The association between hyperuricemia and insulin resistance surrogates, dietary- and lifestyle insulin resistance indices in an Iranian population: MASHAD cohort study.

BACKGROUND: Previous studies have reported insulin resistance (IR) to be associated with hyperuricemia. In this study, we aimed to assess the possible associations between the empirical dietary index for IR (EDIR), the empirical lifestyle index for IR (ELIR), and non-insulin-based surrogates (triglyceride-glucose (TyG) index, triglyceride-to-high-density-lipoprotein-cholesterol (TG/HDL-C) ratio, metabolic score for insulin resistance (METS-IR) and TyG with body mass index (TyG-BMI)) and hyperuricemia in an Iranian population. METHODS: In this cross-sectional study, 6457 participants aged 35-65 years were recruited as part of the MASHAD cohort study. EDIR and ELIR were calculated using dietary intakes, body mass index, and physical activity information. Insulin resistance surrogates including TyG, TyG-BMI, TG/HDL-C, and METS-IR were calculated for all participants. Hyperuricemia was defined as serum uric acid ≥ 7 mg/dl in men or ≥ 6 mg/dl in women. Multivariable logistic regression models were applied to determine the association between indexes of IR and hyperuricemia. RESULTS: The mean ELIR and IR surrogates (TyG, TyG-BMI, TG/ HDL, and METS-IR) were significantly higher in subjects with hyperuricemia compared to non-hyperuricemic subjects (p < 0.001). After adjusting for confounding variables, the association between hyperuricemia and EDIR was not significant, but ELIR had a significant association in all models (p < 0.001). All four IR surrogates (TyG, TyG-BMI, TG/ HDL, and METS-IR) showed a significant association with hyperuricemia (p < 0.001). CONCLUSION: There was a significant association between indexes of insulin resistance: TyG, TyG-BMI, TG/HDL-c, METS-IR, and ELIR with hyperuricemia, in a population sample from northeastern Iran.

The effects of pomegranate consumption on blood pressure in adults: A systematic review and meta-analysis.

Considering the main component of cardiovascular disease and due to the high prevalence of hypertension, controlling blood pressure is required in individuals with various health conditions. Randomized clinical trials (RCTs) which studied the effects of pomegranate consumption on blood pressure have shown inconsistent findings. As a result, we intended to assess the effects of pomegranate consumption on systolic (SBP) and diastolic (DBP) blood pressure in adults. Systematic literature searches up to January 2024 were carried out using electronic databases, including PubMed, Web of Science, and Scopus, to identify eligible RCTs assessing the effects of pomegranate on blood pressure as an outcome. All the individuals who took part in our research were adults who consumed pomegranate in different forms as part of the study intervention. Heterogeneity tests of the selected trials were performed using the I2 statistic. Random effects models were assessed based on the heterogeneity tests, and pooled data were determined as the weighted mean difference (WMD) with a 95% confidence interval (CI). Of 2315 records, 22 eligible RCTs were included in the current study. Our meta-analysis of the pooled findings showed that pomegranate consumption significantly reduced SBP (WMD: -7.87 mmHg; 95% CI: -10.34 to -5.39; p < 0.001) and DBP (WMD: -3.23 mmHg; 95% CI: -5.37 to -1.09; p = 0.003). Individuals with baseline SBP > 130 mmHg had a significantly greater reduction in SBP compared to individuals with baseline SBP < 130 mmHg. Also, there was a high level of heterogeneity among studies (SBP: I2 = 90.0% and DBP: I2 = 91.8%). Overall, the results demonstrated that pomegranate consumption lowered SBP and DBP in adults. Although our results suggest that pomegranate juice may be effective in reducing blood pressure in the pooled data, further high-quality studies are needed to demonstrate the clinical efficacy of pomegranate consumption.

The effects of silymarin consumption on inflammation and oxidative stress in adults: a systematic review and meta-analysis.

