Dietary Magnesium Intake in Relation to Depression in Adults: A GRADE-Assessed Systematic Review and Dose-Response Meta-analysis of Epidemiologic Studies.

CONTEXT: The relation of magnesium (Mg) intake with depression was previously investigated by meta-analyses. However, due to limited data, a dose-response analysis was not performed. OBJECTIVE: Considering the recently published articles, a systematic review and dose-response meta-analysis was conducted to summarize the relation of dietary Mg intake with depression in adults. DATA SOURCES: Medline (PubMed), ISI Web of Science, Scopus, and Google Scholar were comprehensively searched up to August 2023. DATA EXTRACTION: Observational studies that reported the relation of dietary Mg intake and depression in adults were included and their data were extracted. DATA ANALYSIS: A total of 63 214 participants from 10 cross-sectional and 3 cohort studies were included in the current study. Pooling 15 effect sizes from 12 studies (including 50 275 participants) revealed that individuals with the highest Mg intake had a 34% lower risk of depression, compared with those with the lowest Mg intake (RR: 0.66; 95% CI: 0.57, 0.78). Moreover, the linear dose-response analysis revealed that each 100-mg/d increment in Mg intake was associated with a 7% reduced risk of depression (RR: 0.93; 95% CI: 0.90, 0.96). Additionally, based on nonlinear dose-response analysis, increasing Mg intake from 170 to 370 mg/d was associated with a reduced risk of depression. Analyses were also conducted on 9 studies (49 558 participants) with representative populations, and similar results were found in the meta-analysis (RR: 0.71; 95% CI: 0.61, 0.83) and linear (RR: 0.93; 95% CI: 0.90, 0.96) and nonlinear dose-response analysis. CONCLUSION: The current study shows an inverse dose-dependent association between dietary Mg intakes and risk of depression in both a general and representative population of adults in a dose-response manner. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no. CRD42024506570.

Impact of omega-3 fatty acids supplementation on the gene expression of peroxisome proliferator activated receptors-γ, α and fibroblast growth factor-21 serum levels in patients with various presentation of metabolic conditions: a GRADE assessed systematic review and dose-response meta-analysis of clinical trials.

There is some debate about the effects of omega-3 fatty acids on the regulation of adipose tissue related genes. This systematic review and meta-analysis aimed to evaluate the effects of omega-3 fatty acids supplementation on the gene expression of peroxisome proliferator activated receptors (PPAR-α and PPAR-γ) and serum fibroblast growth factor-21 (FGF-21) levels in adults with different presentation of metabolic conditions. To identify eligible studies, a systematic search was conducted in the Cochrane Library of clinical trials, Medline, Scopus, ISI Web of Science, and Google Scholar up to April 2022. Eligibility criteria included a clinical trial design, omega-3 fatty acids supplementation in adults, and reporting of at least one of the study outcomes. Effect sizes were synthesized using either fixed or random methods based on the level of heterogeneity. Fifteen studies met the inclusion criteria. Omega-3 fatty acids supplementation significantly increased the PPAR-γ (10 studies) and PPAR-α (2 studies) gene expression compared to the control group (WMD: 0.24; 95% CI: 0.12, 0.35; p < 0.001 and 0.09; 95% CI: 0.04, 0.13; p < 0.001, respectively). Serum FGF-21 (8 studies) levels exhibited no significant change following omega-3 fatty acids supplementation (p = 0.542). However, a dose-response relationship emerged between the dose of omega-3 fatty acids and both PPAR-γ gene expression and serum FGF-21 levels. Overall, this study suggests that omega-3 fatty acids supplementation may have positive effects on the regulation of adipose tissue related genes in patients with various presentation of metabolic condition. Further research is needed to validate these findings and ascertain the effectiveness of this supplementation approach in this population. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?, CRD42022338344.

The effect of a low versus high sodium diet on blood pressure in diabetic patients: A systematic review and meta-analysis of clinical trials.

