and meta-analysis of randomized controlled trials.

Tomato (Solanum lycopersicum) phytochemicals, which include phytoene, phytofluene, beta-carotene, flavonoids, lycopene, and polyphenols, have been shown to improve the effects of fasting on plasma triglyceride (TG), low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL), total cholesterol (TC), and fasting blood sugar (FBS). The aim of this study was to systematically evaluate the effects of Tomato TC, TG, HDL, LDL, and FBS in humans. A systematic literature search was conducted in PubMed/MEDLINE, Web of sciences, and SCOPUS databases by two researchers for studies published until August of 2019 without language and time limitations. Results were combined with random effect models. Six studies were included in this meta-analysis. Combined results reveal a significant reduction in cholesterol (weighted mean difference [WMD]: -4.39 mg/dl, 95% CI: -7.09, -1.68, I2 = % 48, p heterogeneity: .05), TG (WMD: -3.94 mg/dl, 95% CI: -7.67, -0.21, I2 = % 90, p heterogeneity: .001), LDL levels (WMD: -2.09 mg/dl, 95% CI: -3.73, -0.81, I2 = % 78, p heterogeneity: .001), and increasing in HDL levels (WMD: 2.25 mg/dl, 95% CI: 0.41, 4.10, I2 = % 97, p heterogeneity: .001). Tomato was found to have a higher reduction effect on TG and LDL in younger participants. While pooled results indicate no significant effect on FBS levels (WMD: 0.59 mg/dl, 95% CI: -0.28, 1.46, I2 = % 95, p heterogeneity: .001). In conclusion, the results indicate a significant reduction in total cholesterol, TG, and LDL and increase in HDL levels that is caused by tomato consumption.

The effect of psyllium consumption on weight, body mass index, lipid profile, and glucose metabolism in diabetic patients: A systematic review and dose-response meta-analysis of randomized controlled trials.

Water-soluble dietary fibers have been shown to improve lipid profile and glucose metabolism in diabetes. The aim of this study was to review the effects of psyllium consumption on weight, body mass index, lipid profiles, and glucose metabolism in diabetic patients in randomized controlled trials. A comprehensive systematic search was performed in PubMed/MEDLINE, Web of Sciences, Cochrane, and Scopus by two independent researchers up to August 2019 without any time and language restrictions. The DerSimonian and Laird random-effects model method performed to calculate the pooled results. Inclusion criteria were randomized controlled trial design, adult subjects, and studies reporting the mean differences with the 95% confidence interval for outcome. Eight studies containing nine arms with 395 participants were identified and included in final analysis. Combined results found a significant reduction in triglycerides, low-density lipoprotein, fasting blood sugar, and hemoglobin A1c following psyllium consumption (weighted mean differences [WMD]: -19.18 mg/dl, 95% CI [-31.76, -6.60], I2 = 98%), (WMD: -8.96 mg/dl, 95% CI [-13.39, -4.52], I2 = 97%), (WMD: -31.71 ml/dl, 95% CI [-50.04, -13.38], I2 = 97%), and (WMD: -0.91%, 95% CI [-1.31, -0.51], I2 = 99%), respectively. There was no significant change in high-density lipoprotein, body mass index, cholesterol, and weight. In conclusion, the results demonstrated a significant reduction in triglycerides, low-density lipoprotein, fasting blood sugar, and hemoglobin A1c by psyllium intervention among diabetic patients.

Techniques, perspectives, and challenges of bioactive peptide generation: A comprehensive systematic review.

Due to the digestible refractory and absorbable structures of bioactive peptides (BPs), they could induce notable biological impacts on the living organism. In this regard, the current study was devoted to providing an overview regarding the available methods for BPs generation by the aid of a systematic review conducted on the published articles up to April 2019. In this context, the PubMed and Scopus databases were screened to retrieve the related publications. According to the results, although the characterization of BPs mainly has been performed using enzymatic and microbial in-vitro methods, they cannot be considered as suitable techniques for further stimulation of digestion in the gastrointestinal tract. Therefore, new approaches for both in-vivo and in-silico methods for BPs identification should be developed to overcome the obstacles that belonged to the current methods. The purpose of this review was to compile the recent analytical methods applied for studying various aspects of food-derived biopeptides, and emphasizing generation at in vitro, in vivo, and in silico.

Breakfast consumption pattern and its association with overweight and obesity among university students: a population-based study.

PURPOSE: To determine the association between breakfast consumption habit and overweight and obesity in a sample of Iranian university students. METHODS: A sample of 78,905 university students, aged 18 years or older, was recruited from 28 provinces in Iran to assess breakfast consumption pattern. Breakfast consumption habit was evaluated using a pre-tested questionnaire. Weight and height were measured using standard protocol and then body mass index (BMI) was calculated. Overweight (obesity included) and obesity were defined as BMI ≥ 25 and BMI ≥ 30 kg/m2, respectively. RESULTS: Mean age of participants was 21.50 ± 4.01. After controlling for potential confounders, participants who ate breakfast > 4 days/week had 15% lower risk of overweight compared with those who ate < 1 day/week (OR: 0.85, 95% CI 0.78-0.92). Such significant association was also seen in female students (OR: 0.82, 95% CI 0.72-0.93); however, it was marginally significant in male ones (OR: 0.89, 95% CI 0.79-1.00). In addition, a significant inverse association was found between breakfast consumption and obesity (OR: 0.74, 95% CI 0.64-0.85) such that after adjusting for potential confounders, students who consumed breakfast > 4 days/week were 33% less likely to be obese compared with those who consumed it < 1 day/week (OR: 0.67, 95% CI 0.57-0.78). Such significant inverse association was also seen in either gender. CONCLUSIONS: Breakfast consumption was inversely associated with odds of overweight and obesity in university students. LEVEL OF EVIDENCE: Level V, cross-sectional descriptive studies.

The Association between the Preservative Agents in Foods and the Risk of Breast Cancer.

In the etiology of breast malignancy, dietary habits and lifestyle-related risk factors in the coherence of cancer prevention guidelines, e.g., WCRF/AICR is well documented. In addition, the consumption of staple food products rich in carbohydrate as major calorie resources such as potato, bread, and ready-to-eat cereals are partly object to having roles in breast tumorigenesis. In this review, the possible associations of preservatives and nutritive risk factors of staple foods in dietary patterns with breast cancer development based on the experimental and observational cohort-based studies were discussed. In this regard, the influence kinetics of insulin, insulin-like growth factor-1, and insulin-activated AMPK/Akt pathway on sorts of starch and protein is a concerning biologic concept in promoting the risk of tumorigenesis. Hence, Akt-dependent controlled proliferation, induced apoptosis, and controlled oxidative stress in specific condition could be concentrated as the preventive strategies. Although preservatives such as sorbate, benzoate, and nitrate are considered Generally Recognized as Safe, there are some issues concerning the safety of their applications, including the possibility of allergies and immunosuppressive effects from benzoate, the formation of carcinogenic nitrosamines from nitrites, and interaction sorbate with nitrite in the stomach which consequently can be resulted in the production of a series of genotoxic compounds.