Effect of green-lipped mussel (Perna canaliculus) supplementation on faecal microbiota, body composition and iron status markers in overweight and obese postmenopausal women: a randomised, double-blind, placebo-controlled trial.

The present study aimed to determine the effect of whole meat GSM powder on gut microbiota abundance, body composition and iron status markers in healthy overweight or obese postmenopausal women. This was a 3-months trial involving forty-nine healthy postmenopausal women with body mass index (BMI) between 25 and 35 kg/m2 who were randomly assigned to receive 3 g/d of either GSM powder (n 25) or placebo (n 24). The gut microbe abundance, serum iron status markers and body composition were measured at the baseline and the end of the study. The between-group comparison at the baseline showed a lower abundance of Bacteroides and Clostridium XIVa in the GSM group compared with the placebo (P = 0⋅04). At the baseline, the body fat (BF)% and gynoid fat% were higher in the GSM group compared with the placebo (P < 0⋅05). No significant changes were found in any of the outcome measures, except for ferritin levels that showed a significant reduction over time (time effect P = 0⋅01). Some trend was observed in bacteria including Bacteroides and Bifidobacterium which tended to increase in the GSM group while their abundance decreased or remained at their baseline level in the control group. Supplementation with GSM powder did not result in any significant changes in gut microbe abundance, body composition and iron markers compared with placebo. However, some commensal bacteria such as Bacteroides and Bifidobacteria tended to increase following supplementation with GSM powder. Overall, these findings can expand the knowledge surrounding the effects of whole GSM powder on these outcome measures in healthy postmenopausal women.

Effects of Greenshell™ mussel intervention on biomarkers of cartilage metabolism, inflammatory markers and joint symptoms in overweight/obese postmenopausal women: A randomized, double-blind, and placebo-controlled trial.

Objective: To investigate the effect of whole greenshell mussel (GSM) powder on biomarkers of cartilage metabolism, inflammatory cytokines, and joint symptoms in postmenopausal women with overweight/obesity and joint discomfort. Design: Fifty-five postmenopausal women with overweight/obesity were randomly assigned to receive 3 g/day whole GSM powder or placebo for 12 weeks. Cartilage turnover biomarkers urinary C-telopeptide of type II collagen (CTX-II) and serum cartilage oligomeric matrix protein (COMP) were measured at baseline, week 6 and 12. Plasma cytokines were measured at baseline and week 12. Joint pain and knee-related problems were assessed at baseline and week 12 using a 100 mm Visual Analogue Scale (VAS) and the Knee injury and Osteoarthritis Outcome Score (KOOS) questionnaire, respectively. Results: Forty-nine participants completed the study (GSM n = 25, placebo n = 24). After 12 weeks, urinary CTX-II showed no significant change over time or between the groups (interaction effect P = 0.1). However, in women with symptomatic knees, a significant difference was noted between the group (treatment effect P = 0.04), as it was lower in the GSM group compared to placebo group at week 6 (P = 0.04) and week 12 (P = 0.03). Serum COMP and plasma cytokines were not affected. GSM supplementation showed greater reduction in the VAS pain score than placebo (-13.2 ± 20.3 vs. -2.9 ± 15.9; P = 0.04). No significant change in KOOS domains between the two groups was observed. Conclusion: Oral supplementation of whole GSM powder at 3 g/day may slow down the degradation of type II collagen in postmenopausal women with symptomatic knees. GSM treatment conferred clinical benefit on overall joint pain. No significant effect was noted for inflammatory cytokines, suggesting that GSM may act within the joint microenvironment rather than at the systemic level. Clinical trial registration: [www.australianclinicaltrials.gov.au/clinical-trialregistries], identifier [ACTRN12620000413921p].

Mass Spectrometry-Based Metabolomic and Lipidomic Analysis of the Effect of High Fat/High Sugar Diet and GreenshellTM Mussel Feeding on Plasma of Ovariectomized Rats.

