The effect of conjugated linoleic acid supplementation in comparison with omega-6 and omega-9 on lipid profile: a graded, dose-response systematic review and meta-analysis of randomized controlled trials.

Conjugated linoleic acid (CLA) is a geometrical isomer of linoleic acid, which has anti-inflammatory, anti-diabetic, anti-cancer, and anti-obesity properties. However, the studies reported inconstant results about the CLA-related effects on lipid profiles. As a result, meta-analysis and systematic review were performed to survey the CLA supplementation-related effect on lipid profile including high-density lipoprotein (HDL), low-density lipoprotein (LDL), total cholesterol (TC), and triglycerides (TG). To identify the relevant research, a systematic comprehensive search was initiated on the medical databases such as Scopus and PubMed/Medline until December 2022. The overall effect size was estimated by weighted mean difference (WMD) and 95% confidence interval (CI) in a random effect meta-analysis. In the final quantitative analysis, the meta-analysis considered 35 randomized controlled trials (RCTs) with 1,476 participants (707 controls and 769 cases). The pooled results demonstrated that CLA supplementation, compared with olive oil, significantly increased serum TG levels (WMD: 0.05 mmol/L; 95% CI: 0.01 to 0.1; p = 0.04; I2 = 0.0%, p = 0.91). With regard to TC level, CLA supplementation compared with placebo significantly reduced TC concentrations (WMD: -0.08 mmol/L; 95% CI: -0.14 to -0.02; p < 0.001; I2 = 82.4%). Moreover, the non-linear dose-response analysis indicated a decreasing trend of TC serum level from the 15th week of CLA supplementation compared with olive oil (Pnon-linearity = 0.01). The present meta-analysis and systematic review of 35 RCTs showed that the CLA intervention was able to raise the level of TG in comparison to olive oil; however, it can decrease TC level compared with placebo and olive oil.

Breast Cancer and Chronic Lymphocytic Leukemia and Renal Cell Carcinoma: A Case Report of a Rare Cancer Combination.

Introduction: The incidence of second malignancies in breast cancer survivors has increased because of early detection and improved cancer treatment modalities. The synchronous occurrence of chronic lymphocytic lymphoma (CLL) and renal cell carcinoma (RCC) in the same patient is higher than in the general population. Several factors, including the history of chemotherapy with alkylating agents, genetic alteration, and long-term survival of breast cancer patients may explain this condition, but further research is needed. Case Presentation: In the present report, we discussed the case of a 48-year-old female who had clear cell RCC; 5 months after the diagnosis of CLL and 15 years after invasive ductal carcinoma. Conclusion: Considering the continued elevated risk of second cancers in patients with breast cancer and CLL in a clinical setting, clinicians should be made aware of ongoing medical surveillance.

The effects of probiotic supplements on oxidative stress and inflammation in subjects with mild and moderate Alzheimer's disease: a randomized, double-blind, placebo-controlled study.

Through modulating effects on the gut-brain axis, probiotics are an effective adjuvant treatment for Alzheimer's disease (AD), one of our century's most important medical care challenges (Agahi et al. Front Neurol 9:662, 2018). This trial aimed to examine the effects of two different single-strain probiotics on oxidative stress and inflammation in patients with mild and moderate AD. This was a 12-week placebo-controlled, double-blind, randomized clinical trial performed on 90 patients with AD. Eligible patients were randomly assigned to two different interventions (Lacticaseibacillus rhamnosus HA-114 (7.5 × 109) or Bifidobacterium longum R0175 (7.5 × 109)) and a placebo group, supplemented twice daily. We used mixed-effect models to examine the probiotic's independent effects on clinical results. Significant improvements in serum inflammatory and oxidative stress markers were observed at the end of the trial (P < 0.05). Probiotic supplementation for 12 weeks had beneficial effects on oxidative stress, inflammation, quality of life, and physical activity in patients with mild and moderate AD.

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

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

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

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

The effects of intermittent fasting diet in comparison with low-calorie diet on lipid profile, glycemic status, and liver fibrosis in patients with non-alcoholic fatty liver (NAFLD): a study protocol for a randomized controlled clinical trial.

