Optimizing the Production of Probiotic Yogurt as a New Functional Food for Diabetics with Favorable Sensory Properties Using the Response Surface Methodology.

This study aimed to optimize the processing of probiotic yogurt supplemented with cumin essential oil (CEO), vitamin C, D3 (Vit D), and reduction of fermentation time using response surface methodology as a new functional food for diabetics with desirable sensory properties. The central composite design (CCD) was used to analyze the effect of these independent variables on the growth of the Lactobacillus plantarum A7 (LA7), starter culture, and overall acceptability. Differences between treatments were analyzed. The data were evaluated by analysis of variance at the significance level of 0.05. The effective concentration of CEO and fermentation time had the significant effect on the Lactobacillus plantarum A7 (LA7) number. Variance analysis and three-dimensional graphs show that almost the only effective factor on the overall acceptability of probiotic yogurt containing essential oil and vitamin D3 was CEO. According to the obtained data from the analysis, the optimal amount of independent variables for probiotic yogurt formulation such as CEO, D3, and fermentation time was 0.02% (v/v), 400 IU, and 9 h, respectively. This functional product can be considered an efficient food to reduce or eliminate the complications of diabetes.

Determination of the level of evidence for the association between different food groups/items and dietary fiber intake and the risk of cardiovascular diseases and hypertension: An umbrella review.

Evidence has suggested that nutrition is a preventive factor against cardiovascular disease (CVD) risk. Because of a sharp growth in published meta-analyses and pooled analyses in recent years, a reassessment of old evidence is needed. We aimed to determine the level of evidence for the association between the consumption of different food groups/items and dietary fiber and the incidence risk of CVDs, hypertension, and atrial fibrillation from meta-analyses and pooled analyses of observational studies. Databases Scopus, PubMed/Medline, and Web of Science were searched for related studies. Fifty-eight articles met the inclusion criteria for evidence grading. In summary, grading the level of evidence showed a suggestive inverse association between the higher consumption of fruits, whole grains, fish, legumes, nuts, and dietary fibers with the incidence risk of hypertension and different types of CVD. Also, there was a probable inverse association between the higher consumption of total and low-fat dairy products and the risk of hypertension. Higher red meat consumption had a probable association with the increased risk of ischemic stroke. Higher consumption of processed meat and poultry also had a suggestive direct association with the incidence risk of stroke and hypertension. We have tried to present a comprehensive and useful overview of the level of evidence based on the most updated findings. The summary of results in the current umbrella review can be a helpful tool for nutritionists, dietitians, and researchers to establish new studies and identify research gaps in related issues.

The engineered probiotics for the treatment of chronic diseases: A systematic review.

Engineered probiotics (EPs) are a group of probiotics whose proteome is manipulated by biotechnological techniques. EPs have attracted a lot of attention in recent researches for preventing and treating chronic diseases. The current study has been conducted to provide an overview regarding the EPs application in the treatment of chronic disease by a comprehensive systematic review of the published articles up to January 2022. To retrieve the related publications, three databases (PubMed/MEDLINE, Web of Sciences, and Scopus) were searched systematically. Finally, all human (n = 2) and animal (n = 37) studies were included. The included articles evaluated the effects of EPs on treatment of arthritis (n = 3), cancer (n = 2), autoimmune encephalomyelitis (EAE; n = 6), Parkinson disease (PD; n = 1), Alzheimer diseases (AD; n = 1), colitis (n = 11), celiac disease (n = 1), diabetes (n = 8) and cardiovascular disease (CVD; n = 6). Induction of oral tolerance (OT) is the most important mechanism of EPs action in the treatment of chronic disease. Providing oral vaccine and bioactive compounds are the other mechanisms of EPs action. PRACTICAL APPLICATIONS: The current systematic review gathered evidence about the application of EPs in the treatment of chronic diseases. Evidence suggests that EPs have very broad and potent effects in the treatment of chronic and even genetic diseases.

Is collagen supplementation friend or foe in rheumatoid arthritis and osteoarthritis? A comprehensive systematic review.