BACKGROUND: Owing to the rich phytochemical content of Silymarin, it may effectively manage inflammation and oxidative stress. We, therefore, aimed to examine the existing evidence on the effect of Silymarin consumption on inflammation and oxidative stress factors by conducting a systematic review and meta-analysis of randomized controlled trials. METHODS: A systematic literature search up to September 2023 was completed in PubMed/Medline, Scopus, and Web of Science, to identify eligible RCTs. Heterogeneity tests of the selected trials were performed using the I2 statistic. Random effects models were assessed based on the heterogeneity tests, and pooled data were determined as weighted mean differences with a 95% confidence interval. RESULTS: Fifteen RCTs were included in this meta-analysis. Our findings showed that Silymarin consumption significantly decreased CRP (WMD, - 0.50 mg/L; 95% CI, (- 0.95 to - 0.04); p = 0.03), MDA (WMD, - 1.19 nmol/mL; 95% CI, (- 1.99 to - 0.38); p = 0.004), and IL-6 (WMD, - 0.44 pg/ml; 95% CI, (- 0.75 to - 0.12); p = 0.006). Silymarin consumption had no significant effects on IL-10, TAC, and GSH. A significant non-linear relationship was observed between the duration of the intervention and MDA changes. CONCLUSIONS: Silymarin can help reduce inflammation in patients with diabetes and thalassemia by reducing MDA as an oxidative stress marker and CRP and IL-6 as inflammatory markers.

The effect of acarbose on inflammatory cytokines and adipokines in adults: a systematic review and meta-analysis of randomized clinical trials.

BACKGROUND: Although a large number of trials have observed an anti-inflammatory property of acarbose, the currently available research remains controversial regarding its beneficial health effects. Hence, the purpose of this study was to examine the effect of acarbose on inflammatory cytokines and adipokines in adults. METHODS: PubMed, Web of Science, and Scopus were systematically searched until April 2023 using relevant keywords. The mean difference (MD) of any effect was calculated using a random-effects model. Weighted mean difference (WMD) and 95% confidence intervals (CIs) were calculated via the random-effects model. RESULTS: The current meta-analysis of data comprised a total of 19 RCTs. Meta-analysis showed that acarbose significantly decreased tumor necrosis factor-alpha (TNF-α) (weighted mean difference [WMD]) = - 4.16 pg/ml, 95% confidence interval (CI) - 6.58, - 1.74; P = 0.001) while increasing adiponectin (WMD = 0.79 ng/ml, 95% CI 0.02, 1.55; P = 0.044). However, the effects of acarbose on TNF-α concentrations were observed in studies with intervention doses ≥ 300 mg/d (WMD = - 4.09; 95% CI - 7.00, - 1.18; P = 0.006), and the adiponectin concentrations were significantly higher (WMD = 1.03 ng/ml, 95%CI 0.19, 1.87; P = 0.016) in studies in which the duration of intervention was less than 24 weeks. No significant effect was seen for C-reactive protein (CRP; P = 0.134), interleukin-6 (IL-6; P = 0.204), and leptin (P = 0.576). CONCLUSION: Acarbose had beneficial effects on reducing inflammation and increasing adiponectin. In this way, it may prevent the development of chronic diseases related to inflammation. However, more studies are needed.

The effects of raspberry consumption on lipid profile and blood pressure in adults: A systematic review and meta-analysis.