There have been numerous clinical trials that have investigated the effect of sodium intake on blood pressure in diabetic patients. The purpose of this systematic review and meta-analysis was to evaluate the clinical trial studies performed on the effect of low sodium diet (LSD) versus high sodium diet (HSD) on blood pressure in diabetic patients. PubMed, Scopus, and Web of Science were systematically searched from database inception to July 10, 2021. Both type 1 and 2 diabetes was considered. Overall, there were 15 studies included in this meta-analysis. The weighted (WMD) mean difference with 95% confidence interval (CI) was calculated using a random-effects model. Risk of bias in the studies was assessed based on the Cochrane collaboration tool and the quality of all the studies was considered as good. Overall, LSD significantly reduced SBP (systolic blood pressure) (WMD: -3.79 mmHg, 95% CI: -6.02, -1.56) and DBP (diastolic blood pressure) (WMD: -1.62 mmHg, 95% CI: -2.84, -0.40), in comparison with HSD, in diabetics. However, LSD had no significant effect on MAP (mean arterial pressure) in comparison with HSD (WMD: -1.81, 95%CI: -5.49, 1.87). Although subgroup analysis could not attenuate heterogeneity in SBP, subgroup analysis in DBP based on duration (≤1 week: WMD: -2.35, 95%CI: -3.69, -1.00, I 2  = 48.9%, p = 0.081, >1 week: WMD: -1.04, 95% CI: -2.83, 0.76, I 2  = 74.7%, p = 0.003) and study design (cross-over: WMD: -1.94, 95% CI: -2.71, -1.17, I 2  = 32.1%, p = 0.183, parallel: WMD: -2.17, 95% CI: -6.48, 2.13, I 2  = 82.4%, p = 0.001) successfully detected sources of heterogeneity. LSD significantly reduced SBP and DBP, however, had no effect on MAP, in comparison with HSD.

Longitudinal association of dietary habits and the risk of cardiovascular disease among Iranian population between 2001 and 2013: the Isfahan Cohort Study.

There has been a steady rise in the incidence of cardiovascular disease (CVD) in the Iranian population. The aim of this study is to investigate the association between Global Dietary Index (GDI) and CVD risk among the Iranian adult population. This study was conducted based on Isfahan Cohort Study, a longitudinal study that collected data between 2001 and 2013 on 6405 adults. Dietary intakes were assessed by a validated food frequency questionnaire to calculate GDI. All participants were followed every two years by phone call to ask about death, any hospitalization, or cardiovascular events to examine CVD events. The Average age of participants was 50.70 ± 11.63 and the median of GDI score was 1 (IQR: 0.29). A total of 751 CVD events (1.4 incidence rate, per 100 person-year) occurred during 52,704 person-years of follow-up. One-unit GDI increase was associated with a higher risk of MI by 72% (HR: 1.72; 95% CI 1.04-2.84), stroke by 76% (HR: 1.76; 95% CI 1.09-2.85) and CVD by 30% (HR: 1.48; 95% CI 1.02-2.65). In addition, a one-unit GDI increase was associated with a higher risk of coronary heart disease more than 2 times (HR: 2.32; 95% CI 1.50-3.60) and CVD mortality and all-cause mortality over than 3 times [(HR: 3.65; 95% CI 1.90-7.01) and (HR: 3.10; 95% CI 1.90-5.06), respectively]. Higher GDI had a significant relationship with the increased risk of CVD events and all-cause mortality. Further epidemiological studies in other populations are suggested to confirm our findings.

The Role of Magnesium in Sleep Health: a Systematic Review of Available Literature.

