A systematic review and modeling of the effect of bacteriophages on E. coli O157:H7 reduction in vegetables.

Prevention and control of food pathogens are important for public health and E. coli O157:H7 infections are known as one of the most important food-borne bacterial diseases transmitted to humans. Vegetables can be a major source of E. coli O157:H7 bacteria. Bacteriophages have been considered in recent years as a natural method for controlling pathogens with minimal damage to the quality of vegetables. The performance of these natural antimicrobial agents is affected by various factors including time, temperature, phage and bacterial dose, method of phage application and origin of phages. The aim of the present study was to conduct a systematic review of the works that have examined the effect of different factors to reduce E. coli O157:H7 bacteria by its specific phages and model their effect. In our study, 10 articles were chosen after applying the inclusion and exclusion criteria mentioned in the methodology. The multivariate regression results showed that time, temperature, and method of phage application revealed a positive influence on the phage function, and with each unit of increase, the E. coli O157:H7 reduction increases by 0.4 %, 3 % and 0.94 % respectively, and 6 % for phage dose, but not statistically significant (P = 0.44). In addition, commercial-type phages were more effective than wild-type phages and this result was statistically significant (Beta = 0.99; P = 0.001). The results of this study indicate that the various factors, such as temperature, time, method of phage application and type of vegetables can play an important role to reduce E. coli O157:H7 in vegetables.

Fortified synbiotic dessert for improving malnutrition in hemodialysis patients: A randomized, double-blind, controlled trial.

As dysbiosis of gut microbiota is recognized as a major risk factor for malnutrition in hemodialysis (HD) patients, we aimed to assess the effects of fortified synbiotic dessert on malnutrition, oxidative stress, inflammation, and quality of life in patients undergoing hemodialysis. A total of 50 hemodialysis patients were randomized into two groups of intervention and control to consume either 50 g of synbiotic dessert fortified with vitamin D (1000 IU) and calcium (500 mg) (FSD) or 50 g of control dessert (CD) for 8 weeks, respectively. Changes in nutritional status [Subjective Global Assessment (SGA)], anthropometric measures, malondialdehyde (MDA), total antioxidant capacity (TAC), high-sensitivity C-reactive protein (hs-CRP), ferritin, biochemistry [serum albumin, vitamin D, creatinine, blood urea nitrogen (BUN), complete blood count (CBC), and electrolytes], and quality of life were assessed before and at the end of the trial. The SGA scores and serum ferritin levels decreased significantly in the FSD group compared to the control group (p = .01 and p = .03, respectively). Regarding other markers, no statistically significant changes were found comparing the two groups. This novel fortified synbiotic dessert as a functional food may be effective in reducing the severity of malnutrition by improving SGA score in short term in hemodialysis patients. Thus, it is suggested to do further studies to elucidate the possible mechanisms related to the effects of this dessert on microbiota, skeletal muscle mass, and inflammation in HD in long term.

The effect of spirulina sauce on glycemic index, lipid profile, and oxidative stress in type 2 diabetic patients: A randomized double-blind clinical trial.

We aimed to evaluate the effect of spirulina sauce on glycemic indices, lipid profile, oxidative stress markers, and anthropometric measurement in type 2 diabetic patients. Forty patients were randomly assigned to receive 20 g/day spirulina sauce (containing 2 g of spirulina) or placebo for 2 months. Anthropometric and biochemical indices were measured at the beginning and end of the intervention. Fasting blood glucose (mean difference (MD): -15.3 mg/dL, 95% confidence (CI): -44.2 to 13.60, p = .26), HbA1c (MD: 0.13%, 95% CI: -0.83 to 0.57, p = .75), insulin (MD: -1.46 µIU/mL, 95% CI: -4.0 to 1.09, p = .28), and HOMA-IR (MD: -0.35, 95% CI: -2.0 to 1.32, p = .68) did not change significantly between groups. QUICKI increased significantly (MD: 0.025, 95% CI: 0.006 to 0.045, p = .03). Among the lipid profile, triglyceride (TG) (MD: -68.6 mg/dL, 95% CI: -107.21 to -29.98, p < .001), total cholesterol (MD: -29.55 mg/dL, 95% CI: -55.28 to -3.81, p = .02), and LDL (MD: -17.7 mg/dL, 95% CI: -33.24 to -2.15, p = .01) were significantly decreased in the spirulina group compared to the control; whereas, the change in HDL was non-significant. No significant change was observed in body composition and anthropometric measurements, except waist circumference, which was reduced (MD: -2.65 cm, 95% CI: -3.91 to -1.38, p = .001). Hunger index significantly decreased and fullness increased marginally significantly. Although malondialdehyde was significantly reduced, no change was observed in total antioxidant capacity (TAC). Spirulina sauce was not effective for glycemic control in type 2 diabetes; however, could be useful for controlling appetite and ameliorating lipid profile.

