The Association between Circulating Carotenoids and Risk of Breast Cancer: A Systematic Review and Dose-Response Meta-Analysis of Prospective Studies.

Carotenoids appear to have anticancer effects. Prospective evidence for the relation between serum carotenoids and breast cancer is controversial. The present systematic review and meta-analysis aimed to investigate the link between circulating carotenoids and the risk of breast cancer. We performed a systematic search of PubMed, Scopus, and Web of Science up to 30 November, 2022. Prospective studies on adults aged ≥18 y that have reported risk estimates for the association between circulating carotenoids and breast cancer risk were considered. Study quality was assessed using the Newcastle-Ottawa Scale. A random-effects model was used for combining studies' risk estimates. Dose-response relations were explored through a 1-stage random-effects model. Fifteen publications (17 nested case-control studies and 1 cohort study) with 20,188 participants and 7608 cases were included. We observed an inverse association between the highest level of circulating total carotenoids (relative risk [RR]: 0.76; 95% confidence interval [CI]: 0.62, 0.93; n = 8), α-carotene (RR: 0.77; 95% CI: 0.68, 0.87; n = 13), ß-carotene (RR: 0.80; 95% CI: 0.65, 0.98; n = 15), ß-cryptoxanthin (RR: 0.85; 95% CI: 0.74, 0.96; n = 11), lycopene (RR: 0.86; 95% CI: 0.76, 0.98; n = 13), and lutein (RR: 0.70; 95% CI: 0.52, 0.93; n = 6) and the risk of breast cancer compared with the lowest level. Additionally, each 10 µg/dL of total carotenoids, α-carotene, ß-carotene, and ß-cryptoxanthin was associated with 2%, 22%, 4%, and 10% lower risk of breast cancer, respectively. This relationship was stronger at lower levels of total carotenoids and ß-cryptoxanthin. The certainty of evidence was rated from very low to low. Most studies were performed among Western nations, which should be acknowledged for extrapolation of findings. Total circulating carotenoids, α-carotene, ß-carotene, ß-cryptoxanthin, lycopene, and lutein seem to be related to a decreased risk of breast cancer. Our findings could have practical importance for public health. This study was registered at PROSPERO as CRD42023434983.

Adherence to HEI-2010 and odds of breast cancer according to the menopause status: Evidence from Middle Eastern Country.

BACKGROUND: Majority of earlier studies have assessed the association between individual healthy eating index-2010 (HEI-2010) and the odds of breast cancer (BC). However, no study has been conducted on the effect of compliance with HEI-2010 and the odds of BC in the Iranian population with a large sample size. Therefore, we aimed to investigate the relationship between the HEI-2010 and the odds of BC in the Iranian population. METHOD: This population-based case-control study included 350 newly diagnosed cases of BC and 700 healthy controls randomly selected from adult women. HEI-2010 was examined using validated questionnaires. The adherence to HEI-2010 among the participants was divided into four categories. The general characteristics of the participants in the quartiles of the HEI score for categorical variables and continuous variables were evaluated using chi-square and one-way analysis of variance, respectively. Also, using logistic regression analysis, dietary intakes were evaluated in HEI score quartiles. Also, confounding variables were adjusted in different models. RESULT: People with the highest HEI score had 60% lower odds of BC (OR: 0.40; 95% CI: 0.27, 0.57) than those with the lowest score among post-menopause women. After controlling for age and energy intake, individuals with the highest HEI score were 78% less likely to have BC compared with those with the lowest score (OR: 0.22; 95% CI: 0.14, 0.33). Adjustments for other potential confounders including demographic factors made the association stronger (OR: 0.21; 95% CI: 0.13, 0.32). This association remained significant even after taking BMI into model (OR: 0.27; 95% CI: 0.17, 0.43). CONCLUSION: Finally, in this study we found an association between HEI-2010 and odds of breast cancer. This association was particularly seen in postmenopausal women. No significant association was found between adherence to HEI-2010 and odds of BC among pre-menopausal.

Effects of vitamin D supplementation on liver fibrogenic factors, vitamin D receptor and liver fibrogenic microRNAs in metabolic dysfunction-associated steatotic liver disease (MASLD) patients: an exploratory randomized clinical trial.

