Propolis as an adjunctive therapy for treatment of uncomplicated cystitis in women: A randomized double-blind placebo-controlled trial.

The current research is designed to investigate the effect of propolis supplementation on the clinical manifestations in women suffering from uncomplicated cystitis. In this randomized double-blind, placebo-controlled trial, 120 women with uncomplicated cystitis were selected and randomly assigned into two groups to receive two 500 mg capsules of propolis or placebo daily for 7 days along with ciprofloxacin (250 mg). Clinical symptoms including hematuria, urinary frequency, dysuria, suprapubic pain, and urgency, as well as bacteriuria, were assessed before and after the intervention. After supplementation, participants in the intervention group had significantly fewer days of urinary frequency (p < 0.001), dysuria (p = 0.005), and urgency (p = 0.03). However, there was no significant difference between the two groups regarding hematuria and suprapubic pain (p > 0.05). Furthermore, the severity of bacteriuria decreased significantly in both groups. In conclusion, it seems that propolis supplementation in women with uncomplicated cystitis could improve urinary frequency, dysuria, and urgency. However, further clinical trials should be conducted to fully understand the effects of propolis in women suffering from uncomplicated cystitis.

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.

Chronic Kidney Disease in Isfahan Province, Action Plan for Screening in A Population-based Study.

INTRODUCTION: We intended to explore the prevalence of chronic kidney disease (CKD) and its different stages, as well as CKD associated variables in the adult population in Isfahan province, Iran. METHODS: Adults aged ≥ 18 were recruited in a cross-sectional study from 2017 to 2019. Data including demographics, anthropometrics, and laboratory findings were collected from each subject. The equation of chronic kidney disease- Epidemiology Collaboration (CKD-EPI) was used to estimate glomerular filtration rate (eGFR), and eGFR and UACR values were utilized to determine the stages of CKD. RESULTS: Data from a total of 3374 subjects was analyzed. The mean age of participants was 49.3 ± 14.09 years and 59.3% were female. The prevalence of CKD was 18.5%. Only 0.25 and 3.5% of the population were in CKD stage 3 and 4, while most of the patients were in CKD stage 2 (7.6%) and stage 1 (7.1%). CKD patients were mostly on refined grains diet and used lesser dairy products compared to healthy participants. Variables including systolic blood pressure (OR = 1.018; P < .001), diastolic blood pressure (OR = 1.005; P < .05), fasting blood sugar (OR = 1.011; P < .001), female sex (OR = 1.319; P < .05), body mass index (OR = 1.030; P < .05), married status (OR = 1.335; P < .05), and smoking (OR = 1.529; P < .05) were significantly associated with increased risk of CKD in the logistic regression analysis. CONCLUSION: According to our results, the prevalence of CKD, especially stages 1 and 2, is quite high in central part of Iran. These findings help us to improve the screening for CKD patients and perform larger scale studies to identify the challenges ahead.  DOI: 10.52547/ijkd.7201.

Empirically derived dietary patterns and their association with mental health: a cross-sectional sample of Iranian migraine patients (2019-2020).

OBJECTIVES: Based on a comprehensive search, we realized that there is no previous study conducted among migraine patients to assess the association between major dietary patterns and mental health. Therefore, the present study aims to explore the relationship between empirically-derived dietary patterns and depression, anxiety, and stress in a sample of Iranian migraine patients. METHODS: A total of 262 migraine patients (20-50 years) were selected through simple random sampling method for this study. Dietary intake during the previous year was determined using a validated 168-item, semi-quantitative food frequency questionnaire (FFQ), and major dietary patterns were derived using principal component analysis (PCA). For mental health evaluation, authors used the Depression, Anxiety, and Stress Scales (DASS- 21) questionnaire. Statistical analysis included multinomial logistic regression analysis and results were expressed as odds ratio (OR) with a 95% confidence interval (CI). RESULTS: We identified three major dietary patterns including "traditional", "western", and "healthy". After controlling for potential confounders, those in the highest tertile of the healthy dietary pattern had lower odds of depression (OR = 0.44, 95% CI: 0.22, 0.88; P for trend: 0.030) and stress (OR = 0.50, 95% CI: 0.25, 0.99; P for trend: 0.049). However, no significant association was observed between western and traditional dietary patterns and mental disorders. CONCLUSIONS: In summary, significant associations were documented between healthy dietary patterns and risk of depression and stress. Current findings urge migraine patients to increase their intakes of fruits, vegetables, eggs, whole grains, nuts and seeds, meat, and poultry and reduce the intake of fast foods and snacks, processed meat, fish, cola drink, condiments, dairy, and vegetable pickles to diminish the chance of depression and stress.

