L-Carnitine supplementation reduces biomarkers of inflammatory and oxidative stress in patients with coronary artery disease: a randomised controlled trial.

OBJECTIVE: l-Carnitine has been suggested as a potential nutrient that alleviates the oxidative and inflammatory damages of coronary artery disease (CAD), but the results of the previous studies of the importance of this supplementation remains unclear. This study attempts to evaluate the effects of l-carnitine (LC) supplementation on oxidative stress and inflammatory biomarkers in patients with CAD. METHODS: A double-blind, randomised, placebo-trial was conducted on 75 CAD subjects. Patients were randomly assigned to receive LC (1000 mg/day) or placebo capsules over 3 months. Sera high-sensitivity C-reactive protein (hs-CRP), myeloperoxidase (MPO), nitrotyrosine (NT) and total antioxidant capacity (TAC) were assayed. RESULTS: A significant increase in serum TAC and a significant decrease in MPO, NT, and hs-CRP levels were detected following 12 weeks of LC supplementation, compared to the placebo. CONCLUSIONS: These results suggest that LC supplementation may exert beneficial effect on cardiovascular health through attenuate oxidative and inflammatory markers in CAD patients.

Probiotic Yogurt Fortified with Vitamin D Can Improve Glycemic Status in Non-Alcoholic Fatty Liver Disease Patients: a Randomized Clinical Trial.

Non-alcoholic fatty liver disease (NAFLD) is a significant public health problem globally and the most notable chronic liver disease in Asian countries. Various dietary supplements have been assessed as potential methods to alleviate the metabolic damages related to NAFLD, but the results of these works have been equivocal. This study aimed to evaluate the effects of probiotic yogurt fortified with vitamin D (Pro-YFD) on glycemic and anthropometric indices in patients with NAFLD. One hundred and four NAFLD patients of both sexes were randomly allocated to 2 groups: group A (Pro-YFD) and group B (unfortified yogurt). The intervention period was 3 months. Fasting blood samples were obtained for measuring fasting blood sugar (FBS) and insulin level. Food intake was measured using a validated food frequency questionnaire. Body composition was estimated by bio-impedance. Eighty-eight patients completed the study. The mean serum level of 25(OH)D3 was elevated significantly (p < 0.001), while insulin level decreased significantly (p < 0.003) in group A at the end of the study. FBS levels showed no significant differences between the groups at the end of the trial. Also, there were no significant changes in diet caloric intake, physical activity, or anthropometric indices in the 2 groups during the interventions. Pro-YFD in the diets of patients with NAFLD may attenuate insulin resistance and improve serum level of 25(OH)D3.

The effect of yogurt co-fortified with probiotic and vitamin D on lipid profile, anthropometric indices and serum 25-hydroxi vitamin D in obese adult: A Double-Blind Randomized- Controlled Trial.

Vitamin D deficiency can be regarded as one of the overgrowing health problem in all of the world. Evidence from a clinical trial suggested a role for probiotic bacteria in increasing vitamin D. However, probiotic's effect is strain specific and this effect should be confirmed about different strains. The objective was to determine if yogurt fortification with probiotic bacteria, Lactobillus acidophilus La-B5, Bifidobacterium lactis Bb-12 either alone or in combination with vitamin D can be a complementary treatment for vitamin D deficiency. The end-points were vitamin D, cardio metabolic lipid profile, anthropometric indices (weight, height, waist, hip, fat mass, lean body mass) and dietary intake. A 10-week parallel-group, double-blind, randomized and controlled trial was conducted on 140 obese men and women. The participants were randomly allocated to receive 100 grams either 1) plain low-fat yogurt or 2) probiotic yogurt or 3) vitamin D-fortified yogurt or 4) probiotic and vitamin D cofortified yogurt. All groups received low-calorie diet. Vitamin D increased significantly in group 4 (p = .008), group 3 (p = .001) and group 1 (p = .012 with no difference between groups. Vitamin D-fortified yogurt had the most effect size and showed a significant difference versus plain (p = .018) and probiotic yogurt (p = .002). Regarding lipid profile, there were no significant differences between groups. Data from this study does not support the hypothesis that yogurt fortified with probiotic bacteria, Lactobillus acidophilus La-5 and Bifidobacterium lactis Bb-12 either alone or in combination with vitamin D might impose any increasing effect on serum level of vitamin D in comparison with vitamin D-fortified yogurt.

