The association between lifelines diet score (LLDS) with depression and quality of life in Iranian adolescent girls.

BACKGROUND: It has been proposed that a greater degree of adherence to a healthy dietary pattern is associated with a lower risk of depression and a poor quality of life (QoL). The Lifelines diet score (LLDS) is a new, evidence-base scoring system to define the quality of diet. We designed a cross-sectional study to investigate the association between LLDS with depression and QoL in Iranian adolescent girls. METHODS: A total of 733 female adolescents were recruited from Mashhad and Sabzevar cities, Iran. Depression and QoL were assessed utilizing the Beck Depression Inventory (BDI) and SF-12v2 questionnaires, respectively. The LLDS was defined by dividing intakes of 12 food groups with negative or positive health effects into quintiles ranging 12 to 60 points. To explore the association between LLDS with QoL and depression, logistic regression was used in crude and adjusted models. RESULTS: The prevalence of depression and poor QoL was 24% and 49%, respectively. After adjusting for confounding factors, adolescent girls in the highest quartile of LLDS compared with the participants in the lowest quartile had a 42% lower probability of reporting depressive symptoms (OR: 0.58; 95% CI: 0.35-0.97, P = 0.03). In addition, the participants in the highest quartile of LLDS had lower odds of poor QoL compared with the subjects in the lowest quartile (OR: 0.65; 95% CI: 0.42-0.92, P = 0.04). CONCLUSIONS: There is an inverse relationship between LLDS with risk of depression and poor QoL. Prospective and interventional investigations are needed to reach a clear vision.

Dietary approaches to stop hypertension (DASH) diet improves hepatic fibrosis, steatosis and liver enzymes in patients with non-alcoholic fatty liver disease: a randomized controlled trial.

PURPOSE: Recent evidence suggests that adherence to dietary approaches to stop hypertension (DASH) diet can be effective in managing non-alcoholic fatty liver disease (NAFLD). We investigated the effect of DASH diet on hepatic fibrosis, steatosis and liver enzymes in patients with NAFLD. METHODS: This 12-week randomized controlled trial was conducted among seventy patients with NAFLD who were randomly assigned into two groups including intervention group (DASH diet containing 50-55% carbohydrate, 15-20% protein, and 30% total fat) and the control group (a healthy diet containing 50-55% carbohydrate, 15-20% protein, and 30% total fat). Both diets were calorie-restricted (500-700 kcal lower than the energy requirement). The primary outcomes included hepatic fibrosis, hepatic steatosis, alanine transaminase (ALT), aspartate transaminase (AST) and gamma-glutamyl transpeptidase (GGT). RESULTS: At the baseline, there was no significant difference between two groups in the level of hepatic fibrosis (P = 0.63), hepatic steatosis (P = 0.53), ALT (P = 0.93), AST (P = 0.18) and GGT (P = 0.76). A significant reduction was found in the intervention group compared to the control group in hepatic fibrosis (23 grades reduction vs. 7 grades reduction; P = 0.008) and hepatic steatosis (31 grades reduction vs. 9 grades reduction; P = 0.03) after intervention. In addition, a significant change was observed in the intervention group compared to control group in ALT ( - 8.50 ± 8.98 vs. - 2.09 ± 7.29; P = 0.002), and AST ( - 5.79 ± 6.83 vs. - 0.51 ± 6.62; P = 0.002). CONCLUSIONS: Adherence to DASH diet may be effective in management of NAFLD. TRIAL REGISTRATION: The trial was registered on 06 February 2022 at Iranian Registry of Clinical Trials (IRCT20170117032026N3) with URL: https://www.irct.ir/trial/60887 .

Effect of Cornus mas L. fruit extract on blood pressure, anthropometric and body composition indices in patients with non-alcoholic fatty liver disease: A double-blind randomized controlled trial.

