Muscle mass and function are related to respiratory function in chronic obstructive pulmonary disease.

Background: Chronic obstructive pulmonary disease (COPD), as an airway limitation condition, is accompanied by alteration of muscle mass and function. We aimed to determine the relationship between disease severity and body composition, muscle function, and nutritional status in COPD patients. Methods: This cross-sectional study was conducted on 129 COPD participants. Muscle strength, body composition, and calf circumference (CC) were measured using a hydraulic hand dynamometer, bioelectrical impedance analysis (BIA), and a tape measure, respectively. Furthermore, fat-free mass index (FFMI), body mass index (BMI) and muscle mass value were calculated by equations. Forced expiratory volume in one second (FEV1) was assessed as well. Nutritional status was also evaluated by subjective global assessment (SGA) questionnaire. SPSS software (version 21 ) was used, chi-square, fisher's exact test, univariate and multivariate linear regression models were used for statistical analysis. P-values less than 0.05 were considered significant. Results: Based on FEV1 classification, 52.7% of the patients had severe conditions. The reports indicated that the prevalence of low CC was 54.2%, low muscle mass 38.7%, low FFMI 34.8%, low right handgrip strength 61.2% and low left handgrip strength 64.3%. Furthermore, there was an increasing trend based on FEV1 in low CC (p=0.032), low muscle mass (p=0.005), low FFMI (p=0.002), low right handgrip strength (p=0.004) and low left handgrip strength (p=0.014). The results of univariate analysis showed muscle mass (p=0.036), total protein (p=0.043), FFM (p=0.047), FFMI (p=0.007), SGA (p=0.029), right handgrip strength (p=0.004) and left hand grip strength (p=0.023) were associated with FEV1. In addition, the results of multivariate analysis demonstrated low values of FFMI (p=0.005) and right handgrip strength (p=0.042) were the main detrimental factors for FEV1. The results of multivariate analysis were confirmed by stepwise model. Conclusion: Low values of muscle mass and function are prevalent among COPD patients. The present study revealed that low FFMI and handgrip strength were closely related to disease severity.

Fortified whey beverage for improving muscle mass in chronic obstructive pulmonary disease: a single-blind, randomized clinical trial.

BACKGROUND: The development of effective nutritional supports for patients with chronic obstructive pulmonary diseases (COPD) is still challenging. This study was conducted to investigate the efficacy of daily consumption of fortified whey on inflammation, muscle mass, functionality, and quality of life in patients with moderate-to-severe COPD. METHODS: A single-blind, randomized trial study was performed on patients with COPD (n = 46). Participants in the intervention group (n = 23) daily received 250 ml of whey beverage fortified with magnesium and vitamin C for 8 weeks. Any changes in inflammatory cytokines (including interleukin- 6 (IL-6) and tumor necrosis factor (TNFα)) were the primary outcomes and the secondary outcomes were fat-free mass, handgrip strength, malnutrition, glutathione and malondialdehyde serum concentrations, and health-related quality of life (HRQoL). Body composition and muscle strength were measured by Bioelectrical Impedance Analysis (BIA) and hydraulic hand dynamometer, respectively. Fat-free mass index (FFMI) was also calculated. RESULTS: At the end of the study, 44 patients were analyzed. There were significant decreases in IL-6 concentrations in the intervention group compared to the control group. Also, FFMI, body protein, and handgrip strength increased significantly in the intervention group with significant changes between two groups. Moreover, improvement in health-related quality of life was observed in the intervention group compared to the control group. There were no significant changes in other study variables. CONCLUSIONS: This novel nutritional intervention decreased inflammatory cytokines levels, improved indices of skeletal muscle mass and muscle strength, and ultimately, increased HRQoL in patients with moderate-to-severe COPD. Thus, it is suggested to do further studies to assess the effects of nutrition intervention on COPD progression. TRIAL REGISTRATION: IR.SUMS.REC.1396.85 ( https://www.irct.ir/ ).

The association between dietary intakes and stone formation in patients with urinary stones in Shiraz.

