The effects of policosanol supplementation on blood glucose: A systematic review and dose-response meta-analysis of randomized controlled trials.

Previous studies have assessed how supplementing with policosanol affects blood sugar levels. The outcomes, nevertheless, were not constant. Multiple electronic databases were searched including ISI Web of Science, Cochrane Library, PubMed, Google Scholar, and Scopus until February 9, 2023. To assess the effects of policosanol on glucose, we employed a random-effects or fixed-effects meta-analysis approach to examine the weighted mean differences (WMDs) and associated 95 % confidence intervals (CI) before and after policosanol and placebo administration. The final analysis comprised a total of 25 trials with 2680 participants. Compared to the control group, policosanol supplementation significantly reduced blood glucose levels (WMD: -2.24 mg/dl; 95 % CI: -4.05, -0.42, P = 0.01). Findings from subgroup analysis revealed a significant reduction of policosanol supplementation on glucose levels in period of less than 24 weeks, and in individuals below 50 years of age. Additionally, the reduction was statistically significant in dosage of 10 mg/day. Our dose-response analysis indicates no evidence of a non-linear relationship between policosanol dose and duration and changes in glucose levels (P-nonlinearity = 0.52, and P-nonlinearity = 0.52, respectively). Policosanol supplementation might improve blood glucose. Further trials with more complex designs are required to confirm the findings.

The effect of soy isoflavones supplementation on metabolic status in patients with non-alcoholic fatty liver disease: a randomized placebo controlled clinical trial.

BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) accounts as a crucial health concern with a huge burden on health and economic systems. The aim of this study is to evaluate the effect of soy isoflavones supplementation on metabolic status in patients with NAFLD. METHODS: In this randomized clinical trial, 50 patients with NAFLD were randomly allocated to either soy isoflavone or placebo groups for 12 weeks. The soy isoflavone group took 100 mg/d soy isoflavone and the placebo group took the similar tablets containing starch. Anthropometric indices, blood lipids, glycemic parameters and blood pressure were measured at the beginning and at the end of the study. RESULTS: At the end of week 12 the level of serum triglyceride (TG), low density lipoprotein (LDL) and total cholesterol (TC) was significantly decreased only in soy isoflavone group compared to baseline (P < 0.05). Although waist circumference (WC) decreased significantly in both groups after 12 weeks of intervention (P < 0.05), hip circumference (HC) decreased significantly only in soy isoflavone group (P = 0.001). No significant changes observed regarding high density lipoprotein (HDL) and blood pressure in both groups. At the end of the study, serum glucose level was significantly decreased in the placebo group compared to baseline (P = 0.047). No significant changes demonstrated in the soy isoflavone group in regard to glycemic parameters (P > 0.05). CONCLUSIONS: This study revealed that soy isoflavones could significantly reduce TG, LDL TC, WC and HC in NAFLD patients. TRIAL REGISTRATION: The Ethics committee of Ahvaz Jundishapur University of Medical Sciences approved the protocol of the present clinical research (IR.AJUMS.REC.1401.155). The study was in accordance with the Declaration of Helsinki. This study's registered number and date are IRCT20220801055597N1 and 20.09.2022, respectively at https://fa.irct.ir .

Association between Baltic sea diet and healthy Nordic diet index with risk of non-alcoholic fatty liver disease: a case-control study.

Recent evidence shows the beneficial effects of Baltic Sea diet score (BSDS) and healthy Nordic diet index (HNDI) on chronic diseases, however, there is no evidence to investigate them on the risk of non-alcoholic fatty liver disease (NAFLD). The purpose of this study was to investigate the associations between BSDS and HNDI with the risk of NAFLD. In this case-control study, 552 people in good health and 340 people with NAFLD over the age of 18 took part. The evaluation of BSDS and HNDI employed a validated 168-item semi-quantitative food frequency questionnaire (FFQ). Binary logistic regression was used to determine how OBS and NAFLD are related. The mean BSDS and HNDI were 16.00 ± 2.49 and 11.99 ± 2.61, respectively. The final model's confounder adjustment revealed that greater HNDI adherence scores gave protection against the occurrence of NAFLD (odds ratio [OR]: 0.42; 95% confidence interval [CI] 0.18-0.98; P for trend = 0.043). In addition, those with the highest BSDS scores had significantly lower risks of developing NAFLD compared to subjects with the lowest scores (OR = 0.48, 95% CI 0.32-0.89; p for trend = 0.003). Our findings showed that following a healthy Nordic diet can significantly prevent the risk of developing NAFLD, and suggest that the highly nutritious components of the Nordic diet are beneficial for the prevention of NAFLD.