INTRODUCTION: Non-alcoholic fatty liver disease (NAFLD) is a common liver disease characterized by an increase in fat in liver cells. The outbreak of NAFLD is estimated to be 32.4% worldwide, with higher rates in Asia and Iran. Nutritional factors such as excessive calorie intake, high fructose intake, copper deficiency, and increased iron intake play an important role in NAFLD. Since there is no specific treatment for NAFLD, intermittent fasting (IF) diet has been suggested as an alternative treatment for obesity and related complications. Previous studies showed the potential positive effects of IF on metabolic health and the reduction of oxidative stress in NAFLD. This randomized controlled trial (RCT) will be aimed to examine the effect of the IF diet in comparison with a low-calorie diet (LCD) on lipid profile, glycemic status, and liver fibrosis in patients with NAFLD. METHODS AND ANALYSIS: This is a parallel randomized clinical trial conducted on 52 overweight and obese patients with NAFLD. Participants will be randomly assigned to receive either 16:8 IF (fasting from 8 P.M. to 12 P.M. the next day) or a low-calorie (55% carbohydrate- 30% fat, 15% protein) diet for 12 weeks. Anthropometric measurements, liver assessments, and metabolic evaluations will be assessed before and after the intervention. Primary outcomes include liver steatosis and fibrosis, while secondary outcomes include liver function enzymes, insulin resistance, lipid profile, and anthropometric measurements. DISCUSSION: Since obesity and insulin resistance are the most important risk factors of NAFLD, and there is no treatment for it, it seems that lifestyle changes such as low caloric diet like IF and exercise can improve lipid metabolism and liver enzymes. TRIAL REGISTRATION: Iranian registry of clinical trials (IRCT20170202032367N5).

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

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

Does folic acid supplementation have a positive effect on improving memory? A systematic review and meta-analysis of randomized controlled trials.

Introduction: The results of randomized controlled trials (RCTs) on the effect of folic acid supplementation on memory status due to various heterogeneity, dosage, duration, and cognitive function assessments were inconclusive. Therefore, we have performed a systematic review and meta-analysis to investigate the effect of folic acid supplementation on memory in RCTs. Method: Comprehensive computerized systematic searches were conducted throughout Scopus, PubMed/Medline, and Google Scholar from inception until February 2022 to investigate the effect of folic acid supplementation memory levels in RCTs. The standardized mean difference (SMD) and 95% confidence interval (CIs) were used to estimate the overall effect size using random-effects meta-analyses. Results: The overall results of nine trials with 641 participants, revealed that folic acid supplementation did not significantly change memory score compared to placebo (SMD: 0.12; 95% CI: -0.17, 0.40, p = 0.418; I 2 = 62.6%). However, subgroup analyses showed that supplementation with folic acid had favorable effects on memory levels considering the following conditions: (1) doses lower than 1 mg/day, (2) treatment lasting more than 6 months, (3) conducted in eastern countries, and (4) in participants equal to or older than 70 years old. The dose-response analysis suggested a significant favorable effect on memory status at doses of 6-11 mg/d and a significant decline at doses of 17-20 mg/d. Discussion: Although we did not find a significant effect of folic acid supplementation on memory, there were some suggestions of beneficial effects in the subgroup analyses.

Effects of probiotic supplements on cognition, anxiety, and physical activity in subjects with mild and moderate Alzheimer's disease: A randomized, double-blind, and placebo-controlled study.

Probiotics have been suggested as an effective adjuvant treatment for Alzheimer's disease (AD) due to their modulating effect on the gut microbiota, which may affect the gut-brain axis. Therefore, we aimed to evaluate the effects of two different single-strain probiotics on cognition, physical activity, and anxiety in subjects with mild and moderate AD. Eligible patients (n = 90) with AD were randomly assigned to either of two interventions [Lactobacillus rhamnosus HA-114 (1015 CFU) or Bifidobacterium longum R0175 (1015 CFU)] or placebo group, receiving probiotic supplement twice daily for 12 weeks. The primary outcome of the study was cognitive function measured by using the two tests, namely, the Mini-Mental State Examination (MMSE) and the categorical verbal fluency test (CFT). Secondary outcomes included a performance in Activities of Daily Living (ADL), the Lawton Instrumental Activities of Daily Living (IADL) scale, and the Generalized Anxiety Disorder (GAD-7) scale. Linear mixed-effect models were used to investigate the independent effects of probiotics on clinical outcomes. After 12 weeks, MMSE significantly improved cognition (P Interaction < 0.0001), with post hoc comparisons identifying significantly more improvement in the B. longum intervention group (differences: 4.86, 95% CI: 3.91-5.81; P < 0.0001) compared with both the placebo and L. rhamnosus intervention groups (differences: 4.06, 95% CI: 3.11-5.01; P < 0.0001). There was no significant difference between the two intervention groups (differences: -0.8, 95% CI: -1.74 to 0.14; P = 0.09). In conclusion, this trial demonstrated that 12-week probiotic supplementation compared with placebo had beneficial effects on the cognition status of patients with AD.

Association of fruits, vegetables, and fiber intake with COVID-19 severity and symptoms in hospitalized patients: A cross-sectional study.