Effects of vitamin D supplementation on core symptoms, serum serotonin, and interleukin-6 in children with autism spectrum disorders: A randomized clinical trial.

OBJECTIVES: Children with autism spectrum disorders (ASD) have lower serum vitamin D and higher serotonin and interleukin (IL)-6 levels compared with healthy children. The aim of this study was to evaluate the effect of vitamin D on core symptoms and serum levels of serotonin and IL-6 in these children. METHODS: This parallel randomized double-blind, placebo-controlled trial was conducted with 43 children with ASD (7 girls and 36 boys; 8.91 ± 2.87 y of age). Children were randomly allocated to receive either vitamin D drop (300 IU/kg up to a maximum of 6000 IU daily) or placebo for 15 wk. Serum levels of 25-hydroxyvitamin (OH)D, IL-6, and serotonin were measured at baseline and at the end of the trial. Also, the severity of autism and the social and individual maturity of the children were measured by the Childhood Autism Rating Scale (CARS), the Autism Treatment Assessment Checklist (ATEC), and Aberrant Behavior Checklist-Community (ABC-C) questionnaires before and after intervention. Randomization and allocation to groups were done using computer-generated numbers. RESULTS: More than 86% of patients had vitamin D deficiency at the beginning of the study. Serum levels of 25(OH)D increased significantly in the vitamin D group (P = 0.001). The clinical symptoms of autism measured by CARS and ATEC scales were alleviated significantly (P = 0.021 and P = 0.020, respectively); however, the serum levels of serotonin and IL-6 and the scale of ABC-C remained without a significant change. CONCLUSION: These findings suggest that vitamin D supplementation may improve ASD symptoms; however, more studies with longer duration are indispensable to confirm our results.

Food groups intake in relation to stunting among exceptional children.

BACKGROUND: Although several studies have examined the link between different food groups intake and stunting among children, no study, to our knowledge, was done on exceptional children. The aim of this study was assessed the association of dietary intake and stunting in Iranian exceptional children. METHODS: This cross-sectional study was conducted on 470 exceptional children (226 mentally retarded, 182 deaf and 62 blind children), aged 5-15 years. Height was measured using standard tool. Stunting was defined as height-for-age z-score of <-1. A validated dietary habit questionnaire was applied to assess dietary intakes. RESULTS: Mean age of children was 10.02 ± 2.04 years. Stunting was prevalent among 50.6% of children. Compared with children in the lowest category of dairy consumption, those in the highest category had lower odds of stunting. This association remained significant even after adjusting for covariates (OR: 0.50, 95% CI: 0.29-0.87). In addition, moderate consumption of egg (1-3 time/wk) was inversely associated with stunting either before or after controlling for potential confounders (OR: 0.36, 95% CI: 0.21-0.64). Such finding was also seen among mentally retarded children (OR: 0.38, 95% CI: 0.16-0.89). No other significant association was seen between intakes of other food groups (including meat, fruits and vegetables) and stunting. CONCLUSIONS: We found that higher intake of dairy products and egg was associated with lower risk of stunting. However, intakes of other food groups including meat, fruits and vegetables were not significantly related to stunting.

Relationship Between the Consumption of Milk-Based Oils Including Butter and Kermanshah Ghee with Metabolic Syndrome: Ravansar Non-Communicable Disease Cohort Study.

BACKGROUND: The prevalence of metabolic syndrome (MetS) in recent years has been growing in different societies, which may be due to lifestyle changes including changes in diet, in particular the consumption pattern of edible oils. The purpose of this study was to investigate the relationship between the consumption of animal oils including butter and Kermanshah ghee with MetS and its components in the adult population of Ravansar Non-Communicable Disease (RaNCD) cohort study. METHODS: This cross-sectional study was carried out on 5550 adults aged 35-65 years using baseline data of Ravansar's prospective study center in Iran. MetS was defined according to the criteria of modified NCEP ATP III for Iranian adults. Relationship between the consumption of butter and Kermanshah ghee and MetS was analyzed by logistic regression model using STATA software. RESULTS: In our study, the frequency of MetS was 31.40%. The mean body mass index and mean age were 27.1±4.6 kg/m2 and 47.6±8.2 years. The mean values of consumed butter and Kermanshah ghee were 3.3±1.8 and 5.1±2.3 g/day, respectively. After adjusting the confounding variables, the highest to the lowest quintile of butter and Kermanshah ghee consumption showed a reverse correlation with the MetS (OR = 0.7, 95% CI = 0.5-0.9) and (OR= 0.7, 95% CI=0.6-0.9), respectively. CONCLUSION: This study revealed a reverse relationship between milk and Kermanshah ghee consumption with MetS and its components. Therefore, consumption of milk-based oils may be associated with lower cardiovascular risk factors.