Insulin Resistance/Sensitivity Measures as Screening Indicators of Metabolic-Associated Fatty Liver Disease and Liver Fibrosis.

BACKGROUND: Measures of insulin resistance (IR)/sensitivity (IS) are emerging tools to identify metabolic-associated fatty liver disease (MAFLD). However, the comprehensive assessment of the performance of various indicators is limited. Moreover, the utility of measures of IR/IS in detecting liver fibrosis remains unclear. AIMS: To evaluate the predictive ability of seventeen IR/IS and two beta cell function indices to identify MAFLD and liver fibrosis. METHODS: A cross-sectional study was conducted on individuals aged 25-75 years. Transient elastography was used to estimate liver stiffness and controlled attenuation parameter. The following measures were computed: homeostatic model assessment (HOMA/HOMA2) for IR, IS, and beta cell function; QUICKI; Bennett index; glucose/insulin; FIRI; McAuley index; Reynaud index; SPISE index; TyG; TyG-BMI; TyG-WC; TyG-WHtR; TG/HDL; and METS-IR. Subgroup analyses were performed according to age, gender, diabetes status, and body weight. RESULTS: A total of 644 individuals were included in our analysis. MAFLD and significant liver fibrosis were detected in 320 (49.7%) and 80 (12.4%) of the participants, respectively. All measures of IR/IS identified MAFLD and liver fibrosis. However, TyG-WC, TyG-BMI, and TyG-WHtR were the top three indicators that identified MAFLD. Measures that include insulin level in their mathematical calculation, namely, Raynaud index, HOMA-IR, HOMA 2-IR, FIRI, and QUICKI had the best performance in identifying liver fibrosis in the entire population, as well as among the study subgroups. CONCLUSIONS: TyG-WC, TyG-BMI, and TyG-WHtR were the best predictors of MAFLD. Insulin-based measures had better performances in the detection of advanced fibrosis. This was independent of age, gender, obesity, or diabetes status.

The effect of soy isoflavones on non-alcoholic fatty liver disease and the level of fibroblast growth factor-21 and fetuin A.

A two-arm randomized open labeled controlled clinical trial was conducted on 50 patients with non-alcoholic fatty liver disease (NAFLD). Subjects were randomized to either receive two tablets of soy isoflavone (100 mg/day) or placebo. At week 12, the serum levels of alanine amino transferase (ALT), aspartate amino transferase (AST) and controlled attenuation parameter (CAP) score were significantly decreased only in the soy isoflavone group (P < 0.05). A significant decline in the gamma glutamyl transferase (GGT) level was observed only in the placebo group (P = 0.017). A significant increase in the serum level of fetuin A was shown in both groups at the end of the trial with a significantly greater increment in the soy isoflavone group compared to the placebo group (P < 0.05). The changes in the serum level of FGF-21 were not significant in any of the two groups. Steatosis grade significantly improved only in the soy isoflavone group (P = 0.045). There was no significant change in the fibrosis grade in the groups. Soy isoflavone intake led to a decrease in ALT, AST, CAP score, steatosis grade and an increase in the level of fetuin A. However, no significant changes were observed in the fibrosis grade and serum levels of GGT and FGF-21.

Association between dietary calcium to Phosphorus Ratio and the odds of ulcerative colitis: A case-control study.