BACKGROUND AND AIMS: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a global metabolic problem which can lead to irreversible liver fibrosis. It has been shown that vitamin D and its receptors contribute to fibrogenic pathways in the liver. However, the effect of vitamin D supplementation on liver fibrosis related factors have not been examined. This double blinded placebo controlled clinical trial was designed to investigate the effects on vitamin D supplementation on serum levels of VDR, fibrogenic factors and fibrogenic MicroRNAs in MASLD patients. METHODS: Forty six MASLD patients after block matching for sex and BMI were randomly assigned to receive 4000 IU/d vitamin D or placebo for 12 weeks. Weight, height and waist circumference were measured. Serum fibrogenic microRNAs, laminin, collagen type IV, hyaluronic acid, vitamin D, VDR, PTH, blood fasting glucose, serum fasting insulin, lipid profile, ALT and AST were determined at the baseline and at the end of the trial. Insulin resistance and insulin sensitivity were calculated using the HOMA-IR and QUICKI equation. RESULTS: Supplementation with vitamin D for 12 weeks led to the significant increases in serum 25(OH) vitamin D, VDR and HDL-C compared to placebo (P < 0.001, P = 0.008 and P < 0.001). There were significant decreases in ALT, AST, FBS and LDL-C levels in the vitamin D group as compared to the placebo (P < 0.05). Laminin and hyaluronic acid concentrations were significantly decreased in the vitamin D group as compared to the placebo group, by -10.6 and - 28.7 ng/mL, respectively. Supplementation with vitamin D for 12 weeks resulted in a significant lower MiR-21 and MiR-122 gene expressions compared to the placebo group (P = 0.01 and P < 0.001, respectively). DISCUSSION: As the first randomized controlled trial on the effect of vitamin D supplementation on serum levels of VDR, fibrogenic factors and fibrogenic MicroRNAs in MASLD patients, we found a significant reduction in some liver fibrogenic factors, in liver transaminases and corresponding changes in some fibrosis-related MiRs and some metabolic factors. Further clinical trials with larger sample sizes and direct measures of liver fibrosis are needed to confirm these findings. TRIAL REGISTRATION NUMBER: (available at: http://www.irct.ir , identifier: IRCT201405251485N13), Registration date: 14-03-2017.

Association of alternative healthy eating index and severity of pemphigus vulgaris: A cross-sectional study.

BACKGROUND: Evidence on the association between following healthy eating and the severity of pemphigus vulgaris (PV) is scarce. Therefore, the aim of this cross-sectional study aimed to investigate the relationship between adherence to the alternative healthy eating index (AHEI) and the severity of Pemphigus vulgaris disease in adults. METHODS: In this hospital-based cross-sectional study, a total of 138 pemphigus vulgaris cases were studied, of which 108 had pemphigus disease area index (PDAI) ≤15, and 30 had PDAI>15. Dietary intakes were assessed using a valid 168-item food frequency questionnaire (FFQ). To calculate the AHEI, the data received from the diet were used. The subjects of this index received a score of 1-10. The final AHEI was calculated by summing the component scores. RESULTS: After adjusting for age and sex, we found that individuals with the highest AHEI score were 72% less likely to have increased PV severity compared with those with the lowest score (OR: 0.28; 95% CI: 0.08-0.92, P trend = 0.020). Further control for another potential confounder, intake energy, made the association stronger (OR: 0.24; 95% CI: 0.06-0.88, P trend = 0.017). Also, after controlling the body mass index (BMI) confounding factor, it maintained its strong relationship (OR: 0.24; 95% CI: 0.06-0.88, P trend = 0.016). CONCLUSION: The evidence of our study shows that following the healthy eating index is associated with a reduction in the severity of pemphigus vulgaris. Prospective cohort studies are needed to confirm these findings.

The effect of zinc supplementation on anthropometric measurements in healthy children over two years: a systematic review and meta-analysis.

BACKGROUND: Zinc deficiency is one of the most important micronutrient deficiencies in children that can affect the children's growth pattern. In this regard, different studies were conducted to assess the effect of zinc supplementation on growth patterns in healthy children. To the best of our knowledge, no systematic review has summarized the results of these studies. So, in the present study, we systematically reviewed the result of the studies that assessed the effect of zinc supplementation on anthropometric parameters in healthy, over 2-year-old children. METHODS: A systematic search was carried out in PubMed, Scopus, and Web of Science from inception to November 2021. Data were pooled using the random-effects method and were expressed as weighted mean difference (WMD) and 95% confidence intervals (CI). RESULTS: The pooled results of eight studies, including 1586 participants, showed that zinc supplementation significantly increases height [(WMD): 0.9, 95% CI: (0.27, 1.52), p < 0.001], weight [(WMD): 0.51, 95% CI: (0.06, 0.97), p < 0.001], height for age (HAZ) [(WMD): 0.07, 95% CI: (0.03, 0.10), p < 0.001]. Also, meta-regression analysis did not reveal any significant association between dose and duration of intervention and anthropometric parameters. CONCLUSION: The present study demonstrates the beneficial effects of zinc supplementation on weight, height, and HAZ.