Research into the effects of raspberry on blood pressure and lipid profiles is inconclusive. This meta-analysis was aimed to determine whether raspberry has beneficial effects in clinical practice and to what extent these effects are associated with blood pressure and lipid profiles. A systematic literature search up to September 2023 was completed in PubMed/Medline, Scopus, and Web of Science, to identify eligible RCTs. Heterogeneity tests of the selected trials were performed using the I 2 statistic. Random effects models were evaluated based on the heterogeneity tests, and pooled data were determined as weighted mean differences with a 95% confidence interval. Eleven randomized controlled trials (with 13 arms) were eligible for this meta-analysis. Our findings revealed that Raspberry consumption had no significant effects on the blood pressure and lipid profile markers, including systolic blood pressure (SBP) (WMD, -0.37 mm Hg; 95%CI: -2.19 to 1.44; p = .68), diastolic blood pressure (DBP) (WMD, -2.14 mm Hg; 95%CI: -4.27 to 0.00; p = .05), total cholesterol (TC) (WMD, -6.83 mg/dL; 95%CI: -15.11 to 1.44; p = .10), triglycerides (TG) (WMD, -5.19 mg/dL: 95%CI: -11.76 to 1.37; p = .12), low-density lipoprotein-cholesterol (LDL-C) (WMD, -5.19 mg/dL; 95%CI: -11.58 to 1.18; p = .11), and high-density lipoprotein-cholesterol (HDL-C) (WMD, 0.82 mg/dL; 95%CI: -1.67 to 3.32; p = .51), compared to control groups. Subgroup analysis showed that raspberry consumption significantly decreased total cholesterol and LDL-C levels in people with elevated TC levels, metabolic syndrome, and andropause symptoms, as well as those older than 35, while the consumption of raspberries led to a significant increase in HDL-C levels in females, obese, under 35, and healthy individuals. Raspberry can improve lipid profile and blood pressure, but it is important to keep in mind that further research is necessary to fully understand the exact mechanism of action and a definite conclusion in this regard.

The Effects of Sumac Consumption on Inflammatory and Oxidative Stress Factors: A Systematic Review of Randomized Clinical Trials.

BACKGROUND: Rhus coriaria L., commonly known as Sumac, is a plant from the Anacardiaceae family that is known for its high phytochemical content. These phytochemicals have the potential to effectively manage inflammation and oxidative stress. To explore the existing evidence on the impact of Sumac consumption on inflammation and oxidative stress, we conducted a systematic review of randomized controlled trials. METHODS: We conducted a comprehensive search of Medline/PubMed, Scopus, and Web of Science from inception to August 2023 to identify relevant studies examining the effects of Sumac on biomarkers of inflammation and oxidative stress. The selected studies were assessed for risk of bias using the Cochrane tool. RESULTS: A total of seven trials were included in this review. Among these trials, three focused on diabetes patients, while the remaining four involved individuals with fatty liver, overweight individuals with depression, and those with polycystic ovary or metabolic syndrome. Five studies reported the effects of Sumac on oxidative stress, with four of them demonstrating a significant reduction in malondialdehyde (MDA) levels and an increase in total antioxidant capacity (TAC) and paraoxonase 1 (PON1). Regarding inflammation, one study reported no significant difference in tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) levels between the intervention and control groups. The results for high-sensitivity C-reactive protein levels, reported in five trials, were inconsistent. CONCLUSION: Sumac consumption over time may positively affect oxidative stress, although short-term use shows minimal impact. While one study found no significant effect on IL-6 and TNF-α, hs-CRP levels could decrease or remain unchanged. Further meta-analyses are needed to fully understand Sumac's potential benefits in managing metabolic diseases.

The Effect of Ginseng Supplementation on Lipid Profile: GRADE-assessed Systematic Review and Dose-response Meta-analysis of Randomized Controlled Trials.