To date, no study has critically reviewed the current literature on the association between magnesium (Mg) and sleep health. Therefore, we carried out a systematic review to assess the association between Mg and sleep patterns in adults' population through observational and interventional studies. We searched for relevant studies through PubMed ( http://www.ncbi.nlm.nih.gov/pubmed ), Scopus ( http://www.scopus.com ), and ISI Web of Science ( http://www.webofscience.com ) from the earliest available date until November 2021. Eligibility criteria for study selection were guided by the following components identified using the PI(E)CO (Population, Intervention (Exposure), Comparison, Outcome) framework: P (adult population), I(E) (high dietary intake or supplementation of Mg), C (low dietary intake of Mg or placebo group), and O (sleep pattern including sleep duration, sleep-onset latency, night awakenings, sleep stages, and sleep phases). The present study involved 7,582 subjects from 9 published cross-sectional, cohort, and RCT systematically reviewed the possible links between Mg and sleep quality (daytime falling asleep, sleepiness, snoring, and sleep duration) in an adult population. Observational studies suggested an association between Mg statuses and sleep quality, while the RCTs reported contradictory findings. This systematic review revealed an association between magnesium status and sleep quality (daytime falling asleep, sleepiness, snoring, and sleep duration) according to the observational studies, while the randomized clinical trials showed an uncertain association between magnesium supplementation and sleep disorders. The association between dietary magnesium and sleep patterns needs well-designed randomized clinical trials with a larger sample size and longer follow-up time (more than 12 weeks) to further clarify the relationship.

A Hospital-Based Case-Control Study on Whole- and Refined-Grain Intake and Risk of Stroke.

INTRODUCTION: The aim of the present study was to ascertain the correlation between the intake of whole and refined grains and the risk of stroke in the Iranian adult population. METHOD: This hospital-based case-control study was conducted at Alzahra University Hospital, Isfahan, Iran, in 2008. The cases (n=195) were stroke patients admitted to the neurology ward, and the controls (n=195) were patients admitted to other wards in this center, with no prior history of cerebrovascular accident or any neurological disorders. The usual dietary intakes of the study participants during the previous year were assessed using a validated semi-quantitative food frequency questionnaire. Whole and refined grains were defined according to the definition of the American Association of Cereal Chemists International; foods that contained at least 8 g per 30 g of their weight were considered as whole grains. RESULTS: The mean age of the case and control groups was 68.0 (±13.5) and 61.5 (±10.5) years, respectively; 40% of the cases and 53.3% of the controls were female. The total intake of whole grains (27.8±4.3 vs. 29.4±3.6 g/d, P=0.77) and refined grains (264±11 vs. 296±13 g/d, P=0.07) was not significantly different between the cases and controls. After adjusting for potential confounders, individuals in the second tertile of refined grain intake had a two-fold higher odds of stroke (OR: 2.02; 95% CI: 1.08-3.71), compared to those in the first tertile. Furthermore, no significant relationships were observed between the consumption of whole grains and the risk of stroke, before or after adjustment for confounding variables. No significant trend was found between the tertiles of refined or whole grain intake and the risk of stroke. CONCLUSION: The authors did not find a statistically significant association between the intake of whole and refined grains and the risk of stroke. Further prospective studies on the relationship between both whole and refined grains and stroke are warranted.

Efficacy and safety of the biosimilar denosumab candidate (Arylia) compared to the reference product (Prolia®) in postmenopausal osteoporosis: a phase III, randomized, two-armed, double-blind, parallel, active-controlled, and noninferiority clinical trial.