Sodium and potassium intakes and adiposity among Iranian pre-adolescents and adolescents: a cross-sectional study.

BACKGROUND: High sodium and low potassium intakes are associated with the early development of chronic diseases (e.g., hypertension, obesity). Taking into account the limited data on sodium and potassium intakes by 24-h excretion in urine in pre-adolescents and adolescents, we wished to determine baseline salt intake in Iranian subjects aged 11-18 years. METHODS: This was an observational study involving 374 pre-adolescents and adolescents (154 boys and 220 girls). Sodium and potassium intakes were ascertained by measuring sodium and potassium excretion in urine over 24 h. Creatinine level was used to validate the completeness of the urine collections. The association between sodium and potassium intake and adiposity was determined based on body fat percentage. RESULTS: The mean 24-h urine sodium concentration was 3130 ± 2200 mg/day, equal to 7.961 ± 5.596 g/day salt intake. Approximately half of the study participants exceeded the upper limit of Na intake. The mean potassium intake was estimated 1480 ± 1050 mg/day. There was a positive association between urinary sodium excretion and adiposity in crude (OR 1.79; 95% CI: 1.08-2.74) and full adjusted model (OR: 3.15; 95% CI: 2.28-4.63). Also, in subsample analysis, there was a positive correlation between urinary sodium and adiposity in both pre-adolescents (OR: 2.71; 95% CI: 2.29-3.93) and adolescents (OR: 3.55; 95% CI: 2.17-4.74). However, no significant association was found between 24-h urinary potassium and adiposity. CONCLUSION: Sodium intake, as estimated by 24-h urinary excretion, was higher than recommended and it was positively associated with adiposity. Also, this study reported low compliance of potassium intake recommendations in 11-18 years' Iranian pre-adolescents and adolescents. Health promotion interventions are needed in order to broaden public awareness of high sodium intake and potassium inadequacy to reduce chronic diseases.

Effects of probiotic supplementation on anthropometric and metabolic characteristics in adults with metabolic syndrome: A systematic review and meta-analysis of randomized clinical trials.

AIMS: We conducted a systematic review and meta-analysis to evaluate evidence from randomized controlled trials (RCTs) documenting the effectiveness of supplementation with pro-/synbiotics versus placebo controls on anthropometric and metabolic (glucoregulatory status, lipid profile) indices in adults with metabolic syndrome (MetS). METHODS: Databases of MEDLINE, Scopus, Embase, Web of Science, and Cochrane Library were searched through March 2020 to identify eligible RCTs evaluating the effects of pro-/synbiotic consumption in adults (≥18 years) with MetS. Mean differences (MDs) and 95% confidence intervals (CIs) were pooled using random-effects models. RESULTS: Ten eligible publications (9 RCTs, n = 344 participants) were included. Supplementation with pro-/synbiotics reduced total cholesterol (TC) in adults with MetS versus placebo (MD: -6.66 mg/dL, 95% CI: -13.25 to -0.07, P = 0.04, I2 = 28.8%, n = 7), without affecting weight, body mass index, waist circumference, fasting blood sugar, homeostasis model assessment for insulin resistance, insulin, triglyceride, low-density lipoprotein cholesterol, or high-density lipoprotein cholesterol (P > 0.05). CONCLUSIONS: Pro-/synbiotic consumption may be beneficial in reducing TC levels in adults with MetS. However, our observations do not support the effectiveness of pro-/synbiotics consumption on other anthropometric or metabolic outcomes of MetS. Further investigations with larger sample sizes are required to confirm these findings.

