Association of Mediterranean diet pattern with disease activity in the patients with rheumatoid arthritis: A cross-sectional study on Iranian patients.

BACKGROUND & AIMS: Rheumatoid arthritis is a systemic autoimmune disease that causes joint erosion, as well as damage to extra-articular organs. The aim of this study was the investigation of the association between the Mediterranean diet quality index with disease activity in patients with rheumatoid arthritis. METHODS: In this cross-sectional study 184 females with rheumatoid arthritis were studied in Kermanshah, Iran. The American College of Rheumatology's 2010 criteria were used to diagnose RA. The biochemical tests including erythrocyte sedimentation rate, C-reactive protein, rheumatoid facto, anti-nuclear antibody titration, antibodies against cyclic citrulline peptide, disease activity score 28 and the food frequency questionnaire was used to assess rheumatoid arthritis activity and the Mediterranean diet quality index, respectively. To compare the dietary intakes of participants across tertiles of Mediterranean diet score, we used Analysis of Variance. Multinomial logistic regression with three adjusted models was used to investigate the association between Mediterranean diet score with disease activity. RESULTS: 184 eligible patients with rheumatoid arthritis participated in this study. The mean age and duration of disease, body mass index, waist circumference and percent body fat did not differ significantly among the tertiles of the Mediterranean diet score (P-value>0.05). Participants in the highest tertile of Mediterranean diet score had significantly greater intakes of fruits, vegetables, fish, legume, nuts and had lowest intake of grains (refrain grain) and red and process meats to white meat ratio (P-value<0.05). There was no significant difference in terms of variables related to disease activity among the tertiles of the Mediterranean score (P-value>0.05). In multi-adjusted models, the odds ratio of Mediterranean diet scores no significant different in the third as compared to the first tertile of Mediterranean diet score (P-value>0.05). CONCLUSION: Based on our findings there is no association between the Mediterranean diet score and disease activity of people with rheumatoid arthritis.

Expression pattern of miR-193a, miR122, miR155, miR-15a, and miR146a in peripheral blood mononuclear cells of children with obesity and their relation to some metabolic and inflammatory biomarkers.

BACKGROUND: The widespread presence of childhood obesity has increased considerably over three decades. The present study was designed to investigate expression patterns of miR-146a, miR-155, miR-15a, miR-193a, and miR-122 in peripheral blood mononuclear cells (PBMCs) in children who are obese along with their association with metabolic and inflammatory biomarkers. METHODS: Ninety test subjects were admitted. The profile of blood pressure, resting energy expenditure (REE), anthropometric measures, body composition, dietary intakes, physical activity levels, insulin, and lipid profile, fasting blood glucose (FBG), high-sensitivity C-reactive protein (hs-CRP), and pubertal stage have been measured. Total RNA (including small RNAs) was extracted from PBMCs. The expression levels of miRNAs were measured by stem-loop RT-qPCR. RESULTS: The miR-155a expression level was significantly lower in obese children, children with high hs-CRP, and children with high-fat mass. Obese girls had significantly higher PBMC levels of miR-122. MiR-155a had a significant negative association with fasting insulin, HOMA-IR, and hs-CRP. There were significant positive associations between miR-193a and miR-122 expression levels and fasting insulin, HOMA-IR, and TG. MiR-15a was positively correlated with fasting insulin and HOMA-IR. Children with metabolic syndrome, insulin resistance, and high-fat mass had higher PBMC levels of miR-122 and miR-193a. Higher miR-193a and miR-122 levels were also detected in PBMCs of children with fast REE, compared to those with slow REE, and the subjects with high hs-CRP, respectively. CONCLUSION: lower level of miR-155 expression in obese subjects and significant associations unfolds the need for more studies to detect the possible underlying mechanisms.

Effects of inulin supplementation on inflammatory biomarkers and clinical symptoms of women with obesity and depression on a calorie-restricted diet: a randomised controlled clinical trial.

Major depressive disorder (MDD) is regarded as an inflammatory disorder. Gut microbiota dysbiosis, observed in both MDD and obesity, leads to endotoxemia and inflammatory status, eventually exacerbating depressive symptoms. Manipulation of gut microbiota by prebiotics might help alleviate depression. The present study aimed to investigate the effects of inulin supplementation on psychological outcomes and biomarkers of gut permeability, endotoxemia, inflammation, and brain-derived neurotrophic factor (BDNF) in women with obesity and depression on a calorie-restricted diet. In a double-blind randomised clinical trial, forty-five women with obesity and MDD were allocated to receive 10 g/d of either inulin or maltodextrin for 8 weeks; all the patients followed a healthy calorie restricted diet as well. Anthropometric measures, dietary intakes, depression, and serum levels of zonulin, lipopolysaccharide (LPS), inflammatory biomarkers (TNF-α, IL-10, monocyte chemoattractant protein-1, toll-like receptor-4 and high-sensitivity C-reactive protein), and BDNF were assessed at baseline and end of the study. Weight and Hamilton Depression Rating Scale (HDRS) scores decreased in both groups; between-group differences were non-significant by the end of study (P = 0·333 for body weight and P = 0·500 for HDRS). No between-group differences were observed for the other psychological outcomes and serum biomarkers (P > 0·05). In this short-term study, prebiotic supplementation had no significant beneficial effects on depressive symptoms, gut permeability, or inflammatory biomarkers in women with obesity and depression.