Background & aims: Ulcerative colitis (UC) is a recurrent, inflammatory, autoimmune intestinal disease. The dietary calcium to phosphorus (Ca:P) ratio is suggested to affect the inividuals' normal metabolic and inflammatory pathways. The present study aimed to investigate the association between dietary Ca:P ratio and the odds of developing UC in a case-control format. Methods: The study included sixty-two currently diagnosed UC patients and one hundred twenty-four matched controls, designed as a case-control study. The dietary intakes of the participants were assessed by a food frequency questionnaire (FFQ), and the dietary Ca:P ratio was calculated. The association between tertiles of Ca:P ratio and UC was examined using the logistic regression. P-values <0.05 were considered as significant. Results: The study sample consisted of participants with an average age of 36.63 ± 12.42 years and a mean body mass index (BMI) of 25.39 ± 3.82 kg/m2. The overall energy-adjusted ratio of Ca:P was 0.74 ± 0.11. In the multivariate model, after adjustment for potential confounders, participants in the third tertile of dietary Ca:P ratio had a lower odds of developing UC compared to the lowest tertlie (OR: 0.34, 95% CI: 0.13-0.87; p = 0.026). Conclusion: Our results indicate that a higher ratio of dietary Ca:P ratio might be protective against developing UC. However, further studies are warranted to examine this association in various populations.

Validity and reproducibility of the PERSIAN Cohort food frequency questionnaire: assessment of major dietary patterns.

BACKGROUND: Dietary patterns, encompassing an overall view of individuals' dietary intake, are suggested as a suitable means of assessing nutrition's role in chronic disease development. The aim of this study was to evaluate the validity and reproducibility of a food frequency questionnaire (FFQ) designed for use in the Prospective Epidemiological Research Studies in IrAN (PERSIAN), by comparing major dietary patterns assessed by the FFQ with a reference method. METHODS: Study participants included men and women who enrolled in the PERSIAN Cohort Study at seven of the eighteen centers. These centers were chosen to include dietary variations observed among the different Iranian ethnic populations. Two FFQ were completed for each participant over a one-year study period (FFQ1 upon enrollment and FFQ2 at the end of the study), with 24 interviewer-administered 24-hour dietary recalls (24 h) being completed monthly in between. Spearman correlation coefficients (SCC) were used comparing FFQs 1 and 2 to the 24 h to assess validity, while FFQ1 was compared to FFQ2 to assess reproducibility of the questionnaire. RESULTS: Three major dietary patterns-Healthy, Low Protein/High Carb and Unhealthy-were identified, accounting for 70% of variance in the study population. Corrected SCC ranged from 0.31 to 0.61 in the validity and from 0.34 to 0.57 in reproducibility analyses, with the first two patterns, which accounted for over 50% of population variance, correlated at above 0.5 in both parameters, showing acceptable findings. CONCLUSIONS: The PERSIAN Cohort FFQ is suitable for identification of major dietary patterns in the populations it is used for, in order to assess diet-disease relationships.

Effect of metformin on anti-mullerian hormone levels in women with polycystic ovarian syndrome: a systematic review and meta-regression analysis of randomized controlled trials with.

BACKGROUND: Several interventional studies have evaluated the potential anti-Mullerian hormone (AMH)-reduction effect of metformin. However, the results are still contradictory. In order to obtain a better viewpoint from them, this study aimed to comprehensively investigate the effects of metformin on AMH in the women with with polycystic ovarian syndrome (PCOS). METHODS: Scopus, PubMed/Medline, Web of Science, Cochrane, and Embase databases were searched using standard keywords to identify all controlled trials investigating the AMH levels following metformin administration. Pooled weighted mean difference and 95% confidence intervals were achieved by random-effects model analysis for the best estimation of outcomes. RESULTS: Sixteen studies with 484 participants' were included in this article. The pooled findings showed that AMH levels in the single arm clinical trials were significantly reduced (pooled WMD of -3.06 ng/ml; 95% confidence interval [CI] -4.03 to -2.10; P < 0.001) after use of metformin. Furthermore, compared to the control group, in randomized clinical trials, a reduced significant effect on AMH levels was observed following use of metformin (pooled WMD of -3.47 ng/ml; 95% CI -7.14 to -0.19; P = 0.047). Furthermore, higher reduction in the AMH levels with a metformin dosage ≤ 1500 mg/day and duration of treatment ≤ 12 weeks when compared to higher dosages and duration of intervention, observed in this meta-analysis. CONCLUSIONS: In conclusion, results this meta-analysis of clinical trials confirms the beneficial effect of the treatment with metformin in the reduction of the AMH levels in women.

Dietary acid load and cirrhosis-related mortality: a prospective cohort study.

