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Background: In recent years, the effect of walnut consumption on various components of metabolic syndrome (Mets) in different populations has been investigated. However, the findings on the alterations of cardiometabolic and anthropometric indices following walnut consumption in adults with Mets have not been fully conclusive., Methods: The current study of eight randomized controlled trials (RCTs) examined the effects of walnut consumption on glucose homeostasis factors (fasting plasma glucose (FPG), insulin, hemoglobin A1C (HbA1c)), lipid profile (triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c), and high-density lipoprotein cholesterol (HDL-c)), high sensitivity C-reactive protein (hs-CRP) concentrations and anthropometric indices (body weight (BW), body mass index (BMI), and waist circumference (WC)) in trials of 549 participants. A systematic search was conducted in online databases including MEDLINE, Scopus, and Clarivate Analytics Web of Science uses related keywords to detect eligible studies until December 2021. To calculate the weighted mean difference (WMD) and 95% confidence intervals (CIs), a random-effects model was used., Results: Results from the pooled analysis showed that serum TG concentration was significantly reduced (WMD, - 0.1 mmol/L; 95%CI (- 0.3 to - 0.02); p = 0.02; I 2 = 38.6%; p = 0.10), although other lipid profile components (TC, LDL-c, and HDL-c), glucose homeostasis markers (FPG, insulin, and HbA1c), hs-CRP levels, anthropometric indices (BW, BMI, and WC) and blood pressure (SBP and DBP) were not influenced by walnut consumption. A significant dose-response association was detected between the dose of walnut intake and serum concentrations of FPG (P non-linearity < 0.03, P dose-response < 0.001) and HDL-c (P non-linearity = 0.01, P dose-response = 0.006)., Conclusions: Walnut consumption reduces serum TG levels in individuals with metabolic syndrome, but it cannot affect other cardiometabolic indices. Future well-designed and large RCTs are required to clarify further beneficial effects of walnut consumption on the cardiometabolic profile., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Background & Aims: Malnutrition is prevalent in upper gastrointestinal cancer patients. The purpose of this study was a comprehensive assessment of nutritional status in newly diagnosed patients with esophageal cancer., Methods: Newly diagnosed esophageal cancer patients were referred to a chemo-radiation referral center in Mashhad, Iran, between February 2017 to February 2019. Anthropometric indices, a Patient-Generated Subjective Global Assessment (PG-SGA) tool, body composition, dietary intake, nutritional-related complications, and laboratory tests were assessed., Results: One hundred and eighty-nine patients with a mean age of 67.1 ± 12 and a male to female ratio of 98 to 91 were included. Ninety-seven (51.3%) of patients had experienced significant weight loss and 56 (29.6%) were underweight at diagnosis. According to PG-SGA, 179 (94.7%) needed nutritional interventions. Reduced muscle mass and low handgrip strength were observed in 70 (39.4%) and 26 (14.4%) of patients, respectively. Inadequate intakes of energy (less than 24 kcal/kg/day) and protein (less than 1.2 g/kg/day) were found in 146 (77.8%) and 171 (91%) patients, respectively. The mean total daily energy and protein intakes of subjects were 943.8 ± 540 kcal/day, and 30.6 ± 21 g/day, respectively. The most common nutritional-related complications were as follows: dysphagia (84.8%), anorexia (31.6%), constipation (62.1%), esophageal pain (48.4%), and dyspepsia (41.1%)., Conclusion: Our study demonstrated a high prevalence of malnutrition in newly diagnosed esophageal cancer patients. This fact demonstrates the importance of early screening of nutritional status via PG-SGA tool, clinical evaluation, dietary intake evaluations, and laboratory tests, based on which effective nutritional interventions and Symptoms management may be introduced in these patients., Competing Interests: Conflict of interest The authors declare that there are no conflicts of interest., (Crown Copyright © 2021. Published by Elsevier Ltd. All rights reserved.)

Background & Aims: Critically ill patients are provided with the intensive care medicine to prevent further complications, including malnutrition, disease progression, and even death. This study was intended to assess nutritional support and its' efficacy in the Intensive Care Units (ICUs) of Iran., Methods: This cross-sectional study assessed 50 ICU's patients out of 25 hospitals in the 10 major regions of Iran's health system and was performed using the multistage cluster sampling design. The data were collected from patient's medical records, ICU nursing sheets, patients or their relatives from 2017 to 2018. Nutritional status was investigated by modified NUTRIC score and food frequency checklist., Results: This study included 1321 ICU patients with the mean age of 54.8 ± 19.97 years, mean mNUTRIC score of 3.4 ± 2.14, and malnutrition rate of 32.6%. The mean time of first feeding was the second day and most of patients (66%) received nutrition support, mainly through enteral (57.2%) or oral (37%) route during ICU stay. The patients received 59.2 ± 37.78 percent of required calorie and 55.5 ± 30.04 percent of required protein. Adequate intake of energy and protein was provided for 16.2% and 10.7% of the patients, respectively. The result of regression analysis showed that the odds ratio of mNUTRIC score was 0.85 (95% confidence interval [CI] = 0.74-0.98) and APACHE II was 0.92 (95%CI = 0.89-0.95) for the prediction of energy deficiency. Nutrition intake was significantly different from patient's nutritional requirements both in terms of energy (p < 0.001) and protein (p < 0.001). Also, mean mNUTRIC score varied notably (p = 0.011) with changing in energy intake, defined as underfeeding, adequate feeding, and overfeeding., Conclusion: The present findings shown that, provided nutritional care for ICU patients is not adequate for their requirements and nutritional status., Competing Interests: Conflicts of interest None declared., (Copyright © 2020 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.)