The Effect of Zinc Supplementation on Lipid Profiles in Patients with Type 2 Diabetes Mellitus: A Systematic Review and Dose-Response Meta-Analysis of Randomized Clinical Trials.

Research on the effects of zinc supplementation on lipid profiles in people with type 2 diabetes mellitus (T2DM) has been inconsistent. This systematic review and meta-analysis was performed to summarize the current data on the effects of zinc supplementation on lipid profiles in patients with T2DM. Three online databases including PubMed, Scopus, and Web of Science were searched to find relevant studies published until September 2022. The exposure was zinc supplementation, and the outcomes were low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglyceride (TG), and total cholesterol (TC). Fourteen randomized clinical trials consisting of 1067 patients were included in the statistical analysis. Significant improvement was observed in all 4 lipid profile components. Following zinc supplementation, a significant decrease was observed in TC (weighted mean difference [WMD]: -16.16; 95% confidence interval [CI]: -26.43, -5.89; P = 0.002), LDL (WMD: -6.18; 95% CI: -9.35, -3.02; P < 0.001), and TG (WMD: -13.08; 95% CI: -21.83, -4.34; P = 0.003). After analyzing 13 studies reporting HDL, a significant increase was seen (WMD: 3.76; 95% CI: 1.30, 6.22; P = 0.003). In a nonlinear dose-response analysis, a significant inverse association was observed between <12 wk zinc supplementation and TC, LDL, and TG (TC: WMD: -5, Pnonlinearity < 0.001; LDL: WMD: -5, Pnonlinearity = 0.07, TG: WMD: -16.5, Pnonlinearity = 0.006). Nonlinear dose-response analysis shows that the optimum elemental zinc dosage for the best response to the supplementation for TC, LDL, and TG are 120, 100, and 140 mg/d, respectively (TC: WMD: -5, Pnonlinearity < 0.001; LDL: WMD: -10, Pnonlinearity = 0.006, TG: WMD: -50, Pnonlinearity = 0.031). In conclusion, we found significant changes in all 4 components of the lipid profile through zinc supplementation in T2DM patients. Based on our findings, zinc supplementation may have profound favorable consequences on the lipid profile of T2DM patients, especially in the zinc-deficient group.

The effect of vitamin C on oxidative stress indices and skin regimentation of vitiligo patients.

It has been suggested that vitamin C is involved in suppressing stress oxidation signaling in vitiligo disease. However, the effect of vitamin C supplementation on stress oxidative factors has not been investigated in vitiligo subjects. This study was designed to examine the effects on vitamin C supplementation on serum levels of stress oxidative factors and regimentation in vitiligo patients. Forty-four vitiligo patients will be recruited in this study. After block matching for sex and number of phototherapy sessions, they will be randomly assigned to receive 1000 mg/d vitamin C or placebo for 8 weeks. The weight, height, and waist circumference of participants will be measured. Determination of serum stress oxidative indices (CAT, SOD, GPX, MDA, TOS, TAC) will be done at study baseline and at the end of the trial. Also, the regimentation will be determined using the VASI score. This is the first randomized controlled trial that will determine the effect of vitamin C supplementation on serum levels of stress oxidative indices and regimentation in vitiligo patients. The results of this trial will provide clinical evidence on the effectiveness of vitamin C supplementation in controlling oxidative stress in vitiligo patients. Trial registration number: This study is registered in the Iranian Registry of Clinical Trials website (available at http://www.irct.ir , identifier: IRCT20230123057193N1), Registration date: 2023/04/17.

The relationship between major food sources of fructose and cardiovascular disease, cancer, and all-cause mortality: a systematic review and dose-response meta-analysis of cohort studies.