Background: Kidney stone is a common and costly disease, but it may be improved by a healthy diet. The aim of this study was to evaluate the association between dietary intake and stone formation in patients with urinary stones in Shiraz. Methods: In this cross sectional study, 110 patients with kidney stone were selected from Faghihi hospital, Shiraz. Demographic information was collected, and anthropometric indices, disease-related variables, physical activity (using IPAQ), and dietary intake (using food frequency questionnaire, analyzed by Nut 4 software, to estimate micro and macro nutrients) were evaluated. Independent sample t test and one-way ANOVA were used to compare the quantitative variables between the 2 groups and multi groups, respectively. Chi square test was also used to compare qualitative variables. The correlation between variables was determined using Pearson test. Results: Out of 110 participants in this study, 37 (33.6%) were female, with the mean BMI of 27.0 ± 4.68 kg/m2, and 73 (66.4%) were male, with the mean BMI of 24.21±2.96 kg/m2. The mean intake of calcium-containing foods (p=0.02) and high-fructose beverages (p=0.03) was significantly greater in patients with calcium stones compared to those with uric acid stones. The mean intake of high-purine foods was significantly higher in patients with uric acid stones than in those with calcium stones (p=0.007). The mean intake of vitamin A (p=0.02), beta-carotene (p=0.03), and fructose (p=0.03) was significantly higher in patients with calcium stones than in those with uric acid stones, while caffeine intake was significantly higher in patients with uric acid than in those with calcium stones (p=0.01). There was a significant correlation between consumption of high-oxalic beverages (p=0.005, correlation coefficient = 0.26) and high-fructose (p=0.048, correlation coefficient = 0.18) with spontaneous stone expulsion. Conclusion: There was a significant relationship between consuming vitamin A, beta-carotene, and foods containing calcium, purine, fructose, and oxalate and formation of kidney stones. Therefore, adopting a healthy diet and increasing physical activity may be effective in the treatment of kidney stones.

Effects of supplementation with rice husk powder and rice bran on inflammatory factors in overweight and obese adults following an energy-restricted diet: a randomized controlled trial.

PURPOSE: Overweight and obesity are major public health concerns worldwide which are associated with a low-grade chronic inflammation. Dietary fiber as an important component of diet could be effective in controlling weight and inflammatory factors. The present study aimed to compare the effects of rice husk powder and rice bran on inflammatory factors along with an energy-restricted diet in overweight and obese adults. METHODS: In this randomized trial, 105 eligible individuals were assigned to one of the three energy-restricted diet groups receiving; rice bran (n = 35), rice husk powder (n = 35), and control group (n = 35) for 12 weeks. Demographic data, dietary intake, anthropometric indices and inflammatory factors (serum levels of IL-6 and hs-CRP) were measured at baseline and at the end of the study. RESULTS: Weight, BMI and waist circumference reduced significantly in all groups after 12 weeks of study (P < 0.01 for all). However, pre- and post-measure differences between groups were not significant. Moreover, serum levels of hs-CRP and IL-6 were not significantly different between participants in the rice bran or rice husk groups. However, the reduction in serum levels of hs-CRP in rice husk (mean change = - 0.14 ± 0.05 µg/ml) and rice bran (mean change = - 0.13 ± 0.03 µg/ml) was significantly higher when compared to the control group (mean change = - 0.03 ± 0.02 µg/ml) (P < 0.05 for both groups). The same pattern was found when changes in IL-6 serum levels of participants in rice husk (mean change = - 0.48 ± 0.11 pg/ml) and rice bran (mean change = - 0.57 ± 0.13 pg/ml) groups were compared to the control group (mean change= - 0.19 ± 0.07 pg/ml) (P < 0.05 for both groups). CONCLUSION: The results of this study showed positive effects of rice bran and rice husk powder supplementation, combined with an energy-restricted diet, on inflammatory markers among overweight and obese adults.

Correction to: Effects of supplementation with rice husk powder and rice bran on inflammatory factors in overweight and obese adults following an energy-restricted diet: a randomized controlled trial.

In the original publication, one of the author's name was misspelled. The correct name is "Salma Mahmoodianfard". The original article was corrected.

Effect of coenzyme Q10 on glycaemic control, oxidative stress and adiponectin in type 2 diabetes.