BACKGROUND: This systematic review and meta-analysis aimed to evaluate the overall impact of Panax ginseng on lipid profile by synthesizing existing evidence. Cardiovascular Disease (CVD) is the leading cause of morbidity and mortality among the elderly population, and serum lipids play a crucial role in its development. Maintaining optimal levels of triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and total cholesterol is essential in reducing the risk of CVD. Ginsenosides, the active constituents in ginseng, have shown positive effects on lipid metabolism. This review aimed to provide a comprehensive understanding of the potential benefits of ginseng in managing dyslipidemia, which could have significant implications for the prevention and treatment of CVD. METHODS: A comprehensive analysis of 29 Randomized Controlled Trials (RCTs) was conducted to assess the effects of ginseng supplementation on lipid profile, including Triglyceride (TG), Total Cholesterol (TC), High- -density Lipoprotein Cholesterol (HDL-C), and Low-density Lipoprotein Cholesterol (LDL-C) levels. A systematic search was done in online databases, such as MEDLINE, Scopus, and Clarivate Analytics Web of Science, using relevant keywords and MeSH terms to identify relevant studies until January 2024. RESULTS: The Weighted Mean Differences (WMD) and 95% Confidence Intervals (CI) for TG, TC, LDL-C, and HDL-C did not show significant changes with ginseng supplementation. CONCLUSION: Taking into account the results, using ginseng did not have a statistically significant influence on lipid profile parameters in individuals with different health conditions. Further, well-designed RCTs focusing on specific diseases are needed to clarify the potential beneficial effects of ginseng and its derivatives on lipid profile.

A Healthy Dietary Pattern May Have a Protective Effect Against Cardiovascular Disease Through Its Interaction With the MC4R Gene Polymorphism.

Polymorphisms in the melanocortin 4 receptor (MC4R) gene with occurrence and progression of chronic diseases such as obesity and cardiovascular disease (CVD) have long been addressed but there is a lack of evidence for complex interrelationships, including direct and indirect effects of these variables. This review specifically focuses on studying the effects of healthy diet interaction and MC4R polymorphisms on the development of CVD. The quantity and quality of carbohydrates and proteins consumed are related to obesity susceptibility and cardiometabolic risk factors. A healthy dietary pattern such as a Mediterranean dietary can modulate the association between MC4R polymorphisms (rs17782313) and the risk of CVDs. Also, the Nordic diet can reduce lipid profiles such as low-density lipoprotein cholesterol (LDL-C) and total cholesterol levels. On the other hand, MC4R interaction with the dietary inflammatory index decreases high-density lipoprotein cholesterol levels and increases LDL-C and triglyceride (TG) levels. Additionally, the DASH diet decreases TG, atherogenic index of plasma, systolic blood pressure, diastolic blood pressure, and serum glucose. The interaction between MC4R genes and diets plays an important role in the development of CVD. Adherence to healthy diets such as the Mediterranean, Nordic, Anti-inflammatory, and Dash diets might be an efficient strategy to prevent CVD. The potential for personalized diets to be developed for the treatment and prevention of CVD and its related comorbidities is expected to expand as this field develops.

Dietary mineral intakes predict Coronavirus-disease 2019 (COVID-19) incidence and hospitalization in older adults.

BACKGROUND: The aim of this study was to determine the association between dietary mineral intake and Coronavirus-disease 2019 (COVID-19) infection and its associated hospitalization. METHODS: This cohort study utilized the MASHAD study population, which comprised individuals aged 35-65. Upon recruitment in 2007, dietary intake was documented using a validated 65-item food frequency questionnaire (FFQ). Data on COVID-19 PCR test results was collected from all relevant medical centers in Mashhad between February 2020 and June 2022. The regression model included dietary minerals and employed the backward variable selection method, along with advanced data analysis techniques. RESULTS: The final analysis involved 1957 participants, including 193 COVID-19-positive patients. The mean age was 49.71 and 50.28 years in the COVID-19-positive and negative groups, respectively (p = 0.12). Dietary intakes of magnesium, iron, and potassium were notably lower in COVID-19-positive patients (P < 0.05). Following adjustments for age and sex, dietary iron remained significantly associated with COVID-19 incidence (OR = 0.94, 95% CI: 0.90-0.98). Furthermore, a statistically significant relationship was observed between dietary zinc and hospitalization due to COVID-19 (OR = 0.69, 95% CI: 0.51-0.93). In dynamical system models, intakes of calcium, zinc, and iron below the cut-offs of 1138, 9.7, and 8.17 mg/day, respectively, were linked to an increased risk of COVID-19 incidence. CONCLUSION: Higher dietary iron and zinc intake are associated with decreased risk of COVID-19 infection and hospitalization, respectively.