This study aimed to examine the changes in lipid and metabolite profiles of ovariectomized (OVX) rats with diet-induced metabolic syndrome-associated osteoarthritis (MetOA) after supplementation with greenshell mussel (GSM) using an untargeted liquid chromatography-mass spectrometry (LC-MS) metabolomics approach. Ninety-six rats were fed with one of four diets: control, control supplemented with GSM + GSM, high fat/high sugar (HFHS), or high fat/high sugar enriched with GSM (HFHS + GSM). After 8 weeks on experimental diets, half of the rats in each group underwent OVX and the other half were sham operated. After being fed for an additional 28 weeks, blood samples were collected for the metabolomics analysis. Lipid and polar metabolites were extracted from plasma and analysed by LC-MS. We identified 29 lipid species from four lipid subclasses (phosphatidylcholine, lysophosphatidylcholine, diacylglycerol, and triacylglycerol) and a set of eight metabolites involved in amino acid metabolism (serine, threonine, lysine, valine, histidine, pipecolic acid, 3-methylcytidine, and cholic acid) as potential biomarkers for the effect of HFHS diet and GSM supplementation. GSM incorporation more specifically in the control diet generated significant alterations in the levels of several lipids and metabolites. Further studies are required to validate these findings that identify potential biomarkers to follow OA progression and to monitor the impact of GSM supplementation.

Carbohydrate quality index: Its relationship to menopausal symptoms in postmenopausal women.

OBJECTIVE: The aim of this study was to determine the relationship between carbohydrate quality intake and menopausal symptoms. STUDY DESIGN: This is a cross-sectional study of 393 postmenopausal women attending municipality health houses and health centers in the south of Tehran, Iran, from September 2016 to January 2017. MAIN OUTCOME MEASURES: The dietary intake and menopausal symptoms of the participants were assessed with a validated food frequency questionnaire and a menopause rating scale (MRS) carbohydrate quality index (CQI) was calculated using three indices: dietary fiber, glycemic index, and the ratio of solid carbohydrates to total carbohydrates. Linear and logistic regressions were used to assess the relationship between CQI and menopausal symptoms. RESULTS: After adjustment for age, education, time passed since menopause, body mass index, physical activity and energy intake, an inverse association was found between CQI and total MRS score (TMRSS) (ß -0.61; p <0.001), somatic score (SS) (ß -0.27; p <0.001) and psychological score (PS) (ß -0.37; p <0.001) in multivariable linear regression. In addition, logistic regression analysis revealed that compared with the lowest quartile of CQI, participants in the highest quartile of CQI had a lower TMRSS (odds ratio (OR) 0.36, 95% confidence interval (CI) 0.19-0.68). Moreover, CQI was inversely related to SS (OR 0.34; 95% CI 0.17-0.68) and PS (OR 0.32; 95% CI 0.16-0.61). However, there was no significant association between CQI and urogenital score (US). CONCLUSIONS: Higher-quality carbohydrate intake was found to be associated with lower somatic and psychological symptoms of menopause. These findings suggest that CQI may be an important basis for developing an effective dietary modification for reducing menopausal symptoms.

Potential modulatory mechanisms of action by long-chain polyunsaturated fatty acids on bone cell and chondrocyte metabolism.

Long-chain polyunsaturated fatty acids (LCPUFAs) and their metabolites are considered essential factors to support bone and joint health. The n-6 PUFAs suppress the osteoblasts differentiation via increasing peroxisome proliferator-activated receptor gamma (PPARγ) expression and promoting adipogenesis while n-3 PUFAs promote osteoblastogenesis by down-regulating PPARγ and enhancing osteoblastic activity. Arachidonic acid (AA) and its metabolite prostaglandin E2 (PGE2) are key regulators of osteoclast differentiation via induction of the receptor activator of nuclear factor kappa-Β ligand (RANKL) pathway. Marine-derived n-3 LCPUFAs have been shown to inhibit osteoclastogenesis by decreasing the osteoprotegerin (OPG)/RANKL signalling pathway mediated by a reduction of pro-inflammatory PGE2 derived from AA. Omega-3 PUFAs reduce the expression of cartilage degrading enzyme matrix metalloproteinase-13 (MMP-13) and a disintegrin and metalloprotease with thrombospondin motifs-5 (ADAMTS-5) protein, oxidative stress and thereby apoptosis via nuclear factor kappa-betta (NF-kß) and inducible nitric oxide synthase (iNOS) pathways. In this review, a diverse range of important effects of LCPUFAs on bone cells and chondrocyte was highlighted through different mechanisms of action established by cell cultures and animal studies. This review allows a better understanding of the possible role of LCPUFAs in bone and chondrocyte metabolism as potential therapeutics in combating the pathological complications such as osteoporosis and osteoarthritis.