Effect of Probiotic Consumption on Immune Response in Athletes: A Meta-analysis.

The possible effect of probiotic interventions on immunological markers in athletes is inconclusive. Therefore, to synthesize and quantitatively analyze the existing evidence on this topic, systematic literature searches of online databases PubMed, Scopus, Cochrane Library, and ISI Web of Sciences was carried out up to February 2021 to find all randomized controlled trials (RCTs) concerning the immunological effects of probiotics in athletes. In the random-effects model, weighted mean difference (WMD) and 95% confidence interval (CI) explained the net effect. The authors assessed the likelihood of publication bias via Egger's and Begg's statistics. A total of 13 RCTs (836 participants) were retrieved. Probiotic consumption reduced lymphocyte T cytotoxic count significantly (WMD=-0.08 cells×109/L; 95% CI: -0.15 to -0.01; p=0.022) with evidence of moderate heterogeneity (I 2=59.1%, p=0.044) and monocyte count when intervention duration was ≤ 4 weeks (WMD=-0.08 cells×109/L; 95% CI: -0.16 to -0.001; I 2=0.0%). Furthermore, leukocyte count was significantly elevated (WMD=0.48 cells×109/L; 95% CI: 0.02 to 0.93; I 2=0.0%) when multi-strain probiotics were used. Probiotic supplements may improve immunological markers, including lymphocyte T cytotoxic, monocyte, and leukocyte in athletes. Further randomized controlled trials using diverse strains of probiotics and consistent outcome measures are necessary to allow for evidence-based recommendations.

Beneficial Role of Calcium in Premenstrual Syndrome: A Systematic Review of Current Literature.

Since premenstrual syndrome (PMS) is one of the most common and debilitating disorders in women, risk factor modification is an urgent health priority. Therefore, this systematic review aimed to summarize and discuss the outcomes of observational and interventional studies in humans regarding the relationship between Calcium and PMS. PubMed, Scopus, ISI web of sciences and Google scholar were searched up to January 2019 to identify relevant studies. The Newcastle-Ottawa and Jadad scales were used for quality assessment. A total of 14 studies (8 interventional and 6 observational) met our inclusion criteria. Majority of the studies showed that not only serum calcium levels are lower in PMS subjects, but also calcium supplementation could significantly improve the incidence of PMS and its related symptoms. This systematic review suggests a beneficial role for calcium in PMS subjects. However, in order to draw a firm link between calcium and PMS, further dose-response clinical trials with larger sample size and better methodological design are warranted.

The association between dietary diversity score and general and abdominal obesity in Iranian children and adolescents.

BACKGROUND: To evaluate the association between diet and disease, the consideration of a whole diet has appeared to be more effective than the examination of single-nutrient intake. This study aimed to examine the relationship between dietary diversity score (DDS) and obesity in Iranian children. METHODS: A cross-sectional study was conducted on 456 children aged 11-18 years, who were selected by random cluster sampling. The usual food intake for each participant assessed using a validated Food frequency questionnaire (FFQ). To calculate the dietary diversity score, food items were categorized into 5 broad groups and 23 subgroups based on the US Department of Agriculture Food Guide Pyramid. Participants were categorized based on the DDS tertile cut-off points. Anthropometric measurements were conducted based on standard protocols. Overweight and obesity were defined as 85th ≤ BMI < 95th, and ≥ 95th percentiles of BMI, respectively. Additionally, abdominal obesity was considered as WC ≥ 85th percentile. RESULTS: Mean and standard deviation (SD) of subjects' Body Mass Index (BMI) and waist circumference were 20.88 (SD 4.22) kg/m2 and 74.27 (SD 10.31) cm, respectively. The probability of overweight and obesity was increased as tertiles of DDS increased (OR among tertiles: 1.00, 1.82 and 2.13 for overweight and 1.00, 2.60 and 3.45 for obesity; this was the same for abdominal obesity: 1.00, 2.22 and 3.45, P <  0.001 for all). However, no statistically significant results were found after adjustment for energy intake. CONCLUSION: Dietary diversity positively affected obesity through higher energy intake. Despite the wide recommendation of having high dietary diversity, public health programs should emphasize to improve dietary diversity only in selective food items.