Antihyperlipidemic and Antioxidative Properties of Pistacia atlantica subsp. kurdica in Streptozotocin-Induced Diabetic Mice.

INTRODUCTION: Pistacia atlantica subsp. kurdica is an important food source and a well-known medicinal plant in the Zagros Mountains of Iran. The present study aimed to investigate the effect of P. atlantica extract and essential oil in streptozotocin-induced diabetic mice. MATERIALS AND METHODS: Different doses of hydroalcoholic extract and essential oil of P. atlantica subsp. kurdica (50, 100, and 200 mg/kg) were given to streptozotocin-induced diabetic mice in separate groups for three weeks. At the end of treatment, blood samples were collected; then, oxidative stress markers, TNF-α, and lipid profile were determined in its serum samples. RESULTS: Our findings showed that the administration of P. atlantica extract for three consecutive weeks significantly improved the lipid profile, oxidative stress, and inflammation process by reducing lipid peroxidation and increasing total antioxidant capacity. CONCLUSION: This study showed that P. atlantica subsp. kurdica has antioxidant and blood lipid-lowering effects that can be used as a supplement to improve diabetes complications.

Effect of Cashew Nut on Lipid Profile: A Systematic Review and Meta-Analysis.

INTRODUCTION: Nuts are one of the dietary components which appear to have beneficial effects on cardiovascular disease biomarkers. Studies demonstrate beneficial effects of cash-ews on serum lipids concentration, but results in the literature remain inconclusive. We conducted a review to examine the effects of cashew nut supplementation on serum lipid profile. METHODS: Two reviewers independently searched PubMed, Web of Science, Cochrane Library, Scopus, and EMBASE electronic databases from inception until June 2019 without language limitation. Random- and fixed-effects models were used to calculate 95% confidence intervals (CI) for studies. RESULTS: Six randomized clinical trials comprising 531 participants were included in this systematic review. Three studies were included in the meta-analysis model. There were no significant changes for total cholesterol (TC) (standardized mean difference [SMD]: -0.02, 95% CI: -0.32, 0.28), triglycerides (TG) (SMD: -0.01, 95% CI: -0.22, 0.20), high-density lipoprotein (HDL) cholesterol (SMD: 0.09, 95% CI: -0.16, 0.34), or low-density lipoprotein (LDL) cholesterol (SMD: -0.18, 95% CI: -0.75, 0.39). CONCLUSION: The results of this analysis demonstrate that treatment with cashew nut supplementation alone did not significantly change serum levels of LDL, HDL, TC, or TG.

Effects of coenzyme Q10 supplementation on matrix metalloproteinases and DAS-28 in patients with rheumatoid arthritis: a randomized, double-blind, placebo-controlled clinical trial.

OBJECTIVES: This study aimed to assess the effect of CoQ10 supplementation on serum matrix metalloproteinases (MMPs) and clinical parameters in rheumatoid arthritis (RA) patients. METHOD: In this randomized, double-blind, placebo-controlled trial, 54 RA patients who fulfilled the eligibility criteria (18-56 years, diagnosed at least 6 months ago, with DAS-28 > 3.2) were randomly assigned into two groups to receive 100 mg/day CoQ10 (n = 27) or placebo (n = 27) for 2 months. Serum MMP-1 and MMP-3 levels and clinical status using disease activity score in 28 joints (DAS-28) were assessed before and after supplementation. Data were analyzed using χ2, independent sample t test, paired t test, Wilcoxon, Mann-Whitney, and analysis of covariance. RESULTS: A significant reduction was observed in both CoQ10 and placebo groups in the medians of serum MMP-1 (0.2 to 0.16, P < 0.001), (0.18 to 0.15, P = 0.001); swollen joint count (2 to 0, P < 0.001), (2 to 0, P = 0.009); and the means of DAS-28 (5.01 ± 1.21 to 2.34 ± 0.68, P < 0.001), (4.88 ± 0.96 to 4.04 ± 1.36, P = 0.009) respectively. Serum MMP-3 level increased significantly in placebo group (2.26 to 2.57, P = 0.020), and the MMP-3 changes between groups were significant (P = 0.027). Furthermore, significant reductions were only observed in ESR, pain score, and tender joint count in CoQ10 group compared with baseline (P = 0.001, P < 0.001, and P < 0.001, respectively). Significant differences were observed between two groups in DAS-28, pain score, and swollen and tender joint count after the intervention (P < 0.001, P < 0.001, and P = 0.012 and P < 0.001, respectively). CONCLUSIONS: It seems that CoQ10 may provide a new complementary approach for RA patients.Key Points• CoQ10 supplementation in RA patients attenuated serum MMP-3 level.• CoQ10 supplementation in RA patients improved clinical outcomes and ameliorated disease severity.• CoQ10 may provide a new complementary approach for patients with RA.

