Efficacy of dietary supplements on mortality and clinical outcomes in adults with sepsis and septic shock: A systematic review and network meta-analysis.

AIM: The aim of this network meta-analysis (NMA) was to investigate the effects of different dietary supplements on the mortality and clinical status of adults with sepsis. METHODS: We searched PubMed, EMBASE, and the Cochrane Library Central Register of Controlled Trials until February 2023. The inclusion criteria were: 1) randomized controlled trials (RCT)s; 2) adults suffering sepsis or septic shock; 3) evaluation of short- or long-mortality; and 4) publications between 1994 and 2023. The general information of studies and details of interventions were extracted. The primary outcome was short-term mortality (<90 days), and the secondary outcomes were long-term mortality (≥90 days), length of ICU and hospital stays, and duration of mechanical ventilation (MV). The risk of bias of RCTs was assessed using the Cochrane risk of bias tool 2 (ROB2). A random effect NMA was performed to rank the effect of each intervention using a frequentist approach. RESULTS: Finally, 56 RCTs with 5957 participants met the criteria. Approximately, one-third of RCTs were low risk of bias. NMA analysis revealed that there was no treatment more effective in short- or long-term mortality than control or other interventions, except for magnesium (RR: 0.33, 95% CI: 0.14, 0.79; GRADE = low) and vitamin C (RR: 0.81, 95% CI: 0.67, 0.99; low certainty evidence), which had beneficial effects on short-term mortality. Moreover, eicosapentaenoic acid, gamma-linolenic acid, and antioxidants (EPA + GLA + AOs) combination was the most effective, and magnesium, vitamin D and vitamin C were the other effective approaches in terms of duration of MV, and ICU length of stay. There was no beneficial dietary supplement for hospital stay in these patients. CONCLUSIONS: In septic patients, none of the dietary supplements had a substantial effect on mortality except for magnesium and vitamin C, which were linked to lower short-term mortality with low certainty of evidence. Further investigation into high-quality studies with the use of dietary supplements for sepsis should be highly discouraged.

Association between diabetes risk reduction diet score and risk of breast cancer: A case-control study.

PURPOSE: To assess the association between the diabetes risk reduction diet score (DRRD) and the odds of breast cancer (BC). METHODS: During this hospital-based case-control study we included 149 newly diagnosed cases of BC and 150 controls matched by age. All cases were patients with pathologically confirmed BC, with no history of any form of other cancers. The controls were randomly selected from visitors and families of non-cancer patients in other wards of the same hospital who had no health issues including BC. The dietary intakes were evaluated by a validated 147-item semi-quantitative FFQ. DRRD score was calculated from 9 dietary components published before, with a better score resembling a higher adherence to DRRD. RESULTS: A negative association was found between the chances of BC and DRRD after adjusting for potential confounders, but it was not statistically significant (OR, 0.47; 95%CI, 0.11-2.08; P = 0.531). Also, there were no significant associations between DRRD and therefore the odds of BC in the crude model and also in post-menopausal (OR, 0.45; 95%CI, 0.10-1.99; P = 0.505) and pre-menopausal women (OR, 0.52; 95%CI, 0.18-1.40; P = 0.097) in our study, after adjusting for potential confounders. CONCLUSION: Adherence to a diet with a high DRRD score was not associated with the reduced risk of BC in Iranian adults.

Adherence to Mediterranean dietary quality index and risk of breast cancer in adult women: a case-control study.