BACKGROUND & AIMS: Obesity is linked to the pathogenesis of non-alcoholic fatty liver disease (NAFLD). Patients with NAFLD are at increased risk for hypertension. Some investigations have hypothesized that Cornus mas L. fruit can improve obesity and hypertension. We investigated the effect of C. mas L. fruit extract on blood pressure, anthropometric and body composition indices in patients with NAFLD. METHODS: This 12-week double-blind randomized controlled trial was conducted on fifty patients with NAFLD. Patients received 20 cc/d C. mas L. fruit extract or placebo. We measured diastolic blood pressure (DBP), systolic blood pressure (SBP), weight, waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), body fat mass (BFM), body fat percent (BFP) and fat free mass (FFM) before and after intervention. RESULTS: Treatment group compared to control group showed a significant reduction in DBP (-8.62 ± 11.86 mmHg vs. 0.53 ± 8.53 mmHg; Pcrude = 0.003; Padjucted = 0.03) and SBP (-8.63 ± 14.37 mmHg vs. 0.0 ± 12.67 mmHg; Pcrude = 0.02; Padjucted = 0.02). We found no difference between groups in weight, WC, HC, WHR, BFM, BFP and FFM (P > 0.05). After adjusting for confounding factors, a significant reduction was observed in treatment group compared to control group in BFM (-0.2 ± 3.9 kg vs. 0.7 ± 2.4 kg; P = 0.01) and BFP (-0.2 ± 4.9% vs. 0.8 ± 2.8%; P = 0.02). CONCLUSIONS: C. mas L. fruit extract statistically reduced blood pressure and body fat. However, it had no effect on other anthropometric and body composition indices. Studies with larger sample sizes and higher dosages of extract are needed. TRIAL REGISTRATION: Registered on 30/9/2018 at Iranian Registry of Clinical Trials IRCT20180419039359N1 (https://www.irct.ir/trial/30707).

Effect of probiotic yogurt consumption on glycemic control and lipid profile in patients with type 2 diabetes mellitus: A randomized controlled trial.

BACKGROUND & AIMS: Type 2 diabetes mellitus (T2DM) is a common endocrine disease. Altered gut microbiota (Dysbiosis) is closely associated with development of T2DM. Growing body of evidence hypothesized that probiotics intake may be useful for patients with T2DM. We investigated the effect of probiotic yogurt consumption on glycemic control and lipid profile in patients with T2DM. METHODS: In this 12-week randomized controlled clinical trial, seventy-two patients with T2DM were randomly assigned to the intervention group (IG) that received 200 g/d probiotic yogurt containing 4.65 × 106 CFU/g Lactobacillus acidophilus and Bifidobacterium lactis) or placebo group (PG) that received 200 g/d conventional yogurt. RESULTS: We found no difference between two groups in fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), total cholesterol (TC), triglyceride (TG), high density lipoprotein-cholesterol (HDL-c) and low density lipoprotein-cholesterol (LDL-c) after intervention. After adjusting for baseline values of covariate, a significant reduction in HbA1c (mean change: -0.76 ± 1.3 vs. -0.15 ± 1.3; P = 0.01), TC (mean change: -10.61 ± 27.8 vs. -2.97 ± 35.0; P = 0.02) and LDL-c (mean change: -8.62 ± 21.7 vs. 0.02 ± 25.8; P = 0.004) was observed in the IG compared to the PG. In addition, a non-significant trend to reduction was observed in term of FPG (mean change: -19.61 ± 29.1 vs. -4.19 ± 24.2; P = 0.13). TG and HDL-c remained unchanged. CONCLUSIONS: Probiotic yogurt consumption may be useful for patients with T2DM. More well-designed clinical trials with longer intervention duration are required. Registered on 30 July 2022 at Iranian Registry of Clinical Trials (IRCT20220226054125N1) with URL: https://www.irct.ir/trial/62304.

Garlic supplementation improves intestinal transit time, lipid accumulation product and cardiometabolic indices in subjects with metabolic syndrome: A randomized controlled trial.

Subjects with metabolic syndrome (MetS) are at increased risk for cardiovascular disease (CVD). Altered gut microbiota is involved in the pathogenesis of MetS. It has been hypothesized that garlic can improve intestinal transit time and cardiovascular risks. We investigated the effect of garlic powder supplementation on intestinal transit time, lipid accumulation product (LAP), and cardiometabolic indices in subjects with MetS. A double-blind randomized controlled trial was conducted for 3 months among subjects with MetS. Ninety subjects were randomly assigned to the treatment group (intake of 1,600 mg/d garlic powder) or control group (placebo) using a computer-generated random number table. All participants were asked to follow the common healthy dietary recommendations during follow-up. The primary outcomes included intestinal transit time, LAP, cardiometabolic index (CMI), atherogenic index of plasma (AIP), Castelli risk index I (CRI-I) and Castelli risk index II (CRI-II). Garlic powder compared to the placebo improved intestinal transit time (p = .001), LAP (-21.5 ± 23.4 vs. 0.7 ± 21.5; p < .001), CMI (-0.85 ± 0.8 vs. 0.13 ± 0.8; p < .001), AIP (-0.14 ± 0.1 vs. 0.01 ± 0.1; p < .001), CRI-I (-0.69 ± 0.5 vs. 0.16 ± 0.5; p < .001) and CRI-II (-0.50 ± 0.3 vs. 0.02 ± 0.3; p < .001). Garlic supplementation can improve intestinal transit time, LAP, and cardiometabolic indices.