The validity of resting energy expenditure predictive equations in adults with central obesity: A sub-sample of the RaNCD cohort study.

BACKGROUND: There are different equations for estimating Resting Energy Expenditure (REE). However, these equations were mainly developed based on populations of western countries. AIM: The present study was conducted to determine the validity of REE predictive equations in adults with central obesity. METHODS: This study was conducted with 129 adults with central obesity aged 35-65 years, a sub-sample from a large cohort study (Western Iran), Kurdish population. REE was measured by indirect calorimetry (IC) and REE predictive equations. Data were analysed using Pearson correlation, paired t-test, concordance correlation coefficient (CCC), mean squared deviation (MSD), level of agreement (LOA) and Bland-Altman plot. RESULTS: All REE predictive equations had low CCC and high LOA. Although there was no statistically significant difference in the REE measured with IC and the REE predicted with the Food and Agriculture Organization/World Health Organization/United Nations University (FAO/WHO/UNU), FAO/WHO/UNU (Height), Muller and revised Harris-Benedict equations (P = 0.874, 0.113, 0.619, 0.143 and P = 0.121), other equations had statistically significant differences with IC (P<0.001). In addition, the highest correlation was found between the IC (r = 0.682). The least difference was related to the FAO/WHO/UNU equation, with an agreement limit of -507.96 to 500.79 Kcal/day, with a 95% confidence interval. CONCLUSIONS: The results of this study showed that the FAO/WHO/UNU, Muller, revised Harris-Benedict equations and Mifflin St Jeor equations are relatively acceptable for estimating REE. However, these prediction equations are not good at predicting REE; more precise equations are needed to apply for different ethnic groups.

Dietary pattern in relation to the risk of Alzheimer's disease: a systematic review.

Alzheimer's disease (AD) is a progressive neurodegenerative disease leading to a gradual and irreversible loss of memory, linguistic skills, and perception of time and space, thinking, and behavior. Dietary pattern has been presented as a contributor to the incidence of Alzheimer's. This study aimed at reviewing the evidence on the relation between dietary pattern and AD. This systematic search was performed on the articles available in PubMed, Scopus, and Web of Sciences databases until May 2019 using keywords, including (diet, food, dietary pattern, food pattern) and (Alzheimer's disease) among observational studies. After excluding duplicated, and irrelevant studies, 26 studies were eligible for this review study. We categorized the studied dietary patterns into two groups: healthy and unhealthy diet. This study reviewed two case-control, five cross-sectional, and 19 prospective studies. Eight studies assessed unhealthy diet (high-fat diet, high-glycemic diet, sweetened sugary beverage, etc.) and the risk of AD. In addition, the other studies considered the effect of healthy diet such as Mediterranean diet, dietary approaches to stop hypertension (DASH), Mediterranean-DASH intervention for neurodegenerative delay, and seafood-rich diet on AD. This literature review indicated that adherence to a healthy dietary pattern has neuroprotective effects on AD prevention, while unhealthy diet can cause neurodegenerative effects in AD etiology. In conclusion, our findings showed that adherence to healthy diet can decrease oxidative stress and inflammation and accumulation of amyloid-ß and consequently can decrease the risk of AD.

Effects of Ramadan on food intake, glucose homeostasis, lipid profiles and body composition composition.