BACKGROUND: Breast cancer (BC) is the fifth most prevalent cause of cancer-related deaths in Iran. Given that the role of whole-diet on cancer risk is important, this study aimed to assess the association of MedDQI and breast cancer risk. METHODS: This hospital-based case-control study was performed on 150 women with pathologically confirmed breast cancer within the period of less than 3 months. Controls were 150 apparently healthy that were matched by age. Dietary data was collected using a validated questionnaire. To examine participants' adherence to MedDQI, the MedDQI was created according to foods and nutrients highlighted or minimized in the MedDQI construction. RESULTS: After adjusting for possible confounders, participants in the highest quartile of the MedDQI score had 55% lower odds of breast cancer than women in the bottom quartile (OR: 0.45, 95% CI: 0.21, 0.94, P trend: 0.02). Stratified analysis by menopausal status showed such association in postmenopausal women (OR: 0.24, 95% CI: 0.07, 0.8, P trend: 0.055) after controlling for age and energy intake. CONCLUSION: The results showed an inverse association between adherence to the MedDQI and risk of breast cancer among Iranian women. More prospective studies are needed to confirm our results.

Comparative effectiveness of single foods and food groups on body weight: a systematic review and network meta-analysis of 152 randomized controlled trials.

PURPOSE: This study aimed at quantifying and ranking the effects of different foods or food groups on weight loss. METHODS: We searched PubMed, Scopus, Cochrane Central Register of Controlled Trials, and Embase to April 2021. We included randomized trials evaluating the comparative effects of two or more food groups, or compared a food group against a control group (usual diet, no intervention) for weight loss in adults. We conducted random-effects network meta-analysis with Bayesian framework to estimate mean difference [MD] and 95% credible interval [CrI] of the effect of food groups on weight loss. RESULTS: 152 RCTs with 9669 participants were eligible. Increased consumption of fish (MD - 0.85 kg, 95% CrI - 1.66, - 0.02; GRADE = low), whole grains (MD - 0.44 kg, 95% CrI - 0.88, 0.0; GRADE = very low), and nuts (MD - 0.37 kg, 95% CI - 0.72, - 0.01; GRADE = low) demonstrated trivial weight loss, well below minimal clinically important threshold (3.9 kg), when compared with the control group. Interventions with other food groups led to no weight loss when compared with either the control group or other food groups. The certainty of the evidence was rated low to very low with the point estimates for all comparisons less than 1 kg. None of the food groups showed an important reduction in body weight when restricted to studies conducted in participants with overweight or obesity. CONCLUSIONS: Interventions with a single food or food group resulted in no or trivial weight loss, especially in  individuals with overweight or obesity. Further trials on single foods or food groups for weight loss should be highly discouraged.

Meat consumption and the risk of general and central obesity: the Shahedieh study.

OBJECTIVE: This study aimed to investigate the relations of total meat intake and its subtypes, including red and processed meat, white meat, poultry, fish, and organ meat to the risk of general/central obesity. METHODS: This cross-sectional study included a total of 7312 Iranian adults with the age range of 35-70 years from the Shahedieh cohort study, Yazd, Iran. Dietary intake of subjects was evaluated using a validated 120-item Food Frequency Questionnaire. General obesity was defined as body mass index ≥ 30 kg/m2 and central obesity as waist circumference ≥ 102 cm in men and ≥ 88 cm in women. RESULTS: After controlling for potential covariates including energy intake, age, marital status, gender, physical activity, supplement use, house possession, education, family size, current smoking, night shift working, history of thyroid disease and depression, and intakes of vegetables, legumes, nuts, fruits, whole grains, and dairy, a significant direct association was found between the higher consumption of white meat (OR = 1.31; 95% CI: 1.06-1.61) and poultry (OR = 1.23; 95% CI: 1.04-1.45) with odds of general obesity. Processed meat was a significant predictor for central obesity in the fully adjusted model, so that individuals in the fourth quartile of processed meat intake, compared with those in the first quartile, had a 22% (OR = 1.22; 95% CI: 1.04-1.43) increased risk to be centrally obese. CONCLUSION: This study reveals that higher intakes of white meat and poultry are associated with increased risk of general obesity, while, processed meat consumption was associated with central obesity.

Association of Empirically Derived Food-Based Inflammatory Potential of the Diet and Breast Cancer: A Hospital-Based Case-Control Study.