BACKGROUND/OBJECTIVE: Osteoporosis is a global health concern with an increasing prevalence worldwide. Denosumab is an antiresoptive agent that has been demonstrated to be effective and safe in osteoporotic patients. This study aimed to compare the efficacy and safety of the biosimilar denosumab candidate (Arylia) to the originator product (Prolia®) in postmenopausal osteoporotic patients. METHODS: In this randomized, double-blind, active-controlled, noninferiority trial, postmenopausal osteoporotic patients received 60 mg of subcutaneous Arylia or Prolia® at months 0, 6, and 12 and were followed up for 18 months. The primary endpoint was the noninferiority of the biosimilar product to the reference product in the percentage change of bone mineral density (BMD) in 18 months at the lumbar spine (L1-L4), total hip, and femoral neck. The secondary endpoints were safety assessment, the incidence of new vertebral fractures, and the trend of bone turnover markers (BTMs). RESULTS: A total of 190 patients were randomized to receive either biosimilar (n = 95) or reference (n = 95) denosumab. In the per-protocol (PP) analysis, the lower limits of the 95% two-sided confidence intervals of the difference between Arylia and Prolia® in increasing BMD were greater than the predetermined noninferiority margin of - 1.78 at the lumbar spine, total hip, and femoral neck sites (mean differences [95% CIs] of 0.39 [- 1.34 to 2.11], 0.04 [- 1.61 to 1.69], and 0.41 [- 1.58 to 2.40], respectively). The two products were also comparable in terms of safety, new vertebral fractures, and trend of BTMs. CONCLUSION: The efficacy of the biosimilar denosumab was shown to be noninferior to that of the reference denosumab, with a comparable safety profile at 18 months. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03293108 ; Registration date: 2017-09-19.

The effect of red pepper/capsaicin on blood pressure and heart rate: A systematic review and meta-analysis of clinical trials.

Several studies have assessed the effect of red pepper on blood pressure (BP) and heart rate (HR) and reported controversial results. The aim of this study was to perform a systematic review and meta-analysis of clinical trials that evaluated the effect of red pepper/capsaicin consumption on BP and HR. Medline, Scopus, Cochrane Library, and Google Scholar were systematically searched, from database inception to August 2020, to ascertain clinical trials that evaluated the effects of red pepper or capsaicin on systolic blood pressure (SBP), diastolic blood pressure (DBP), or HR. Pooled effect size was calculated using a random-effects method. We performed subgroup analyses to discern probable sources of between-study heterogeneity. Meta-analysis showed no significant effect of red pepper/capsaicin on SBP (0.43 mmHg, 95% CI: -1.15 to 2.01), DBP (-0.45 mmHg, 95% CI: -2.14 to 1.24), and HR (-0.60 bpm, 95% CI: -1.97 to 0.78). Although between-study heterogeneity was high for SBP and DBP, we could not discern the potential sources of heterogeneity. In conclusion, red pepper/capsaicin had no effect on BP and HR. The findings should be interpreted with caution because between-study heterogeneity was high. Further well-designed and high-quality studies are required to investigate the efficacy and safety of red pepper/capsaicin supplement on BP and HR.

High frequency of concurrent anti-C1q and anti-dsDNA but not anti-C3b antibodies in patients with Lupus Nephritis.

Lupus Nephritis (LN) in patients with Systemic Lupus Erythematosus (SLE) is one of the most serious and prevalent manifestations. The procedure of renal biopsy is harmful and accompanied by potential hazards. Therefore, introducing reliable biomarkers to predict LN is exceedingly worthwhile. In the present study, we compared the diagnostic values of circulating autoantibodies against dsDNA, C1q, C3b, SSA, SSB, and Sm alone or in combination to predict LN. This study evaluated the abovementioned autoantibodies in 40 healthy controls (HCs) and 95 SLE patients with different kidney involvements, including absent (n = 40), inactive (n = 20), and active (n = 35) LN using EIA method. The frequency and odds ratio of anti-dsDNA (71.4%, OR = 4.2), anti-C1q (62.9%, OR = 5.1), and the simultaneous existence of anti-C1q and anti-dsDNA (51.4%, OR = 6) antibodies were significantly higher in the active LN group compared with both inactive and absent LN groups. Moreover, the levels of anti-C1q and anti-dsDNA antibodies positively correlated with disease activity in patients with SLE. The prevalence of these autoantibodies was associated with the severity of LN biopsies. These data suggest that anti-C1q and anti-dsDNA antibodies and also their simultaneous presence may be valuable diagnostic biomarkers for LN prediction in patients with SLE.

