Association between protein intake and risk of gestational diabetes mellitus: A systematic review and dose-response meta-analysis of cohort studies.

BACKGROUND: Gestational diabetes mellitus (GDM) is a common condition in pregnancy, the prevalence of which has increased. Identifying modifiable risk factors for GDM, such as dietary factors, could prevent or delay the onset of the condition. Our goal was to perform a comprehensive meta-analysis of cohort studies, to summarize the current evidence on the relationship between total, animal, and plant protein intake during pregnancy, as well as pre-pregnancy protein intake, and the risk of GDM. METHODS: A literature search was completed using Scopus, PubMed, Web of Science, and Google Scholar up to January 2023 and references of retrieved relevant articles. Observational studies examining the association between the consumption of dietary protein from different sources in pre-pregnancy or/and during pregnancy and the risk of GDM were included. To combine effect sizes for the comparison between the highest and lowest categories of protein intake, a random effects model was utilized. Dose-response relationships were investigated using a 1-stage random-effects model. RESULTS: 8 observational studies were included in the systematic review and 5 prospective cohort studies in the meta-analysis, involving a total of 24,160 participants and 2450 cases of GDM. The analysis revealed a significant association between total protein intake during pregnancy and an elevated risk of GDM (relative risk (RR): 2.24, 95 % confidence interval (CI): 1.67-3.00, P = 0.000). Conversely, no significant association was found between total protein intake before pregnancy and the risk of GDM. Both animal protein intake before pregnancy (RR: 1.47, 95 % CI: 1.06-2.03, P = 0.021) and during pregnancy (RR; 2.31, 95 % CI: 1.43-3.73, P = 0.001) showed a significant association with GDM. Interestingly, there was no significant association between the consumption of plant protein both before and during pregnancy and the risk of GDM. Further analysis revealed that an additional 5 % energy from total protein and animal protein per day was associated with a 24 % and 32 % before and 114 % and 67 % increased risk of GDM during pregnancy respectively. CONCLUSION: In conclusion, consumption of animal protein and total protein before pregnancy is associated with an increased risk of GDM, although the association is not significant for total protein. Conversely, plant protein intake is linked to a decreased risk of GDM, however, the results are not significant. The intake of any protein type (plant/animal/total) during pregnancy is associated with an elevated risk of GDM, with this association being statistically insignificant for plant protein. Further cohort studies are required to validate the findings presented in this study. REGISTRATION: PROSPERO (CRD42023396215).

No association between infant growth and adherence to the dietary approaches to stop hypertension (DASH) diet in lactating women.

OBJECTIVE: Breastmilk is considered an optimal food for infant development especially during the first 6 months of life. However, little evidence exists regarding maternal dietary intake and infant growth. We evaluated how adherence to the DASH diet in lactating women is associated with the infant weight, height and head circumference at birth, 2 and 4 months of age. STUDY DESIGN: A cross-sectional study. METHODS: The present study was conducted with 292 lactating mothers and their infants. A validated and reliable 168-item food frequency questionnaire (FFQ) was used to assess mothers' dietary intakes. To evaluate adherence to the DASH diet among lactating mothers, we scored food items based on the Fung method. RESULT: Lactating mothers in the highest tertile of adherence to the DASH diet consumed significantly lower amounts of fat, cholesterol, salt, red and process meats and higher amounts of vitamin C, B1, B9, whole grains, low-fat dairy, fruits, vegetables and dietary fiber compared to lactating mothers in the lowest tertile (P < 0.05). No significant association was found between mothers' adherence to the DASH dietary pattern and any of the infant growth indices (P > 0.05). CONCLUSION: Lactating mothers' adherence to the DASH diet was not associated with growth indices among exclusively breastfed infants.

Association between overweight/obesity with depression, anxiety, low self-esteem, and body dissatisfaction in children and adolescents: a systematic review and meta-analysis of observational studies.