BACKGROUND: Diet may be a modifiable factor in the prevention of breast cancer (BC) by modulating inflammation. We used a food-based empirical dietary inflammatory index (FDII) to evaluate the association between FDII and odds of breast cancer in Iranian women. METHODS: The present case-control study carried out on 150 age-matched women with newly diagnosed breast cancer and controls. Data for dietary intake and anthropometric measures were collected. FDII score was developed according to participants dietary intakes of 27 pre-defined food groups. Multivariate odds ratios (OR) with 95% confidence intervals (CI) were used to investigate the association of empirically derived food-based inflammatory potential of the diet and breast cancer. RESULTS: The odds ratios of BC according to quartiles of FDII score by multivariate logistic regression models indicated the FDII score was significantly associated with BC risk (OR: 2.38; 95% CI: 1.23-4.59, Ptrend = .04). After controlling confounders, multivariate logistic regressions remained significant which revealed in participants at the fourth quartile of FDII score chance of breast cancer was 2.8 times higher than participants in the first quartile. CONCLUSIONS: The results of our study suggested that more pro-inflammatory diet (higher FDII scores) was associated with increased BC risk. These findings suggest that developing an effective dietary modification based on FDII may reduce risk of BC.

Higher Fruits and Vegetables Consumption Is not Associated with Risk of Breast Cancer in Iranian Women.

We aimed to investigate the association of fruits and vegetables (FVs) and their all subgroups intakes with breast cancer (BC) risk in Iranian women.The present case-control study conducted on 150 age-matched women with newly diagnosed BC and apparently healthy controls. Anthropometric measures were collected and eventually, the mean intakes of total FVs and each subgroup were obtained from a validated 147-item food frequency questionnaire. Multivariate regression analysis was used to estimate odds ratios (OR) with 95% confidence intervals (CI).Our findings revealed that the intake of only dark yellow vegetable was significantly higher in BC patients (P = 0.03) after controlling for covariates. OR of BC across tertiles of FVs intake, showed that there was not any statistical association of total FVs (OR: 1.83, CI: 0.54-6.24, P-trend = 0.3) and their subgroups intakes with BC risk. Except for berry fruits intake which was adversely associated with BC risk (OR: 0.36, CI: 0.09-1.37, P-trend = 0.02).Our findings did not support the hypothesis that higher total FVs and their subgroups intakes reduce BC risk and suggested that only higher berry fruits intake may have an association with lower BC risk.

The Prevalence of Vitamin D and Calcium Supplement use and Association with Serum 25-Hydroxy-vitamin D (25(OH)D) and Demographic and Socioeconomic Variables in Iranian Elderly.

AIMS: The objective of this study was to determine the prevalence of vitamin D and calcium supplement use, and association with serum 25-hydroxy-vitamin D(25(OH)D) and demographic and socioeconomic variables in Iranian elderly. SETTINGS AND DESIGN: This cross-sectional study was conducted in health centers of Tehran, capital of Iran. METHODS: A total of 600 men and women were recruited using a two-stage cluster sampling method from 60 health centers. Participant's inclusion criteria included enrolling older adults over 60 years old who able to answer questions. We used valid and reliable questionnaires to record dietary intake of vitamin D and calcium. Any dietary supplements which included vitamin D/calcium were recorded. 25(OH)D level was measured. Participants were categorized as supplement users if they had taken supplements during last month. RESULTS: The mean age of participants was 67.16 ± 6.07 years. Vitamin D supplements were used more often by females (OR = 11.89, 95% confidence interval (CI): 4.82-29.34), high educated subjects (OR = 3.49, 95% CI: 1.45-8.44), participants who did more physical activities (OR = 2.75, 95% CI: 1.52-5.00), and subjects who took antiosteoporosis medications (OR = 6.90, 95% CI: 2.84­16.78). Calcium supplements were used more often by females (OR = 13.05, 95% CI: 5.19-32.81), more physical activities participants (OR = 2.17, 95% CI: 1.20-3.92), and antiosteoporosis users (OR = 8.31, 95% CI: 3.43-20.14). Significant positive associations were seen between 25(OH) D levels and osteoporosis (P = 0.020), vitamin D supplement use (P < 0.0001), and sun exposure (P = 0.093). CONCLUSION: In this population of Tehranian adults, the prevalence of vitamin D and calcium supplement use may be attributed to educational level and underlying disease. Vitamin D supplementation, osteoporosis, and sun exposure were the strong predictors of vitamin D status.