We aimed to summarize the associations between food sources of fructose and cardiovascular diseases (CVD), cancer, and all-cause mortality risk using a systematic review and meta-analysis. We searched PubMed, Scopus, and Web of Science up to November 2020. We included cohort studies that investigated the relationship between mortality risk (all-cause, CVD, specific CVD, and total and site-specific cancers) and intake of ≥1 food source of fructose (fruit, fruit juice, breakfast cereals, sugar-sweetened beverages (SSBs), sweets, and yogurt) in general adult population. Summary hazard ratios and 95% CIs were estimated using a random-effects model for linear and nonlinear relationships. Findings indicated that each 100 g/d increase in fruit intake was associated with 8-13% lower risk of CVDs, stroke, gastrointestinal, and lung cancer mortality. For all-cause mortality, there was a beneficial relationship up to 200 g/d fruit, and then plateaued. For ischemic heart disease and cancer mortality, there was a beneficial relationship up to 300 g/d followed by a slight increase. Ingestion of breakfast cereals and sweets was also associated with lower risk of all-cause mortality. For yogurt, a non-linear marginal decrease in all-cause mortality was found. Ingestion of each 200 g/d yogurt was associated with a 14% lower risk of CVD mortality. Every 60 g/d increase in sweet intake was linked to a 5% lower risk of all-cause mortality. Contrariwise, every 250 g/d increase in SSBs intake was associated with 7-10% higher risk of all-cause and CVD mortality. In conclusion, beneficial associations were found between fruit, breakfast cereals, sweets, and yogurt with all-cause and/or CVD mortality risk. Fruit intake had also an inverse link with cancer mortality. Conversely, SSBs had a harmful relationship with all-cause and CVD mortality.Supplemental data for this article is available online at https://doi.org/10.1080/10408398.2021.2000361 .Registry number: CRD42019144956.

Effects of Fish-Oil Consumption on Psychological Function Outcomes in Psychosis: A Systematic Review and Dose-Response Meta-Analysis of Randomized Controlled Trials.

Research on the effects of fish oil on clinical symptoms and psychosocial functioning in people with psychosis has been inconsistent. We conducted this systematic review and meta-analysis to summarize the available data on the effects of oral intake of fish oil on psychological functioning in patients with psychosis. Three online databases including PubMed, Scopus, and Web of Science were searched to identify relevant studies published by April 2021. The exposure was oral fish-oil supplementation. The Positive and Negative Syndrome Scale (PANSS), the Brief Psychiatric Rating Scale (BPRS), and the Global Assessment of Functioning (GAF) were our outcome measures. Seventeen randomized clinical trials involving 1390 patients were included. No change in PANSS was observed following oral fish-oil intake [weighted mean difference (WMD): -0.87; 95% CI: -16.99, 15.26; P = 0.92]. In a nonlinear dose-response analysis, a significant inverse association was observed between <10 wk of fish-oil supplementation and PANSS (WMD: -10; P-nonlinearity = 0.02). Although analysis of 4 studies showed a nonsignificant reduction in BPRS after fish-oil intake (WMD: -2.990; 95% CI: -6.42, 0.44; P = 0.08), a nonlinear dose-response analysis revealed significant inverse associations between dose (>2200 mg/d) and duration of fish-oil supplementation (<15 wk) with BPRS score (WMD: -8; P-nonlinearity = 0.04). Combined effect sizes from 6 randomized clinical trials showed significant increases in GAF after oral administration of fish oil (WMD: 6.66; 95% CI: 3.39, 9.93; P < 0.001). In conclusion, we did not find any significant changes in PANSS and BPRS scores following fish-oil supplementation. Nevertheless, oral fish-oil intake significantly contributed to improvement in GAF scores. This is the first meta-analysis to examine the effects of fish oil on the psychological functioning scores of PANSS, BPRS, and GAF simultaneously.

Association between Adherence to the Mediterranean Diet and Risk of Type 2 Diabetes: An Updated Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies.

Despite earlier meta-analyses on the association between adherence to a Mediterranean diet (MD) and risk of diabetes, there is no comprehensive and updated study assessing this issue. Furthermore, no earlier study has examined the nonlinear dose-response relation between consumption of an MD and risk of diabetes. The current systematic review and meta-analysis was conducted to investigate the linear and nonlinear dose-response relation between MD and incidence of diabetes. Using relevant keywords, electronic searches for prospective studies were conducted in ISI Web of Science, PubMed, and Scopus until January 2022. The reported HRs or ORs in the primary studies were regarded as RRs. The overall effect was calculated using a random-effects model that accounts for between-study variability. The potential nonlinear dose-response associations were tested using a 2-stage hierarchical regression model. Based on 16 prospective studies (with 17 effect sizes), we found that the greatest adherence to the MD was significantly associated with a reduced risk of diabetes (pooled RR: 0.83; 95% CI: 0.77, 0.90; I2 = 79%, P ≤ 0.001). Based on linear dose-response analysis, each 1-score increase in the Mediterranean diet score was associated with a 3% decreased risk of diabetes (HR = 0.97; 95% CI: 0.96, 0.98; P < 0.001). A nonlinear relation (P-nonlinearity = 0.001) was also observed between MD score and risk of type 2 diabetes. Even modest adherence to the MD was linked to a decreased incidence of type 2 diabetes. The protocol is also registered in the International Prospective Register Of Systematic Reviews (PROSPERO) database (https://www.crd.york.ac.uk/PROSPERO/; registration ID: CRD 42021265332).