Background and aims: Fruits and vegetables are rich in fiber and a good source of anti-inflammatory and immune-boosting vitamins, minerals, and antioxidants. We investigated the association between fruits, vegetables, and fiber intake and severity of COVID-19 and related symptoms in hospitalized patients. Methods: A total of 250 COVID-19 hospitalized patients aged 18 to 65 years were recruited for this cross-sectional study in Kashan, Iran, between June and September of 2021. Dietary intakes were assessed using an online validated 168-item food frequency questionnaire (FFQ). COVID-19 severity and symptoms were evaluated using the National Institutes of Health (NIH) COVID-19 Treatment Guidelines. Moreover, we examined COVID-19 symptoms, inflammatory biomarkers, and additional factors. Results: The mean age of participants was 44.2 ± 12.1 years, and 46% had severe COVID-19. Patients with higher consumption of fruits (OR: 0.28; 95% CI: 0.14-0.58, P-trend <0.001), vegetables (OR: 0.33; 95% CI: 0.16-0.69, P-trend <0.001), and dietary fiber (OR: 0.25; 95% CI: 0.12-0.53, P-trend <0.001) had lower odds of having severe COVID-19. In addition, they had shorter hospitalization and convalescence periods, lower serum C-reactive protein (CRP), and a reduced risk of developing COVID-19 symptoms such as sore throat, nausea and vomiting, dyspnea, myalgia, cough, weakness, fever, and chills. Conclusion: Higher consumption of fruits, vegetables, and fiber was inversely linked with COVID-19 severity, clinical symptoms, hospitalization and convalescence duration, and CRP concentrations. The results should be interpreted with caution in light of the limitations, and prospective cohort studies are required to further evaluate these findings.

Does Ashwagandha supplementation have a beneficial effect on the management of anxiety and stress? A systematic review and meta-analysis of randomized controlled trials.

Clinical trial studies revealed conflicting results on the effect of Ashwagandha extract on anxiety and stress. Therefore, we aimed to evaluate the effect of Ashwagandha supplementation on anxiety as well as stress. A systematic search was performed in PubMed/Medline, Scopus, and Google Scholar from inception until December 2021. We included randomized clinical trials (RCTs) that investigate the effect of Ashwagandha extract on anxiety and stress. The overall effect size was pooled by random-effects model and the standardized mean difference (SMD) and 95% confidence interval (CIs) for outcomes were applied. Overall, 12 eligible papers with a total sample size of 1,002 participants and age range between 25 and 48 years were included in the current systematic review and meta-analysis. We found that Ashwagandha supplementation significantly reduced anxiety (SMD: -1.55, 95% CI: -2.37, -0.74; p = .005; I2  = 93.8%) and stress level (SMD: -1.75; 95% CI: -2.29, -1.22; p = .005; I2  = 83.1%) compared to the placebo. Additionally, the non-linear dose-response analysis indicated a favorable effect of Ashwagandha supplementation on anxiety until 12,000 mg/d and stress at dose of 300-600 mg/d. Finally, we identified that the certainty of the evidence was low for both outcomes. The current systematic review and dose-response meta-analysis of RCTs revealed a beneficial effect in both stress and anxiety following Ashwagandha supplementation. However, further high-quality studies are needed to firmly establish the clinical efficacy of the plant.

Higher Adherence to the Mediterranean Dietary Pattern Is Inversely Associated With Severity of COVID-19 and Related Symptoms: A Cross-Sectional Study.

Background and Aims: Adherence to the Mediterranean diet (MD) has been associated with a decreased risk of developing a variety of chronic diseases that are comorbidities in COVID-19 patients. However, its association to the severity and symptoms of COVID-19 are still unknown. This study aimed to examine the association between adherence to the MD pattern and COVID-19 severity and symptoms in Iranian hospitalized patients. Methods: In this cross-sectional study, 250 COVID-19 patients aged 18 to 65 were examined. We employed a food frequency questionnaire (FFQ) to obtain data on dietary intake of participants in the year prior to their COVID-19 diagnosis. COVID-19 severity was determined using the National Institutes of Health's Coronavirus Disease 2019 report. Additionally, symptoms associated with COVID-19, inflammatory markers, and other variables were evaluated. The scoring method proposed by Trichopoulou et al. was used to assess adherence to the MD. Results: The participants' mean age was 44.1 ± 12.1 years, and 46% of them had severe COVID-19. Patients who adhered more closely to the MD had lower serum C-reactive protein levels (7.80 vs. 37.36 mg/l) and erythrocyte sedimentation rate (14.08 vs. 42.65 mm/h). Those with the highest MD score were 77% less likely to have severe COVID-19 after controlling for confounding variables. The MD score was also found to be inversely associated with COVID-19 symptoms, including dyspnea, cough, fever, chills, weakness, myalgia, nausea and vomiting, and sore throat. Conclusion: Higher adherence to the MD was associated with a decreased likelihood of COVID-19 severity and symptoms, as well as a shorter duration of hospitalization and convalescence, and inflammatory biomarkers.