The effects of pomegranate consumption on glycemic indices in adults: A systematic review and meta-analysis.

BACKGROUND AND AIM: Epidemiologic studies have shown that type 2 diabetes (T2D) is more prevalent worldwide; therefore, improving glycemic indices to prevent or control T2D is vital. Randomized controlled trials (RCTs) on the effects of pomegranate consumption on glycemic indices have shown inconsistent results. Therefore, we aim to evaluate the impact of pomegranate consumption on fasting blood glucose (FBG), fasting insulin, hemoglobin A1c (HbA1c), and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) in adults. METHODS: A systematic literature search was performed using electronic databases, including PubMed, Web of Science, and Scopus, up to May 2023 to identify eligible RCTs evaluating the effect of pomegranate consumption on glycemic indices. Heterogeneity tests of the included trials were performed using the I2 statistic. Random effects models were assessed based on the heterogeneity tests, and pooled data were determined as the weighted mean difference with a 95 % confidence interval. RESULTS: Of 1999 records, 32 eligible RCTs were included in the current study. Our meta-analysis of the pooled findings showed that pomegranate consumption significantly reduced FBG (WMD: -2.22 mg/dL; 95 % CI: -3.95 to -0.50; p = 0.012), fasting insulin (WMD: -1.06 µU/ml; 95%CI: -1.79 to -0.33; p = 0.004), HbA1c (WMD: -0.22 %; 95% CI: -0.43 to -0.01; p = 0.037), and HOMA-IR (WMD: -0.30; 95%CI: -0.61 to -0.00; p = 0.046). CONCLUSION: Overall, the results demonstrated that pomegranate consumption benefits glycemic indices in adults. However, further research with long-term interventions is required. PROSPERO REGISTRATION CODE: CRD42023422780.

A systematic review, meta-analysis, dose-response, and meta-regression of the effects of acarbose intake on glycemic markers in adults.

Purpose: Prior research has yielded mixed results regarding the impact of acarbose intake on glycemic markers. To provide a more comprehensive analysis, a systematic review and meta-analysis was performed to compile data from various randomized controlled trials (RCTs) examining the effects of acarbose intake on fasting blood sugar (FBS), insulin, hemoglobin A1C (HbA1c), and homeostasis model assessment of insulin resistance (HOMA-IR) in adults. Methods: To identify relevant literature up to April 2023, a comprehensive search was conducted on various scholarly databases, including PubMed, Web of Science, and Scopus databases. The effect size of the studies was evaluated using a random-effects model to calculate the weighted mean differences (WMD) and 95% confidence intervals (CI). Heterogeneity between studies was assessed using Cochran's Q test and I2. Results: This systematic review and meta-analysis included a total of 101 RCTs with a total of 107 effect sizes. The effect sizes for FBS in milligrams per deciliter (mg/dl), insulin in picomoles per liter (pmol/l), hemoglobin A1C (HbA1c) in percentage (%), and homeostasis model assessment of insulin resistance (HOMA-IR) were 92, 46, 80, and 22, respectively. The pooled analysis indicated that acarbose intake resulted in significant decreases in FBS (p = 0.018), insulin (p < 0.001), HbA1c (p < 0.001), and HOMA-IR (p < 0.001). Conclusion: The findings of this systematic review and meta-analysis suggest that acarbose intake can potentially lead to significant improvements in glycemic parameters by decreasing the levels of FBS, HbA1c, and insulin. However, larger and more rigorously designed studies are still needed to further evaluate and strengthen this association.

The association of dietary indices for hyperinsulinemia and insulin resistance with the risk of metabolic syndrome: a population-based cross-sectional study.