OBJECTIVE: To assess the effects of Coenzyme Q10 supplementation on glycaemic control, oxidative stress and adiponectin levels in people with type 2 diabetes. METHODS: The randomised, single-blind, placebo-controlled study was conducted in the city of Shiraz, Iran, in 2012 and comprised type 2 diabetes subjects recruited from various health facilities. Subjects and controls received 100mg Coenzyme Q10 or placebo twice a day for eight weeks respectively. A variety of measurements were made at baseline and at the end of the intervention. These included measuring markers of glycaemic control (fasting blood glucose and glycated haemoglobin); a marker of oxidative stress (malondialdehyde); and an anti-inflammatory marker (adiponectin). SPSS 15 was used for statistical analysis. RESULTS: Of the 52 patients, 28(54%) were male and 24(46%) were female, with an overall mean age of 51.73±7.34 years. There were 16(62% male and 10(39%) females in the intervention group, and 12(46%) male and 14(54%) female subjects in the control group. Among the cases, Coenzyme Q10 resulted in a significant reduction in malondialdehyde levels (p=0.04). However, the difference within the controls for this factor was not significant (p>-0.05). Moreover, fasting blood glucose, glycated haemoglobin and adiponectin levels showed no significant differences within or between the groups (p>0.05 each). CONCLUSIONS: Coenzyme supplementation may reduce oxidative stress in type 2 diabetics. However, it may not have any effects on glycaemic control and adiponectin levels.

Nutrient intake and growth indices for children at kindergartens in Shiraz, Iran.

OBJECTIVE: To evaluate energy and nutrient intake and determine growth indices for pre-school children in Iran. METHODS: The study was conducted from June to September 2010 and included 150 children aged between 3 and 5 years who attended kindergartens in Shiraz, Iran. Following a measurement of the participants' height and weight, three 24-hour dietary recalls were completed based on interviews with their parents. The data was entered into various computer softwares. The prevalence of underweight, stunting, wasting, at-risk-of-overweight and overweight children was then calculated, and energy and nutrient intake was compared with the recommended values. RESULTS: The mean intake of energy, calcium and iron for the children were less than the recommended values. In contrast, the mean intakes of carbohydrate, protein, zinc and vitamin C were higher than the recommendations. Fat intake, however, was within the Acceptable Macronutrient Distribution Range. In addition, the rates of prevalence of the underweight, stunting, wasting, and overweight or at-risk-of-overweight were found to be 27 (18.6%), 37 (25.5%), 18 (12.4%) and 34 (23.4%), respectively. Finally, underweight children had lower intake of energy, carbohydrate, protein, fat, iron and zinc, while overweight or at-risk-of-overweight ones had higher intake of protein, calcium and zinc. CONCLUSION: There is a need for children in kindergartens of Shiraz to improve their mean intake of energy, calcium and iron. Moreover, about one-fourth of the children were stunted and about the same proportion were either overweight or at the risk of being so.

Benefits of fermented synbiotic soymilk containing Lactobacillus acidophilus, Bifidobacterium lactis, and inulin towards lead toxicity alleviation.

This study aims to evaluate the effect of fermented synbiotic soy milk containing Lactobacillus acidophilus, Bifidobacterium lactis, and inulin on a series of hematological and oxidative stress parameters, as well as serum lead levels in rats. In this study, 56 male Sprague-Dawley rats were randomly assigned to assess probiotics (L. acidophilus or B. lactis), probiotics with prebiotics (i.e., inulin), and the corresponding controls. Several hematologic parameters (red blood cell (RBC)), hematocrit (HCT) and hemoglobin (Hgb)), serum lead levels, superoxide dismutase (SOD) activity, and malondialdehyde (MDA) presence was measured to evaluate changes on day 42. Although a significant difference was observed in serum lead levels, there were no significant changes in hematological and oxidative stress parameters between the study groups. In conclusion, this study demonstrates that administering synbiotic fermented soy milk containing the probiotic Lactobacillus acidophilus and the prebiotic inulin may significantly improve serum lead levels in rats.

The relationship between the Mediterranean diet and Axis I disorders: A systematic review of observational studies.

Axis I disorders are one of the major health burdens worldwide. Evidence suggests that Mediterranean diet has key biological factors associated with reducing the progression of these disorders. This systematic review aimed to clarify the relationship between Mediterranean diet and Axis I disorders. PubMed and Scopus databases were searched from January 2016 up to June 2021. Those observational studies in English language that assessed the relationship between Mediterranean diet and Axis I disorders (such as depression, anxiety, eating disorders, schizophrenia, etc.) were included in this review. The Newcastle-Ottawa Scale was used to evaluate the quality of studies. Thirty-six studies (15 cohorts, 19 cross-sectional, and 2 case-control) met the inclusion criteria. The results revealed that more than two-thirds of the studies (25 studies, 69.44%) had significant protective relationship between receiving Mediterranean diet and reducing the symptoms or incidence of Axis I disorders. Most studies were performed on depression (29 studies measured depression at least as one of the Axis I disorders), of which 72.41% reported an inverse relationship. There were also 9 studies on anxiety (studies that measured anxiety at least as one of the Axis I disorders), that 77.77% of them observed protective association. Moreover, majority of the studies (25 studies, 69.44%) had high quality, of which 76% found an inverse relationship. In conclusion, it seems that the Mediterranean diet can reduce the symptoms or the occurrence of Axis I disorders (especially depression and anxiety). However, more extensive review studies, particularly with interventional designs, are necessary to prove the result.