Effect of GreenshellTM mussel on osteoarthritis biomarkers and inflammation in healthy postmenopausal women: a study protocol for a randomized double-blind placebo-controlled trial.

BACKGROUND: New Zealand Greenshell™ mussels (GSM; Perna canaliculus) have recently been shown to decrease cartilage degradation in a rat model of induced metabolic osteoarthritis (MetOA). However, this effect has not been investigated in human subjects. This study aims to determine the effect of GSM powder on biomarkers of cartilage metabolism, bone resorption, and inflammation in New Zealand healthy overweight/obese postmenopausal women who are at early stage or at high risk of OA. METHOD: Fifty overweight or obese (BMI 25-35 kg/m2) postmenopausal women (aged 55-75 years) will be recruited by advertisement. Participants will be randomized based on a double-blind randomization schedule and stratified randomization based on BMI and age distribution. The participant will be assigned with a 1:1 allocation ratio to receive 3 g/d whole meat GSM powder or placebo (sunflower seed protein) for 12 weeks. Data on socio-demographics, physical activity, and dietary intake will be collected for each subject. Cartilage turnover biomarkers [(C-telopeptide of type II collagen (CTX-II), C-propeptide of type II procollagen (CPII), Cartilage oligomeric matrix protein (COMP)], and bone resorption marker (CTX-I) will be measured in blood and urine samples. Inflammatory status (hs-CRP and cytokine panel) will be assessed and iron status will be measured. Body composition including fat mass (FM), lean mass (LM), and fat percentage will be measured using dual-energy X-ray absorptiometry (DXA). Joint pain and knee function will be assessed using a 100-mm visual analog scale (VAS) and the Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire, respectively. DISCUSSION: This trial will be the first to explore the effects of whole meat GSM powder on cartilage turnover, bone resorption, and inflammation biomarkers in overweight/obese postmenopausal women. The results from this trial will provide evidence on the efficacy of GSM in the prevention of OA. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12620000413921p . Registration on 27 March 2020.

Glycemic index, but not glycemic load, is associated with an increased risk of metabolic syndrome: Meta-analysis of observational studies.

BACKGROUND: Diets with high glycemic index (GI) or high glycemic load (GL) have been linked to important risk factors associated with the development of metabolic syndrome (MetS), such as dyslipidemia, higher blood glucose, and insulin concentrations. However, the role of GI and GL in relation to Mets is still understudied and controversial. This review, therefore, assessed whether high GI or GL contribute to development of Mets. METHODS: A systematic search of four bibliographic databases was conducted (MEDLINE/PubMed, EMBASE, Web of Sciences, and Scopus) from inception to January 2020 for observational studies assessing GI/GL in relation to MetS. Risk estimates were pooled using random-effect models for the highest versus lowest intake categories, and assessed for heterogeneity using subgroup analysis. The dose-response nature of the relationship was also investigated. Sensitivity analysis and Egger test were used to check the robustness of findings and the possibility of publication bias, respectively. RESULTS: Data from 12 publications (one cohort study and eleven cross-sectional studies) with a total sample size of 36,295 subjects are included. The pooled effect sizes from the nine studies indicated high versus low dietary GI was associated with increased risk of MetS (OR = 1.05, 95% CI: 1.01 to 1.09) (I2  = 58.1, P = .004). This finding was supported by all subgroup analyses except where studies used 24-h recalls for dietary assessment. Additionally, a linear dose-response investigation revealed that each 5-point increment in GI was associated with 2% increase in the risk of MetS (OR = 1.02, 95% CI: 1.01 to 1.02); non-linear pattern was insignificant, however (p-nonlinearity = 0.63). Moreover, pooled effect sizes from ten studies suggested that no association was found between the GL and MetS with results remaining consistent in all subgroup analyses. CONCLUSION: A diet with lower GI may protect against MetS. Nutrition policy and clinical practices should encourage a diet with low GI. Future studies should include both GI and GL and different criteria of MetS to provide a better comparison.

Green-lipped (greenshell™) mussel (Perna canaliculus) extract supplementation in treatment of osteoarthritis: a systematic review.