Interactive Effect of Probiotics Supplementation and Weight Loss Diet on Metabolic Syndrome Features in Patients With Coronary Artery Diseases: A Double-Blind, Placebo-Controlled, Randomized Clinical Trial.

Background. Nutrition and probiotics supplementation are considered as nondrug strategies for the control of coronary artery disease (CAD). The aim of the present study was to investigate the interactive effects of probiotic supplementation and weight loss program on anthropometric and metabolic syndrome (MetS) indices in patients with CAD. Methods. A randomized, double-blind, placebo-controlled trial was performed in 44 overweight CAD patients. All the patients received weight loss program (5% to 10% of initial body weight) throughout the study course. The subjects were randomly assigned into intervention or placebo groups (n = 22, each) and received a probiotic or maltodextrin capsule/day, respectively, for 12 consecutive weeks. Anthropometric and MetS indices were assessed. Results. There was a significant decrease in total cholesterol (-30.7 ± 49.83 vs -5.9 ± 65 mmol/L, P = .043) and low-density lipoprotein cholesterol (-25.64 ± 51.7 vs -5.44 ± 70.1 mg/dL, P = .049) in the probiotic group compared to the placebo group. Other MetS feature indices and blood pressure did not differ significantly within or between groups. Conclusion. Probiotics supplementation improved total cholesterol and low-density lipoprotein cholesterol but had no effect on other lipid profile parameters and anthropometric indices. The weight loss diet plus probiotics supplementations resulted in more favorable decrease of cardiovascular risk factors compared to a weight loss program alone.

Daily consumption effects of probiotic yogurt containing Lactobacillus acidophilus La5 and Bifidobacterium lactis Bb12 on oxidative stress in metabolic syndrome patients.

BACKGROUND AND AIMS: Available evidence substantiates a strong association between metabolic syndrome and elevated oxidative stress. This study was aimed to assess the effects of probiotic yogurt containing Lactobacillus acidophilus La5 and Bifidobacterium lactis Bb12 on the oxidative stress biomarkers in patients with metabolic syndrome. Furthermore, the association between uric acid levels and insulin resistance indexes was assessed. METHODS: An 8-week randomized, double-blind, placebo-controlled, parallel study was designed. Forty-four patients, 22 males and 22 females aged 20-65 years, were assigned into two groups. Treatment (n = 22) and control (n = 22) groups consumed 300 g/d of probiotic and regular yogurt, respectively. The serum concentration of uric acid, oxidized Low-Density Lipoprotein (oxLDL), Malondialdehyde (MDA) and Total Antioxidant Capacity (TAC) were measured at the beginning and the end of the trial. This study was recorded at http://www.irct.ir (code: IRCT201608213140N17). RESULTS: Probiotic yogurt consumption resulted in a significant decrease in the level of serum uric acid and a significant increase in the level of TAC (p < 0.05). A positive significant association between uric acid with insulin concentration and the homeostasis model assessment of insulin resistance (HOMA-IR) and an inverse significant relationship with insulin sensitivity (Quicki) were also found (p < 0.05). CONCLUSION: Probiotic yogurt consumption through improvement in insulin sensitivity may exert positive effects on the oxidative stress and uric acid levels. However, further studies are needed to make concise conclusions.

Are spexin levels associated with metabolic syndrome, dietary intakes and body composition in children?

AIMS: The aim of the present study was to investigate whether circulating levels of spexin is related to metabolic syndrome, some dietary intakes (Total energyintake, Macronutrient intakes) and body composition in children. METHODS: 90 children were recruited in the present cross sectional study. Anthropometric measures, body composition, blood pressure, dietary intakes, resting metabolic rate, physical activity level, appetite status, pubertal stage, serum spexin, fasting blood glucose, high-sensitivity C-reactive protein, insulin and lipid profile were measured using standard techniques. RESULTS: 14 children met the criteria for metabolic syndrome. Median (IQR) of spexin levels were significantly lower in children with high fat mass and children with higher systolic blood pressure (SBP), compared to children with normal fat mass and normal SBP: (P < 0.05). A protective independent effect was detected for the highest tertile of serum spexin on metabolic syndrome in adjusted models; Crude OR (CI): 0.23 (0.04-1.2), P-trend = 0.08; Model 1: OR (CI): 0.15(0.02-1.01), P-trend = 0.05; Model 2: OR (CI): 0.10 (0.01-0.90), P-trend = 0.03. There was a significant negative association between spexin and total dietary fat intake (r= - 0.21; P < 0.04). CONCLUSION: This findings can further highlight the importance of the relationship between spexin, adipose tissue and adipose tissue metabolism.