Effect of vitamin D supplementation on brain waves, behavioral performance, nitric oxide, malondialdehyde, and high-sensitivity C-reactive protein in children with attention deficit/hyperactivity disorder: study protocol for a randomized clinical trial.

BACKGROUND: Attention deficit/hyperactivity disorder (ADHD) is the most common chronic mental and behavioral disorder among children. Some studies showed the lower levels of vitamin D in patients with ADHD compared with the healthy people. Few clinical trials were conducted in this field. The present study will be performed to examine the effect of vitamin D supplementation in children with ADHD. METHODS: We will conduct a double-blind, randomized controlled clinical trial to investigate the effect of vitamin D supplementation on brain waves, behavioral performance, serum nitric oxide, malondialdehyde, and high-sensitivity C-reactive protein in 50 patients with ADHD. The intervention group will receive one capsule 50,000 IU vitamin D every week, for 8 weeks. The control group will receive one placebo capsule containing 1000 mg olive oil every week. Electroencephalography will be performed for 10 min using Brain Master Discovery from 19 scalp sites both before the first intervention and the 10 sessions of the therapy. The artifact-free periods of 1-min electroencephalography data will be analyzed for quantitative electroencephalography measures. DISCUSSION: For the first time, this clinical trial will evaluate the effect of vitamin D supplementation on brain waves, serum nitric oxide, malondialdehyde, and high-sensitivity C-reactive protein in patients with ADHD. The results of the present clinical trial will provide a better vision about the vitamin D efficacy in patients with ADHD. TRIAL REGISTRATION: Registered on 5 November 2020 at Iranian Registry of Clinical Trials with code number IRCT20200922048802N1 ( https://www.irct.ir/trial/51410 ).

Effects of curcumin and/or coenzyme Q10 supplementation on metabolic control in subjects with metabolic syndrome: a randomized clinical trial.

BACKGROUND: Metabolic syndrome (MetS) as a cluster of conditions including hyperlipidemia, hypertension, hyperglycemia, insulin resistance, and abdominal obesity is linked to cardiovascular diseases and type 2 diabetes. Evidence suggested that intake of curcumin and coenzyme Q10 may have therapeutic effects in the management of MetS. AIMS: We investigated the effects of curcumin and/or coenzyme Q10 supplementation on metabolic syndrome components including systolic blood pressure (SBP), diastolic blood pressure (DBP), waist circumference (WC), triglyceride (TG), high density lipoprotein-cholesterol (HDL-c) and fasting plasma glucose (FPG) as primary outcomes, and total cholesterol (TC), low density lipoprotein-cholesterol (LDL-c) and body mass index (BMI) as secondary outcomes in subjects with MetS. METHODS: In this 2 × 2 factorial, randomized, double-blinded, placebo-controlled study, 88 subjects with MetS were randomly assigned into four groups including curcumin plus placebo (CP), or coenzyme Q10 plus placebo (QP), or curcumin plus coenzyme Q10 (CQ), or double placebo (DP) for 12 weeks. RESULTS: The CP group compared with the three other groups showed a significant reduction in HDL-c (P = 0.001), TG (P <  0.001), TC (P <  0.001), and LDL-c (P <  0.001). No significant differences were seen between the four groups in terms of SBP, DBP, FPG, WC, BMI and weight. CONCLUSION: Curcumin improved dyslipidemia, but had no effect on body composition, hypertension and glycemic control. Furthermore, coenzyme Q10 as well as the combination of curcumin and coenzyme Q10 showed no therapeutic effects in subjects with MetS. The trial was registered on 09/21/2018 at the Iranian clinical trials website (IRCT20180201038585N2), URL: https://www.irct.ir/trial/32518 .

Effect of L-carnitine supplementation on lipid accumulation product and cardiovascular indices in women with overweight/obesity who have knee osteoarthritis: a randomized controlled trial.