OBJECTIVES: Intervention studies using New Zealand green-lipped or greenshell™ mussel (GSM) (Perna canaliculus) extract in osteoarthritis (OA) patients have shown effective pain relief. This systematic review summarises the efficacy of GSM extracts in the treatment of OA. METHODS: A literature search of the three databases EMBASE, MEDLINE, and Scopus was performed to identify relevant articles published up to March 2020. Inclusion criteria were clinical trials published in English measuring the effect of supplementation of whole or a lipid extract from GSM on pain and mobility outcomes in OA patients. RESULTS: A total of nine clinical trials were included in systematic review, from which five studies were considered appropriate for inclusion in a forest plot. Pooled results showed that GSM extracts (lipid extract or whole powder) provide moderate and clinically significant treatment effects on a visual analogue scale (VAS) pain score (effect size: - 0.46; 95% CI - 0.82 to - 0.10; p = 0.01). The whole GSM extract improved gastrointestinal symptoms in OA patients taking anti-inflammatory medications. The GSM extract was considered to be generally well tolerated in most of the studies. CONCLUSION: The overall analysis showed that GSM provided moderate and clinically meaningful treatment effects on OA pain. However, the current evidence is limited by the number and quality of studies, and further larger and high-quality studies are needed to confirm the effectiveness and to identify the optimal GSM format. Nevertheless, it is worth considering using GSM extracts especially for patients seeking alternative pain relief treatments with fewer side effects compared to conventional treatment.

Dietary Fat Quality and Pre-diabetes: A Case-control Study.

BACKGROUND: The relationship between dietary fat quality (DFQ) indices and pre-diabetes has not been well studied. This study aimed to determine the association of DFQ indices and fatty acid intake with pre-diabetes. METHODS: This case-control study included 150 subjects with normal fasting blood glucose (FBG) and 147 pre-diabetic subjects. Dietary intake was assessed by a validated food-frequency questionnaire. DFQ indices including atherogenicity (AI) and thrombogenicity (TI), the ratios of hypo- and hypercholesterolemic (h:H), polyunsaturated:saturated (P:S) and n-3:n-6 polyunsaturated fatty acids were calculated. FBG test and 2-hour oral glucose tolerance test (OGTT) were measured. RESULTS: After adjustment for some confounding variables, a positive association was found between intake of total saturated fatty acids (SFA), myristic acid, palmitic acid, and pre-diabetes, and a negative association was observed among n-3 polyunsaturated fatty acids, eicosapentaenoic, docosahexaenoic and arachidonic acids intake and pre-diabetes. AI was found to be positively associated with pre-diabetes (OR 6.68, 95% CI 2.57-17.34). An inverse relationship was observed between n-3:n-6 (OR 0.37, 95% CI 0.14-0.93) and h:H (OR 0.20, 95% CI 0.07-0.52) ratios with pre-diabetes. CONCLUSIONS: Higher intake of dietary n-3 fatty acids was adversely, whereas SFA intake was positively related to pre-diabetes morbidity. DFQ indices may be a useful measure to investigate fat intakes and blood glucose disturbances.

Effect of soy protein containing isoflavones on endothelial and vascular function in postmenopausal women: a systematic review and meta-analysis of randomized controlled trials.

IMPORTANCE: The beneficial role of soy protein in cardiovascular health has been well documented in observational studies. However, evidence from clinical trials on effects of soy protein on endothelial function in postmenopausal women has been conflicting. OBJECTIVE: We aimed to systematically review and conduct a meta-analysis of randomized controlled trials (RCTs) investigating the impact of soy protein supplement containing isoflavones on endothelial function in postmenopausal women. EVIDENCE REVIEW: We searched PubMed-Medline, SCOPUS, Embase, and Google Scholar until March 2020 to find RCTs evaluating the impact of soy protein supplementation on endothelial function parameters. Random effects model (using DerSimonian-Laird method) was applied to synthesize quantitative data. We performed the leave-one-out method for sensitivity analysis. To quantitatively assess heterogeneity, the I index was applied. FINDINGS: From a total of 267 studies identified from the initial search 15 and 5 studies were considered appropriate for inclusion into the systematic review and meta-analysis, respectively. In the meta-analysis, an insignificant enhancement in flow-mediated dilation (FMD) after soy protein supplementation (0.882%; 95% CI: -1.059 to 2.822; P = 0.373) was found. However, subgroup analysis showed that supplementation of isolated soy protein had significant effect on FMD (3.39%; 95% CI: 0.733-6.01; P = 0.01). CONCLUSIONS AND RELEVANCE: Our findings suggest that soy protein supplementation does not lead to meaningful improvement in FMD in postmenopausal women. However, this finding is based on a limited number of studies. Additional high-quality large-scale RCTs are warranted.