Background: Morbid obesity is a chronic disease that contributes to increased oxidative stress. Gastric bypass surgery is the gold standard method in treating co-morbidities., Objectives: The objective of this study was to evaluate the relation between pro-oxidant antioxidant balance (PAB) as one measure of oxidative stress and glycolipid profile 6 months after gastric bypass surgery., Setting: Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran., Methods: Thirty-five morbidly obese patients with body mass index ≥35 kg/m 2 with co-morbidities or ≤40 kg/m 2 were randomly recruited. The PAB assay was used to estimate oxidative stress. Anthropometrics and glycolipid profile were collected at recruitment and 6 months after surgery. Statistical analysis was performed using SPSS 16 software., Results: The study showed a significant postoperative reduction in serum PAB values compared with the baseline (P<.001). All anthropometric and several glycolipid parameters significantly reduced after surgery (P<.001), while serum high-density lipoprotein cholesterol was unaffected. Repeated measures analysis of variance showed that postoperative PAB values were affected by gastric bypass surgery (F = 12.51, P = .001). Regression analysis demonstrated medication usage controlling co-morbidities (β^ = -.6, P = .002) and fasting blood glucose (β^ = .41, P = .04) as independent factors in predicting PAB values 6 months after surgery., Conclusions: Gastric bypass surgery can reduce PAB values in favor of antioxidants 6 months after the operation. Accordingly, fasting blood glucose after gastric bypass surgery can be an independent factor in predicting PAB values., (Copyright © 2018 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.)

Background & Aims: Several genome-wide-association-studies have identified genetic variants in a region on chromosome 9p21 that are associated with an increased risk of Cardiovascular disease (CVD) and diabetes. Here we have explored the interaction of a genetic variant of the CDKN2A/B-rs10811661 gene locus with cardiovascular risk factors and environmental-exposures (e.g., diet and physical activity) in 1165 individuals recruited from the Mashhad-Stroke and Heart-Atherosclerotic-Disorders cohort., Methods: Genotyping was carried out using TaqMan-real-time-PCR based method. The association of CDKN2A/B-rs10811661 locus and its interaction with dietary intake in association with the main determinants of dyslipidemia, and cardiovascular-risk-factors were assessed in 2 cohorts., Results: Our data showed that obese subjects with a TT genotype had a higher level of TG, TG/HDL ratio and Hs-CRP, compared to the subjects with the wild type genotype, or individuals with a normal BMI. Moreover, the presence of a TT genotype was associated with increased risk of hypercholesterolemia, insulin resistance and CVD. These effects were more pronounced in the sub-group with low physical activity and a high dietary energy intake (e.g., the interaction between TT genotype and total energy intake on serum cholesterol was positive (RERI: 0.2, 95%CI (-0.96-1.3), AP: 0.1, 95%CI (-0.5-0.7) and SI: 1.2, 95%CI (0.3-5.1)))., Conclusions: We have found a significant association between the CDKN2A-rs10811661 polymorphism with cardiovascular risk factors and dyslipidemia in a non-diabetic population. It is possible that a low energy diet and high physical activity could ameliorate the unfavorable effects of T allele of CDKN2A/B locus. Functional analysis is warranted to investigate the value of this genetic biomarker of CVD risk in obese people., (Copyright © 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.)

Background: Increased oxidative stress (OS) and lipid peroxidation may be involved in the pathogenesis of preeclampsia (PE). We conducted a case-control study to evaluate the levels of plasma lipids and trace elements as well as activity of superoxide dismutase (SOD) in PE., Materials and Methods: The study consisted of 100 patients who had been diagnosed with PE and 100 normotensive pregnant women who underwent medical checkups that served as the control group. Lipid profile, zinc (Zn) and copper (Cu) levels and SOD activities were measured in the plasma of all subjects., Results: Our results showed that the plasma levels of triglycerides and SOD activity were significantly elevated and the levels of Zn and Cu were significantly reduced in patients with PE compared with healthy controls. Increased levels of SOD may indicate antioxidant protective mechanisms against OS in PE-complicated pregnancies. This finding may suggest an involvement of OS in the pathophysiology of PE., Conclusion: This study demonstrated a significant negative correlation between SOD activity and levels of trace elements. Furthermore, we suggest that higher triglyceride levels and SOD activity combined with lower Zn and Cu levels may be associated with an increased risk of PE., (Copyright © 2017 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.)