Health-Related Quality of Life and Nutritional Status Are Related to Dietary Magnesium Intake in Chronic Obstructive Pulmonary Disease: A Cross-Sectional Study.

An insufficient intake of magnesium may be associated with the development of chronic obstructive pulmonary disease (COPD). We aimed to determine the relationship between health related quality of life (QoL), anthropometric indices and nutritional status with dietary magnesium intake in COPD patients. Sixty-one COPD patients participated in this cross-sectional study. QoL and nutritional status were assessed. Furthermore, body composition, calf circumference, and muscle strength were measured; equations were used to calculate fat-free mass index, body mass index, and muscle mass value. Dietary magnesium intake was assessed by three 24-hours recalls and magnesium intake was categorized as ≤ 188.08 mg/day (A group) and > 188.08 mg/day (B group). The χ2, independent-sample t-test and Mann-Whitney test were used for statistical analysis. The p values less than 0.05 were considered significant. Of QoL assessments the total and impact mean scores of St. George's respiratory questionnaire in the B group were significantly lower than the means of the A group (p value = 0.007 and 0.005, respectively). The instrumental activity of daily living score was significantly improved in patients with higher consumption of dietary magnesium (p = 0.02). Participants had a significantly lower mean score of patient-generated subjective global assessment in the B group compared to the A group (p = 0.003). Higher intake of dietary magnesium can lead to improve QoL and nutrition status.

Effect of alpha-lipoic acid and vitamin E supplementation on oxidative stress, inflammation, and malnutrition in hemodialysis patients.

INTRODUCTION: Increased oxidative stress, inflammation, and malnutrition are present in hemodialysis patients and these factors exacerbate cardiovascular comorbidities. Vitamin E and alpha-lipoic acid (ALA) may have a protective role against cardiovascular disease risk factors via anti-oxidative and anti-inflammatory properties. The aim of this study was to evaluate the effect of ALA and vitamin E administration (alone or combined) on hemodialysis-induced stress oxidation, inflammation, and malnutrition. MATERIALS AND METHODS: In a randomized placebo-controlled trial, we examined the effects of 2-month supplementation by vitamin E and ALA (alone or combined) on biomarkers of lipid peroxidation (malondialdehyde), inflammation (high-sensitivity C-Reactive protein and interleukin-6), and malnutrition (Subjective Global Assessment and body mass index) in 85 hemodialysis patients receiving ALA (600 mg), vitamin E (400 IU), ALA and vitamin E, and placebo. RESULTS: After supplementation, no significant changes were observed in malondialdehyde level; however, there was a decrease in the ALA and vitamin E group during the period of the study. Also, a nonsignificant decrease was seen in the high-sensitivity C-Reactive protein concentration of the interventional groups. Supplementation of vitamin E with and without ALA significantly reduced interleukin-6 concentration. A significant improvement was observed in malnutrition status of all groups. CONCLUSIONS: Vitamin E and ALA supplementation, especially their combination, might improve inflammation and malnutrition status, which suggest it as a potential preventive strategy against CVD among end-stage renal disease patients.

Nutrition knowledge: application and perception of food labels among women.

Knowing the level of consumers' nutritional knowledge is useful for promoting dietary habits. The aim of this study was to assess women's nutritional knowledge and their food label perception and their correlates. Three hundred and eighty Women referring to four large supermarkets in Shiraz were selected for this study. Data were collected through face-to-face interview. The NKQ questionnaire was used for designing the study questionnaire. The first part contained demographic characteristics and the second section encompassed questions related to nutritional knowledge of consumers about food components. The third part consisted of questions about labeling. Data were analyzed using SPSS 16. ANOVA and t-test were used for analyzing multi-variant variables. Chi-square test was used for evaluating the relationship between variables. 49.7% of the participants were healthy and others had chronic diseases. The mean score of the women's nutrition knowledge was 20.13 (from 24) and the average knowledge of women about food components were near 50%. Consumers' information about food labels application was less than 50% for all situations. The lowest use of labels was about low-salt labels and the highest for calorie content of foods. There was a significant relationship between educational status and food label use and also a significant relationship between information about added sugar and using low-sugar labels and between knowledge about low-salt foods and using low-salt labels. A significant relationship was also seen between knowledge about fat and cholesterol use for low fat foods. So, label application was correlated with educational level and nutritional knowledge of women.