As a global health concern, cirrhosis contributes significantly to morbidity and mortality. This prospective cohort study aimed to investigate the association between dietary acid load (DAL) and cirrhosis-related mortality. Present study was conducted on 121 patients with newly diagnosed cirrhosis who were followed up for 48 months. Anthropometric measures, nutritional status and dietary intakes were assessed and DAL was estimated based on potential renal acid load (PRAL) and net endogenous acid production (NEAP) scores. Crude and multivariable-adjusted hazard ratios (HR) with 95% confidence intervals (CI) were estimated using Cox proportional hazard analyses. Participants in the high PRAL and NEAP scores had significantly higher intakes of grains and lower intakes of fruits and vegetables. Also, the intake of dairy products and legumes, nuts and seeds decreased significantly with increasing NEAP score. After adjustment of all the confounders, the risk of mortality in the second and third tertiles of PRAL was 5.9 times and 10.97 higher than those in the first tertile, respectively (P trend: 0.006). Similarly, comparing the risk of mortality in the second and third tertiles with the first tertile of NEAP showed a 4.46-fold and 12.3-fold increased risk, respectively (P trend: 0.010). Our findings suggested that DAL was significantly associated with cirrhosis-related mortality and highlight the need for further research to understand the underlying mechanisms and establish optimal DAL levels in cirrhotic patients.

The association between dietary patterns and disease severity in patients with ulcerative colitis.

Ulcerative colitis (UC) is a chronic inflammatory disease involving the colon and rectum. One of the most modifiable environmental factors affecting UC severity is the patient's dietary pattern. Although the role of dietary patterns on UC aetiology has been investigated previously, its relationship with disease severity has not yet been elucidated. This study examined the association between UC patients' dietary patterns and disease severity. This cross-sectional study was conducted in 340 UC patients. Using an FFQ, food patterns were assessed. Twenty-five food categories were categorised based on the similarity of the nutrient composition of the food using the factor analysis method. A simple clinical colitis activity index was used to determine disease severity. Three dietary patterns were identified based on the factor analysis: healthy, unhealthy and Western dietary pattern. After adjusting for potential confounding factors, patients who were in the highest tertile of healthy dietary pattern compared with the lowest tertile were 92 % less likely to have severe UC (OR: 0·08; 95 % CI: 0·03, 0·22). Also, those in the highest tertile of the Western dietary pattern were 3·86 times more likely to have severe UC than those in the lowest tertile (OR: 3·86; 95 % CI: 1·86, 8·00). Even after controlling for confounding variables, unhealthy dietary pattern did not increase the risk of severe UC. Our data indicate the beneficial role of healthy dietary pattern in amelioration of disease severity in UC patients. To confirm this association, more studies are needed, especially prospective cohort studies.

Consumption of dairy products and odds of ulcerative colitis: An Iranian case-control study.

The association between dairy product consumption and the risk of ulcerative colitis (UC) is not well elucidated. This case-control study examined the association between Iranian adults' dairy consumption and UC risk. We used a valid food frequency questionnaire to analyze dietary intakes in 340 patients with pathologically confirmed cases of UC and 782 controls as part of a case-control research. Pasteurized milk, cheese, and yogurt dietary intakes were calculated along with dairy products. Other variables were acquired using questionnaires. Study participants' mean (± SD) age and body mass index were 41.5 ± 14.1 years and 27.4 ± 4.77 kg/m2, respectively. After adjusting for potential variables, individuals who consumed more total dairy products were less likely to get UC than those who consumed less (odds ratio [OR]: 0.44; 95% confidence interval (CI): 0.24, 0.79). We found a significant reverse association between milk intake (OR: 0.13; 95% CI: 0.07-0.24) and yogurt intake (OR: 0.52; 95% CI: 0.29-0.91) and UC, after controlling for potential confounders. Also, no significant association was found between cheese and UC risk (OR: 1.38; 95% CI: 0.84-2.28). Higher consumption of total dairy products may reduce UC risk. To be specific, milk and yogurt are inversely associated with this disorder. However, no link was found between cheese intake and UC. Longitudinal observational studies, especially cohorts, are needed to further assess these associations.

The effects of astaxanthin supplementation on liver enzymes levels.