Is phase angle a valuable prognostic tool in cancer patients' survival? A systematic review and meta-analysis of available literature.

BACKGROUND & AIMS: The phase angle (PA), expressed via bioelectrical impedance, is an indicator of cell membrane health and integrity, hydration, and nutritional status, and may have further application as a prognostic marker in cancer survival. However, the associations between PA and cancer survival are inconsistent and unclear. The present systematic review and meta-analysis investigated the relationship between PA and survival among adult patients diagnosed with cancer. METHODS: A systematic search of observational studies up to November 2020 was conducted through PubMed, Scopus, and ISI Web of Science. The critical appraisal of the eligible studies was performed using the Newcastle-Ottawa Quality Assessment Scale. Statistical analyses were performed using STATA 11.2 software. A P-value <0.05 was considered statistically significant. RESULTS: A total of 14 studies covering 2625 participants were included in this study. There was a positive and significant correlation between PA and cancer survival (Fisher's Z: 0.30; 95% CI, 0.21-0.40; P < 0.001; I2 = 0.0%). Also, there was a significant prognostic role for PA on patients' survival (HR 0.77; 95% CI, 0.74-0.81; P < 0.001; I2 = 0.0%). In other words, patients with low values of PA were 23% less likely to survive than patients with high values of PA. CONCLUSIONS: Given that predicting survival in advanced cancer patients remains a challenge, the findings of this systematic review and meta-analysis suggest that phase angle may be an important prognostic factor of survival in this population.

Human adenovirus 36 improves insulin sensitivity and lipid profiles and increases inflammatory markers in Wistar rats.

Human adenovirus 36 (Ad-36) causes obesity with increased adiposity, in contrast, Ad-36 infection reduces glucose and lipid metabolism; the results, however, are not consistent. In the current study, the effects of Ad-36 infection on glucose and lipid profile and inflammatory markers in Wistar rats were investigated. Sixty male Wistar rats were randomly divided into infected and control groups. Ad-36 virus suspension was injected in the experimental group rats. Blood samples were collected in the beginning and after 12 weeks in both groups. After 12 weeks, a significant improvement was observed in fasting blood glucose, fasting serum insulin, insulin sensitivity, serum triglycerides and total cholesterol in the infected group compared with the non-infected groups. There were no significant differences in inflammatory biomarkers including tumor necrosis factor-α, interleukin 6 and monocyte chemoattractant protein-1 levels between infected and control groups. This study showed that Ad-36 had favorable effects on glycemic and lipid control in infected rats, but inflammatory biomarker levels were similar for 2 groups. Ad-36 infections could potentially be a new way to develop novel antidiabetic and antihyperlipidemic therapeutic agents.

The effect of saffron supplement on clinical outcomes and metabolic profiles in patients with active rheumatoid arthritis: A randomized, double-blind, placebo-controlled clinical trial.

Rheumatoid arthritis (RA) is a systemic autoimmune and inflammatory disease. Our study aimed to determine the effect of saffron supplement on clinical outcomes and metabolic profiles in patients with active RA. In this randomized, double-blind, placebo-controlled trial, 66 women older than 18 years old received 100 mg/day either saffron supplement in the intervention group (n = 33) or matched placebo in the placebo group (n = 33) for a period of 12 weeks. Sixty-one patients (30 in the control and 31 in the saffron group) remained for the final analysis. No adverse effects were reported by the patients. Saffron supplementation significantly decreased the number of tender (-1.38 ± 1.66 vs. 0.10 ± 0.40, p < .001) and swollen (-2.12 ± 2.34 vs. 0.63 ± 2.79, p < .001) joints, pain intensity based on visual analogue scale (-18.36 ± 15.07 vs. -2.33 ± 5.04), p < .001), and disease activity score (DAS28) (-0.75 ± 0.67 vs. 0.26 ± 0.77, p < .001) at the end of intervention between the two groups and in saffron group compared with baseline values. Physician Global Assessment (p = .002) and erythrocyte sedimentation rate were significantly improved after intervention (24.06 ± 12.66 vs. 32.00 ± 14.75, p = 0.028). High-sensitivity C-reactive protein reduced at the end of the intervention in the saffron group compared with baseline values (12.00 ± 7.40 vs. 8.82 ± 7.930, p = .004). Tumor necrosis factor alpha, interferon gamma, and malondialdehyde were decreased, and total antioxidant capacity were increased, but their differences between the two groups were not significant (p > .05). According to the results, saffron supplements could positively and significantly improve clinical outcomes in RA patients.