Rheumatoid arthritis (RA) and osteoarthritis (OA) both are chronic diseases affecting joints. Immune response against collagen in both diseases may have a role in the initiation and progression of the disease. There is a hypothesis that suppression of immune response vs collagen could be a therapeutic approach in RA and OA. Exposure of gut immune system to collagen is a way to suppress immune response against collagen in the joints. So, the current systematic review is aimed to evaluate the effects of collagen supplementation in OA and RA patients. In the current systematic review, online electronic databases including PubMed/MEDLINE, Web of Sciences and Scopus were searched and finally 19 articles were included. The enrolled articles evaluated the effects of collagen supplementation on treatment of OA (n = 9) and RA (n = 10). Intact (n = 4) and hydrolyzed (n = 5) collagen were used to treat OA. All of the studies on RA used intact and type II collagen in their intervention. The last trials on collagen supplementation in RA and OA patients were performed in 2011 and 2016, respectively. High adverse effects of collagen supplementation and its low efficiency compared to routine treatments were reported by several included studies. Also, risk of bias assessment showed that most of the studies had poor quality. Therefore, it is not possible to definitely decide on the beneficial or detrimental effects of collagen supplementation on OA and RA patients. Further studies are needed to reach a final decision.

Food Products with the Child-Targeted Packaging in Food Stores around Primary Schools in Tehran, Iran.

The local retail food environment around schools can have an important role in encouraging children to low-quality food choices; and may act as a potential risk factor in their diet. Thus, evaluating the food environment is essential for adopting policies and programs that support healthy nutrition in children. This study aimed to investigate the frequency and nutritional characteristics of packaged processed/ultra-processed food and beverage products with child-oriented marketing attributes in food stores around primary schools in Tehran, Iran. This cross-sectional study was conducted on 239 food stores located within a 500-meter buffer around 64 primary schools in Tehran province. The presence of marketing strategies directed at children and nutrition information from traffic light labels of packaged foods available in these stores were extracted. Data were analyzed overall and separately for the subset of foods placed on front shelves at the entrance of stores. Among 445 discrete food products marketed to children via their packaging, 198 (44.49%) were placed on shelves in front of the stores entrance. Potato chips and bulky cereals group had the highest energy density (507.15 ± 44.05 Kcal/100gr). Due to the color code of traffic light labels, 100% of fruit juices had high levels of sugar. Of potato chips and bulky cereals, 89.38% were assigned a red color traffic light for total fat levels. Moreover, 62.50% of processed fruit and vegetables contained high levels of salt. The level of trans-fatty acids were not high in any of the food products. The high amount of sugar, salt, and fat in a remarkable proportion of food products marketed to children can be considered a risk factor for children's health. Initiation and implementation of appropriate policies to control the food environment around schools in Iran is recommended.

Systematic review and meta-analysis of the most common processed foods consumed by Iranian children.

BACKGROUND: The trend of increasing overweight and obesity among children is a huge burden on health systems. In this regard, the growing availability of processed foods, often energy dense and nutrient poor, has become a major concern. Changing this trend will require evidence-based policies. AIMS: This systematic review aimed to identify the most common processed/ultraprocessed foods consumed by 4-12-year-old Iranian children. METHODS: We searched PubMed, Scopus and Web of science, as well as Persian scientific search engines, including Iran Research Information System, Scientific Information Database and Mag-Iran. We also assessed grey literature, that is, national studies and papers presented at relevant Iranian congresses. All data collected from studies were converted to daily servings (S/D). Mean and standard deviations of the included results were combined by performing meta-analysis with a random effects model. The I2 test was used to compute heterogeneity. Egger's test was used to assess publication bias. RESULTS: Ten studies with 67 093 children were included in this review. The meta-analysis demonstrated that the highest consumption of processed foods belonged to the sugars and sweets group with 8.01 S/D, followed by oils, and biscuits and cakes with 5.58 S/D and 3.33 S/D, respectively. CONCLUSION: Given the high consumption of less healthy processed foods, robust policies to support healthy eating and help improve Iranian children's food environment are recommended.

Does food insecurity affect musculoskeletal symptoms, fatigue, and productivity of municipality cleaners? A cross-sectional study.

BACKGROUND: Municipality cleaners are exposed to food insecurity, Musculoskeletal Symptoms (MSs), and fatigue. OBJECTIVE: This study aimed to investigate the effect of food insecurity on MSs, fatigue, and productivity among municipality cleaners. METHODS: This study was conducted on 399 Iranian male municipality cleaners with at least one year of working experience. The data were gathered via a demographic/occupational questionnaire, the Persian version of the Household Food Insecurity Access Scale (P-HFIAS), the Persian version of Nordic Musculoskeletal Questionnaire (P-NMQ), the Persian version of the Multidimensional Assessment of Fatigue scale (P-MAF), and the Persian version of Health and Work Questionnaire (P-HWQ). Data were analyzed using descriptive statistics, multiple logistic regression (Forward Wald), and multiple linear regression (Stepwise). RESULTS: The findings revealed that 42.6%of the municipality cleaners were in the 'severely food insecure' category. The highest prevalence of MSs in the past week were related to knees (35.8%), lower back (35.1%), and ankles/feet (28.8%). Based on the results, the chance of MSs in the shoulders (OR = 1.66) and ankles/feet (1.60) regions, and MSs at least in one body region (OR = 1.47) was higher in the individuals with severe food insecurity than the others. Considering the P-MAF, food insecurity was associated with the 'degree and severity', 'distress that it causes', and 'timing of fatigue' subscales and 'total fatigue'. Considering the P-HWQ, food insecurity was associated with 'productivity', 'other's assessment', 'concentration/focus', 'supervisor relations', 'non-work satisfaction', and 'impatience/irritability' subscales. CONCLUSION: The study revealed an association between food insecurity and MSs in some body regions and fatigue and productivity subscales among the municipality cleaners. Nutritional and ergonomic programs are recommended to reduce municipality cleaners' food insecurity, MSs, and fatigue and enhance their productivity.