According to previous studies, astaxanthin exerts various biological effects due to its anti-inflammatory and antioxidant capabilities; however, its effects on liver enzymes have not yet been well elucidated. Therefore, we conducted a meta-analysis to assess astaxanthin's effects on liver enzymes. A systematic literature search was conducted using scientific databases including PubMed, Scopus, Web of Science, the Cochrane databases, and Google Scholar up to February 2023 to find relevant randomized controlled trials (RCTs) examining the effects of astaxanthin supplementation on alanine transaminase (ALT), aspartate transaminase (AST), gamma-glutamyl transferase (GGT), and alkaline phosphatase (ALP). A random-effects model was used for the estimation of the pooled weighted mean difference (WMD). Overall, we included five trials involving 196 subjects. The duration of the intervention was between 4 and 48 weeks, and the dose was between 6 and 12 mg/day. ALT levels increased in the intervention group compared to the control group following astaxanthin supplementation (WMD: 1.92 U/L, 95% CI: 0.16 to 3.68, P=0.03), whereas supplementation with astaxanthin had a non-significant effect on AST (WMD: 0.72 U/L, 95% CI: -0.85 to 2.29, P=0.36), GGT (WMD: 0.48 U/L, 95% CI: -2.71 to 3.67, P=0.76), and ALP levels (WMD: 2.85 U/L, 95% CI: -7.94 to 13.63, P=0.60) compared to the placebo group. Our data showed that astaxanthin supplementation increases ALT concentrations in adults without affecting the levels of other liver enzymes. Further long-term and well-designed RCTs are necessary to assess and confirm these findings.

What is the influence of policosanol supplementation on liver enzymes? A systematic review and dose-response meta-analysis of randomized controlled trials.

OBJECTIVE: Policosanol is a mixture of long chain alcohols refined from sugar cane. Significant reductions in liver enzymes have been observed in some studies. However, the impact of policosanol on liver enzymes remained controversial. The current meta-analysis aims to evaluate the effect of policosanol supplementation on the levels of alanine transaminase (ALT) and aspartate transaminase (AST). METHODS: The literature was systematically searched for studies published up to November 2023 in PubMed/Medline, Google Scholar, EMBASE, and Scopus. Randomized controlled trial (RCT) studies were included to evaluate the intervention effect of policosanol compared to placebo on ALT and AST. DerSimonian and Laird models were used to calculate effect sizes. RESULTS: Twenty-three trials including 2535 participants were included in the study. The combination of effect sizes, regarding the random-effects model, demonstrated significant changes in ALT serum levels after intervention (WMD: -1.48 U/L; 95% CI: -2.33 to -0.64; P = 0.001), and AST (WMD: -1.10 U/L; 95% CI: -1.70 to -0.51; P < 0.001). Subgroup analysis of AST and ALT showed that this reduction effect was most often observed at the dose of 20 mg/d. The dose-response analysis represented a non-significant non-linear connection between the dosage and duration of policosanol intervention in ALT and AST serum reduction. CONCLUSION: Policosanol supplementation exerts a beneficial effect on liver enzymes as well as ALT and AST concentrations in adults. However, further long-term and well-designed RCTs with better quality are needed to further assess and confirm these results.

The effects of Garcinia cambogia (hydroxycitric acid) on lipid profile: A systematic review and meta-analysis of randomized controlled trials.

Garcinia cambogia (GC) has antioxidant, anticancer, antihistamine, and antimicrobial properties. To determine the effect of GC on lipid profiles, a systematic review and meta-analysis was carried out. Up to February 9, 2023, six electronic databases (Web of Science, Cochrane Library, Embase, PubMed, Scopus, and Google Scholar) were searched at any time without limitations. Trials examining the impact of GC on serum levels of total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol (HDL-C) in adults were included. The total effect was shown as a weighted mean difference (WMD) and 95% confidence interval (CI) in a random-effects meta-analysis approach. This systematic review and meta-analysis included 14 trials involving 623 subjects. Plasma levels of TC (WMD: -6.76 mg/dL; CI: -12.39 to -0.59, p-value = 0.032), and TG (WMD: -24.21 mg/dL; CI: -37.84 to -10.58, p < 0.001) were significantly reduced after GC use, and plasma HDL-C (WMD: 2.95 mg/dL; CI: 2.01 to 3.89, p < 0.001) levels increased. low-density lipoprotein cholesterol levels (WMD: -1.15 mg/dL; CI: -16.08 to 13.78, p-value = 0.880) were not significantly affected. The effects of lowering TC and TG were more pronounced for periods longer than 8 weeks. Consuming GC has a positive impact on TC, TG, and HDL-C concentrations. The limitations of this study include the short duration of analyzed interventions and significant heterogeneity. Nevertheless, it is imperative to conduct well-structured, and high-quality long-term trials to comprehensively evaluate the clinical effectiveness of GC on lipid profile, and validate these findings.