Are serum vitamin D, calcium and phosphorous associated with restless leg syndrome? A systematic review and meta-analysis.

BACKGROUND: It is hypothesized that vitamin D deficiency, and calcium/phosphate imbalance could be involved in the pathophysiology of restless leg syndrome (RLS). This systematic review and meta-analysis of observational studies were carried out to reach a firm conclusion regarding the possible association between vitamin D, calcium and phosphorous levels with RLS in end-stage renal disease (ESRD) patients, other comorbidities and healthy population. METHODS: PubMed, Scopus, ISI Web of Science, and Cochrane's library were systematically searched up to June 2020. Quality assessment of the included observational studies was performed using Newcastle-Ottawa Quality Assessment Scale. Statistical analyses were done using STATA 11.2. A P-value <0.05 were considered statistically significant. RESULTS: A total of 36 studies involving 9590 participants were included in this systematic review and meta-analysis. We found that serum vitamin D level is significantly lower (WMD -3.39 ng/mL; 95% CI, -5.96 to -0.81; P = 0.010; I2 = 86.2%) and phosphorous (SMD 0.19; 95% CI, 0.04-0.34; P = 0.011; I2 = 83.6%) is significantly higher in RLS individuals compared to the non-RLS individuals. However, the mean difference of serum calcium was not significant in comparison between RLS and control groups (SMD -0.01; 95% CI, -0.19 to 0.18; P = 0.957; I2 = 89.2%). CONCLUSION: Results revealed a significant association between serum vitamin D and phosphorous with RLS. However, further prospective cohort studies and clinical trials are needed for better understanding of the relationship between these variables.

Association between vitamin D and dry eye disease: A systematic review and meta-analysis of observational studies.

PURPOSE: A number of studies have examined the association between vitamin D and dry eye disease in different populations, but findings are inconclusive. Herein, available observational studies were systematically reviewed to elucidate the overall relationship between vitamin D and dry eye disease among adult population. METHODS: PubMed, Scopus, Google scholar and ISI web of science databases were searched until January 2020 for studies assessing the association between vitamin D and dry eye disease. The Newcastle-Ottawa Quality Assessment Scale was used to examine the quality of each study. RESULTS: A total of 14 studies out of 252 met the inclusion criteria and were included in this systematic review and meta-analysis. Serum 25(OH) D3 was lower in dry eye disease subjects compared to healthy ones (WMD -5.93; 95 % CI, -7.47 to -4.40; P < 0.001) with evidence of significant heterogeneity (I2 = 94.6 % p < 0.001). Also, in final analysis, vitamin D correlated significantly with ocular surface disease index (Fisher's Z: -0.26; 95 % CI, -0.48 to -0.04; P = 0.018), with significant heterogeneity between studies (I2 = 59.3 %, P = 0.043). CONCLUSION: It was found that serum vitamin D had a significantly lower level in dry eye disease patients, and correlated with ocular surface disease index but no other dry eye disease parameter. The findings add to the existing literature supporting the concept that nutrition especially vitamin D plays an important role in human eye health. Prospective studies are needed to confirm this relationship.

The Effect of Nutrition Education Program on Overweight/Obese Patients with Non-Alcoholic Fatty Liver Disease: a Single-Blind Parallel Randomized Controlled Trial.