A combined healthy lifestyle score in relation to glioma: a case-control study.

BACKGROUND: The evidence on the association between adherence to a healthy lifestyle and risk of glioma are scarce. This is particularly relevant to Middle Eastern countries where lifestyle factors including dietary intakes, physical activity and environmental contributors are different from other parts of the world. The aim of this case-control study was, therefore, investigating the association between adherence to a healthy lifestyle and odds of glioma among adults. METHODS: Totally, 128 newly diagnosed glioma cases and 256 age- and sex-matched controls were recruited in this hospital-based case-control study. Dietary intakes were examined by the use of a 126-item validated FFQ. International Physical Activity Questionnaire (IPAQ) was used for measuring physical activity of participants. To construct a healthy lifestyle score (HLS), data from dietary intakes, physical activity and BMI were used. Subjects in the low risk categories of the mentioned components received the score of 1, otherwise they received the score of 0. The final HLS was computed through summing up the scores of components. RESULTS: After adjustment for age and sex, we found that individuals with the highest HLS score were 55% less likely to have glioma compared with those with the lowest score (OR: 0.45; 95% CI: 0.22, 0.92). Additional controlling for other potential confounders made the association stronger (OR: 0.28; 95%CI: 0.12, 0.66). In terms of individual components of healthy lifestyle score, subjects with a healthy diet had 54% lower odds of glioma than those with a non-healthy diet (OR: 0.46; 95%CI: 0.26, 0.80). No significant associations were seen between physical activity level or BMI status and glioma. CONCLUSION: We found evidence indicating that adherence to a healthy lifestyle, in particular a healthy diet, was associated with a lower odds of glioma. Prospective cohort studies are needed to confirm these findings.

The Association between Dietary Calcium Intake and Breast Cancer Risk among Iranian Women.

No information is available from Middle Eastern countries linking dietary calcium intake and odds of breast cancer. OBJECTIVE: This study was conducted to investigate the association between dietary calcium intake and odds of having breast cancer among Iranian women.In this population-based case-control study, 350 newly diagnosed breast cancer cases were recruited and 700 age-matched subjects were enrolled as controls. Dietary intakes were examined by the use of a 106-item validated FFQ. Total dietary calcium intake of each participant was computed by summing up calcium intake from all foods and dishes. The quartile cutoff points of energy-adjusted calcium intake was obtained in the control group. These cutoff points were used to classify all study participants into quartiles in terms of dietary calcium intake.After adjustment for age and energy intake, we found that individuals in second quartile of calcium intake were 43% less likely to have breast cancer compared with those in the bottom quartile (OR: 0.57; 95% CI: 0.38-0.86). This significant association disappeared after further controlling for other potential confounders including dietary factors and BMI (OR: 0.91; 95% CI: 0.57-1.45). When the analyses were done by menopausal status, premenopausal women with the greatest calcium intake were 60% less likely to have breast malignancy than those with the lowest intake (OR: 0.40; 95% CI: 0.16-0.99). Adjustment for potential confounders did not substantially influence this finding (OR: 0.32; 95% CI: 0.11-0.95). The association remained significant even after additional controlling for dietary covariates (OR: 021; 95% CI: 0.06-0.72) and BMI (OR: 0.21; 95% CI: 0.04-0.93). No significant association was found between dietary calcium intakes and odds of breast cancer in postmenopausal women.Dietary calcium intake was protectively associated with odds of breast cancer in premenopausal women, but not in postmenopausal women. Further prospective investigations are needed to confirm these findings.

Association between Dietary Fat Intake and Odds of Gastro-esophageal Reflux Disorder (GERD) in Iranian Adults.