The effects of purslane consumption on blood pressure, body weight, body mass index, and waist circumference: a systematic review and meta-analysis of randomised controlled.

The effects of purslane consumption on anthropometric measurements and blood pressure have been studied in numerous experiments. However, the research findings conflict with one another. In order to assess the impact of purslane on weight, body mass index (BMI), waist circumference (WC), systolic blood pressure (SBP), and diastolic blood pressure (DBP), this meta-analysis was carried out. Up until February 2023, PubMed, Web of Science, Scopus, Google Scholar, and the reference lists of the identified pertinent randomised controlled trials (RCTs) were all searched. The random-effects model was used to calculate the effect size and then to describe it as a weighted mean difference (WMD) and 95 % confidence interval (CI) (CRD42023427955). The systematic review was able to incorporate seven RCTs. Meta-analysis showed that purslane significantly decreased body weight (WMD): -0⋅73 kg, 95 % confidence interval (CI): -1⋅37, -0⋅09, P=0⋅025), BMI (WMD: -0⋅35 kg/m2, 95 % CI: -0⋅64, -0⋅07, P=0⋅016), and SBP (WMD: -3⋅64 mmHg, 95 % CI: -6⋅42, -0⋅87, P = 0⋅01), and for WC, there was no discernible effect (WMD: -0⋅86 cm; 95 % CI, -1⋅80 to 0⋅07; P = 0⋅06) and DBP (WMD: -0⋅36 mmHg; 95 % CI, -1⋅75 to 1⋅03; P = 0⋅61). Purslane consumption, especially in participants with a BMI of <30, might play a role in decreasing SBP, body weight, BMI, and WC. Purslane consumption significantly reduced body weight, BMI, and SBP; however, WC and DBP did not experience a reduction. More investigation is needed to verify the impact of purslane consumption on anthropometric parameters and blood pressure.

Gluten restriction in irritable bowel syndrome, yes or no?: a GRADE-assessed systematic review and meta-analysis.

Background: More than half of patients with irritable bowel syndrome (IBS) report aggravating their symptoms with certain foods. Currently, Low fermentable oligo-, di-, and monosaccharides and polyols diet (LFD) is the most accepted dietary intervention for IBS. Recent randomized controlled trials (RCTs) have been suggested that gluten restriction may reduce the symptoms of patients with IBS. However, the results from these studies are conflicting. This study filled this knowledge gap by evaluating the impact of the gluten-free diet (GFD) on IBS symptoms. Methods: A systematic search was carried out in Pubmed/Medline, Cochrane CENTRAL, Scopus, and Web of Science up to April 2023. A random-effect model was applied to estimate the standardized mean difference (SMD) and 95% confidence interval (95% CI) for each outcome. Results: A total of nine controlled trials were included in the meta-analysis. In contrast to gluten-containing diet, GFD was unable to reduce overall symptoms (SMD - 0.31; 95% CI -0.92, 0.31), bloating (SMD -0.37; 95% CI -1.03, 0.30), and quality of life (SMD -0.12, 95% CI -0.64, 0.39); but had a slight trend to reduce abdominal pain (SMD -0.68; 95% CI -1.36, -0.00). Also, LFD significantly reduced the IBS-Severity score system (SMD 0.66, 95% CI 0.31, 1.01) and improved quality of life (SMD -0.36, 95% CI -0.70, -0.01), compared to GFD. Conclusion: A GFD is not robust enough to be routinely recommended for IBS patients, and its efficacy is significantly lower than that of an LFD. Only a certain subgroup of IBS patients may benefit from GFD; further studies are needed to target this subgroup.

Vitamin D status as a predictor for liver transplant outcomes.