BACKGROUND: Osteoarthritis is associated with obesity, dyslipidemia and cardiovascular diseases. It has been hypothesized that L-carnitine can improve cardiovascular risk factors. We aimed to investigate the effect of L-carnitine supplementation on lipid accumulation product (LAP) and atherogenic indices in women with overweight/obesity who have knee osteoarthritis. METHODS: In this double-blind randomized controlled trial, seventy-six women with overweight/obesity who had knee osteoarthritis were assigned into the intervention group and control group for 12 weeks. The intervention group received 1000 mg/day L-carnitine as capsule, and the control group received placebo. The primary outcomes were LAP, atherogenic index of plasma (AIP), atherogenic coefficient (AC) and Castelli risk index II (CRI-II). RESULTS: We found no significant difference between the groups in baseline values of LAP, AIP, AC and CRI-II. After the intervention, a significant reduction in LAP was observed in intervention group compared to the control group (- 11.05 (- 28.24 to 0.40) vs. - 5.82 (- 24.44 to 2.68); P = 0.03). However, there was no significant difference between two groups in AIP (- 0.05 ± 0.16 vs. - 0.01 ± 0.13; P = 0.19), AC (- 0.40 ± 0.81 vs. - 0.30 ± 0.67; P = 0.67) and CRI-II (- 0.20 ± 0.76 vs. - 0.21 ± 0.47; P = 0.11). CONCLUSIONS: L-carnitine supplementation for 12 weeks can improve LAP, but it has no effect on cardiovascular outcomes. To reach a definitive conclusion, further clinical trials with larger sample sizes and higher dosages of L-carnitine are needed. TRIAL REGISTRATION: Registered on 27/4/2017 at Iranian Registry of Clinical Trials IRCT2017011932026N2.

Association between dietary behaviors and depression in adolescent girls.

BACKGROUND: The growing prevalence of depression has become a major public health problem. There is limited evidence regarding the relationship between dietary behaviors and depression. The present study was designed to evaluate the association between dietary behaviors and depression score. METHODS: A total of 933 Iranian adolescent girls aged 12 to 18 years were included in this cross-sectional study. Depression severity score was assessed using a validated Persian version of Beck's depression inventory. Dietary behaviors were pre-defined and assessed in ten domains using a standard questionnaire. To investigate the association between dietary behaviors and depression score, the linear regression analysis in crude and adjusted models was used. RESULTS: 67.7% of participants had no or minimal depression symptoms and 32.3% of participants were categorized with mild-to-severe depression symptoms. There were significant inverse relationships between main meal consumption (Beta: -0.141; 95% CI: - 3.644 to - 1.000; P = 0.001), snack consumption (Beta: -0.100; 95% CI: - 2.400 to - 0.317; P = 0.002), regular meal consumption (Beta: 0.23; 95% CI: 0.13-0.42; P = 0.001) and food chewing (Beta: -0.152; 95% CI: - 2.279 to - 0.753; P = 0.03) with depression score. These associations remained significant after adjustment for confounding variables. In addition, frequency of intra-meal fluid intake (Beta: 0.096; 95% CI: 0.288 to 1.535; P = 0.004) and spicy foods consumption (Beta: 0.076; 95% CI: 0.098 to 1.508; P = 0.02) were directly associated with depression score in the crude model. These significant relations were disappeared in full adjusted model. No significant association was found between breakfast consumption, intake of fried foods, chewing ability, and tooth loss with depression score (P > 0.05). CONCLUSIONS: Significant associations were observed between specific eating behaviors with depression score. Prospective studies are needed to confirm these findings.

The association between dietary phytochemical index with depression and quality of life in iranian adolescent girls.

BACKGROUND: There is increasing evidence that the dietary intake of phytochemicals is inversely associated with severity of depression and positively associated with quality of life (QoL). The present study investigated the relationship between dietary phytochemical index (DPI) with depression and QoL scores in Iranian adolescent girls. METHODS: A total of 733 adolescent girls from Mashhad and Sabzevar cities in northeastern Iran were entered into this cross-sectional study. Assessment of depression and QoL was performed utilizing the Beck Depression Inventory (BDI) and SF-12v2 questionnaire, respectively. Assessment of dietary intake was undertaken by a qualified dietitian, using a validated food-frequency questionnaire (FFQ) containing 168 food items. To explore the association between DPI with QoL and depression, logistic regression was used in crude and adjusted models. RESULTS: The participants in the fourth quartile of DPI compared with the first quartile had a 50% lower odds of depression (OR: 0.50; 95% CI: 0.30-0.84, P = 0.009) This relation remained significant in all adjusted models. The adolescents in highest quartile of DPI compared with the first quartile had 38% lower odds of poor QoL (OR: 0.62; 95% CI: 0.41-0.94, P = 0.02). This association remained significant in adjusted models I and II, but not after adjusting for all confounding variables (OR: 0.67; 95% CI: 0.43-1.02, P = 0.06) (Model III). CONCLUSIONS: DPI was inversely associated with risk of depression. The association between DPI score and QoL remained unclear. Further prospective and interventional studies are required.