BACKGROUND: Most information on the association of dietary fat intake and gastro-esophageal reflux disorder (GERD) came from developed countries, where lifestyle and other dietary components might be different from those in developing countries. This cross-sectional study was, therefore, conducted to investigate the association between dietary fat intake and odds of having GERD in a large group of Iranian population. STUDY DESIGN: This cross-sectional study was done among 3362 adult population in Isfahan, Iran. Dietary intakes were collected by the use of a validated semi-quantitative food frequency questionnaire. METHODS: Assessment of GERD was done using a validated self-administered questionnaire examining the frequency of heartburn in the last 3 months. Individuals with the presence of heartburn symptoms sometimes, often or always during the last 3 months were defined as having GERD. RESULTS: Participants in the top category of dietary fat intake had higher daily intakes of energy, macronutrients and micronutrients. Dietary intakes of all food groups were also significantly higher among those in the top quintile as compared with those in the bottom category of dietary fat intake (P < 0.001 for all). There were no significant associations between dietary fat intake and incidence of GERD in general population. Crude and multivariable-adjusted models revealed no significant associations between dietary fat intake and having GERD in either gender. CONCLUSIONS: We found no significant association between dietary fat intake and odds of having GERD in this population. Further studies, in particular of prospective designs, are warranted to clarify this association.

Macronutrients Intake and Stomach Cancer Risk in Iran: A Hospital-based Case-Control Study.

BACKGROUND: Stomach cancer (SC) is one of the most common cancers in the world. Dietary risk factors of SC are not fully understood. This study aimed to investigate the association between macronutrient intakes and the risk of SC. STUDY DESIGN: A hospital-based case-control study. . METHODS: The data were obtained from a hospital-based case-control study conducted at the Cancer Institute of Iran from 2010 to 2012. Patients were 40 years or older and were diagnosed with SC in less than one year with no history of any cancers. On the other hand, the controls were healthy subjects who were caregivers or visitors of the patients. Demographic characteristics were collected using a structured questionnaire through face to face interviews by trained interviewers. Dietary data were obtained using a validated Diet History Questionnaire. The age and gender-adjusted odds ratios (ORs), as well as the adjusted ORs of age, gender, energy, education, smoking, and body mass index, were reported for continuous and tertiles of intakes. RESULTS: Totally, 207 SC patients and 217 controls participated in this study. In the full adjusted model, after comparing the highest tertiles to the lowest ones, the intake of sucrose (OR: 2.94; 95% CI: 1.66-5.19; P-trend<0.001), protein (OR: 2.04; 95% CI: 1.17-3.55; P-trend=0.011), cholesterol (OR: 2.22; 95% CI: 1.28-3.85; P-trend=0.005), and percent of calories from protein (OR: 3.09; 95% CI: 1.69-5.61; P-trend<1.001) showed a positive significant association with SC. Moreover, a significantly negative association was found between the percent of calories obtained from carbohydrates and SC (OR: 0. 57; 95% CI: 0.33-0.98; P-trend=0.015). CONCLUSION: The findings in this study showed that macronutrient intakes might be associated with the etiology of SC in Iran.

Comparison of validity of the Food Frequency Questionnaire and the Diet History Questionnaire for assessment of energy and nutrients intakes in an Iranian population.

BACKGROUND: Dietary intakes are important for development and prevention of chronic disease. The Food Frequency Questionnaire (FFQ) has been suggested as an acceptable feasible method for assessing the association of dietary intake and disease. However, FFQs are sensitive to dietary habits and culture and should be valid in the study population. AIMS: We investigated the validity of the Diet History Questionnaire (DHQ) and the Food Frequency Questionnaire in healthy Iranians. METHODS: Participants were healthy relatives of cancer patients in the Cancer Institute of Iran. They participated in face-to-face interviews. We took telephone based 24-hour recalls every 2 months over a 1-year period. Assuming the mean intakes of 24-hour recalls as the gold standard, we estimated Pearson correlation coefficients to measure the reliability of the FFQ and the DHQ. We investigated how the FFQ or DHQ categorized individuals in different intake groups comparing with the 24-hour recalls. RESULTS: Overall, 102 subjects took part in our study. Deattenuated Spearman correlations were ≥ 0.5 for energy, carbohydrate, protein, carotene, niacin, folate, vitamin B12, biotin, vitamin C, iron, zinc and selenium in both DHQ and FFQ. Level of agreement with 24-hour recall in classifying individuals into different categories of intakes ranged from 0.81 for riboflavin and carotene to 0.92 for carbohydrate and zinc in the DHQ and from 0.75 for riboflavin to 0.96 for carbohydrate in the FFQ. CONCLUSIONS: Both DHQ and FFQ were valid in assessing most nutrient intakes and classifying individuals in different categories of intakes in the Iranian population.

Effects of probiotics on salivary cytokines and immunoglobulines: a systematic review and meta-analysis on clinical trials.