It is well known that vitamin D plays a pivotal role in immune system modulation; however, its role in liver transplantation (LT) has not yet been well elucidated. This study aimed to assess the association between vitamin D status and LT outcomes. This retrospective cohort study was conducted on 335 registered cirrhotic patients with end-stage liver disease (ESLD) who underwent LT during 2019-2021 and had measurement of serum vitamin D before LT. The association of vitamin D levels before LT with the odds of acute cellular rejection (ACR) and risk mortality was assessed by applying logistic and cox regression, respectively. The mean MELD-Na and serum level of vitamin D were 20.39 ± 9.36 and 21.52 ± 15.28 ng/ml, respectively. In the final adjusted model, there was a significant association between vitamin D deficiency in the pre-transplant period and odds of ACR (odds ratio [OR] 2.69; 95% confidence interval [CI] 1.50-4.68). Although in the crude model, vitamin D deficiency in the pre-transplant period was significantly associated with an increased risk of mortality after two years of follow-up (Hazard ratio (HR) = 2.64, 95% CI 1.42-4.33), after adjustment for potential confounders, the association of vitamin D status and mortality became non-significant (HR = 1.46, 95% CI 0.71-3.00). The present study provides evidence that pre-transplant serum vitamin D levels may be a predictor for ACR in patients with cirrhosis undergoing LT.

Relationship Between Dairy Intake and Hospitalization Risk and Disease Severity in Patients With COVID-19.

The aim of this study was to investigate whether dairy intake was associated with the severity of coronavirus disease 2019 (COVID-19) disease and the probability of hospitalization of patients. This cross-sectional study was conducted on 141 patients with COVID-19 with an average age of 46.23 ± 15.88 years. The number of men (52.5%) participating in this study was higher than that of women. The association between dairy intake and COVID-19 was evaluated by multivariable logistic regression analysis. The risk of hospitalization in the highest tertile of dairy intake was 31% lower than in the lowest tertile (odds ratio [OR], 0.69; 95% confidence interval [CI], 0.37-1.25, p trend = 0.023). Higher milk and yogurt intake was associated with a reduced risk of hospitalization due to COVID-19. Patients in the third tertiles were about 65% (p for trend = 0.014) and 12% (p for trend = 0.050) less likely to be hospitalized than those in the first tertile, respectively. Dairy consumption, especially low-fat ones, was associated with a lower risk of hospitalization due to COVID-19 and lower severity of COVID-19.

Higher intakes of fiber, total vegetables, and fruits may attenuate the risk of all-cause and cause-specific mortality: findings from a large prospective cohort study.

BACKGROUND: Although studies have reported an inverse association between fruits, vegetables, and fiber consumption and all-cause and cause-specific mortality, the issue remains incompletely defined in the Middle Eastern population. AIMS: The current study aimed to investigate the association between dietary fiber, fruit, and vegetable intake and all-cause and cause-specific mortality. METHODS: A total of 48632 participants (mean age = 52years), 57.5% (n = 27974) women and 42.5% (n = 20658) men, were recruited from an ongoing large-scale prospective cohort study (the Golestan Cohort Study (GCS)), in the north of Iran. Using a validated semi-quantitative 116-item food questionnaire, dietary intakes were collected. Hazard ratios (HRs) and 95% confidence intervals (95%CIs) of all-cause and cause-specific mortality were reported. RESULTS: After approximately 14 years of follow-up, 10,774 deaths were recorded. In the fully adjusted model, compared to those in the lowest quintile of intake, those in the second and third quintiles of dietary fiber intake had a 7%-10% reduction in risk of all-cause mortality, and a 15%-17% reduction in the risk of mortality from other causes. Increasing consumption of fruits was also associated with a decreased risk of mortality for all-cause mortality by 9%-11%, and all cancer by 15-20%. Further, those in the third and fourth quintiles of vegetables intake had 11%-12% lower risk for CVD mortality. DISCUSSION: The results from the GCS further support the current recommendations on following a healthy diet containing proper amounts of fiber, vegetables, and fruits, as health-protective dietary items. CONCLUSIONS: Higher intake of dietary fiber, fruits, and vegetables has the potential to reduce both overall and cause-specific mortality rates. However, additional cohort studies with larger sample size and long-term follow-up durations are required to establish these findings.