Benefits of fermented synbiotic soymilk containing Lactobacillus acidophilus, Bifidobacterium lactis, and inulin towards lead toxicity alleviation.

This study aims to evaluate the effect of fermented synbiotic soy milk containing Lactobacillus acidophilus, Bifidobacterium lactis, and inulin on a series of hematological and oxidative stress parameters, as well as serum lead levels in rats. In this study, 56 male Sprague-Dawley rats were randomly assigned to assess probiotics (L. acidophilus or B. lactis), probiotics with prebiotics (i.e., inulin), and the corresponding controls. Several hematologic parameters (red blood cell (RBC)), hematocrit (HCT) and hemoglobin (Hgb)), serum lead levels, superoxide dismutase (SOD) activity, and malondialdehyde (MDA) presence was measured to evaluate changes on day 42. Although a significant difference was observed in serum lead levels, there were no significant changes in hematological and oxidative stress parameters between the study groups. In conclusion, this study demonstrates that administering synbiotic fermented soy milk containing the probiotic Lactobacillus acidophilus and the prebiotic inulin may significantly improve serum lead levels in rats.

Fabrication of ɛ-Polylysine-Loaded Electrospun Nanofiber Mats from Persian Gum-Poly (Ethylene Oxide) and Evaluation of Their Physicochemical and Antimicrobial Properties.

In the present study, electrospun nanofiber mats were fabricated by mixing different ratios (96:4, 95:5, 94:6, 93:7, and 92:8) of Persian gum (PG) and poly (ethylene oxide) (PEO). The SEM micrographs revealed that the nanofibers obtained from 93% PG and 7% PEO were bead-free and uniform. Therefore, it was selected as the optimized ratio of PG:PEO for the development of antimicrobial nanofibers loaded with ɛ-Polylysine (ɛ-PL). All of the spinning solutions showed pseudoplastic behavior and the viscosity decreased by increasing the shear rate. Additionally, the apparent viscosity, G', and G″ of the spinning solutions increased as a function of PEO concentration, and the incorporation of ɛ-PL did not affect these parameters. The electrical conductivity of the solutions decreased when increasing the PEO ratio and with the incorporation of ɛ-PL. The X-ray diffraction (XRD) and Fourier-transform infrared (FTIR) spectra showed the compatibility of polymers. The antimicrobial activity of nanofibers against Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus) was investigated, and the samples loaded with ɛ-PL demonstrated stronger antimicrobial activity against S. aureus.

A systematic review and modeling of the effect of bacteriophages on Salmonella spp. Reduction in chicken meat.

Prevention and control of foodborne pathogens are of vital public health importance, and poultry meat is recognized as a major source of Salmonella infection in humans. Therefore, it is necessary to reduce the presence of salmonella in poultry meat. This article provided a systematic review and modeling to assess the effect of various factors on bacteriophages' function on Salmonella spp. Reduction in poultry meat. Twenty-two studies were included based on the inclusion and exclusion criteria mentioned in the methodology. The results showed that each unit increase in bacterial dose, phage dose, and temperature increases the Salmonella reduction by about 7%, 20%, and 1%, respectively. In addition, wild-type phages were more efficient than commercial-type phages, and this result was statistically significant (ß = 1.124; p-value <0.001). This multivariate analysis is a helpful tool to predict the role of various factors in the role of phage in reducing Salmonella in poultry meat.