Adherence to Mediterranean diet and attention-deficit/hyperactivity disorder in children: A case control study.

OBJECTIVE: Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders. The Mediterranean diet as a plant-based diet has a beneficial effect on mental health. The present study was designed to investigate the association between adherence to Mediterranean diet and odds of ADHD in Iranian children. METHODS: This age and gender matched case-control study was conducted on 360 children 7-13 years old in Yazd, Iran. Children were categorized into new diagnosed case (n = 120) and control groups (n = 240). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSMIV-TR) was used to diagnose ADHD. A validated food frequency questionnaire was used to measure food intake. The association of adherence to the Mediterranean with the odds ratio of ADHD examined by logistic regression. RESULTS: After adjusting for potential confounders including energy intake, parents' educational level, economic status, family history ADHD and physical activity, the children in the highest tertile of adherence to Mediterranean diet had a lower odd of ADHD (odds ratio [OR]: 0.49; 95% Confidence Interval [CI]: 0.27-0.89) compared to the children in the lowest. In addition, an association was observed between increasing trend adherence to Mediterranean diet and decrease odds of ADHD after full adjustments (P for trend <0.001). CONCLUSION: We found that higher adherence to Mediterranean diet containing vegetables, legumes, fruits and nuts, grains, and fish could decrease the odds of ADHD in primary school children. Further studies are suggested to approve our vision.

Effect of Cornus mas L. fruit extract on lipid accumulation product and cardiovascular indices in patients with non-alcoholic fatty liver disease: A double-blind randomized controlled trial.

BACKGROUND & AIMS: Non-alcoholic fatty liver disease (NAFLD) is associated with high risk of cardiovascular diseases. The experimental studies have suggested that Cornus mas L. (cornelian cherry) fruit can improve cardiovascular risk factors. We designed a study to investigate the effect of cornelian cherry fruit extract on cardiovascular outcomes in patients with NAFLD. METHODS: We conducted a double-blind, randomized controlled trial. Fifty patients with NAFLD were randomly assigned into the treatment and the control groups. The treatment group received 20 cc/d cornelian cherry fruit extract as liquid form and the control group received 20 cc/d placebo for 12 weeks. The primary outcomes included lipid accumulation product (LAP), atherogenic index of plasma (AIP), Castelli risk index I (CRI-I), CRI-II and atherogenic coefficient (AC). RESULTS: At the baseline, there was no significant difference between two groups in values of LAP, AIP, CRI-I, CRI-II and AC. After the intervention, no significant change was found in the treatment group compared to the control group in LAP (-0.64 (-6.25 to 8.29) vs. 0.0 (-8.66 to 19.01); P = 0.91), AIP (0.0 ± 0.08 vs. 0.0 ± 0.1; P = 0.84), CRI-I (-0.18 ± 0.63 vs. -0.31 ± 0.49; P = 0.42), CRI-II (-0.23 ± 0.56 vs. -0.15 ± 0.32; P = 0.52) and AC (-0.18 ± 0.63 vs. -0.31 ± 0.49; P = 0.42). CONCLUSION: Cornelian cherry fruit extract has no effect on cardiovascular outcomes. Further studies with longer intervention durations are needed. TRIAL REGISTRATION: Registered on 30 September 2018 at Iranian Registry of Clinical Trials (IRCT20180419039359N1).

The effect of L-carnitine supplementation on insulin resistance, sex hormone-binding globulin and lipid profile in overweight/obese women with polycystic ovary syndrome: a randomized clinical trial.