We aimed to investigate the association between an empirical dietary index for hyperinsulinemia (EDIH), empirical dietary index for insulin resistance (EDIR), and MetS and its components in an adult Iranian population. In this cross-sectional study, a total of 6482 participants aged 35-65 years were recruited as part of the MASHAD cohort study. Dietary intakes were assessed using a validated food frequency questionnaire (FFQ). The International Diabetes Federation (IDF) criteria were used to define MetS. Multivariable logistic regression models were applied to determine the association between EDIH, EDIR, and MetS and its components. The mean age and BMI of participants were 48.44±8.20 years, and 27.98±4.73 kg/m2, respectively. Around 59% of the population was female. Of the total population, 35.4% had MetS. According to the full-adjusted model, there was no significant association between higher quartiles of EDIH and EDIR and odds of MetS (Q4 EDIH; OR (95%CI):0.93 (0.74-1.18), Q4 EDIR; OR (95%CI):1.14 (0.92-1.40). Regarding MetS components, EDIR was associated with increased odds of hypertension and diabetes (Q4 EDIR; OR (95%CI):1.22 (1.04-1.44) and 1.22 (1.01-1.47), respectively). EDIH was also associated with decreased odds of hypertriglyceridemia (Q4 EDIH; OR (95%CI): 0.72 (0.60-0.87)). This study showed no significant association between hyperinsulinemia and insulin resistance potential of diet and odds of MetS among Iranian adults. However, EDIR was significantly associated with increased odds of hypertension and diabetes as MetS components.

Effects of Portulaca oleracea (purslane) on liver function tests, metabolic profile, oxidative stress and inflammatory biomarkers in patients with non-alcoholic fatty liver disease: a randomized, double-blind clinical trial.

Background: Non-alcoholic fatty liver disease (NAFLD) is a prevalent chronic liver disease. Portulaca oleracea exhibits anti-oxidant, anti-inflammatory, and hepatoprotective effects. This clinical trial aimed to investigate the potential benefits of Portulaca oleracea in improving NAFLD. Methods: This double-blind, randomized clinical trial enrolled 70 patients with NAFLD assigned to either the intervention group (n = 35) or placebo group (n = 35) using stratified block randomization. The intervention group received 700 mg Portulaca oleracea supplement for eight weeks, while the control group received placebo capsules. In addition, all participants received a calorie-restricted diet. Liver steatosis and fibrosis were assessed using elastography along with liver function and metabolic tests, blood pressure measurements, body composition analysis and dietary records pre-and post-intervention. Results: The average age of the participants was 44.01 ± 8.6 years, of which 34 (48.6%) were women. The group receiving Portulaca oleracea showed significant weight changes, body mass index, fat mass index, and waist circumference compared to the placebo (p < 0.001). In addition, blood sugar, lipid profile, liver enzymes aspartate and alanine transaminase, gamma-glutamyl transferase, and systolic blood pressure were significantly improved in the intervention group compared to those in the placebo (p < 0.05). During the study, inflammatory and oxidative stress indicators, improved significantly (p < 0.05). Based on the elastography results, the hepatorenal ultrasound index and liver stiffness decreased significantly in the Portulaca oleracea group compared to the placebo (p < 0.001). Conclusion: The present clinical trial showed that receiving Portulaca oleracea supplement for eight weeks can improve the condition of liver steatosis and fibrosis in patients with NAFLD.

Effects of whole-body vibration on chronic ankle instability: a systematic review.

Background and objective: Chronic ankle instability (CAI) is one of the most common sports injuries, and whole-body vibration (WBV) training has been used lately as a potential rehabilitation modality for these patients. The authors conducted a systematic review and meta-analysis to assess whether WBV training positively affects patients with CAI. Materials and methods: The authors systematically searched four databases, including MEDLINE (PubMed), Scopus, Web of Science, and Cochrane Central Register of Controlled Trials, for randomized and non-randomized trials evaluating the effects of WBV on individuals with CAI. The authors used Cochrane RoB2 to assess the risk of bias in randomized trials. A meta-analysis was conducted if three or more studies measured the same outcome. Effect estimates were pooled using a random-effects model. Results: Results were retrieved from seven articles encompassing 288 participants who had CAI. The reach distance of the Star Excursion Balance Test (SEBT) was regarded as the study's main finding. The authors saw a significant training effect on certain planes of motion on dynamic balance. The findings showed that the post-intervention measurements in the WBV group compared to control groups showed improvements in the posterolateral, posteromedial, and medial directions, respectively. There were also promising results on improvements in muscle activity, strength, and proprioception sense measurements with a great diversity in the reported parameters. Conclusion: The authors observed a significant WBV training effect on dynamic balance over posterolateral, posteromedial, and medial reach distances. These findings suggest future studies on the effects of WBV on muscle activity, strength, and proprioception in addition to dynamic and static balance.