PURPOSE: Childhood and Adolescent overweight and obesity may be associated with psychological problems. We aimed to conduct a systematic review and summarize published articles on the association between overweight/obesity with risk of depression, anxiety, low self-esteem, and body dissatisfaction among children and adolescents. METHODS: PubMed and Scopus databases were used to conduct a comprehensive search and identify eligible literature published prior to July 2020. The random-effects models (DerSimonian-Laird method) were applied to pool the effect sizes. Subgroup analysis was performed to find potential sources of heterogeneity. RESULTS: 28 studies (3 prospective cohorts and 25 cross-sectional) were included in the current systematic review and meta-analysis. The total sample sizes ranged from 244 to 60252. A positive significant association was found between overweight (pooled risk estimate: 1.15, 95% CI: 1.00-1.31, P = 0.04) and obesity (pooled risk estimate: 1.53, 95% CI: 1.16-2.02, P = 0.003) with risk of low self-esteem, respectively. A significant positive association was found between obesity and risk of body dissatisfaction (pooled risk estimate: 4.05, 95% CI: 2.34-7.023, P = 0.0001). Moreover, no association was found between overweight and risk of body dissatisfaction among children and adolescents. Also, no association was observed between overweight/obesity and risk of depression and anxiety. CONCLUSIONS: Findings showed a positive association between obesity and the risk of body dissatisfaction and low self-esteem among children and adolescents. Moreover, there was a significant positive association between overweight and the risk of low self-esteem.

Associations between mother-child dyad dietary patterns and child anthropometric measures among 6-year-old children.

The goals of this study were to study relationships between maternal and children's dietary patterns (DPs) and to assess how children's DP was associated with child anthropometry. This cross-sectional study included 788 pairs of 6-year-old girls and mothers in health centers in Tehran, Iran. Information on dietary intake was collected with a 168-item food frequency questionnaire. Principal component factor analysis was performed to label different data-driven dietary patterns. Three different binary logistic regression models were used to evaluate the associations between child's DPs and child anthropometry. A positive correlation was found between all maternal patterns and child's Western DP (p < 0.001). Maternal prudent and Western DPs were correlated with child's high-protein DP (p < 0.001). Children's high-protein DP was negatively correlated with maternal high fat DP (p < 0.001). Maternal prudent and high fat DPs were correlated with prudent DP in children (p < 0.001). In adjusted models, a child being in the highest compared to the first quartile of the high-protein DP was associated with decreased odds of underweight and wasting (OR 0.43; 95% CI 0.23-0.80).Conclusion: The present study showed inverse associations between a high-protein DP in children and being underweight and wasted. Also, a positive correlation was found between all maternal DPs and children's Western DPs. This correlation should be taken into account while managing child nutrition by means of educating parents on the influence of their own dietary pattern on their children. Moreover, getting enough protein through a balanced diet should be considered in children. What is Known: • Some research exists on the intake of specific foods in relation to risk of abnormal growth in children. • Less is known about the relationship between mothers' and children's food intake. What is New: • Better adherence to a high-protein dietary pattern was significantly associated with lower risk of being both underweight and wasted. • This study suggests that correlation between mothers' and their children's dietary patterns exists, which should be taken into consideration when managing child nutrition.

Red meat, overweight and obesity: A systematic review and meta-analysis of observational studies.

AIM: The present study aimed to review and perform a meta-analysis summarizing the available evidence on the association between red meat consumption and obesity. METHODS: A computerized search strategy was performed up to Feb 9, 2020. PubMed, Scopus, and web of science were used to conduct a comprehensive search for all relevant publications. The quality of the included articles was determined by using the Newcastle-Ottawa Scale. A random-effects model was conducted for analysis of the included cross-sectional studies. In the case of significant heterogeneity, subgroup analyses were conducted to explore possible sources of inter-study heterogeneity. RESULTS: In the overall pooled estimate of 3 studies, it was shown that red meat consumption was not associated with overweight (pooled effect size: 1.19, 95% CI: 0.97-1.46, p = 0.099). The results from combining 7 studies showed a non-significant association between red meat intake and obesity (pooled effect size: 1.16, 95% CI: 0.93-1.44, p = 0.199) with significant heterogeneity among studies (I2 = 87.3%, pheterogeneity < 0.0001). CONCLUSION: In conclusion, results extend the evidence that red meat consumption was not associated with the risk of overweight as well as no association between total meat consumption and obesity.