Higher intakes of fruits and vegetables are related to fewer menopausal symptoms: a cross-sectional study.

OBJECTIVES: The aim of this study was to explore the associations between fruit and vegetable (FV) intake, and its subgroups and menopausal symptoms along with its subtypes in postmenopausal women. METHODS: This cross-sectional study included 393 postmenopausal women in municipality health centers in the south of Tehran, Iran. Sociodemographic data, dietary intakes, and anthropometric measures were obtained from individuals. Menopause rating scale (MRS) questionnaire was employed to measure menopausal symptoms. The total MRS score (TMRSS) was the sum of the somatic score (SS), psychological score (PS), and urogenital score (US). Participants were divided into low and high total MRS and its domain scores. RESULTS: After adjustment for confounding variables, an inverse relationship was found between total FV with TMRSS (odds ratio [OR] 0.23, 95% confidence interval [CI] 0.06-0.81) and SS (OR 0.30, 95% CI 0.11-0.82). In addition, the consumption of total fruits was significantly related to lower SS (OR 0.27, 95% CI 0.10-0.71). Only intake of citrus fruits was inversely associated with TMRSS (OR 0.23, 95% CI 0.07-0.71) and SS (OR 0.28, 95% CI 0.11-0.70). Likewise, intakes of total FV (OR 2.46, 95% CI 1.37-4.41), total vegetables (OR 2.54, 95% CI 1.10-5.88), green leafy vegetables (OR 3.59, 95% CI 1.47-8.75), dark yellow vegetables (OR 2.28, 95% CI 1.00-5.18), other vegetables (OR 5.23, 95% CI 1.17-15.39), and citrus fruits were linked to higher US (OR 4.35, 95% CI 1.77-10.71). CONCLUSION: The results of the present study showed that some FV subgroups had inverse associations with climacteric symptoms, whereas higher intake of some subgroups of FV appeared to be associated with more urogenital symptoms in postmenopausal women.

Dietary inflammatory index and dietary energy density are associated with menopausal symptoms in postmenopausal women: a cross-sectional study.

OBJECTIVES: No previous study has evaluated the association of the dietary inflammatory index (DII) and dietary energy density (DED) with menopausal symptoms and its subclasses in postmenopausal women. The aim of this study was to evaluate the association of DII score and DED with menopausal symptoms and its subtypes in Iranian postmenopausal women. METHODS: This cross-sectional study was conducted on 393 postmenopausal women who attended health centers in the south of Tehran, Iran. The DII score was calculated using dietary factors obtained by a validated food frequency questionnaire. DED was defined as average daily energy intake (kcal) per gram of food. The Menopause Rating Scale questionnaire was used to evaluate the menopausal symptoms. The total Menopause Rating Scale score (TMRSS) was the sum of the somatic score (SS), psychological score (PS), and urogenital score. Linear regression analysis was used to assess the association of the DII score and DED with menopausal symptoms. RESULTS: After adjusting for covariates, participants in the highest tertile of DII score had greater SS compared to those in the lowest tertile (ßDIIt3vs1= 0.032, 95% confidence interval (CI): 0.004-0.068, P = 0.04). No significant relationship was found between DII score and PS, urogenital score or TMRSS. Furthermore, higher DED was associated with greater SS (ßDIIt3vs1 = 0.071, 95% CI: 0.028-0.115, P = 0.001), PS (ßDIIt3vs1 = 0.065, 95% CI: 0.012-0.121, P = 0.01) and TMRSS (ßDIIt3vs1 = 0.053, 95% CI: 0.017-0.088, P = 0.004). CONCLUSION: A proinflammatory diet was associated with higher menopause-specific somatic symptoms and higher DED was positively associated with menopausal symptoms.

Effects of vitamin D supplementation on advanced glycation end products signaling pathway in T2DM patients: a randomized, placebo-controlled, double blind clinical trial.