The effects of Anethum graveolens (dill) supplementation on lipid profile and glycemic control: a systematic review and meta-analysis of randomized controlled trials.

There is an increased interest in the potential health benefits of nutraceutical therapies, such as Anethum graveolens (dill). Therefore, this systematic review and meta-analysis aimed to evaluate the effects of Anethum graveolens supplementation on lipid profiles and glycemic indices in adults. A systematic search was performed for literature published through November 2020 via PubMed/Medline, Scopus, ISI Web of Science, and Embase to find randomized controlled trials (RCTs) evaluating the effects of oral supplementation with A. graveolens on lipid profile and measures of glycemic control in adults. The random-effects model was applied to establish the weighted mean difference (WMD) and associated 95% confidence intervals (CI). Seven RCTs with a total number of 330 subjects were included in the final analysis. Pooled results indicated that A. graveolens supplementation significantly decreased low-density lipoprotein cholesterol (LDL) concentration (WMD: -15.64 mg/dL; 95% CI: -24.55 to -6.73; P = 0.001), serum insulin (WMD: -2.28 µU/ml; 95% CI: -3.62 to -0.93; P = 0.001), and HOMA-IR (WMD: -1.06; 95% CI: -1.91 to -0.20; P = 0.01). However, there was no significant effect on serum total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL), and fasting blood glucose (FBS). Subgroup analysis suggested that using A. graveolens in higher doses and long-term duration had beneficial effects on lipid profiles. Dose-response analysis also showed a significant reduction in FBS at doses of 1500 mg/d. The present meta-analysis indicated that Anethum graveolens could exert favorable effects on insulin resistance and serum LDL. Further research is necessary to confirm our findings.

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

Existing evidence has uncovered the potential health benefits of cinnamon intake; however, its effect on liver function is unclear. Thus, the aim of this systematic review and meta-analysis was to examine the effect of cinnamon supplementation on liver enzymes. Relevant articles were identified through a systematic search in PubMed/Medline, Scopus, Web of Science, Cochrane Library, and Embase up to September 2020. All trials assessing the effect of oral cinnamon supplementation on serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and alkaline phosphatase (ALP) in adults were included. The pooled effect sizes were obtained using the random-effects model and expressed as mean difference (MD) and 95% confidence intervals (CI). A total of seven original trials (nine treatment arms) involving a total of 256 subjects were included in the final analysis. The pooled analysis indicated that cinnamon supplementation had no significant effect on serum levels of ALT, AST, and ALP. However, there was a significant reduction in ALT levels in patients with type 2 diabetes (MD: -4.01 U/L; 95% CI: -6.86, -1.15) and in trials with low-dose supplementation (<1,500 mg/d), follow-up duration longer than 12 weeks, and in the elderly patients (aged>50 years). The beneficial effects of cinnamon intake were also shown in AST levels in patients with type 2 diabetes and trials with long-term follow-up (>12 weeks). Longer-term, oral cinnamon supplementation may improve serum levels of liver enzymes in patients with type 2 diabetes. Further high-quality studies are needed, especially in populations with abnormal liver enzyme levels, to firmly establish the clinical efficacy of cinnamon on liver function.

Comparing serum levels of zinc, copper, certain antioxidant vitamins and dietary intakes in acute lymphoblastic leukemia (ALL) patients before and after chemotherapy.

Acute lymphoblastic leukemia (ALL) is a malignant hematologic disease. Cancer and its treatments can affect biological functions and change the nutritional status of patients. Zinc and copper are important cofactors for several enzymes and play an important role in maintaining the integrity of DNA. In ALL, we have oxidative conditions in the body that can cause oxidative damage to lipids and the production of malondialdehyde (MDA). So that the aim of this study is comparing serum levels of copper, zinc and inflammation before and after chemotherapy. Thirty ALL patients between 15 to 65 years old participated in this study. A blood sample of 10 cc was taken before and after eight course of chemotherapy. We observed a significant increase in serum zinc as well as a significant decrease in serum copper, vitamin D and Malondialdehyde. We have not seen any significant differences in hs-CRP after chemotherapy. These changes might be due to chemotherapy and changing lifestyle of patients toward healthy eating nutrition and serum vitamin D get worse and because of sedentary life style in these patients there is an essential need to anthropometric measurements during treatment.