Curable Syncope in Primary Pulmonary Hypertension with Novel Atrial Flow Regulator.

Pulmonary artery hypertension (PAH) occurs when mean pulmonary artery pressure (PAP) is higher than 25 mmHg in rest or 30 mmHg during activity. Idiopathic pulmonary artery hypertension (IPAH) is defined as PAH without a definite reason. The IPAH is a rare disease with a high mortality rate if left untreated. To date, there has been no definite cure for this entity, and most treatments are for symptom relief or improvement in the quality of life. For many years, decompressing the right heart through a hole in the interatrial septum has been advised to alleviate some of their symptoms, specifically syncope. Atrial flow regulator (AFR) is a device to make an iatrogenic interatrial hole and finally a unidirectional shunt. It has been used for some PAH patients for symptom relief. Herein, we report a 36-year-old female case with diagnosed IPAH for 6 years. In the last 3 years, the case had frequent syncope with shortening intervals. The AFR was implanted for her without any complications. Then, within 6 months of follow-up, she had only one syncope episode. A significant change was observed in her 6-minute walk and PAP.

Association between adherence to the Mediterranean diet and renal function biomarkers and cardiovascular risk factors among diabetic patients with nephropathy.

BACKGROUND AND AIM: Although the relationship between a Mediterranean diet (Med diet) and cardiovascular disease (CVD) risk factors has been widely established, no reports exist regarding this association in patients with Diabetes Nephropathy (DN). The aim of this study was to determine the association between level of adherence to a Med diet and renal and CVD risk factors among patients with DN. STUDY DESIGN: A cross-sectional study. METHODS: The current study was conducted in 270 patients with DN. A validated food frequency questionnaire was used to assess dietary intake. The Med diet score was determined based on the eight characteristics of a traditional Med diet. Anthropometrics, fasting blood glucose (FBS), total cholesterol (TC), low-density lipoproteins (LDL-c), triacylglycerol (TG), hemoglobin A1C (HbA1c), creatinine (Cr) and blood urea nitrogen (BUN) were detected using standard methods. Kidney function was estimated using the Modification of Diet in Renal Disease (MDRD) formula for estimated glomerular filtration rate (eGFR). RESULTS: In fully-adjusted models, high serum TC and diastolic blood pressure (DBP) were reduced in participants that demonstrated a greater adherence to a Med diet, but did not reach statistical significance (OR: 0.20; 95% CI: 0.01, 5.52; P = 0.299; OR: 0.81; 95% CI: 0.28, 2.36; P = 0.667). Waist circumference (WC) was non-significantly lower in male participants (OR: 0.91; 95% CI: 0.27, 3.05; P = 0.889). Greater compliance with a Med diet showed a non-significant reduced risk for increased bodyweight (OR: 0.82; 95% CI: 0.23, 2.85; P = 0.730) and obesity (OR: 0.45; 95% CI: 0.03, 6.06; P = 0.493). CONCLUSION: Adherence to a Med diet was not significantly associated with cardiovascular risk factors and renal function among patients with Diabetes Nephropathy.

The association of maternal plant-based diets and the growth of breastfed infants.

Background: Studies are needed to further understand how different plant-based dietary patterns of mothers relate to infant growth. Thus, we investigated the association between maternal plant-based diets and infant growth in breastfed infants during the first 4 months of life. Methods: This cross-sectional study included 290 Iranian mothers and infants. Maternal dietary intake was assessed using a 168-question validated semi-quantitative food frequency questionnaire (FFQ). Three plant-based diet indices (PDIs) were then created to evaluate dietary intakes. Eighteen food groups were classified in three main categories by scoring method: wholeplant diet, healthy plant diet, and animal and unhealthy plant diet. Results: Participants in the top tertile of unhealthy PDI (uPDI) had a lower intake of potassium,phosphorus, zinc, magnesium, calcium, folate and vitamin C, B1, B2, and B3. The upper tertileof uPDI was associated with stunting at 4-month in infants (uPDI: odds ratio [OR] = 3.27, 95%CI= 1.32, 8.10). There were no significant associations between plant-based diet scores and anthropometric indices, including weight, weight status and head circumference (P > 0.05). Conclusion: In conclusion, higher adherence to uPDI may be associated with stuntingamong Iranian infants. Other PDIs were not associated with anthropometric measures. Future studies are needed to further understand the association between plant-based diets and infant growth.