The effects of soymilk plus probiotics supplementation on cardiovascular risk factors in patients with type 2 diabetes mellitus: a randomized clinical trial.

OBJECTIVE: Type 2 diabetes mellitus (T2DM) is associated with an increased risk of cardiovascular diseases. This study aimed to assess the effects of soymilk plus probiotics co-administration on cardiovascular risk factors in T2DM patients. METHODS: One hundred patients with T2DM (aged 40-75 years old) were randomly assigned into 4 groups (soymilk + probiotics supplement, soymilk + placebo, conventional milk + placebo, and probiotics supplement) for 6 weeks. Standard protocols were followed for the collection of fasting blood samples, dietary intakes, and anthropometric measurements. RESULTS: It was shown that soymilk + probiotics consumption significantly decreased diastolic blood pressure (DBP) (p = 0.001), triglycerides (TG) (P < 0.001), total cholesterol (TC) (p < 0.01), and insulin (P < 0.003) levels and significantly increased high-density lipoprotein cholesterol (HDL-C) (P = 0.002) levels. Soymilk + placebo administration significantly decreased DBP (p = 0.01), insulin (p = 0.006), and TG (p = 0.001) levels and significantly increased HDL-C (p = 0.03) levels. A significant decrease in insulin (p = 0.003) and systolic blood pressure (SBP) (p = 0.01) levels and an increase in HDL-C (p = 0.04) levels were observed after supplementation with probiotics. Findings from between-group comparisons showed a significant decrease in SBP levels in the probiotics supplement group compared to conventional milk group (p < 0.05). CONCLUSION: Soymilk and probiotics consumption might improve some cardiovascular risk factors in patients with T2DM. However, possible synergic effects while consumption of soymilk plus probiotics supplement didn't show in this study which warranted further research.

The effect of acorn muffin consumption on glycemic indices and lipid profile in type 2 diabetic patients: A randomized double-blind placebo-controlled clinical trial.

Acorn is a nutritious fruit with the reported potential of ameliorating diseases, including diabetes. This research aimed to assess the effects of acorn muffin consumption on glycemic, lipid indices, and appetite in patients with type 2 diabetes. Sixty-six subjects were dichotomized to receive either one muffin containing 10 grams of acorn flour or a placebo muffin containing white wheat flour (no bran), per day, for 8 weeks. Acorn muffin consumption improved glycated hemoglobin (p = .06, mean difference [MD] = -0.65), triglyceride (p = .06, MD = -36.38), and high-density lipoprotein (p = .05, MD = 1.30), albeit only marginally significantly. Among appetite parameters, hunger, desire to eat, and prospective to eat were significantly lower, and satiety and fullness were significantly higher, in the acorn muffin group. In conclusion, acorn muffins could be utilized as an adjuvant therapy to control appetite and ameliorate glycated hemoglobin in patients with type 2 diabetes. However, further investigations are required for a more comprehensive conclusion.

Application of the lytic bacteriophage Rostam to control Salmonella enteritidis in eggs.

Foodborne Salmonella enteritidis infections place human health at risk, driven by regular outbreaks and individual cases by different contaminated food materials. This study was conducted to characterize and employ a single bacteriophage as a potential biocontrol agent. Phage Rostam was isolated, characterized and then applied as biocontrol agent against S. enteritidis in liquid whole eggs and eggshell. Rostam is a novel myovirus belonging to the Rosemountvirus genus and active against Escherichia coli and Salmonella spp. Rostam is stable in a pH range from 4 to 10, a salt concentration of 1-9 %, whereas UV radiation gradually reduces phage stability, and its 53 kb genome sequence indicates this phage does not contain known toxins or lysogeny-associated genes. Its latent period is short with a burst size of 151 PFU/cell, under standard growth conditions. Killing curves indicate that at higher multiplicities of infection (MOI), the reduction in S. enteritidis count is more pronounced. Phage Rostam (MOI 10,000) reduces S. enteritidis growth to below the detection limit at 4 °C in both liquid whole eggs and on the eggshell within 24 h. Due to its high lytic activity and stability in relevant conditions, Rostam has the potential to be an efficient biopreservative for egg and egg products.