PURPOSE: Polycystic ovary syndrome (PCOS) is a common endocrine disorder among reproductive-age women. Insulin resistance and dyslipidemia are linked to PCOS. L-Carnitine supplementation as a management strategy for women with PCOS has been proposed. The effect of L-carnitine supplementation on insulin resistance, sex hormone-binding globulin (SHBG) and lipid profile in overweight/obese women with PCOS was investigated. METHODS: This randomized, double-blind, controlled clinical trial, was conducted on 62overweight/obese women with PCOS. Participants were randomly assigned into two groups to receive 1000 mg/day L-carnitine or placebo (1000 mg starch) for 12 weeks. RESULTS: L-Carnitine supplementation compared to the placebo showed a significant improvement in insulin [- 0.7 (- 7.3 to 4.0) vs. 0.7 (- 3.0 to 5.2); P = 0.001], homeostatic model assessment for insulin resistance [- 0.4 (- 1.7 to 1.1) vs. 0.0 (- 0.7 to 1.3); P = 0.002], quantitative insulin sensitivity check index (+ 0.01 ± 0.02 vs. - 0.01 ± 0.01; P = 0.02) and a non-significant change toward improvement in SHBG (+ 11.5 ± 40.2 vs. - 3.2 ± 40.2; P = 0.2). However, there was no significant differences between the two groups in serum levels of fasting plasma glucose, total cholesterol, triglyceride, low density lipoprotein-cholesterol and high density lipoprotein cholesterol (P > 0.05). CONCLUSION: 12-week L-carnitine supplementation in overweight or obese women with PCOS ameliorate insulin resistance, but has no effect on SHBG and lipid profile. Studies with higher dosages and duration of L-carnitine intake are required. The trial was registered on 30 December 2019 at Iranian Registry of Clinical Trials IRCT20191016045131N1. TRIAL REGISTRATION: Registered on 30th December 2019 at Iranian Registry of Clinical Trials (IRCT20191016045131N1).

Dietary phytochemical index and attention-deficit/hyperactivity disorder in Iranian children: a case control study.

OBJECTIVE: Attention Deficit/Hyperactivity Disorder (ADHD) is a common behavioral disorder among children. Based on literature, it has been hypothesized that the higher intake of rich sources of phytochemicals may be inversely related to the risk of ADHD. We investigated the association of dietary phytochemical index (DPI) with odds of ADHD. METHODS: This case-control study was conducted on 360 children and adolescents 7-13 years old in Yazd, Iran. Subjects were categorized into the case (n = 120) and control groups (n = 240) based on matching age and sex. To diagnose ADHD, the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSMIV-TR) was used. Food frequency questionnaire was used to measure food intake. DPI was calculated by percent of daily energy intake from phytochemical-rich foods. The association of DPI with the odds ratio of ADHD was examined by logistic regression. RESULTS: Subjects in the highest quartile of DPI have higher intake of macronutrient, eicosatetraenoic acid, docosahexaenoic acid, calcium, zinc, iron, vitamins B12, B6, and folic acid compared to lowest quartile. After adjusting for potential confounders, subjects in the highest quartile of DPI compared with subjects in the lowest quartile showed a lower risk of ADHD (OR: 0.44; 95% CI: 0.18-0.90). There was a significant decreasing trend in the odds of ADHD across increasing quartile of DPI (P for trend: 0.02). CONCLUSION: We found that higher DPI score is associated with lower risk of ADHD in children. Cohort and clinical studies are necessary to approve our results.

Effect of Mediterranean diet on liver enzymes: a systematic review and meta-analysis of randomised controlled trials.

Elevated levels of liver enzymes are the main markers of liver dysfunction. Liver enzymes are the important indicators of non-alcoholic fatty liver disease (NAFLD) in the general population. Previous randomised clinical trials (RCT) investigated the effects of Mediterranean diet (MedDiet) as a plant-based diet on features of NAFLD like liver enzymes, but their results are contradictory. This study aimed to systematically review and meta-analyse RCT investigating the effect of MedDiet on liver enzymes. PubMed, Web of Science, Scopus and Google Scholar were searched until December 2020. A total of ten RCT (n 705 participants) evaluating the effect of MedDiet on liver enzymes including aspartate aminotransferase (AST), alanine transaminase (ALT) and γ-glutamyltransferase (GGT) were included. A random effects model was used to estimate the pooled effect size. To evaluate the heterogeneity among the included studies, the Cochran's Q-test and I-squared test were used. The MedDiet significantly reduced AST (weighted mean difference (WMD) = -0·38 IU/l; 95 % CI - 0·73, -0·03 IU/l; P = 0·03) and GGT (WMD = -0·16 IU/l; 95 % CI - 0·32, -0·006 IU/l; P = 0·04) but had no significant effect on ALT (WMD = -0·55 IU/l; 95 % CI - 1·25, 0·13 IU/l; P = 0·11). However, sensitivity analysis revealed that the overall effects of MedDiet on AST, GGT and ALT were significantly influenced by removing some studies. There was no publication bias based on Begg's and Egger's tests. Generally, MedDiet can improve liver enzymes. To better conclusion, further RCT investigating the effect of MedDiet on liver enzymes, especially in patients with NAFLD, are still required.