Different spexin level in obese vs normal weight children and its relationship with obesity related risk factors.

BACKGROUND AND AIMS: Spexin (SPX) is a novel peptide recently discovered as an important regulatory adipokine in obesity and related metabolic diseases. The aim of the current study was to determine the potential role of Circulating levels of SPX in obese children and explore its relationships with obesity-related risk factors, and its potential role in preventing obesity. METHODS AND RESULTS: Forty-five obese children and 45 normal-weight children of similar age and sex, with mean age of 13.73 (2.68) were recruited in this Study. Weight and height, blood pressure, resting metabolic rate (RMR), physical activity level, stress, anxiety and depression, appetite status, daily energy intake, pubertal stage, serum Spexin, Interleukin-10 (IL-10), IL-1ß, high-sensitivity C-reactive protein (hs-CRP), fasting glucose, insulin and lipid profile, were measure during standard techniques. Median (IQR) of Spexin levels were significantly lower in obese vs. normal-weight children [120.70 (77.7) pg/mL vs.145 (186.7)pg/mL; P = 0.03]. Based on the tertiles of the serum Spexin levels, a protective independent effect was observed for the highest tertile of serum Spexin concentrations. Crude OR (CI): 0.33 (0.11-0.95), P-trend = 0.04. Model 1 OR (CI): 0.20 (0.05-0.73), P- trend = 0.01, Model 2 OR (CI): 0.22 (0.05-0.86), P -trend = 0.03. Serum Spexin concentration was significantly associated with IL-10, IL-1ß, fasting Insulin and HOMA-IR (P < 0.05). CONCLUSION: The lower circulating levels of Spexin in obese children compared to their normal-weight peers, the protective independent effect found for the highest tertile of serum Spexin, and its association with glucose metabolism and immune function observed in our study, suggest a potential role for this novel peptide in childhood obesity and its related metabolic disorders.

Can psychobiotics "mood" ify gut? An update systematic review of randomized controlled trials in healthy and clinical subjects, on anti-depressant effects of probiotics, prebiotics, and synbiotics.

BACKGROUND & AIMS: Depression is a major debilitating health problem with high global prevalence. Gut microbiota dysbiosis might be implicated in pathophysiology of depression. Hence, probiotics, prebiotics and synbiotics (psychobiotics) have been administered in clinical trials in attempt to relieve depressive symptoms. This update systematic review aimed to evaluate the current body of research concerning the effects of psychobiotics on depression. METHODS: PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed in this review. Search was performed in MEDLINE, ProQuest, EMBASE, PsycNET, and Scopus databases for randomized clinical trials which assessed the effects of psychobiotics on depressive symptoms among adults, and were published in English language, since inception until September 2018. RESULTS: Out of 3374 records screened, 32 articles met the study criteria; only seven studies reported significant anti-depressant effects of psychobiotics. Some probiotic strains showed beneficial effects on depressive symptoms; the results were inconsistent, though. Few studies investigated the effects of prebiotics or synbiotics on depression, and did not come up with much promising results The overall risk of bias was judged to be unclear across the included studies, and major confounding factors were not considered in their design. CONCLUSION: Since probiotics may affect depression in strain-specific manner, the current evidence is not sufficient to either support or decline anti-depressant effects of probiotics; results of studies on prebiotics and synbiotics are not conclusive, either. More well-designed studies with emphasis on specific probiotic strains, inter-individual gut microbiota variations, and depression subtypes are warranted. PROSPERO REGISTRATION NUMBER: CRD42018107356.

Spexin status in relation to obesity and its related comorbidities: a systematic review.

PURPOSE: Spexin, a novel 14-amino acid peptide, has multiple physiological functions. The purpose of this paper was to systematically evaluate the current literature on the role of Spexin neuropeptide in obesity and its related comorbidities, food intake and overall metabolic status in human, animal and in vitro studies. METHODS: Multiple databases, including PubMed, EMBASE, ProQuest, Scopus and Google Scholar were searched for English-language papers published since inception until December 2018, that investigated Spexin levels in relation to chronic metabolic diseases, overall metabolism control and feeding-related behaviors.The quality of the included observational studies was assessed by a version of the Newcastle Ottawa Scale (NOS) designed for non-randomized studies and SYRCLE's assessment tool for animal models. RESULTS: Out of 224 records screened, search results led to a total of 24 related studies (12 human studies (ten cross-sectional studies, one cohort study, and one longitudinal study) and 12 studies in either animals or in vitro).Nine of the included cross-sectional studies and one Longitudinal study had moderate to good study quality, and one cross-sectional and one cohort study had high-quality (or low risk of bias). CONCLUSION: It appears that Spexin has a positive impact on overall metabolic status. As a novel appetite-regulating peptide, Spexin can act as an anorexigenic factor. Information about Spexin is very limited, and well-designed randomized controlled clinical trials are warranted for replicating, validating, and extending the current findings. PROSPERO REGISTRATION NUMBER: CRD42018117198).