BACKGROUND/OBJECTIVES: Changes in food consumption patterns during Ramadan may cause metabolic changes, but these have not been well studied. We aimed to determine food intake, glucose homeostasis, lipid profiles, and body composition before, during, and after Ramadan fasting. METHODS: 160 healthy men were enrolled and investigated at three times (before, at the end of, and 1 month after Ramadan). Body composition was estimated by bio-impedance. Fasting blood samples were obtained for measuring fasting blood sugar (FBS), lipid profiles and insulin level. Insulin resistance (IR) was identified by the homeostatic model assessment (HOMA) of peripheral IR. Food intake was measured using a validated food frequency questionnaire before and during Ramadan. Statistical analysis was performed by SPSS 16 and P < 0.05 considered the level of significance. RESULTS: Anthropometric parameters such as body weight, body mass index, and body fat percentage (BFP) as well as FBS and circulating triglycerides were all decreased significantly at the end of Ramadan compared with the same indices measured prior to Ramadan (all P < 0.001). In contrast, at the end of Ramadan, HOMA-IR was significantly elevated (P < 0.001). One month after Ramadan, these traits had all started to return to their pre-Ramadan levels, but were still disrupted. Food intake of all food groups except carbohydrates were decreased during Ramadan. CONCLUSION: Ramadan fasting may lead to both positive and negative health effects such as a decrease in FBS, weight, BFP, and increase in LDL and IR in healthy adults. However, these effects were all transitory.

Comparison of 3 Nutritional Questionnaires to Determine Energy Intake Accuracy in Iranian Adults.

A precision instrument is required to assess the nutritional status. This study was conducted on comparison of 3 nutritional questionnaires to determine energy intake (EI) accuracy in adults in Ravansar Non-Communicable Chronic Disease (RaNCD) cohort study. This cross-sectional study was conducted on 118 of participant's RaNCD. EI was evaluated with 3 questionnaires including food frequency questionnaire (FFQ), 24-hours recall (24HR), and food habits questionnaire (FHQ). Resting metabolic rate (RMR) was measured using indirect calorimetry. We used EI/RMR cut off to evaluate EI reporting status. The mean ± standard deviation of age in men and women were 44.1 ± 6.5 and 43.7 ± 5.25 respectively and 50.8% of participants were men. Among 3 EI estimating questionnaires, FFQ was more accurate than 2 other questionnaires (67.8%). We observed that implausible reporters of 24HR were likely overweight (p < 0.005) but we did not observe a significant difference between EI reporting of FFQ and FHQ with participants' body composition. Our finding showed that EI underreporting of 24HR and FHQ were high. Under reporters were seemed to be overweight. Therefore, these results suggested that among 3 nutritional questionnaires the FFQ was an appropriate approach to determine EI in this population due to plausible EI reporting was higher than 2 other nutritional questionnaires (24HR and FHQ).

Dietary Diversity Score and Its Related Factors among Employees of Kermanshah University of Medical Sciences.

Dietary diversity score (DDS) is known as an indicator of food quality. Dietary diversity can promote health status. The aim of this study was determined DDS and its related factors in Kermanshah University of Medical Sciences (KUMS) employees. This cross-sectional study was conducted on 190 employees of KUMS in 2015. According to the population of KUMS centers which were selected randomly (Paramedical, Public Health faculties, Imam Reza Hospital and province health center), subjects were selected by convenience sampling method. Food frequency questionnaire (FFQ) was used to calculate DDS. Foods were divided into 5 main groups: grains, vegetables, fruits, meat, and dairy products. The main groups had 23 subgroups. Total DDS divided to 4 quartiles: less than 3.0, 3.0-5.5, 5.6-8.5, and more than 8.5. Anthropometric parameters including: weight, height, waist circumference (WC), and hip circumference were measured. Data were analyzed by Kolmogorov-Smirnov test, χ2 test, and analysis of variance (ANOVA) test with SPSS 20 software (IBM Corp., Chicago, IL, USA). The mean ± standard deviation of DDS and body mass index (BMI) were 5.68 ± 1.73 and 25.1 ± 3.42 kg/m2, respectively. The average of the waist-to-hip ratio (WHR) in men and women was 0.92 ± 0.04 and 0.86 ± 0.06, respectively. There was statistically significant difference between DDS and self-reported economic status (p < 0.022). No significant difference was observed between DDS and BMI or WC. However, significant negative correlation was observed between DDS and WHR in men (p < 0.019). This study showed that DDS had a negative correlation with the WHR. Therefore, dietary diversity may improve health status by effect on fat distribution in body.