Anthropometric characteristics and dietary pattern of women with polycystic ovary syndrome.

OBJECTIVE: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among women of reproductive age. PCOS is considered to be not only a reproductive endocrinopathy, but also a metabolic disorder. The objective of the present study was to characterize the anthropometric and dietary profile of women with PCOS and to compare it with that of healthy age-matched women. DESIGN: In this case-control study, 65 women with PCOS served as cases. The control group consisted of 65 age-matched healthy women. For each participant, demographic, anthropometric and dietary intake data were gathered and compared between the two groups. RESULTS: There was no significant difference between the mean of the body mass index of the two groups, but the mean of waist circumference was significantly higher in the PCOS group, than the control group (P = 0.016). Compared to the normal weight PCOS patients, a significantly higher percentage of overweight patients had hirsutism (P = 0.009). In dietary analysis, women with PCOS consumed more calories and more fat than healthy women (P = 0.001 and P = 0.019, respectively). CONCLUSION: It is concluded that in PCOS patients, android obesity is a common feature and this abdominal adiposity may be related to the syndrome's complications. PCOS symptoms were more severe in overweight patients than the normal weight. Regarding the dietary pattern, it was indicated that patients with PCOS consume more calories and more fat in their diets and this might have been correlated to their disease.

Nutritional evaluation in chronic obstructive pulmonary disease patients.

Malnutrition is a common problem in moderate or severe Chronic Obstructive Pulmonary Disease (COPD) patients which affects body composition and food intake of these patients. In this study, the relationship of the stage of COPD with nutritional intake and body mass index in COPD patients were investigated and compared with healthy people and Dietary Reference Intake tables. A total of 93 COPD patients were referred by pulmonary physicians in Motahari and Faghihi medical centers. Pulmonary Function Test (PFT) was used in order to confirm the diagnosis of COPD and also categorize the patients into three categories (mild, moderate and sever). The control group consisted of 108 adults matched to the cases by age and gender. Anthropometric indices and physical activity and a 24 h dietary recall were recorded. All analyses were performed using the SPSS 14. All data presented as means (+/- SD). The mean intake of energy (p = 0.002), protein (p < 0.001), fat (p = 0.007), vitamin C (p = 0.003), vitamin E (p < 0.001), magnesium (p < 0.001) and omega-3 (p < 0.001) was significantly lower in COPD patients compared with controls. The mean BMI of the severe group was significantly lower than the controls (p = 0.016). The mean intake of energy, carbohydrate, fat, vitamin E, magnesium and omega-3 was significantly lower in both case and control groups compared to the RDA (p < 0.001) for all of the mentioned nutrients). Vitamin C intake was lower than RDA in the case (p < 0.001) and also in the control males (p < 0.001). In COPD patients, there is a significant relationship between the stage of COPD and nutrients intake and their BMI.

Effect of vitamin C supplementation on postprandial oxidative stress and lipid profile in type 2 diabetic patients.

Diabetes mellitus is one of the most wide spread endocrine disorders and an important developing health problem in the world. Cardiovascular disease is a common complication of type 2 diabetes. Several risk factors for coronary heart disease cosegregate in type 2 diabetes, including hyperglycemia, hyperlipaemia, increases production of free radical and decrease in antioxidant defense system. In this study we evaluated the effect of vitamin C supplementation on fasting and postprandial oxidative stress and lipid profile in type 2 diabetic patients. 30 patients with type 2 diabetes from Nader Kazemi Clinic, Shiraz, Iran were randomly divided into 2 groups; vitamin C treatment group (1000 mg d(-1)) and placebo group from May to September 2010. Fasting and postprandial lipid profile and Malondialdehyde (MDA) level were measured at the beginning of the study and after six weeks of supplementation. Data analysis was carried out using Mann-Whitney U test with p < 0.05 being significant by SPSS software version 16.The result of the study showed a significantly decrease in fasting (p = 0.006) and postprandial MDA (p < 0.001) in vitamin C group compare to placebo group but not in lipid profile. This study suggests that vitamin C supplementation can decrease fasting and postprandial oxidative stress and may prevent diabetes complication.