Scrutinize of healthy school canteen policy in Iran's primary schools: a mixed method study.

BACKGROUND: Schools provide an opportunity for developing strategies to create healthy food environments for children. The present study aimed to analyze the Healthy School Canteen (HSC) policy and identify challenges of its implementation to improve the school food environment in Iran. METHODS: This mixed method study included two qualitative and quantitative phases. In the qualitative phase, triangulation approach was applied by using semi-structured interviews with key informants, documents review and direct observation. Data content analysis was conducted through policy analysis triangle framework. In the quantitative phase, food items available in 64 canteens of primary schools of Tehran province were gathered. The food's nutrient data were evaluated using their nutrition facts label. The number and proportion of foods that met the criteria based on Iran's HSC guideline and the World Health Organization nutrient profile model for the Eastern Mediterranean Region (WHO-EMR) were determined. RESULTS: The main contextual factors that affected adoption of HSC policy included health (nutritional transition, high prevalence of non-communicable diseases and unhealthy food environment in and around the schools), political (upstream supportive policies and joint memorandums about health children between the Ministry of Health and Medical Education and Ministry of Education), structural (the lack of unified stewardship, inadequate human resource capacity, poor inter-sectional cooperation), economic (school financial problems, poor fiscal supportive of food policies), and socio-cultural (mothers working outside the home, the role of children's peer group, low nutrition knowledge of school principals) factors. Assessment of the school canteens showed that a large proportion of available foods did not comply with the national guidelines (54.7 ± 2.54%) and WHO-EMR model (85.6 ± 2.34%). The main reasons identified for incomplete implementation of the policy were inadequate physical and economic infrastructure to set up standard school canteens, lack of scientific criteria for food categorization, poor monitoring, high price of healthy foods, and conflict of interest among the actors. CONCLUSION: The majority of foods and beverages available in the school canteens did not comply with national and regional standards. Iran HSC policy needs to be improved by using an evidence-based approach and active interaction between all key actors.

Enabling Food Environment in Kindergartens and Schools in Iran for Promoting Healthy Diet: Is It on the Right Track?

Enabling policies related to kindergarten and school food environments can be effective approaches in preventing childhood obesity. This study investigated policies and/or programs with direct or indirect effects on the food environment in kindergartens and schools in Iran. In this scoping review, we systematically searched PubMed, Scopus, and Web of science, as well as Iranian scientific search engines, including Scientific Information Database and Magiran from January 1990 to October 2020, to identify literature on policies/programs affecting the food environment in kindergartens and schools in Iran. A total of 30 studies and policy documents were included in this review relevant to eight policies/programs. These programs have helped to control food availability in schools, increase nutritional awareness, positively influence physical function and school performances, and reduce malnutrition in rural kindergartens. However, improving the food environment in schools and kindergartens requires proper revisions and local adaptation of many of these policies, strengthening of cross-sectoral collaborations, provision of necessary financial and human resources, and ensuring regular monitoring and evaluation. Reflecting on Iran's health policies and interventions provides insight into the progress achieved and challenges faced. Lessons can benefit the country itself, as well as other countries with similar contexts.

Determinants of Household Food Basket Composition: A Systematic Review.

BACKGROUND: Demographic, socioeconomic, and environmental determinants are important to population health status in all countries and diet is the main way that these factors could affect health. We aimed to conduct a systematic review of recent research evidence about these determinants of household food basket composition. METHODS: The PRISMA guideline was used to the reproducibility of this systematic review. Three databases including PubMed, Scopus and Google Scholar were systematically searched from 1991 to Dec 2017. RESULTS: Thirty four studies were included. Most studies were done in the United States. Three categories of determinants including the demographic, socioeconomic, and environmental define the contribution of different food groups in the household food basket. These factors determine the healthiness of family diet. CONCLUSION: Many determinants affect household food basket. Comprehensive consideration of policymakers to these factors is essential to creating and maintaining a healthy society.