Findings on the effects of probiotics on salivary cytokines and immunoglobulines have been conflicting. We aimed to perform a systematic review and meta-analysis on clinical trials that examined the effects of oral intake and local administration of probiotics on salivary cytokines and immunoglobulines in adults. We searched PubMed, MEDLINE, SCOPUS, EMBASE, and Google Scholar up to April 2020 for all relevant published papers assessing probiotic intakes and salivary cytokines and immunoglobulines. We included all randomized clinical trials that investigated the effect of oral probiotic supplementation or lozenges tablets on inflammatory biomarkers in adults. Studies that reported their effect sizes as mean ± SD or mean ± SEM were included. After excluding non-relevant papers, 8 studies remained in this review. Combining findings from 3 studies with 4 effect sizes, we found no significant reduction in salivary IgA concentrations after oral probiotic supplementation [weighted mean difference (WMD): -0.26; 95% CI: (-0.86, 0.35)]. A significant increase in salivary IL-1ß concentrations reached after local probiotic supplementation (WMD: 28.21; 95% CI: 18.42, 38.01); however, no significant changes in salivary IL-6 concentrations after local probiotic supplementation was found (WMD: 0.36; 95% CI: -0.85, 1.56). We observed a significant increase in salivary IL-8 concentrations after local probiotic supplementation (WMD: 31.82; 95% CI: 27.56, 36.08). In case of salivary IL-10 concentrations after local probiotic administration, no significant reduction was seen (WMD: -0.02; 95% CI: -0.10, 0.06). we found that oral and local administrations of probiotics might influence some of salivary cytokines. However, additional clinical trials are required to examine these effects on further pro- and anti-inflammatory cytokines and immunoglobulines.

Effects of Alpha Lipoic Acid Supplementation on Serum Levels of Oxidative Stress, Inflammatory Markers and Clinical Prognosis among Acute Ischemic Stroke Patients: A Randomized, Double Blind, TNS Trial.

Purpose: Stroke is one of the most common conditions causing death. There have been few studies examining the effects of alpha lipoic acid (ALA) on stroke patients. In this regard, the present randomized controlled clinical trial was conducted to examine the effects of ALA supplementation on serum albumin, and inflammatory and oxidative stress markers in stroke patients. Methods: The present paralleled randomized controlled clinical trial involved 42 stroke patients who were over 40 years and under enteral feeding. The participants were randomly assigned into two groups and finally 40 patients completed the study. Patients in alpha lipoic acid group (n=19) took 1200 mg ALA supplement daily along with their meal, and participants in control group (n=21) underwent the routine hospital diet for 3 weeks. Fasting blood samples were obtained and albumin, oxidative stress, and inflammatory indices were assessed at baseline, as well as at the end of the trial. Results: After 3 weeks, treatment of patients with ALA led to a significant decrease in tumor necrosis factor alpha (TNF-α) and interleukin 6 (IL-6) levels (P=0.01) compared to baseline. But serum levels of albumin, total antioxidant capacity (TAC), malondialdehyde (MDA), highsensitivity C-reactive protein (hs-CRP), IL-6 and TNF-α did not change significantly vs. control group (P>0.05). Conclusion: ALA did not significantly change the serum levels of albumin and inflammatory as well as antioxidant capacity indices in stroke patients compared with the control group. More clinical trials with large sample sizes and long duration are needed to clarify the effects of ALA on these patients.

The effect of vitamin E supplementation on biomarkers of endothelial function and inflammation among hemodialysis patients: A double-blinded randomized clinical trial.