BACKGROUND: Several researches have recommended vitamin D possible health benefits on diabetic complications development, but a few number of studies have been accomplished on the molecular and cellular mechanisms. Certain cellular pathways modification and also some transcription factors activation may protect cells from hyperglycemia condition induced damages. This study purpose was to determine the vitamin D supplementation effect on some key factors [advanced glycation end products (AGEs) signaling pathway] that were involved in the diabetic complications occurrence and progression for type-2 diabetes participants. METHODOLOGY: 48 type-2 diabetic patients (T2DM) randomly divided into two groups (n = 24 per group), receiving: 100-µg vitamin D or placebo for 3 months. At this study beginning and the end, the receptor expression for advanced glycation end products (RAGE) and glyoxalase I (GLO1) enzyme from peripheral blood mononuclear cells (PBMCs) and AGEs and tumor necrosis factor-α (TNF-α) serum levels were measured by the use of real-time PCR and ELISA methods, respectively. RESULTS: This study results demonstrated that vitamin D supplementation could down-regulate RAGE mRNA [fold change = 0.72 in vitamin D vs. 0.95 in placebo) P = 0.001)]. In addition, no significant changes were observed for GLO1 enzyme expression (P = 0.06). This study results also indicated that vitamin D serum level significantly increased in vitamin D group (P < 0.001). Moreover, AGES and TNF-α serum levels significantly reduced in vitamin D group, but they were remained unchanged in the placebo group. CONCLUSION: In conclusion, vascular complications are more frequent in diabetic patients, and vitamin D treatment may prevent or delay the complications onset in these patients by AGEs serum level and RAGE gene expression reducing.Trial registration NCT03008057. Registered December 2016.

Effects of vitamin D supplementation on circulatory YKL-40 and MCP-1 biomarkers associated with vascular diabetic complications: A randomized, placebo-controlled, double-blind clinical trial.

AIM: Diabetic patients predispose to vascular diseases such as nephropathy, and retinopathy. Poor adherence to medical treatment and dietary recommendations in uncontrolled diabetes leads to vascular damages. Vitamin D has been extensively studied and found to be protective against diabetes mellitus. YKL-40 and Monocyte chemoattractant protein-1 (MCP-1) are considered to exert crucial role in diabetes and its complications. Therefore, this study was designed to investigate effects of vitamin D supplementation on serum levels of YKL-40 and MCP-1 involved in the development of diabetic complications. METHODS: For 12 weeks, 48 type 2 diabetic patients enrolled in the trial and randomly were divided into two groups (n = 24 per group), receiving one of the following: 100 µg (4000 IU) vitamin D or placebo. Before and after intervention, serumYKL-40, MCP-1, insulin, IL-6, TNF-α, 25- (OH) vitamin D and HbA1c were measured. RESULTS: Our results revealed that serum levels of 25 (OH) vitamin D significantly increased in vitamin D group (p < 0.001). Vitamin D supplementation also significantly reduced serum YKL-40 levels (-22.7 vs. -2.4 ng/ml; (p-value = 0.003)). There was a significant decline in MCP-1 concentration in intervention group at the end of the study (-45.7 vs. -0.9 pg/ml; (p = 0.001)). Furthermore, there was a significant decrease in IL-6, fasting insulin and HOMA-IR in intervention group after 3 months supplementation. CONCLUSIONS: Daily vitamin D supplementation effectively reduced circulatory YKL-40 and MCP-1 levels in patients with type-2 diabetes and vitamin D deficiency. Vitamin D might contribute in reducing diabetic complications via modulating YKL-40 and MCP-1 signaling pathways.

Effects of vitamin D supplementation on depressive symptoms in type 2 diabetes mellitus patients: Randomized placebo-controlled double-blind clinical trial.