Water intake and risk of type 2 diabetes: A systematic review and meta-analysis of observational studies.

BACKGROUND AND AIMS: The association of water intake with type 2 diabetes mellitus (T2DM) is still unclear. Therefore, the aim of this systematic review and meta-analysis was to synthesize the knowledge about the relationship between water intake and the risk of T2DM. METHODS: We conducted a systematic search in PubMed and Scopus up to June 2018 for observational studies. Risk ratios (RR)s and 95% confidence intervals (95% CI)s were calculated and fixed effects models were used. RESULTS: Overall, 6 studies were included in the meta-analyses. There was an inverse relationship between water intake and risk of T2DM (RR: 0.94; 95% CI: 0.91-0.97, P < 0.001) with low heterogeneity (I2 = 24%, P = 0.24). CONCLUSION: Our findings indicated that the intake of water was correlated with reduced risk of type 2 diabetes in women and men. These results support the current recommendations of water intake as an inseparable part of a diet with the lowest risk of diabetes mellitus.

Effect of bariatric surgery on endogenous sex hormones and sex hormone-binding globulin levels: a systematic review and meta-analysis.

BACKGROUND: Most studies have shown beneficial effect of bariatric surgery (BS) on serum levels of sex hormones. OBJECTIVE: A systematic review and meta-analysis was conducted to examine the magnitude of possible changes in levels of sex hormones following BS. SETTINGS: Electronic databases were searched, including PubMed, Scopus, Web of Science, and Embase, for relevant studies. METHODS: The heterogeneity of the studies was examined by χ2 tests and the degree of heterogeneity was estimated using I2 statistic. RESULTS: The results of pooled analyses revealed that BS caused a significant increase in luteinizing hormone (LH), follicular stimulating hormone (FSH), total testosterone (TT), and sex hormone binding globulin (SHBG) levels and conversely, decreased dehydroepiandrosterone (DHEA) and estradiol (E2) levels in males. For females, BS significantly increased LH, FSH, and SHBG levels and conversely, decreased androstenedione (AE), E2 and TT levels. Additionally, the level of progesterone (P), prolactin (PRL), free testosterone (FT) and dehydroepiandrosterone sulfate (DHEA-S) showed no significant changes in patients who had undergone BS. CONCLUSION: BS changed most sex hormones levels including LH, FSH, TT, SHBG, AE, DHEA, and E2. It seems that BS is able to exert substantial impacts on sex hormones levels and as well as sexual function, however, larger, and more precise trials are required to specifically focus on these claims.

The Lack of Association between Plant-Based Dietary Pattern and Breast Cancer: a Hospital-Based Case-Control Study.