The association between low-carbohydrate diet score and sleep duration among Iranian adults.

Sleep disorders are linked to obesity, type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). The evidence suggests that dietary carbohydrate content may be related to sleep duration. We designed a study to investigate the association between a low-carbohydrate diet (LCD) with long sleep duration (> 8 h) and short sleep duration (< 5 h). This cross-sectional analysis was conducted on data obtained from the recruitment phase of Yazd Health Study (YaHS) and the Taghzieh Mardom-e-YaZd (TAMYZ). The dietary intake was assessed using a validated food frequency questionnaire. The LCD score was calculated for each subject based on summing up assigned scores to deciles of percentages of energy from macronutrients. Sleep duration was assessed using a nocturnal sleep questionnaire. The association between LCD and sleep duration was evaluated using logistic regressions in crude and adjusted models. A total of 5929 subjects were entered into the analysis. Most of the participants were aged 20-29 years (24.8%), male (52.2%) and never smokers (87.7%). After adjusting for level of physical activity, age, sex, total energy, smoking status and body mass index in model III, a significant direct association was observed between LCD score with long sleep duration (OR 1.15; 95% CI1-1.32, P = 0.049) and short sleep duration (OR 1.29; 95% CI 1.02-1.62, P = 0.028). Higher LCD score is associated with higher chance of long sleep duration and short sleep duration. Regarding the nature of our study, cohort and clinical trial studies in future are required to reach a causal association and a definitive conclusion.

Effect of omega-3 supplementation on cardiometabolic indices in diabetic patients with non-alcoholic fatty liver disease: a randomized controlled trial.

BACKGROUND: Patients with non-alcoholic fatty liver disease (NAFLD) as well as type 2 diabetes mellitus (T2DM) are at increased risk for cardiovascular diseases (CVD). Omega-3 supplementation has been proposed as a possible strategy for management of cardiometabolic risk. Cardiometabolic indices can predict and evaluate the cardiometabolic risk. AIMS: We investigated the effect of omega-3 supplementation on accurate and available cardiometabolic indices including atherogenic index of plasma (AIP), Castelli risk index I, Castelli risk index II and atherogenic coefficient (AC) in diabetic patients with NAFLD. METHODS: We conducted a double-blind, randomized controlled trial (RCT) for 12 weeks. From August 2016 to March 2017, the subjects referred to Faghihi hospital in Shiraz, Iran, were recruited. Sixty diabetic patients with NAFLD were randomly assigned into the omega-3 (2000 mg/d omega-3 capsule contained 360 mg/d eicosapentaenoic acid and 240 mg/d docosahexaenoic acid) and the placebo (liquid paraffin) groups using computer-generated random number table. RESULTS: Omega-3 supplementation compared to the placebo had no significant effect on AIP (- 0.11 ± 0.20 vs. -0.03 ± 0.16; P = 0.11), Castelli risk index I (- 0.25 ± 0.6 vs. -0.07 ± 0.7; P = 0.42), Castelli risk index II (- 0.24 ± 0.5 vs. -0.14 ± 0.5; P = 0.63) and AC (- 0.25 ± 0.6 vs. -0.07 ± 0.7; P = 0.42). After adjusting for confounding factors, the findings remained without change. CONCLUSION: Omega-3 supplementation (2000 mg/d) for 12 weeks has no effect on cardiometabolic risk. It seems, higher doses of omega-3 can improve cordiometabolic risk. The trial was registered at Iranian Registry of Clinical Trials IRCT2016102530489N1.

Effect of l-carnitine supplementation on liver fat content and cardiometabolic indices in overweight/obese women with polycystic ovary syndrome: A randomized controlled trial.