Dietary Inflammatory Index and Risk of Multiple Sclerosis in a Case-Control Study from Iran.

BACKGROUND: Diet and inflammation have been suggested to be important risk factors for multiple sclerosis (MS). OBJECTIVES: In this study, we examined the ability of the dietary inflammatory index (DII) to predict MS in a case-control study conducted in Iran. METHODS: This study included 68 MS cases and 140 controls hospitalized for acute non-neoplastic diseases. The DII was computed based on dietary intake assessed by a previously validated food frequency questionnaire. Logistic regression models were used to estimate ORs adjusted for age, energy, sex, body mass index, season of birth, rubella history, history of routine exercise before MS, smoking and history of consumption of cow's milk in the first 2 years of life. RESULTS: Subjects with higher DII scores (i.e., with a more pro-inflammatory diet) had a higher risk of MS, with the DII being used both as a continuous variable (ORcontinuous 1.66; 95% CI 1.19-2.31; 1 unit increase corresponding to ≈15% of its range in the current study) and a categorical variable (ORDII (>1.43 vs.≤1.43) 2.68; 95% CI 1.15-6.26). CONCLUSIONS: These results indicate that a pro-inflammatory diet is associated with increased risk of MS.

Mediterranean diet adherence and risk of multiple sclerosis: a case-control study.

BACKGROUND AND OBJECTIVES: We conducted a hospital-based, case-control study to examine the association between Mediterranean diet (MD) and the risk of multiple sclerosis (MS) in Iran. METHODS AND STUDY DESIGN: A total of 70 patients with MS and 142 controls underwent face-to-face interviews in the major neurological clinics of Tehran, Iran. Adherence to a MD was assessed using the 9-unit dietary score, to evaluate the level of conformity of the individual's diet to the Mediterranean dietary pattern. Multivariate logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI). RESULTS: Higher consumption of fruits (OR=0.28, 95% CI: 0.12-0.63, p-value: 0.002) and vegetables (OR=0.23, 95% CI: 0.10-0.53, p-value: 0.001) were significantly associated with reduced MS risk. In both age adjusted and multivariate adjusted model, the OR of MS decreased significantly in the third as compared to the first tertile of MD score (age adjusted OR: 0.21, 95% CI: 0.06-0.67; p-trend: 0.01, Multivariate adjusted OR: 0.23, 95% CI: 0.06-0.89, p-trend: 0.04). CONCLUSIONS: Our study suggests that a high quality diet assessed by MD may decrease the risk of MS.

Healthy Eating Index in Patients With Cataract: A Case-Control Study.

BACKGROUND: Nutritional factors play an important role in cataract disease and the healthy eating index (HEI) is a unique approach to study the relationships between diet and diseases. OBJECTIVES: The current study aimed to evaluate and compare healthy eating index among the patients with cataract and healthy individuals. PATIENTS AND METHODS: This case-control study was conducted on 97 patients with cataract and 198 healthy people (as a control group) in Iran. Individuals were selected by the convenience sampling method and the food frequency questionnaire (FFQ) was completed for them. At first, HEI was calculated and then the HEI scores were compared in cataract patients and healthy individuals. RESULTS: The analysis of FFQ showed that the scores of vegetables (7.81 v. 10), nutritional variation (5.5 v. 7) and sodium (2 v. 6) groups (P < 0.001) were significantly lower among the patients with cataract than the healthy individuals. Also this significant difference was observed in the scores of total HEI and fruits (respectively 73.26 v.79.30 and 7.1 v. 9.8) (P < 0.01). On the other hand, the scores of saturated fatty acids (10 v. 9; P = 0.02), total fat (8 v. 7; P = 0.004) and cereals (10 v. 10; P < 0.001) were higher among the patients with cataract than the healthy individuals. The comparison of dietary intake among all types of cataract shows that the scores of the meat group were significantly higher in the patients with nuclear cataract and mixed cataract than the ones with posterior cataract (respectively 9.4 v. 6.5 and 9 v. 6.5) (P = 0.02). In addition, after adjusting the confounding factors the results showed that the HEI high score was associated with reducing the risk of coming down with cataract (OR = 0.18, CI: 95%, P < 0.001, 0.08 - 0.41). CONCLUSIONS: The results of the current study suggest that increasing the quality of the diet calculated according to HEI can reduce the risk of coming down with cataract.