A combination of modified atmosphere packaging and two chemical disinfectants: Effects on microbial, sensory, and physicochemical properties of raw ready-to-eat leek.

In the present study, the effect of modified atmosphere packaging (MAP) on microbial (total aerobic count, yeasts and molds, Enterobacteriaceae, psychrotrophic bacteria, and lactic acid bacteria), physicochemical (pH, moisture content, and color), and sensory properties of raw ready-to-eat leek was investigated after disinfection using Percidin-Nanosil disinfectants. There were six different treatments, of which four samples were packaged as MAP (T1 to T4) and two samples were packaged as non-MAP (T5 and T6). The highest and the lowest reduction in the number of microorganisms after disinfection was observed in psychrotrophic bacteria and total aerobic count, respectively. The count of microbial variables in T2 sample (87% N2, 3% CO2, and 10% O2) was lower than in other treatments. No significant difference was observed in the physcochemical properties (moisture and pH) of treated samples except for the color of T6 sample (cling film) compared to other treatments (p < .05). It is noteworthy that the panelists did not recognize differences among T1, T2, and T5 samples. However, T2 treatment was effective in maintaining microbial, physicochemical, and sensory properties of leek compared to the other treatments. Also, T6 sample showed the lowest quality in all parameters. Disinfection combined with MAP was able to maintain the physicochemical, microbial, and sensory properties of raw ready-to-eat leek during storage.

Assessment of Questionnaire of Physical Activity at Workplace Based on the Social Cognitive Theory (PAWPQ-SCT): A Psychometric Study in Iranian Gas Refinery Workers.

Background: This study aimed to develop and assess the psychometric features of the Physical Activity at Workplace Questionnaire (PAWPQ) based on the Social Cognitive Theory (SCT) to evaluate employees' physical activity (PA) behaviors at the workplace. Methods: This psychometric cross-sectional study was conducted on 455 employees working in one of the gas refineries in Iran. The participants were selected using the proportional stratified sampling method in 2019. The data collection tools were a demographic information questionnaire, the short form of the International Physical Activity Questionnaire (IPAQ), and a questionnaire developed based on the SCT, whose psychometric features were confirmed in terms of validity and reliability. Data were analyzed using SPSS22 and AMOS20 software. Results: The first version of PAWPQ-SCT had 74 items. After evaluating content and face validity, nine items were removed. The results of the content validity index (0.98), content validity ratio (0.86), and impact score (3.62) were acceptable for the whole instrument. In exploratory factor analysis, after removing seven items-58-item final version of the scale-six factors could explain 73.54% of the total variance. The results of structural equation modeling showed the acceptable fit of the model into the data (RMSEA = 0.052, CFI = 0.917, NFI = 0.878, TLI = 0.905, IFI = 0.917, CMIN/DF = 2.818). Cronbach's alpha coefficient and Intraclass Correlation were 0.90 and 0.86, respectively. Conclusion: This study confirmed that the psychometric features of the 58-item final version of PAWPQ-SCT constructs were acceptable in a sample of Iranian employees. This questionnaire can be used as a valid and reliable tool to evaluate Iranian employees' PA behaviors and develop effective educational interventions for workers and managers.

A comparison of the effects of cinnamon, ginger, and metformin consumption on metabolic health, anthropometric indices, and sexual hormone levels in women with poly cystic ovary syndrome: A randomized double-blinded placebo-controlled clinical trial.