The aim of this study was to assess the effects of a nutrition education program on overweight/obese patients with non-alcoholic fatty liver disease (NAFLD). This single-blind, parallel randomized controlled trial was conducted on 82 NAFLD patients (mean age 48.89 ± 9.85 years) in Isfahan, Iran. Patients were randomly allocated to receive nutrition education program combined with usual care or usual care alone for 2 months. Metabolic markers, including lipid profile, fasting blood glucose (FBG) and dietary intakes were obtained for each patient at baseline and at the end of the study. Nutrition education intervention resulted in a significant decrease compared with usual care in serum levels of total cholesterol (TC) and triglyceride (TG) (p < 0.05). However, our intervention did not lead to a significant improvement in FBG, low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C), respectively (p > 0.05). Furthermore, energy and sugar intakes of patients were reduced significantly in response to our intervention (p < 0.05). Nutrition education intervention significantly reduced serum levels of TC and TG but did not affect other metabolic markers including FBG, LDL-C, and HDL-C. Also, it could reduce total energy and sugar intake. Thus, this study could be useful to use this educational program for NAFLD patients in order to influence their metabolic markers and dietary intakes. TRIAL REGISTRATION: IRCT Identifier: IRCT2014101811763N17.

The Association Between Vitamin D and Premenstrual Syndrome: A Systematic Review and Meta-Analysis of Current Literature.

A number of studies have assessed the association between vitamin D and premenstrual syndrome (PMS) in different populations, but the findings have been inconclusive. Herein, we systematically reviewed available observational and interventional evidence to elucidate the overall relationship between vitamin D and PMS. PubMed, Cochrane Library, ScienceDirect, Scopus, Google Scholar, and ISI Web of Science databases were searched for all available articles until September 2018. The Newcastle-Ottawa quality assessment scale and Jadad scale were used to assess the quality of the observational and interventional studies, respectively. A total of 16 studies out of 196 met our inclusion criteria and were included in the final analysis. Although no significant association between serum 25(OH)D and PMS (weighted mean difference (WMD) = 3.35; 95% confidence interval, -7.80 to 1.11; p = 0.14) was indicated in observational studies, vitamin D supplementation was effective in ameliorating PMS symptoms based upon findings from interventional studies. These results add to the existing literature supporting the fact that nutrition, especially vitamin D, plays an important role in women's health. Additional well-designed clinical trials should be considered in future research to develop firm conclusions on the efficacy of vitamin D on PMS. KEY TEACHING POINTS 5-8% of women experience severe PMS. Nutrition especially vitamin D plays an important role in the women's health. Vitamin D could exert significant clinical effects on PMS symptoms. This is a systematic review and meta-analysis in this regard.

Barberry (Berberis vulgaris L.) is a safe approach for management of lipid parameters: A systematic review and meta-analysis of randomized controlled trials.

OBJECTIVE: We performed a meta-analysis to evaluate the efficacy of barberry supplementation on plasma lipid concentration in adult population. METHODS: The search included PubMed, Scopus, ISI Web of Science, Cochrane library, and Google Scholar (up to October 2018) to identify randomized controlled trials (RCTs) investigating the effects of barberry supplementation on serum lipid parameters. Mean Difference (MD) was pooled using a random-effects model. RESULTS: Meta-analysis on 5 RCTs with 339 participants indicated that barberry supplementation significantly decreased the levels of total cholesterol (MD: -23.58 mg/dl, 95% CI: -31.00 to -16.16, P ≤ 0.001), triglyceride (MD: -29.16 mg/dl, 95% CI: -42.91 to -15.41, P ≤ 0.001), and low-density lipoprotein cholesterol (MD: -13.75 mg/dl, 95% CI: -19.31 to -8.20, P ≤ 0.001) whereas changes in high-density lipoprotein cholesterol (MD: 3.40 mg/dl, 95% CI: -0.06-6.87, P = 0.054) was not statistically significant. CONCLUSION: This systematic review and meta-analysis suggested the efficacy of barberry supplementation on lipid parameters. However, further large-scale studies are needed to confirm these results.