The effects of pomegranate consumption on obesity indices in adults: A systematic review and meta-analysis.

Evidence supports the potential application of polyphenols as agents against obesity. Pomegranate is one of the fruits that possess a high content of polyphenols. This systematic review and meta-analysis of randomized controlled trials (RCTs) sought to evaluate the effects of pomegranate consumption on obesity indices, including body mass index (BMI), body weight, waist circumference (WC), fat mass (FM), body fat percentage (BFP), and fat-free mass (FFM) in adults. Relevant RCTs were obtained by searching databases, including PubMed, SCOPUS, and Web of Science, up to May 2023. Heterogeneity tests of the included trials were performed using the I 2 statistic. Random effects models were assessed based on the heterogeneity tests, and pooled data were determined as the weighted mean difference with a 95% confidence interval. Pooled analysis of 28 trials revealed that pomegranate consumption led to a significant reduction in body weight (WMD: -1.97, 95% CI: -2.91, -1.03, p < .05), and a significant decrease in BMI (WMD: -0.48, 95% CI: -0.76, -0.20, p < .05) in comparison with the control group. However, there were no significant effects on WC, FM, FFM, and BFP in comparison with the control group. Pomegranate consumption may yield a beneficial effect on body weight and BMI in adults. However, there were no significant effects on WC, FM, FFM, and BFP, by pomegranate consumption. Also, pomegranate consumption can reduce body weight, BMI, WC, and BFP in obese adults. Long-term trials with different doses of pomegranate are needed.

Efficacy of trigger point dry needling on pain and function of the hip joint: a systematic review of randomized clinical trials.

OBJECTIVE: The objective of this study was to assess the evidence for the impact of dry needling (DN) on hip pain and function. METHODS: Medline/PubMed, Embase, Scopus, Web of Science and Cochrane CENTRAL databases were searched systematically through June 2022 for randomized clinical trials (RCTs) investigating the impact of DN on hip pain and function. Version 2 of the Cochrane risk-of-bias tool for randomized trials (RoB 2) was used to assess risk of bias. Descriptive analysis was conducted to explain the outcomes and adverse events of DN in hip joint diseases. Meta-analysis was not feasible due to significant heterogeneity. RESULTS: A total of seven eligible studies (including 273 patients) were included out of 2152 screened records. Five studies were in participants with hip osteoarthritis (OA; n = 3), greater trochanteric pain syndrome (GTPS; n = 1) or piriformis syndrome (n = 1); the other two studies were conducted in healthy athletes (n = 2). Two articles assessed changes in participants' short-term visual analog scale (VAS) scores (<1 week), one of which showed that DN significantly reduced pain (P < 0.05). One-week VAS scores were analyzed in three studies, all of which demonstrated reduced scores following DN (P < 0.05). Hip range of motion (ROM) and muscle force were also improved following DN. No serious side effects were reported. CONCLUSION: DN may be safe and effective at relieving hip pain and improving hip function. DN performs significantly better than several different types of control intervention (including sham DN, no treatment, corticosteroid injections and laser). Strong evidence (high degree of certainty around the results) is lacking, and future studies should ideally use longer follow-up periods and larger sample sizes. REVIEW REGISTRATION NUMBER: CRD42022297845 (PROSPERO).