Background/objectives: Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder in women that can alter blood glucose, lipid profile and sexual hormonal level. Therefore, the evaluation of potential therapeutic agents in this population is important. The aim of the study was to determine the effects of cinnamon, ginger, and metformin intake on improvement of sex hormones level, metabolic health (lipid profiles, insulin level and fasting blood glucose) and anthropometric indices (weight, body mass index (BMI), etc.) in women with PCOS. Methods: A total of 100 women with PCOS were randomly assigned to one of the following four groups: cinnamon (500 mg of cinnamon, 3 × day), ginger (500 mg of ginger, 3 × day), metformin (500 mg of metformin 3 × day) or placebo. However, 17 participants were excluded for various reasons and consequently, 83 participants were considered for analysis. Sexual hormones, anthropometrics, glycemic and lipid markers were evaluated before and after the 8-week intervention. Results: Weight and BMI decreased significantly in all intervention groups. The consumption of metformin and cinnamon significantly decreased insulin resistance (HOMA-IR) in comparison to the placebo and ginger groups (P < 0.05). Moreover, a significant decrease in FSH (follicle-stimulating hormone) and LH (Luteinizing hormone) levels were observed in the ginger compared to the placebo group. While metformin and cinnamon significantly lowered testosterone levels (P < 0.05), none of the groups experienced a significant change in DHEA (dehydroepiandrosterone). Conclusion: Our findings suggest that in women with PCOS, cinnamon supplementation causes similar reductions in insulin resistance and testosterone level to that of metformin. Ginger supplementation decreased FSH and LH, hormonal effects not seen following metformin consumption. Overall, cinnamon and ginger supplementations may potentially be used as alternative treatment in women with PCOS. Clinical trial registration: [https://www.irct.ir/trial/28548], identifier [IRCT20171227038105N1].

Identification of Tartrazine adulteration and evaluating exposure to synthetic dyes of sunset yellow and Quinoline yellow through consumption of food products among children.

Excessive consumption of synthetic food dyes by children may raise concerns about their health. These dyes may aggravate the hyperactivity symptoms and exacerbate asthma in sensitive children. The purpose of this study was to determine the presence of sunset yellow and quinoline yellow dyes, as well as tartrazine in dairy-free fruit ice cream, freeze pop, jelly, and candy. Additionally, we evaluated the amount of two food dyes consumed by children. To do so, a total of 150 food samples, including 20 dairy-free fruit ice creams, 25 freeze pops, 57 jelly products, and 48 types of candy were randomly selected from stores in Shiraz, Iran. Then, using the high-performance liquid chromatography (HPLC) method and an ultraviolet (UV) detector, we measured the amounts of sunset yellow and quinoline yellow dyes and identified the use of tartrazine. Also, the per capita consumption (grams per day) of the mentioned foods was calculated using a checklist in two groups of male and female primary schoolchildren aged 6-9 years and 10-13 years in Shiraz, Iran. According to the results, 11 (7.33%) samples contained only tartrazine and 107 (71.33%) samples contained quinoline yellow and sunset yellow synthetic dyes. In addition, of 107 samples that used quinoline yellow and sunset yellow, 102 (95.33%) contained unauthorized tartrazine. Only seven (6.54%) samples contained exceedingly high concentrations of authorized quinoline yellow and sunset yellow synthetic dyes. However, the exposure assessment showed that the intake of quinoline yellow and sunset yellow was at average levels and the 95th percentile in both age groups was less than the associated acceptable daily intake (ADI). For synthetic dyes, the target hazard quotient (THQ) and hazard index (HI) were less than one, indicating that ingestion of these two dyes via food products does not pose a risk to children's overall health.

Development of fortified probiotic dairy desserts with added date extract, whey protein, inulin, folic acid, vitamin D and calcium.

This study aimed to develop fortified dairy desserts containing Lactobacillus casei and evaluate the physicochemical, sensory, and microbiological characteristics of the product during 28 days of storage. Seven dairy desserts were formulated by date extract (8%), whey protein (1.56%), inulin (4%(, folic acid (0.00066%), vitamin D (0.002%) and gluconate calcium (0.66%). The addition of date extract and inulin increased total solids while whey protein incorporation into dairy desserts led to the improvement of protein and phosphorous content. Furthermore, all fortified dairy desserts showed higher antioxidant activity and total phenolic content. Fortification of dairy desserts had no negative effect on the sensory acceptability and syneresis was not observed. In addition, the pH reduction and increased acidity did not adversely affect the count of L. casei, which remained above 8 log CFU g-1 during storage. Consequently, the fortified dairy dessert developed in this research is an innovative food product with good acceptability and high nutritional quality.