24-h urinary sodium to potassium ratio and its association with obesity in children and adolescents.

PURPOSE: There are epidemiologic studies indicating a positive correlation between high sodium and low potassium intake and body mass index. Therefore, this study was conducted in a cross-sectional sample of Iranian children and adolescents to evaluate the link between 24-h urinary Na:K ratio and risk of obesity. METHODS: In this cross-sectional study, 374 participants aged 11-18 years were included. One 24-h urine sample was collected by each participant to estimate Na:K ratio. Anthropometric measurements were carried out and overweight/obesity was defined as a BMI ≥ 85th percentile and abdominal obesity as a waist:height ratio (WHtR) of more than 0.5. RESULTS: As expected, 24-h urinary Na:K ratio showed significant associations with risk of overweight/obesity. Risk of adiposity assessed by WC and PBF was significantly associated with Na:K ratio after adjusting for SSBs consumption and calorie intake. Urinary Na:K ratio showed significant association with risk of adiposity assessed by WC only in girls in the highest tertile group with OR of 2.71 (95% CI 1.14-6.43), only after the addition of calorie intake. Adiposity assessed by PBF was only associated with Na:K ratio among boys with OR of 4.47 (95% CI 1.44-9.87) and 3.87 (95% CI 1.20-8.48), after adjusting for SSBs consumption and calorie intake, respectively. CONCLUSION: Our findings suggest that reducing Na and increasing K intake could be used as a useful approach to lower the risk of obesity and associated burden of disease in Iran. However, more studies are warranted.

Aged Garlic and Cancer: A Systematic Review.

Cancer is one of the leading causes of morbidity and mortality worldwide, which increases health-care costs. It has been reported that some dietary components such as aged garlic, one of the garlic preparations with no strong odor and harsh irritating taste, exhibits anticancer effects. This review summarizes the potential beneficial effects of aged garlic on cancer incidences as well as prevention and improvement of factors related to malignancy. Electronic databases, including MEDLINE, Web of Science, the Cochrane Library, and Google Scholar were searched. All study designs which were focused on cancer incidence, or indices related to malignancy as outcomes in human, animal, and human cells studies, and aged garlic and its ingredients as exposures were reviewed in accordance to the items for systematic reviews (PRISMA) guidelines. Initially, 304 articles were identified. Then, 25 articles which met the inclusion criteria were selected. Based on the evaluation, overall quality score of human studies was well. Although there were inconsistent evidence from human studies, results of the animal and laboratory results were mostly consistent. The overall findings may suggest that intakes of aged garlic are inversely associated with cancer. In this regard, the studies have shortcomings. Therefore, more precise investigations will be necessary to decide whether aged garlic consumption is recommendable as a part of cancer prevention or control programs. However, due to anticancer properties of aged garlic, its consumption along with healthy diet may have beneficial effects on cancer.

The effect of ginger supplementation on lipid profile: A systematic review and meta-analysis of clinical trials.