The effect of educational and encouragement interventions on anthropometric characteristics, obestatin and adiponectin levels.

BACKGROUND: Lifestyle modification is the most important strategy for control of obesity and overweight. Obestatin and adiponectin are the biomarkers of obesity. Thus, this study was performed to examine the effect of educational and encouragement interventions and lifestyle modifications on obesity anthropometric as well as obestatin and adiponectin levels. METHODS: This semi-experimental study was conducted on a subsample of TABASSOM study. Participants were 41 overweight and obese children and adolescents aged 6-18 years old and 45 overweight and obese adults aged 19-65 years old. Anthropometric characteristics including height, weight, waist and hip circumferences, and body fat percentage (BFP) were measured at the first and after one year at the end of study. We implemented some educational and encouragement interventions regarding dietary modification and physical activity during the study. Obestatin and adiponectin levels were measured at the first and end of study by enzyme-linked immunosorbent assay (ELISA) method. RESULTS: The study did not show significant effect on anthropometric characteristics such as body mass index (BMI) and waist circumference (WC). BFP decreased significantly in boys, total children and adolescent group, and waist-to-hip ratio (WHR) decreased significantly only in adolescent boys after 1 year (P < 0.050). CONCLUSION: Educational and encouraging interventions and lifestyle modifications could lead to decrease of body WHR and BFP in adolescent boys. This is helpful in controlling the increasing rate of obesity.

Wegener's Granulomatosis Presenting as Wallenberg Syndrome: A Case Report.

Granulomatosis with polyangiitis (GPA), formerly known as Wegener's granulomatosis, a vasculitis affecting small and medium sized vessels usually affects the upper and lower respiratory tract, the kidneys, and the eyes. Neurologic manifestation in central nervous system (CNS) is less frequent than the peripheral and usually is in form of stroke. Few cases of lateral medullary ischemic stroke (Wallenberg syndrome) due to GPA have been reported. A 41 year-old female, presented with acute vertigo, nausea/vomiting, hiccups, dysphagia. In physical examination she had a saddled nose, horner syndrome, soft palate paralysis, crossed hypoesthesia of face, and limbs and hemi-ataxia. Brain magnetic imaging revealed a left lateral medullary infarction and sinusitis confirmed by paranasal Sinus CT scans. Chest CT showed a cavitary mass. Laboratory findings were remarkable for anemia, elevated erythrocyte sedimentation rate, and C-reactive protein. Cytoplasmic antineutrophil cytoplasmic antibody (ANCA)/anti-proteinase 3 was positive. Diagnosis of GPA was established and treatment was started. During 6-month follow-up improvement was satisfying and no relapses occurred. Medullary infarct is reported in few GPA patients, especially at presentation. Definite diagnosis is based on tissue biopsy. Although in context of extra CNS involvement and positive ANCA diagnosis can be made confidently. Treatment of choice in CNS involvement is not clear, corticosteroids and immunosuppressives seem effective. CNS involvement, especially stroke may present GPA or accompany extra CNS symptoms. Prompt diagnosis and treatment is essential.

Orem's Self-Care Model With Trauma Patients: A Quasi-Experimental Study.