Effects of Probiotic Soy Milk Fermented by Lactobacillus plantarum A7 (KC 355240) added with Cuminum Cyminum Essential Oil on Fasting Blood Glucose Levels, Serum Lipid Profile and Body Weight in Diabetic Wistar Rats.

BACKGROUND: There is some separate evidence that probiotic soy milk and Cuminum cyminum (C. cyminum) have positive effects on the prevention and reduction of diabetic complications. While the impact of probiotic soymilk mixed with herbal essential oils has not been investigated so far, the objective of this study is to examine the effects of probiotic soy milk using Lactobacillus plantarum A7 (KC 355240) added with essential oil of C. cyminum on diabetic rats. METHODS: 50 streptozotocin-nicotinamide (STZ-NA) induced diabetic Wistar rats were divided into five groups: Control group (C group), soy milk group (SM group), probiotic soy milk group (PSM group), soy milk containing essential oil of C. cyminum group (SMC group) and probiotic soy milk containing essential oil of C. cyminum group (PSMC group). The animals consumed these products (1 ml/day) for 30 days. The fasting blood glucose (FBS), the serum lipid levels, and body weight variation were analyzed in 10-day intervals. RESULTS: FBS, total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) decreased significantly, whereas high-density lipoprotein cholesterol (HDL-C) increased in the PSMC group compared with that of other groups (P < 0.05). This product also led to weight gain (P < 0.05). CONCLUSIONS: A mixture of probiotic soy milk and herbal essential oil consumption could impose a positive effect on reducing FBS as well as serum lipid profile in STZ- NA diabetes-induced rat. Also, it results in an increase in their weight gain.

Comparison of Energy and Nutrient Contents of Commercial and Noncommercial Enteral Nutrition Solutions.

BACKGROUND: Nutritional support plays a major role in the management of critically ill patients. This study aimed to compare the nutritional quality of enteral nutrition solutions (noncommercial vs. commercial) and the amount of energy and nutrients delivered and required in patients receiving these solutions. MATERIALS AND METHODS: This cross-sectional study was conducted among 270 enterally fed patients. Demographic and clinical data in addition to values of nutritional needs and intakes were collected. Moreover, enteral nutrition solutions were analyzed in a food laboratory. RESULTS: There were 150 patients who fed noncommercial enteral nutrition solutions (NCENS) and 120 patients who fed commercial enteral nutrition solutions (CENSs). Although energy and nutrients contents in CENSs were more than in NCENSs, these differences regarding energy, protein, carbohydrates, phosphorus, and calcium were not statistically significant. The values of energy and macronutrients delivered in patients who fed CENSs were higher (P < 0.001). Energy, carbohydrate, and fat required in patients receiving CENSs were provided, but protein intake was less than the required amount. In patients who fed NCENSs, only the values of fat requirement and intake were not significantly different, but other nutrition delivered was less than required amounts (P < 0.001). CENSs provided the nutritional needs of higher numbers of patients (P < 0.001). In patients receiving CENSs, nutrient adequacy ratio and also mean adequacy ratio were significantly higher than the other group (P < 0.001). CONCLUSION: CENSs contain more energy and nutrients compared with NCENSs. They are more effective to meet the nutritional requirements of entirely fed patients.

Antioxidant Capability of Ultra-high Temperature Milk and Ultra-high Temperature Soy Milk and their Fermented Products Determined by Four Distinct Spectrophotometric Methods.

BACKGROUND: Due to the recent emerging information on the antioxidant properties of soy products, substitution of soy milk for milk in the diet has been proposed by some nutritionists. We aimed to compare four distinct antioxidant measuring methods in the evaluation of antioxidant properties of industrial ultra-high temperature (UHT) milk, UHT soy milk, and their fermented products by Lactobacillus plantarum A7. MATERIALS AND METHODS: Ascorbate auto-oxidation inhibition assay, 2,2-diphenyl-1-picryl-hydrazyl-hydrate (DPPH) free radical scavenging method, hydrogen peroxide neutralization assay and reducing activity test were compared for the homogeneity and accuracy of the results. RESULTS: The results obtained by the four tested methods did not completely match with each other. The results of the DPPH assay and the reducing activity were more coordinated than the other methods. By the use of these methods, the antioxidant capability of UHT soy milk was measured more than UHT milk (33.51 ± 6.00% and 945 ± 56 µM cysteine compared to 8.70 ± 3.20% and 795 ± 82 µM cysteine). The negative effect of fermentation on the antioxidant potential of UHT soy milk was revealed as ascorbate auto-oxidation inhibition assay, DPPH method and reducing activity tests ended to approximately 52%, 58%, and 80% reduction in antioxidant potential of UHT soy milk, respectively. CONCLUSIONS: The antioxidative properties of UHT soy milk could not be solely due to its phenolic components. Peptides and amino acids derived from thermal processing in soy milk probably have a main role in its antioxidant activity, which should be studied in the future.