BACKGROUND: Elevated levels of blood lipids are a major cause of atherosclerosis and consequently cardiovascular disease. Several studies used ginger as a lipid lowering agent. PURPOSE: The aim of the present systematic review and meta-analysis was to clarify the effect of ginger supplementation on lipid parameters. METHODS: PubMed, Scopus, Science Direct, ISI Web of Science and Google Scholar were systematically searched until May 2017 to find clinical trials which examined effect of ginger supplementation on level of lipid parameters in adult participants. Means for blood lipids and potential sources of heterogeneity were extracted. A subgroup analysis was applied to find out potential sources of inter-study heterogeneity. RESULTS: A total of 12 trials (586 participants) were included in the meta-analysis. Pooled analysis suggested that ginger supplementation reduced triacylglycerol (TAG) (-17.59 mg/dl; 95% CI: -29.32 to -5.87) and low density lipoprotein cholesterol (LDL-C) (-4.90 mg/dl; 95% CI: -22.30 to -6.17). Ginger had no significant effect on total cholesterol (TC) (-5.13 mg/dl, 95% CI: -11.05 to 0.78; P = 0.089) and high density lipoprotein cholesterol (HDL-C) (2.18 mg/dl, 95% CI: -0.08 to 4.45; P = 0.059). As inter-study heterogeneity was high, studies were classified by ginger dosage. Stratified analysis showed a significant reduction in TC (-12.26 mg/dl; 95% CI: -22.37 to -2.16) and TAG (-38.42 mg/dl; 95% CI: -57.01 to -19.82) in studies which used ≤2 g/day of ginger. However, a similar significant effect was not observed in trials with >2 g/day of ginger. Neither studies which used ≤2 g/day nor trials which used >2 g/day of ginger showed significant changes in LDL-C or HDL-C. CONCLUSION: The present systematic review and meta-analysis suggests that ginger had a favorable effect on TAG and LDL-C. Also, the result revealed that low dose of ginger (≤2 g/day) had greater lowering impact on TAG and TC. Further studies with large-scale and better design are needed to confirm this result.

Relationship of sodium intake with obesity among Iranian children and adolescents.

BACKGROUND: Emerging evidence suggests a relationship between sodium (Na) intake and obesity risk. The aim of this study was to investigate the link between 24-hour (24-h) urinary Na excretion and adiposity measures in a sample of Iranian children and adolescents. METHODS: This cross-sectional study was performed among 374 healthy individuals aged 11-18 years old. Random cluster sampling method was used to select the participants from 4 districts in Isfahan, Iran. Na excretion was estimated using a 24-h urinary sample. Creatinine (Cr) level was used to confirm the completeness of samples. Anthropometric measures including weight, height and waist circumference (WC) were obtained based on standard protocols. RESULTS: The odds ratio (OR) for overweight/obesity in subjects with the highest tertile of Na excretion compared with the lowest tertile was 8.01 [95% confidence interval (CI) 4.20-15.3] in crude model and 8.33 (95% CI 4.14-16.8) after adjusting for potential confounders. The association was independent of intake of energy and sugar-sweetened beverages (SSBs). The OR for abdominal obesity in the highest tertile of Na excretion compared with the lowest tertile was 9.12 (95% CI 4.78- 17.4) in crude model and 9.75 (95% CI 4.88-19.5) after controlling for potential confounders. The association was independent of energy intake or SSBs consumption. CONCLUSION: Our study showed a positive association between Na excretion and obesity among children and adolescents. Further investigation through longitudinal studies using a more representative sample of children and adolescents is suggested to determine whether this is a causal relationship.

Potential mechanisms linking probiotics to diabetes: a narrative review of the literature.

CONTEXT AND OBJECTIVE:: Some studies have suggested a wide range of possible mechanisms through which probiotics may play a role in diabetes prevention and treatment. However, the underlying mechanisms are not fully understood. We conducted this study to review the potential mechanisms suggested for the effect of probiotics in diabetes. DESIGN AND SETTING:: Narrative review conducted at the Food Security Research Center of Isfahan. METHODS:: A search in the electronic databases MEDLINE (PubMed), Cochrane Library, Web of Science and Google scholar was performed up to October 2016. RESULTS:: The initial search yielded 1214 reports. After removing duplicates, 704 titles and abstracts were screened. Finally, out of 83 full-text articles that were reviewed for eligibility, 30 articles were included in the final analysis. The anti-diabetic mechanisms for probiotics reported encompass intraluminal and direct effects on the intestinal mucosa and microbiota (n = 13), anti-inflammatory and immunomodulatory effects (n = 10), antioxidative effects (n = 5), effects on endoplasmic reticulum (ER) stress and expression of genes involved in glucose homeostasis and insulin resistance (n = 6), with some studies pointing to more than one mechanism. CONCLUSION:: The results may throw some light on the capacity of probiotics as a novel approach towards controlling diabetes. However, further human studies are warranted to elucidate and confirm the potential role of probiotics in diabetes prevention and treatment. Also, it needs to be ascertained whether the effectiveness of probiotics in diabetes prevention and treatment is dependent on the strain of the microorganisms.