To examine if the application of Orem's self-care model could improve self-care knowledge, attitudes, practices, and respiratory conditions of trauma patients with chest tubes, a quasi-experimental study was conducted. The participants were assigned to two groups-namely, Orem's model and routine care. Although the patients' self-care knowledge, attitudes, and practices were improved in both groups over the course of 3 days since the initial assessments, there was a greater degree of improvement in the experimental group than that in the control group. However, there were no differences in the improvement of the chest parameters between the two groups. Orem's model was effective in improving self-care in patients with chest tube.

Using rats as a research model to investigate the effect of human adenovirus 36 on weight gain.

BACKGROUND: Recent evidence has shown a positive correlation between obesity and viral infections with a particular emphasis on the human adenovirus-36 (Ad-36). Ad-36 is the first human virus that may increase adiposity in animals, and it is considered as a possible risk factor for obesity in humans; however, the results were not consistent across all the studies. The present study was conducted to examine the influence of Ad-36 infection on obesity in a rat model. METHODS: Eight-week-old male Wistar rats weighing 170-240 gram (g), were randomly divided into two groups, infection group (48 rats) and a control group (12 rats). The rats in the infection group were infected with human Ad-36. All rats were given free access to a normal chow diet and water. They were weighed weekly. RESULTS: The mean ± standard deviation (SD) body weights were 229.0 ± 25.9 g and 232.3 ± 16.6 g in the infection and control groups, respectively at the time of infection. The mean ± SD body weight of the infection group (304.0 ± 39.0 g) was higher than the control group (301.0 ± 36.5 g) at 12 weeks post-infection (P = 0.82). Although two groups had approximately same food intakes, the mean change in body weight was greater in the infection group than the control group (75.8 ± 27.9 g vs. 70.8 ± 24.5 g) but it was not significant (P = 0.57). CONCLUSION: We did not find a statistically significant association between weight gain and Ad-36 infection in the rat model. It seems that longer follow-up duration is needed to develop a significant weight gain in the infected rats. Rats can be used as a good animal model for further investigations about Ad-36-induced obesity, provided not to rely merely on weight measurements. Evaluating body composition or histopathological assessments are suggested.

Vinegar consumption can attenuate postprandial glucose and insulin responses; a systematic review and meta-analysis of clinical trials.

OBJECTIVE: Postprandial hyperglycemia plays a decisive role in the development of chronic metabolic disorders. The effect of vinegar intake with a meal on postprandial glucose has been studied in several trials with conflicting results. RESEARCH METHODS AND PROCEDURES: The purpose of the current study was to systematically review control trials that report on the effect of vinegar intake on postprandial glucose response. Postprandial insulin response was considered as secondary outcome. RESULTS: The pooled analysis of studies revealed a significant mean glucose and insulin area under the curve (AUC) reduction in participants who consumed vinegar compared with the control group (standard mean difference=-0.60, 95%CI -1.08 to -0.11, p=0.01 and -1.30, 95%CI -1.98 to -0.62, p<0.001, respectively). CONCLUSIONS: The findings suggest that vinegar can be effective in reducing postprandial glucose and insulin levels, indicating it could be considered as an adjunctive tool for improving glycemic control.

Effects of Concentrated Pomegranate Juice on Subclinical Inflammation and Cardiometabolic Risk Factors for Type 2 Diabetes: A Quasi-Experimental Study.