Our purpose was to assess the association between plant-based dietary patterns and breast cancer (BrCa) among Iranian women. This hospital-based case-control study included 150 newly diagnosed BrCa cases and 150 age-matched controls from the Cancer Research Center, Imam Khomeini hospital, Iran. Three indices of a plant-based diet were first calculated: plant-based diet index (PDI), the healthy PDI (hPDI), and the unhealthy PDI (uPDI). In the overall PDI, all plant foods scored positively. In hPDI and uPDI, healthy and less healthy plant foods scored positive, respectively. The adjusted odds ratio (OR) in the highest adherence of PDI was 1.00 (95% confidence interval [CI], 0.55-1.83). In hPDI, 0.89 (95% CI, 0.49-1.62); in uPDI, 1.80 (95% CI, 0.95-3.42). The adjusted OR after subgroup analysis for body mass index (BMI) was as follow, BMI > 25: 0.77(95% CI, 0.37-1.61) comparing highest with the lowest tertile of PDI, 0.91(95% CI, 0.44-1.89) comparing highest with the lowest tertile of hPDI and this value for uPDI was 2.04 (95% CI, 0.91-4.56). BMI < 25: OR for top tertile of PDI was 1.82 (95% CI, 0.48-6.93), top tertile of hPDI was 1.47 (95% CI, 0.35-6.22) and top tertile of uPDI was 2.29 (95% CI, 0.54-9.70). Our results revealed no significant association between none of the PDIs and the chance of BrCa in Iranian women. Continued and expanded research, evaluated by different methods and BrCa is urgently needed to build the foundation for future progress in evidence-based public health efforts.

Association of major dietary patterns with muscle strength and muscle mass index in middle-aged men and women: Results from a cross-sectional study.

BACKGROUND: Dietary patterns may affect muscle mass, strength, and function; hence, we evaluated the association of major dietary patterns in relation to muscle mass index (MMI) and muscle strength in middle-aged adults. We hypothesized that unhealthy dietary patterns are associated with reduced muscle mass and muscle strength. SUBJECTS: and methods: The present cross-sectional study recruited 270 adults (118 males and 152 females) aged between 18 and 75 years' old. Socio-demographic data, body composition and muscle strength were determined. MMI was calculated by total fat free mass (FFM) (kg)/height2 (m). Dietary intake was assessed using a 168-item validated food frequency questionnaire. Factor analysis was conducted, and as a result, 3 factors were extracted. These factors were labeled as healthy, mixed and western dietary patterns. RESULTS: After control for potential confounders, there were a positive trend between tertiles of "healthy dietary pattern" and muscle strength (p = 0.03). Moreover, we found that those who were in the third tertile of "mixed dietary pattern" compared to those at the first tertile had no significant relationship with muscle strength (p = 0.42) and MMI (p = 0.36) even after controlling for potential confounders. In contrast, the adherence to the "Western dietary pattern" was associated with reduced MMI (p = 0.02). CONCLUSION: Adherence to healthy dietary pattern might be associated with better muscle strength and greater adherence to Western pattern appears to reduce MMI.

Higher dietary acid load is not associated with risk of breast cancer in Iranian women.

BACKGROUND: Dietary acid load (DAL) may play a key role in certain cancers, including breast cancer (BC); however, evidence showing a causal relationship is lacking. AIM: We examined the relationship between DAL, assessed with both the potential renal acid load (PRAL) and the net endogenous acid production (NEAP) scores, and BC risk. METHODS: We identified 150 women who had a diagnosis of BC recently and 150 age-matched apparently healthy controls. Data from dietary intake and anthropometric measures were collected from participants and eventually, PRAL and NEAP scores were obtained from nutrient intakes. Multivariate odds ratios (OR) with 95% confidence intervals (CI) were used to evaluate the relationship of BC risk with PRAL and NEAP scores. RESULTS: The odds ratios (OR) of BC according to tertiles of PRAL and NEAP scores by multivariate logistic regression models revealed that both PRAL (P-trend = 0.8) and NEAP (P-trend = 0.1) scores were not significantly associated with BC risk. After controlling confounders, multiple logistic regressions still remained non-significant which indicated no significant associations between PRAL (P-trend = 0.9), NEAP (P-trend = 0.4) scores and risk of BC. CONCLUSION: The results of our study suggested that there is no significant relationship between DAL and BC incidence among Iranian women.

Association of dietary energy density with cardiometabolic risk factors and metabolic syndrome in Tehranian older adults.