BACKGROUND: Polycystic ovary syndrome (PCOS) is a common endocrine disorder among reproductive-age women, and is associated with cardiovascular diseases as well as non-alcoholic fatty liver disease. The recent evidence suggested the beneficial effects of l-carnitine in women with PCOS. OBJECTIVE: The present study aimed to investigate the effect of l-carnitine supplementation on liver fat content and cardiometabolic outcomes in overweight/obese women with PCOS. METHODS: The present study was designed as a 12-week double-blind, randomized controlled clinical trial. Sixty-two overweight/obese women with PCOS were assigned into the treatment (received 1000 mg/d l-carnitine capsule) and the control (received placebo capsule) groups. The outcomes included lipid accumulation product (LAP), atherogenic index of plasma (AIP), atherogenic coefficient (AC) and Castelli II indices. RESULTS: At the end of the trial, there was no significant difference between the treatment and the control groups in terms of LAP (-1.1 vs. -4.0; P = 0.45), AIP (0.0 vs. -0.09; P = 0.14), AC (-0.2 vs. -0.8; P = 0.06) and Castelli II index (-0.2 vs. -0.6; P = 0.07) after controlling the mean change of waist circumference. CONCLUSION: l-carnitine supplementation for 12 weeks has no beneficial effect on liver fat content and cardiometabolic outcomes in overweight or obese women with PCOS. TRIAL REGISTRATION: Registered on 30 December 2019 at Iranian Registry of Clinical Trials IRCT20191016045131N1.

Effect of omega-3 supplementation on fatty liver and visceral adiposity indices in diabetic patients with non-alcoholic fatty liver disease: A randomized controlled trial.

BACKGROUND AND AIMS: Non-alcoholic fatty liver disease (NAFLD) as the most common chronic liver disease is closely linked to type 2 diabetes mellitus (T2DM). Omega-3 supplementation has been proposed as a strategy to manage T2DM and NAFLD. The present study aimed to investigate the effect of omega-3 supplementation on fatty liver index, lipid accumulation product and visceral adiposity index in diabetic patients with NAFLD. METHODS: In this 12-week double-blind, randomized controlled clinical trial, sixty diabetic patients with NAFLD were randomly assigned into the omega-3 and placebo groups for 12 weeks. The omega-3 group received 2000 mg/d omega-3 as capsule. RESULTS: Fifty-six participants completed the study. No significant difference was found between the two groups in the terms of fatty liver index, lipid accumulation product and visceral adiposity index at the baseline. Omega-3 supplementation compared with the placebo led to a significant improvement in fatty liver index (-3.6 ± 12.1 vs. 0.9 ± 8.9; P = 0.04), lipid accumulation product (-14.2 ± 27.9 vs. 8.0 ± 26.3; P = 0.002) and visceral adiposity index (-0.5 ± 0.9 vs. 0.0 ± 0.8; P = 0.01). CONCLUSION: Omega-3 supplementation for 12 weeks improves fatty liver index, lipid accumulation product and visceral adiposity index. The study protocol was registered under Iranian Registry of Clinical Trials identifier number IRCT2016102530489N1.

Effects of garlic powder supplementation on metabolic syndrome components, insulin resistance, fatty liver index, and appetite in subjects with metabolic syndrome: A randomized clinical trial.

The prevalence of metabolic syndrome (MetS) is increasing. It is closely linked to nonalcoholic fatty liver disease. Garlic consumption as a strategy for the management of MetS has been suggested. We investigated the effect of garlic supplementation on MetS components, insulin resistance, fatty liver index (FLI), and appetite in subjects with MetS. Ninety subjects were assigned to receive 1,600 mg/d garlic powder or placebo for 3 months. The primary outcomes included MetS components. The secondary outcomes included insulin resistance, FLI, and appetite. Garlic supplementation compared with the placebo led to a significant increase in high density lipoprotein-cholesterol (4.5 vs. -1.8, p < .001) and a significant reduction in waist circumference (-1.3 vs. 0.0, p = .001), diastolic blood pressure (-6.7 vs. 0.0, p < .001), systolic blood pressure (-7.7 vs. 0.5, p < .001), triglyceride (-40.0 vs. 0.1, p < .001), γ-glutamyl transferase (-3.2 vs. 0.6, p = .01), FLI (-5.5 vs. 0.1, p < .001), insulin (-2.9 vs. -1.1, p < .001), homeostatic model of assessment for insulin resistance (-0.5 vs. -0.3, p < .001) and appetite (hunger: -11.7 vs. 1.7, p < .001; fullness: 10.0 vs. 0.3, p = .001; desire to eat: -6.7 vs. 2.1, p < .001; and ability to eat: -11.5 vs. -1.0, p < .001). Garlic improves MetS components, insulin resistance, FLI, and appetite.