Patterning of Food Preferences Among Iranian Adults: Results from SEPAHAN Study.

BACKGROUND: The present study was conducted to evaluate the pattern of food preference among a large sample of Iranian adults. METHODS: In a cross-sectional study within the study on the epidemiology of psychological alimentary health and nutrition (SEPAHAN) projects, a total of 6239 of 8694 subjects completed a 106-item food preference questionnaire. Subjects indicated whether they liked, disliked or had gastrointestinal symptoms for each food item separately. They also reported the frequency of consumption for each food item. RESULTS: We observed that presence of some foods such as yogurt, fruits and vegetables in the list of the most preferred food items and presence of kalbas, sausages and chips in the list of the most disliked food items, were representative of healthy dietary pattern in this population. Results also revealed that women liked unhealthy foods more than men (P value <0.05 for all significant food items). Moreover, in most of the food items, men reported less gastrointestinal symptoms than women (P value <0.05 for all significant food items). Our findings revealed that smokers disliked most of the healthy food items. We also observed that pregnant women regardless of the trimesters, reported dislike for sweet-tasting food items. CONCLUSIONS: More researches are suggested in order to indicate the origins of preferences and recommend some practical alternatives to improve the dietary pattern in society.

The effects of isolated soy protein, isolated soy isoflavones and soy protein containing isoflavones on serum lipids in postmenopausal women: A systematic review and meta-analysis.

Background: Many randomized controlled trials (RCTs) have assessed the effects of soy products on serum lipids. However, the responsible soy components and the magnitude of effects in healthy or hypercholesterolemic postmenopausal women are unclear. This review assessed the quality of these RCTs and estimated the effects of isolated soy protein, isolated soy isoflavones and soy protein containing isoflavones on total cholesterol (TC), LDL-C, HDL-C, triglycerides (TG), Apolipoprotein (Apo) A-1 and Apo B among postmenopausal women.Design: Forty-six eligible randomized controlled trials published up to 20 May 2019 were identified from the PubMed, Web of Science and Scopus databases. Weighted mean effect sizes were calculated for net changes in serum lipid concentrations by using random-effect models. Specific subgroup analyses were performed to identify the effect of covariates on serum lipid changes.Results: Soy consumption was associated with significant decrease in TG (mean differences (MD): -5.04 mg/dl; 95% CI: -9.95, -0.13; P = 0.044), TC (MD: -3.02 mg/dl; 95% CI: -5.56, -0.47; P = 0.02), LDL-C (MD: -3.27 mg/dl; 95% CI: -6.01, -0.53; P = 0.019) and HDL-C (MD: -2.28 mg/dl; 95% CI: -4.27, -0.29; P = 0.025). The reduction in LDL-C, TG and HDL were larger in subjects consuming isolated soy protein than isolated soy isoflavones. There was a significant decrease in serum TG and HDL levels with dosages of >25 grams per day soy protein rather than lower dosages of soy protein. The reductions in Apo A-1 were significantly larger in hypercholesterolemic subjects than in healthy subjects.Conclusions: Isolated soy protein significantly reduced serum TG, TC, LDL-C, HDL-C and Apo-B levels in postmenopausal women. Isolated soy isoflavones had a significant lowering effect on serum TC and Apo B levels. Soy protein containing isoflavones significantly reduced TG, TC, LDL-C and Apo B levels. Therefore, hyperlipidemia risk reduction with soy products is not uniform and strongly depends on the protein and isoflavone content of soy products, duration and dosage of consumption.