Introduction: The objective of this study was to evaluate the association between the consumption of an energy-dense diet and cardiometabolic risk factors in Iranian older adults. Methods: This cross-sectional study was conducted on 226 older adults who were living in Tehran, Iran. Dietary energy density (DED) was calculated as energy per weight of food, kcal/g. The usual intake of participants was measured using a validated semi-quantitative food frequency questionnaire. Anthropometric measurements, fasting blood sugar, serum lipid profile and blood pressure and were assessed. The metabolic syndrome was defined according to National Cholesterol Education Program Adult Treatment Panel-III (NCEP ATP III). Results: Those who were in the third tertile of DED compared to the first tertile had 19% lower odds of having the cardiometabolic risk factors and metabolic syndrome (MetS) 0.81 (0.39,1.68) but the association was no significant (P =0.58). There was a significant inverse association between DED and systolic blood pressure (SBP) (ß=-0.14, P =0.03) and diastolic blood pressure (DBP) (ß=-0.17, P =0.01). We did not find any significant association between intake of energy-dense foods and serum levels of triglyceride (TG) (P =0.62), fasting blood sugar (FBS) (P =0.06), high-density lipoprotein (HDL) (P =0.72) and waist circumference (WC) (P=0.28). Conclusion: DED is negatively associated with SBP and DBP in Iranian older adults. Prospective studies are needed to establish a causal link between DED and MetS and risk factors of cardiovascular disease (CVD).

Birth Weight and Risk of Cardiovascular Disease Incidence in Adulthood: a Dose-Response Meta-analysis.

PURPOSE OF REVIEW: Studies have revealed a relation between birth weight (BW) and later risk of cardiovascular diseases (CVDs). This meta-analysis aimed to report the dose-response relationship between BW and risk of CVDs. RECENT FINDINGS: The relation of BW to CVD subtypes was found to be U-shaped as BW below ~ 2500 g and above ~ 4000 g affected positively CVD risk (OR = 1.14 = 95%CI 1.03-1.27 and OR = 1.08; 95%CI 0.99-1.18, respectively). Regarding CVD subtypes, low BW was directly linked to greater risk of CHD (OR = 1.15; 95%CI 1.02-1.29) and stroke (OR = 1.28; 95% CI 1.05-1.55), while high BW was related to increased risk of arterial fibrillation in adulthood. A U-shaped nonlinear relationship was specifically demonstrated between BW and overall CVD and its subtypes. There is a U-shaped association between BW and all CVD subtypes.

Vitamin C supplementation and C-reactive protein levels: Findings from a systematic review and meta-analysis of clinical trials.

Background and purpose C-reactive protein (CRP) is an inflammatory biomarker which prognosticates cardiovascular disease. Previous studies have reached mixed conclusions regarding the effect of vitamin C on reducing CRP or hs-CRP level. The present systematic review and meta-analysis was conducted to resolve these inconsistencies. Materials and methods: Related articles published up to August 2018 were searched through PubMed, Scopus, Ovid, ISI web of science, Embase, and Cochrane databases by relevant keywords. Clinical trials which examined the effect of either vitamin C supplementation or vitamin C-enriched foods on CRP and hs-CRP levels were included. A total of 11 studies with 14 data sets involving 818 subjects were included. Results Overall, the pooled analysis revealed that vitamin C could decrease CRP level relative to placebo group (Weighted mean difference [WMD]=-0.73 mg/L: 95% CI: -1.30 to -0.15, p=0.013) with a considerable heterogeneity (I2=98%, p<0.001). Moreover, subgroup analyses revealed that the beneficial effect of vitamin C on CRP level alternation only was found in male (p=0.003), non-smoker (p=0.041), healthy (p=0.029) and younger participants (p=0.010). Vitamin C could improve CRP level only at doses of less than 500 mg/day (p=0.009). Regarding hs-CRP changes, the pooled analysis did not show any significant effect of vitamin C (WMD=-0.65 mg/L: 95% CI: -2.03 to 0.72, p=0.35). This finding was confirmed by all subgroup analyses expect for high quality articles in which hs-CRP level was elevated after vitamin C supplementation (p=0.026). Conclusion In conclusion, supplementation with vitamin C might have a significant effect only on CRP reduction. Further studies are needed to confirm this effect.