Potential mechanisms linking probiotics to diabetes: a narrative review of the literature / Mecanismos potenciais ligando probióticos a diabetes: uma revisão narrativa da literatura

ABSTRACT CONTEXT AND OBJECTIVE: Some studies have suggested a wide range of possible mechanisms through which probiotics may play a role in diabetes prevention and treatment. However, the underlying mechanisms are not fully understood. We conducted this study to review the potential mechanisms suggested for the effect of probiotics in diabetes. DESIGN AND SETTING: Narrative review conducted at the Food Security Research Center of Isfahan. METHODS: A search in the electronic databases MEDLINE (PubMed), Cochrane Library, Web of Science and Google scholar was performed up to October 2016. RESULTS: The initial search yielded 1214 reports. After removing duplicates, 704 titles and abstracts were screened. Finally, out of 83 full-text articles that were reviewed for eligibility, 30 articles were included in the final analysis. The anti-diabetic mechanisms for probiotics reported encompass intraluminal and direct effects on the intestinal mucosa and microbiota (n = 13), anti-inflammatory and immunomodulatory effects (n = 10), antioxidative effects (n = 5), effects on endoplasmic reticulum (ER) stress and expression of genes involved in glucose homeostasis and insulin resistance (n = 6), with some studies pointing to more than one mechanism. CONCLUSION: The results may throw some light on the capacity of probiotics as a novel approach towards controlling diabetes. However, further human studies are warranted to elucidate and confirm the potential role of probiotics in diabetes prevention and treatment. Also, it needs to be ascertained whether the effectiveness of probiotics in diabetes prevention and treatment is dependent on the strain of the microorganisms.

RESUMO CONTEXTO E OBJETIVO: Alguns estudos têm sugerido ampla gama de possíveis mecanismos, pelos quais os probióticos podem desempenhar um papel na prevenção e tratamento do diabetes. No entanto, os mecanismos subjacentes não são totalmente compreendidos. Realizamos este estudo para revisar os possíveis mecanismos sugeridos para o efeito dos probióticos na diabetes. TIPO DE ESTUDO E LOCAL: Revisão narrativa conduzida no Food Security Research Centro de Isfahan. MÉTODOS: Busca sistemática nas bases de dados eletrônicas MEDLINE (PubMed), Cochrane Library, Web of Science e Google scholar até outubro de 2016. RESULTADOS: A busca inicial resultou em 1.214 artigos. Após a remoção de duplicatas, foram pesquisados 704 títulos e resumos. Finalmente, de 83 artigos completos revisados para elegibilidade, 30 foram incluídos na análise final. Os mecanismos antidiabéticos relatados dos probióticos abrangem efeitos intraluminais e diretos na mucosa e microbiota intestinal (n = 13), efeitos anti-inflamatórios e imunomoduladores (n = 10), efeitos antioxidativos (n = 5), efeitos sobre o estresse de retículo endoplasmático (RE) e expressão de genes envolvidos na homeostase da glicose e resistência à insulina (n = 6), com alguns estudos apontando para mais de um mecanismo. CONCLUSÃO: Os resultados podem lançar alguma luz sobre os probióticos como uma nova abordagem no controle do diabetes, no entanto, mais estudos em humanos são justificados para elucidar e confirmar o papel potencial dos probióticos na prevenção e tratamento do diabetes. Além disso, deverá ser determinado se a eficácia dos probióticos na prevenção e tratamento do diabetes é dependente da cepa dos microrganismos.