OBJECTIVES: The present study was aimed to investigate the effect of alpha-tocopherol supplementation on biomarkers of endothelial function (Intercellular Adhesion Molecule 1 and Vascular Cell Adhesion Protein 1) and inflammatory markers (Interleukin 6 and high-sensitivity C-reactive protein) among the hemodialysis patients. METHODS: To conduct this randomized, double-blinded, and placebo-controlled clinical trial, 49 hemodialysis patients, aged 20-60 years, were recruited and randomly divided into the intervention and control groups. The intervention group (n = 25) received 600 IU alpha-tocopherol soft gels (200 IU three times daily), while the controls (n = 24) consumed the identical placebo soft gels for 10 weeks. At the baseline and end of the study, 7 ml pre-dialysis blood samples were taken from all participants to measure their serum concentrations of ICAM-1, VCAM-1, IL-6, and hs-CRP. RESULTS: Alpha-tocopherol supplementation reduced the serum levels of ICAM-1 and VCAM-1 significantly (-140.67 ± 57.25 ng/ml vs. -15.97 ± 79.19 ng/ml, P = 0.001 for ICAM-1 and --6.79 ± 4.76 ng/ml vs. 1.02 ± 3.22 ng/ml, P = 0.019 for VCAM-1). However, no significant difference was observed between the two groups regarding the serum levels of hs-CRP (-0.15 ± 0.19 mg/l vs. 0.02 ± 0.12 mg/l; P = 0.32) and IL-6 (-0.03 ± 0.1 pg/ml vs. - 0.06 ± 0.11 pg/ml; P = 0.65). CONCLUSIONS: Our results showed that 10 weeks of supplementation with 600 IU alpha-tocopherol improved ICAM-1 and VCAM-1 levels, but did not have any effect on the serum concentration of IL-6 and hs-CRP in hemodialysis patients. Further studies are required to confirm these findings.

Association between healthy lifestyle score and breast cancer.

BACKGROUND: Majority of earlier studies have assessed the association between individual lifestyle factors and the risk of breast cancer (BC); however, limited information is available linking the whole lifestyle factors to BC. We aimed to examine the association between combined lifestyle score (diet, physical activity (PA) and smoking) and risk of BC in Iranian population. METHODS: This population-based case-control study included 350 newly diagnosed cases of BC and 700 healthy controls randomly selected from adult women. Dietary intakes, PA and smoking status of study participants were examined using validated questionnaires. The lifestyle risk factors examined in this study included cigarette smoking, physical inactivity, and Healthy Eating Index-2010 (HEI-2010). The lifestyle score ranged from zero (non-healthy) to 3 (most healthy) points. Logistic regression models were fitted to investigate the association between combined lifestyle scores and odds of BC. RESULTS: Mean age and body mass index (BMI) of study participants were 62.4 years and 24.3 kg/m2, respectively. In the whole study population, individuals with the highest healthy lifestyle score (HLS) were 0.38 times less likely to have BC than those with the lowest score (OR: 0.62; 95% CI: 0.40, 0.93, Ptrend = 0.01). The analysis by menopausal status showed that postmenopausal women with the highest HLS had 44% lower odds of BC compared with those with the lowest score (OR: 0.56; 95% CI: 0.36, 0.88, P trend = 0.004). Such association was not seen in premenopausal women. After analyzing each component of HLS, we found that individuals with the highest HEI score were 46% less likely to have BC than those with the lowest score (OR: 0.54; 95% CI: 0.35, 0.82, Ptrend <  0.001). No other significant associations were found between PA and smoking and risk of BC. CONCLUSIONS: Significant inverse associations were found between HLS and HEI with BC especially among postmenopausal women. Prospective studies are required to confirm these findings.

Consumption of sugar sweetened beverages and dietary fructose in relation to risk of gout and hyperuricemia: a systematic review and meta-analysis.

Background: Findings on the association of sugar sweetened beverages (SSB) and fructose intakes with gout and hyperuricemia have been conflicting.Objective: We aimed to perform a systematic review and meta-analysis on studies that examined the association of SSB and fructose consumption with gout and hyperuricemia in adults.Methods: We searched PubMed, Scopus and Google Scholar up to Aug 2017 for all relevant published papers assessing SSB and fructose intakes and risk of gout and hyperuricemia. After excluding non-relevant papers, 10 studies remained in our systematic. Meta-analysis on SSB consumption and risk of gout was done on three effect sizes from cohort studies and five effect sizes from case-control studies. For risk of hyperuricemia, the meta-analysis was done on six effect sizes from cross-sectional studies. All analyses were performed on ORs or RRs.Results: We found an overall significant positive association between SSB consumption and risk of gout in both cohort (summary effect size: 1.35; 95% CI: 1.18-1.55) and case-control studies (summary effect size: 1.33; 95% CI: 1.06-1.66). Meta-analysis on cross-sectional studies revealed that SSB consumption was associated with 35% greater odds of hyperuricemia (summary effect size: 1.35; 95% CI: 1.19-1.52). No evidence of between-study heterogeneity as well as publication bias was found. Although the studies on fructose intake and risk of gout and hyperuricemia were included in our systematic review, we did not perform met-analysis on these studies due to insufficient number of publications.Conclusion: We found that SSB consumption was significantly associated with increased risk of gout and hyperuricemia in adult population. Further studies are needed to examine the association between dietary fructose intake and risk of gout and hyepruricemia.