Production assessment of non-carrier-added 199Au by (n,γ) reaction.

Gold-199 is a promising theranostic radionuclide for targeted radioimmunotherapy as well as for scintigraphy and dosimetry. 199Au can be produced in two methods in the direct and indirect routes of the reactor production via 197Au(n,γ)198Au(n,γ)199Au as the direct or 198Pt(n,γ)199Pt→199Au as the indirect method. This investigation described the development of a method for the reactor production of no-carrier-added (NCA) 199Au through neutron activation of natural Pt in Tehran Research Reactor (TRR) at a thermal neutron flux of 3.5 × 1013 n cm-2 s-1. Also, in this paper, the activity of 199Au has been estimated using the MCNPX code. In this case, first, the reactor core is simulated. Then the calculated results are compared with the corresponding experimental values. Moreover, two different chemical separation methods are investigated experimentally in details.

Associations Between Dietary Energy Density in Mothers and Growth of Breastfeeding Infants During the First 4 Months of Life.

Objectives: Despite the overwhelming impact of dietary energy density on the quality of the entire diet, no research has investigated dietary energy density among lactating mothers. Hence, the present study was undertaken to assess the influence of maternal dietary energy density during lactation on infant growth.Method: Three hundred healthy lactating mother-infant pairs were enrolled in the study. Detailed demographic information and dietary intake data were collected from the lactating mothers. Anthropometric features such as infant weight, height, and head circumference at birth and 2 and 4 months and mother's pregnancy and postpartum weight and height were derived from health center records. Data on physical activity were reported using the International Physical Activity Questionnaire.Results: After adjusting for confounding variables, infant weight, length, weight-for-height, and head circumference at birth, 2 months, and 4 months did not show significant differences among four dietary energy density categories (all p values > 0.01).Conclusions: Our study showed no association among quartiles of dietary energy density among lactating mothers and infant weight, length, weight-for-height, and head circumference growth by 2 and 4 months of age.

Effect of Coenzyme Q10 Supplementation on Diabetes Biomarkers: a Systematic Review and Meta-analysis of Randomized Controlled Clinical Trials.

BACKGROUND: Several studies have investigated the effect of Co-Q10 on diabetes biomarkers, but findings are inconsistent. This systematic review and meta-analysis of clinical trials was conducted to summarize the effect of Co-Q10 supplementation on diabetes biomarkers. METHODS: We searched Pubmed, EMBASE, Science direct, ISI web of science, and Google Scholar for randomized controlled trials from 1989 until March 2016. We included randomized controlled trials reporting fasting blood glucose (FBG), fasting insulin and HbA1c. In total, we found 16 articles that examined the effect of Co-Q10 on fasting blood glucose, fasting insulin and HbA1c. Mean ± standard deviations (SD) of defined outcomes were used for calculating standardized mean differences (SMD) and its 95% confidence interval (95%CI) between intervention and control treatments based on Hedges' estimator. RESULTS: Our preliminary meta-analysis on 14 eligible studies regarding the effect of Co-Q10 supplementation on FBG indicated a slightly significant decrement (SMD:-0.28 mg/d; 95% CI: -0.12, 0.04), with a substantial between-study heterogeneity (Cochrane Q test, I2 = 93.9%, P < 0.0001). After removal of three studies, heterogeneity was eliminated and a slightly significant decrease was found in FBG (SMD: -0.20 mg/dL, 95% CI: -0.38, -0.02). The effect of Co-Q10 on HbA1c and fasting insulin was not significant. SMDs for the effect of Co-Q10 on HbA1c and fasting insulin were -0.05% (95% CI: -0.22, 0.12) and 0.12 pmol/L (95% CI: -0.21, 0.44), respectively. CONCLUSION: Co-Q10 supplementation slightly but significantly reduced fasting blood glucose, but not fasting insulin and HbA1c. More long-term studies are necessary to examine the association between Co-Q10 supplementation and diabetes biomarkers. This study was funded by the School of Nutrition and Food Science, Isfahan University of Medical Sciences.