BACKGROUND: The health benefits of pomegranate juice have been reported in several studies. However, limited clinical trials have examined the effects of concentrated pomegranate juice (CPJ) on inflammatory factors. OBJECTIVES: This study aimed to investigate the effects of CPJ on metabolic risk factors, including inflammatory biomarkers, in patients with type 2 diabetes mellitus. PATIENTS AND METHODS: In a quasi-experiment trial, 40 type 2 diabetic patients were asked to consume 50 g of CPJ daily for 4 weeks. Anthropometric indices, dietary intake, blood pressure measurements, and fasting blood samples were conducted at baseline and 4 weeks after the intervention. RESULTS: The intake of CPJ produced a significant increase in both total and high-density lipoprotein cholesterol (HDL-C) (4.7% and 3.9%, respectively) from baseline (P < 0.05). However, changes that were observed in serum triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), fasting blood glucose, and blood pressure were not statistically significant. Administration of CPJ caused significant reduction in serum interleukin-6 (IL-6) (P < 0.05), but tumor necrosis factor-α (TNF-α) and high-sensitivity C-reactive protein (hs-CRP) remained unchanged during the study. The mean value of serum total antioxidant capacity (TAC) was substantially increased (~ 75%) from 381.88 ± 114.4 at baseline to 1501 ± 817 after 4 weeks of CPJ consumption. CONCLUSIONS: Consumption of CPJ (50 g/day) appears to have favorable effects on some markers of subclinical inflammation, and to increase plasma concentrations of antioxidants in patients with type 2 diabetes.

The effect of dietary approaches to stop hypertension (DASH) diet on weight and body composition in adults: a systematic review and meta-analysis of randomized controlled clinical trials.

BACKGROUND: Dietary approaches to stop hypertension (DASH) diet is rich in foods that are proposed to be inversely associated with obesity. Therefore, DASH might better affect body weight; however, published data are conflicting. OBJECTIVE: To assess the effect of DASH on body weight and composition in adults. METHODS: PubMed, EMBASE, Scopus and Google scholar were searched up to December 2015, for relevant randomized controlled clinical trials. Mean changes in body weight, body mass index (BMI) and waist circumference (WC) were extracted. RESULTS: Thirteen articles (ten for body weight, six for BMI and two for WC) were eligible. Meta-analysis revealed that adults on DASH diet lose more weight (weighted mean difference [WMD] = -1.42 kg, 95% confidence interval [95%CI]: -2.03, -0.82) in 8-24 weeks, BMI (WMD = -0.42 kg m(-2) , 95%CI: -0.64, -0.20) in 8-52 weeks and WC (WMD = -1.05 cm, 95%CI: -1.61, -0.49) in 24 weeks compared with controls. Low caloric DASH led to even more weight reduction when compared with other low-energy diets. In addition, the effect was greater in overweight/obese participants and when compared with typical (Western or population's usual) diets. CONCLUSION: DASH diet is a good choice for weight management particularly for weight reduction in overweight and obese participants.

Low-carbohydrate-diet score and metabolic syndrome: An epidemiologic study among Iranian women.

OBJECTIVE: Epidemiologic studies linking carbohydrate consumption and risk for metabolic syndrome (MetS) are limited. The association between low-carbohydrate-diet score and MetS has not been investigated. The aim of this study was to investigate low-carbohydrate-diet score in relation to MetS among a group of Iranian women. METHOD: This cross-sectional study was conducted with 442 Iranian female teachers >20 y of age. Usual dietary intakes were assessed using a validated, dish-based semiquantitative food frequency questionnaire. Metabolic syndrome was defined according to the American Heart Association/National Heart, Lung, and Blood Institute/International Diabetes Federation definition guidelines. RESULTS: The prevalence of MetS in the lowest and highest quintile of low-carbohydrate-diet score was 17.5% and 18.8%, respectively (P = 0.97). There was no statistically significant difference in the prevalence between extreme quartiles low-carbohydrate-diet score and MetS (odds ratio, 0.93; 95% confidence interval, 0.38-2.28). After controlling for age, energy intake, and other potential confounders, low-carbohydrate-diet score was not significantly associated with MetS. A significant association was observed between this score and abnormal fasting plasma glucose. We failed to find a significant relationship between this score and other components of MetS. CONCLUSIONS: Diets with lower amounts of carbohydrate and higher contents of fat and protein were not significantly associated with the risk for MetS in a cross-sectional study with a group of Iranian women. More longitudinal studies are needed to confirm these results.