Evaluation of Response Surface Methodology to Predict Optimum Growth Conditions for Lactobacillus plantarum A7 (KC 355240) in Probiotic Soy Milk Containing Essential Oil of Cuminum cyminum.

BACKGROUND: A new product from soy milk, which is a combination of probiotics and essential oils, can be regarded as a functional food with new added health benefit. OBJECTIVES: This study aimed to evaluation of the results of response surface methodology (RSM) in prediction of the optimum growth condition of Lactobacillus plantarum A7 (KC 355240) (LA7) cultured in soy milk enriched with different concentrations of essential oil of Cuminum cyminum in comparison with the classical growth curve monitoring method. METHODS: Bacterial growth was investigated in the samples of probiotic soy milk containing three concentration levels (0.01%, 0.02% and 0.03% (v/v)) of the essential oil of C. cyminum. The experiments were repeated three times. Concentration of C. cyminum essential oil and the fermentation time were considered as factors and experiments were conducted based on a small composite design of response surface methodology. RESULTS: According to the tests carried out, the optimum conditions were determined as the concentration of 0.02% (v/v) essential oil and 9 hours of fermentation. CONCLUSIONS: These results were in accordance with the outcomes of classical growth curve monitoring method. There are several patents that have recently shown a diverse mix of soy milk in functional foods. Results of this study can be used in the preparation of functional products, enriched with medicinal plants.

Comparison of soymilk and probiotic soymilk effects on serum high-density lipoprotein cholesterol and low-density lipoprotein cholesterol in diabetic Wistar rats.

BACKGROUND: Soy milk (SM) and its fermented products are identified as rich sources of bioactive compounds helping to manage and to reduce the risk of chronic disease. This study aimed to compare the effects of SM and probiotic SM (PSM) consumption on serum low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) in diabetic Wistar rats. METHODS: Probiotic SM was prepared by fermentation of the plain SM with a native strain of Lactobacillus plantarum. 20 streptozotocin-nicotinamide-induced diabetic Wistar rats were divided into two groups based on the type of administered SM (SM group and PSM group). The animals were fed with 1 ml/day of either soy or PSM for 21 days. The serum lipoprotein levels were analyzed at baseline and the end of the intervention period. RESULTS: HDL-C increased significantly in PSM group. Furthermore, this group showed more percent of change in increased HDL-C in compression with SM group (P < 0.050). Regarding LDL-C level, rats fed with SM was not significantly different from the PSM group (P < 0.050); though, this biomarker was reduced in both group. CONCLUSION: Probiotic SM could modulate blood lipoprotein levels. Thus, it may be considered in managing diabetes complications and atherosclerotic risks.

A Systematic Review on Exposure to Toxic and Essential Elements through Black Tea Consumption in Iran: Could It be a Major Risk for Human Health?

BACKGROUND: Tea is the most popular nonalcoholic beverage worldwide. In recent years, some Iranian studies have shown the occurrence of toxic elements in fresh or dried tea leaves as well as in brewed tea. The present study aimed to ascertain the health risks associated with exposure to toxic and essential element through black tea consumption in Iran by systematically reviewing the accredited articles in the field. METHODS: In order to obtain the relevant articles and academic databases, the search engines covering the specific disciplines were searched for the keywords, including tea, elements, heavy metals and determination. Having provided the complete list of sound articles, being conducted in Iran was considered as the inclusion criteria. Exclusion criteria were established as failure to provide information on the validity parameters and accuracy in the analytical methods. Choosing well conducted, reliable studies, analytical results for the concentration of each element in black tea were utilized in the determination of the hazard quotient (HQ) for the given element and the hazard index (HI) was then determined for all of the elements in each study. RESULTS: Among the total studies, two were considered to be reliable. Aluminum was found to be the most abundant element in black tea marketed in Iran. Although the HQ for manganese was the highest among the studied elements, HQ and HI values for both toxic elements and essential elements were calculated as less than 1. CONCLUSIONS: The hazard of excessive element intake through black tea consumption should be considered as negligible in Iran. However, related risk for manganese appeared to be more than toxic metals.