Carbulin: A Comprehensive Mobile Application for Advanced Carbohydrate Counting and Diet- and Insulin-Regimen Planning for Type 1 Diabetic Patients.

Nowadays, the introduction of the so-called 'diabetes technology', either hardware/device or software, to different aspects of day-to-day living in patients with diabetes aims to improve blood glucose control and various lifestyle features. The coordination of vast context of diabetes education/training, particularly in the area of medical nutrition therapy, is considered as a great concern. On the other hand, Iranian food culture consists of a set of traditional dietary patterns and food consumption habit. The study was aimed to develop "the Comprehensive Mobile Application of Advanced Carbohydrate Counting and Diet- and Insulin-Regimen Planning" to help type 1 diabetic patients, improving their health status. The programming language of Kotlin, JavaScript, Node JS, and HTML5 was used for the mobile app development. The app was developed with the following abilities: 1) educating users on different aspects of disease control including, updated general treatment guidelines on physical activity, medical nutrition and insulin therapy, stress management, and the patient's specific goals and dietary needs, 2) performing advanced carbohydrate counting using both picture-represented and kitchen-scale of carbohydrate foods as well as traditional Iranian foods, 3) recommending the patient's specific insulin dose, either short- or rapid-acting, based on the carbohydrate content of the selected meal or the selected amount of Iranian foods, 4) recommending the personalized insulin dose needed for decreasing the high blood glucose levels, and 5) performing 3 and 4 simultaneously. Developing Carbulin was an effort to increase type 1 diabetes self-management using the traditional Iranian dietary pattern and menu.

Therapeutic activity of fucoidan and carrageenan as marine algal polysaccharides against viruses.

Marine resources are today a renewable source of various compounds that are used in numerous industries. In recent years, considerable attention has been focused on diverse algae or their metabolites to develop several novel bioactive substances. Algae derivatives are defined as a food or part of food that has health benefits and prevention or treatment of disease. Algal sulfated polysaccharides have a high potential as a source of functional ingredients with a wide range of applications in the food and pharmaceutical industries. Fucoidan and carrageenan, as two main seaweed sulfated polysaccharides, possess numerous biological properties. These polysaccharides are highly valuable in food and healthy immune system diet and also can be applied in the pharmaceutical field. They have shown antiviral activity against SARS-CoV-2 causes COVID-19 infection by preventing virus entry into the cell or interfering with viral replication. Thus, they may provide some novel ingredients for the production of healthy functional foods, antiviral supplement formulations, or algal-based treatments for viral respiratory diseases, especially anti-COVID-19 and recommend solutions to this global health problem in the future. This article provides a review of recent researches on immune-boosting food ingredients, the antiviral activity of algae bioactive compounds, fucoidan, and carrageenan, in particular against SARS-CoV-2.

Dietary patterns in association with the expression of pro-metastatic genes in primary breast cancer.