The effect of chocolate-based products on some appetite-related hormones: a systematic review.

Studies have shown the effects of chocolate-based products on appetite-related indicators; however, the results of these studies are equivocal. Thus, the aim of the present study was to conduct a systematic review of studies investigating the acute and long-term response of appetite-related hormones to chocolate intake in adults. A systematic search of MEDLINE and EMBASE for published studies, in English, was performed from inception up to November 2018. It appears that ghrelin and leptin are not responsible for the satiating effect of chocolate products. Gastric infusion of milk chocolate elicited a greater increase in cholecystokinin (CCK), in comparison with oral ingestion of milk chocolate and gastric infusion of non-caloric products. Moreover, viscosity seems to have no effect on active CCK and glucagon-like peptide-1. Due to the heterogeneity between studies, limited sample, low quality of evidence, and substantial variation in methods and chocolate products, caution is suggested in interpreting these results.

Dose-Response Meta-Analysis of the Impact of Body Mass Index on Mortality in the Intensive Care Unit.

INTRODUCTION: Both low and high body mass index (BMI) are associated with mortality in the intensive care unit (ICU). Although many studies have been done to determine the relationship between BMI and risk of mortality in the ICU, their results were inconsistent. This study aimed to conduct a dose-response meta-analysis of published observational studies to assess the effect of BMI on the risk of mortality in patients admitted to the ICU. METHODS: PubMed, Scopus, and Google Scholar were searched to identify articles up to May 2019. A total of 31 relevant articles, with 238,961 patients and a follow-up period of 1 month to 11 years, were analyzed. RESULTS: Linear analysis showed a 0.6% decrease in mortality rate per unit (kg/m2 ) increase in BMI (odds ratio: 0.99; 95% CI, 0.98-0.99). In addition, nonlinear analysis showed a decrease in risk of mortality for a BMI of 35 (P < .001) and then increased the risk of mortality with a BMI > 35 (P < .001). CONCLUSION: This dose-response meta-analysis revealed that a BMI ≤ 35 can be a protective agent against mortality, but a BMI > 35 is a life-threatening factor in patients admitted to the ICU.

Effects of berberine and barberry on anthropometric measures: A systematic review and meta-analysis of randomized controlled trials.

OBJECTIVE: Despite controversies, no study has systematically summarized findings from earlier studies on the effect of berberine and barberry on anthropometric measures. Therefore, the current systematic review and meta-analysis was conducted on the effect of berberine and barberry on body mass index (BMI), body weight (BW), waist circumference (WC) and waist-hip ratio (WHR) in adults. METHODS: Relevant studies, published up to August 2019, were searched through PubMed/Medline, Scopus, ISI Web of Science, Embase and Google Scholar. All randomized clinical trials investigating the effect of berberine and barberry on the anthropometric measures including BMI, BW, WC or/and WHR were included. RESULTS: Out of 252 citations, 12 trials that enrolled 849 subjects were included. Berberine and barberry resulted in no significant change in BMI (Weighted mean differences (WMD): -0.16 kg/m2; 95 % CI: -0.43 to 0.11, P = 0.247), BW (WMD: -0.11 kg; 95 % CI: -0.13 to 0.91, P = 0.830), and berberine resulted in not significant in WC (WMD: -0.58 cm; 95 % CI: -1.89 to 0.72, P = 0.379) and significant reduction in WHR (WMD: -0.03; 95 % CI: -0.04 to -0.01, P < 0.0001). CONCLUSION: We found a significant reduction in WHR following berberine consumption in adults. Further clinical trials with high quality according to challenges mentioned seem to be helpful to use berberine and barberry as a supplement for certain health conditions, efficiently.

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.