The Effects of L-Carnitine Supplementation on Blood Pressure in Adults: A Systematic Review and Dose-response Meta-analysis.

PURPOSE: Hypertension stands as a prominent risk factor for cardiovascular disease, making it of utmost importance to address. Studies have shown that L-carnitine supplementation may lower blood pressure (BP) parameters in different populations. Therefore, we have conducted a systematic review and dose-response meta-analysis of published Randomized Controlled Trials (RCTs), including the most recent articles on the effect of L-carnitine supplementation on BP. METHODS: PubMed, ISI Web of Science, Cochrane databases, and Scopus were used to collect RCT studies published up to October 2022 without limitations in language. Inclusion criteria were adult participants and recipients of L-carnitine in oral supplemental forms. The funnel plot test, Begg's test, and Egger's test were used to examine publication bias. FINDINGS: After the search strategy, 22 RCTs (n = 1412) with 24 effect sizes fulfilled the criteria. It was found L-Carnitine supplementation did not have a significant effect on systolic blood pressure (SBP) (mm Hg) (weighted mean difference [WMD] = -1.22 mm Hg, 95% CI: -3.79, 1.35; P = 0.352; I2 = 85.0%, P < 0.001), and diastolic blood pressure (mm Hg) (WMD = -0.50 mm Hg, 95% CI: -1.49, 0.48; P = 0.318; I2 = 43.4%, P = 0.021) in the pooled analysis. Subgroup analyses have shown that L-carnitine supplementation had no lowering effect on SBP in any subgroup. However, there was a significant reduction in diastolic blood pressure in participants with a baseline body mass index >30 kg/m2 (WMD = -1.59 mm Hg; 95% CI: -3.11, -0.06; P = 0.041; I2 = 41.3%, P = 0.164). There was a significant nonlinear relationship between the duration of L-carnitine intervention and changes in SBP (coefficients = -6.83, P = 0.045). IMPLICATIONS: L-carnitine supplementation in adults did not significantly affect BP. But anyway, more studies should be done in this field on different individuals.

The effects of L-carnitine supplementation on cardiovascular risk factors in participants with impaired glucose tolerance and diabetes: a systematic review and dose-response meta-analysis.

AIMS: L-carnitine plays a role related to cardiometabolic factors, but its effectiveness and safety in CVD are still unknown. We aim to assess the effect of L-carnitine supplementation on CVD risk factors. METHODS: A systematic literature search was conducted in PubMed, Web of Science, and Scopus until October 2022. The main outcomes were lipid profiles, anthropometric parameters, insulin resistance, serum glucose levels, leptin, blood pressure, and inflammatory markers. The pooled weighted mean difference (WMD) was calculated using a random-effects model. RESULTS: We included the 21 RCTs (n = 2900) with 21 effect sizes in this study. L-carnitine supplementation had a significant effect on TG (WMD = - 13.50 mg/dl, p = 0.039), LDL (WMD = - 12.66 mg/dl, p < 0.001), FBG (WMD = - 6.24 mg/dl, p = 0.001), HbA1c (WMD = -0.37%, p = 0.013) HOMA-IR (WMD = -0.72, p = 0.038 (, CRP (WMD = - 0.07 mg/dl, P = 0.037), TNF-α (WMD = - 1.39 pg/ml, p = 0.033), weight (WMD = - 1.58 kg, p = 0.001 (, BMI (WMD = - 0.28 kg/m2, p = 0.017(, BFP (WMD = - 1.83, p < 0.001) and leptin (WMD = - 2.21 ng/ml, p = 0.003 (in intervention, compared to the placebo group, in the pooled analysis. CONCLUSIONS: This meta-analysis demonstrated that administration of L-carnitine in diabetic and glucose intolerance patients can significantly reduce TG, LDL-C, FBG, HbA1c, HOMA-IR, CRP, TNF-α, weight, BMI, BFP, and leptin levels. PROSPERO registration code: CRD42022366992.