AIM: Diabetes increases the odds of depression and depression is often associated with poor glycemic control and complications of diabetes. Vitamin D is also believed to improve glycemic control and ameliorate depressive symptoms. Therefore, we examined effects of vitamin D monotherapy (without antidepressant drugs) on depressive symptoms in Type 2 diabetic patients with mild to moderate depressive symptoms. METHODS: We conducted 12 weeks, placebo-controlled, double-blind, randomized trial on 68 subjects with T2DM and mild to moderate depressive symptoms. Subjects received 100 µg (4000 IU) vitamin D (n = 32) or placebo (n = 34) daily. Beck Depression Inventory-II (BDI-II-PERSIAN) was applied for assessment of the severity of depression. Depression scores and metabolic profiles were measured at the beginning and end of trail. RESULTS: after 3 months of vitamin D supplementation, mean values of 25(OH) D increased from 15.5 ±â€¯8.8 to 32.2 ±â€¯8.9 ng/ml (p-value <0.001) in the vitamin D group. Moreover, BDI-II scores decreased from 15.2 ±â€¯9.6 to 9.8 ±â€¯7.2 (p-value <0.001) in the vitamin D group and 15.5 ±â€¯11.2 to 13.7 ±â€¯11.5 (p-value = 0.03) in placebo group. This decrease in BDI-II scores were significant (27.6% vs 10.8%) compared with placebo (p-value = 0.02). In term of metabolic profiles, mean change in level of Hemoglobin A1c (HbA1c), insulin and triglycerides (TG) were significantly higher in response to the treatment with vitamin D compared to placebo (p-value <0.02). CONCLUSIONS: In conclusion, supplementation of vitamin D in T2DM patients may protect these patients against the onset of major depressive disorder (MDD), with noticeable favorable effects on measures of metabolic profiles. TRIAL REGISTRATION: NCT03008057.

The dietary acid load is higher in subjects with prediabetes who are at greater risk of diabetes: a case-control study.

BACKGROUND: We aimed to examine the association of dietary acid load and prediabetes in a case-control study. METHODS: This study recruited 297 subjects including 147 prediabetic subjects and 150 controls referred to diabetes screening center in Shahreza, Iran. Participants were frequency-matched by sex and age. Blood pressure, anthropometric measures and blood glucose levels were measured. Dietary intake was assessed using a validated 168-items food frequency questionnaire (FFQ). The dietary acid load scores including the potential renal acid load (PRAL) and net endogenous acid production (NEAP) were calculated based on nutrients intake. NEAP and PRAL scores were categorized by quartiles based on the distribution of controls. Logistic regression models were used to estimate multivariable odds ratio (OR) of prediabetes across the energy-adjusted and sex-specific quartiles of NEAP and PRAL scores. RESULTS: Participants of control group in the higher quartiles of NEAP and PRAL tended to have higher body weight compared to the lower quartiles (P-trend < 0.04). After adjustment for multiple confounding variables, participants in the highest quartiles of NEAP and PRAL had increased OR for prediabetes (OR = 14.48 95% CI 5.64-37.19), and (OR = 25.61 95% CI 9.63-68.08) (P-trend < 0.001), respectively. CONCLUSION: Our data indicated subjects with prediabetes had diets with more acid-forming potential than control group. Our findings suggest that higher dietary acid load was associated with increased prediabetes morbidity. Interventional studies are warranted to elucidate the role of acidogenic diets in the development of prediabetes.

Dietary total antioxidant capacity is inversely associated with depression, anxiety and some oxidative stress biomarkers in postmenopausal women: a cross-sectional study.

BACKGROUND: Postmenopausal women are at higher risk of mental disorders. Oxidative stress has implication in the development of these disorders. Dietary total antioxidant capacity (DTAC) has been proposed as a tool for assessing dietary antioxidants intake. The relationship between DTAC with depression, anxiety and stress has not been investigated in postmenopausal women. Thus, we aimed to assess the association between DTAC and depression, stress and anxiety as well as oxidative stress biomarkers. METHODS: This cross-sectional study was carried out on 175 postmenopausal women. Data on dietary intake and mental health were collected by 147-item semi-quantitative food frequency questionnaires (FFQ) and Depression Anxiety Stress Scales (DASS-42), respectively. Dietary and serum total antioxidant capacity (TAC), malondialdehyde (MDA), oxidized-LDL, and superoxide dismutase (SOD) were measured. ANOVA test was applied to compare the mean of variables across the tertiles of DTAC. The relationship between DTAC and oxidative stress biomarkers was determined through ANCOVA method. Simple and multivariate linear regression tests were performed to measure the relationship between DTAC and mental health. RESULTS: Serum MDA level was significantly lower in the subjects at the highest tertiles of DTAC (P-value < 0.001). In addition, serum TAC level was significantly higher in subjects at the second tertile of DTAC (P-value = 0.04). DTAC was inversely and independently related to depression (ß = - 0.16, P-value = 0.03) and anxiety scores (ß = - 0.21, P-value = 0.007). There was no significant association between DTAC and stress score (ß = - 0.10, P-value = 0.1). CONCLUSION: An inverse relationship was found between DTAC with depression, anxiety scores and some oxidative stress biomarkers in postmenopausal women. These findings indicate DTAC may be used for developing effective dietary measures for reducing depression and anxiety in these women.