PURPOSE: Metastasis is a major leading cause of mortality in female breast cancer (BrCa). Cellular motility is a pathological process of metastasis remarked by the overexpression of cortactin (CTTN), Ras homolog family member-A (RhoA), and Rho-associated kinase (ROCK) genes. Their balance is responsible for upholding the integrity of healthy epithelial cell junctions. This study aimed to explore the associations between a posteriori dietary patterns and the expression levels of pro-metastatic genes in primary BrCa. METHODS: In this consecutive case series, 215 eligible women, newly diagnosed with histologically confirmed non-metastatic BrCa (stage I-IIIA), were recruited from Hospitals in Tabriz, Northwestern Iran (2015-2017). The tumoral expression levels of genes were quantified using real-time reverse transcription-polymerase chain reaction. Dietary data assessment was carried out using a validated food frequency questionnaire. RESULTS: Three dietary patterns were identified using principal component analysis (KMO = 0.699). Adherence to the "vegan" pattern (vegetables, fruits, legumes, nuts, seeds, and whole grains) was inversely associated with the expression levels of RhoA (ORAdj.T3vs.T1 = 0.24, 95%CI 0.07-0.79) and ROCK (ORAdj.T3vs.T1 = 0.26, 95%CI 0.08-0.87). In addition, the highest adherence to the "prudent" pattern (spices, seafood, dairy, and vegetable oils) decreased the odds of overexpressions at RhoA (ORAdj.T3vs.T1 = 0.26, 95%CI 0.08-0.84) and ROCK genes (ORAdj.T3vs.T1 = 0.29, 95%CI 0.09-0.95). The highest adherence to "Western" pattern (meat, processed meat, hydrogenated fat, fast food, refined cereals, sweets, and soft drinks) was a risk factor associated with the overexpression of RhoA (ORAdj.T3vs.T1 = 3.15, 95%CI 1.12-8.85). CONCLUSION: Adherence to healthy dietary patterns was significantly associated with the downregulation of pro-metastatic genes. Findings provided new implications to advance the nutrigenomic knowledge to prevent the odds of over-regulations in pro-metastatic genes of the primary BrCa.

Evaluating the effects of dark chocolate formulated with micro-encapsulated fermented garlic extract on cardio-metabolic indices in hypertensive patients: A crossover, triple-blind placebo-controlled randomized clinical trial.

This study aimed to investigate the health-related effects of microencapsulated fermented garlic extract (FGE) containing dark chocolate in hypertensive adults. For this purpose, 36 hypertensive adults (15 males vs. 21 females) were randomized to receive the FGE (5 g/day) dark chocolate containing 650 mg of FGE powder or the placebo. Intervention periods lasted for 6 weeks and were separated by a 3-week wash-out period. The response variables included blood pressure, anthropometric indices, lipid profile, and inflammatory and oxidative stress indices. Statistical analyses were performed using the Pkcross procedure, and Cohen's d was estimated for all response variables. There was no significant inter-period difference between the mean changes of body weight, waist circumference, and body mass index (BMI). Furthermore, no significant change was confirmed in participants' blood pressure, triglycerides, total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), very low-density lipoprotein (VLDL), serum homocysteine, high-sensitive c-reactive protein (hs-CRP), malondialdehyde (MDA), and total antioxidant capacity (TAC). It seems that the dose of FGE used in this study was not sufficient to cause any significant changes in the outcomes. Therefore, further studies with dose-response designs and longer durations are recommended.

The effect of Spirulina sauce, as a functional food, on cardiometabolic risk factors, oxidative stress biomarkers, glycemic profile, and liver enzymes in nonalcoholic fatty liver disease patients: A randomized double-blinded clinical trial.

OBJECTIVE: This study sought to investigate the effect of Spirulina on cardiometabolic risk factors, oxidative stress biomarkers, glycemic profile, and liver enzymes in nonalcoholic fatty liver disease (NAFLD) patients. METHODS: This randomized, double-blind clinical trial was performed on 46 NAFLD patients. Subjects were allocated to consume either Spirulina sauce or placebo, each 20 g/day for 8 weeks. Fatty liver grade, liver enzymes, anthropometric parameters, blood pressure, and serum lipids, glucose, insulin, malondialdehyde, and antioxidant capacity were assessed pre- and postintervention. RESULTS: Fatty liver grade was significantly different between the two groups. A significant change for ALT (alanine aminotransferase) and AST (aspartate aminotransferase) was seen between the two groups (p = .03 and .02, respectively), while ALP (alkaline phosphatase) serum levels were not significantly different within or between groups. Pertaining to glycemic profile, all variables, except HOMA-IR, were not significantly different within or between groups. Finally, statistically significant changes were seen in both MDA (malondialdehyde) and TAC (total antioxidant capacity) among the groups (p = .04 and <.001, respectively). CONCLUSIONS: Spirulina may improve fatty liver grade by modifying liver enzymes, oxidative stress, and some lipid profiles; however, there was effect of Spirulina on anthropometric characteristics and blood pressure.