Correction to: Evaluation of serum 25-Hydroxy vitamin D levels in children with autism Spectrum disorder.

The original article [1] contained an error in author Mohammad Taghi Mansouri's name.

Dietary patterns and their association with menopausal symptoms: a cross-sectional study.

OBJECTIVE: Although menopause is a natural event in a woman's life, some of its symptoms can be severe enough to adversely affect her health. There is some evidence to suggest that diet has an influence on menopausal symptoms, but less attention has been paid to dietary patterns. The purpose of this study is to determine the association of dietary patterns with physical, mental, and genitourinary menopausal symptoms. METHODS: A cross-sectional study design was applied using a sample of 400 postmenopausal women who attended health centers in the south of Tehran, Iran. The menopausal symptoms were assessed by a Menopause Rating Scale (MRS) questionnaire; a 147-item, semi-quantitative food-frequency questionnaire was used to collect dietary information, and major dietary patterns were identified by principal component analysis. Linear regression was used to evaluate the relationship between menopausal symptoms and dietary patterns. RESULTS: Three major dietary patterns were identified: vegetables and fruits (VF); mayonnaise, liquid oils, sweets, and desserts (MLSD); and solid fats and snacks (SFS). It has been found that the VF dietary pattern is inversely associated with general (ß = -1.37; SE = 1.08; P for trend <0.001), physical (ß = -1.54; SE = 1.09; P for trend <0.001), and mental (ß = -1.58; SE = 1.11; P for trend <0.001) symptoms. A stronger adherence to the MLSD dietary pattern was directly associated with general (ß = 1.15; SE = 1.08; P for trend <0.001) and genitourinary symptoms (ß = 1.54; SE = 1.1; P for trend <0.001). Moreover, the SFS dietary pattern was directly related to the general (ß = 1.23; SE = 1.09; P for trend = 0.01), physical (ß = 1.24; SE = 1.09; P for trend = 0.04), and mental (ß = 1.29; SE = 1.12; P for trend < 0.001) symptoms. CONCLUSION: The present study demonstrated that there is an inverse association between VF dietary pattern and menopausal symptoms. In contrast, the MLSD and SFS dietary patterns were correlated to an increased risk of these symptoms.

Evaluation of serum 25-Hydroxy vitamin D levels in children with autism Spectrum disorder.

BACKGROUND: Vitamin D plays an important role in etiology of Autism Spectrum Disorders (ASDs). We aimed to evaluate the serum 25 - hydroxyl vitamin D level among children with ASDs in Ahvaz city, Iran. METHODS: It was a cross-sectional study which had conducted on 62 subjects in two groups: a case group (n = 31) consisted of ASD children who study in especial schools; and a control group (n = 31) of healthy children who were selected by simple random sampling from regular schools in Ahvaz city, Iran during 2016. Maching between two groups has done regarding Socioeconomic status, type and amount of food intake, place of living and age. The levels of serum 25 - hydroxyl vitamin D were assessed in early morning means fasted state and also measured using ELISA method. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 20. The significant level was considered < 0.05. RESULTS: In ASD children, the average serum 25-hydroxyvitamine D level was 9.03 ± 4.14 ng/mg. In ASD group, 96.8% (30 subjects) had vitamin D deficiency. In healthy children group, average serum 25-hydroxyvitamine D level was 15.25 ± 7.89 ng/mg. Average serum 25-hydroxyvitamine D level in intervention group was significantly lower than the control group (P > 0.001). Although the parents of patients in control group reported longer exposure to sun (27.42 m per day against 33.06 m per day), no significant difference was observed between these groups in terms of exposure to sun (P < 0.05). CONCLUSIONS: A significant difference was observed between serum 25-hydroxyvitamine D levels between the healthy and ASD children. It is recommended to use vitamin D supplement in children with ASDs under medical care.